Story code: ST-000784
Part 2: The Mandate
“You cut me right now,” Sarah hissed, her voice a wet, ragged rasp that barely carried over the shrieking medical equipment. “You cut me right now, or I swear to God…”
Her threat dissolved into a choked, bubbling cough, spraying a fine mist of crimson across Aris’s pristine white collar. She refused to let go of the lanyard. The thick blue nylon dug sharply into the back of Aris’s neck, pulling his posture into an uncomfortable, subservient crouch.
Maya watched the surgeon’s hands-still shoved aggressively deep into his coat pockets-twitch against the fabric. He was vibrating with panic, his eyes wide behind his smudged glasses. “I can’t,” Aris squeaked, his voice pitching up an octave. “The liability. The state mandate. If I open you up and the fetus doesn’t survive the surgical trauma, it’s a Class B felony. I go to prison, Sarah. The hospital loses its state funding.”
Maya froze. Her gloved hands slipped against the saturated pressure dressing she was holding against Sarah’s abdomen. *A Class B felony.* The chaotic pieces of Aris’s frantic babbling suddenly slammed together in Maya’s mind, locking into a horrifying realization. He wasn’t inventing bureaucratic red tape to cover for cowardice; he was hiding behind the new fetal preservation statutes that had quietly gone into effect at midnight. The sweeping legal overhaul that the nursing staff had assumed was just political posturing to win an upcoming election.
Sarah’s grip finally failed. Her fingers uncurled, slick with her own blood, and her hand slid down Aris’s chest, leaving a dark, smeared handprint directly over his heart. Her eyes rolled back, showing the yellowing whites, and her head lolled heavily against the thin paper pillow.
The fetal monitor dipped sharply. Ninety beats per minute. Eighty-five.
Maya threw her upper body weight onto Sarah’s abdomen, desperately trying to compress the severed artery blindly through layers of muscle and uniform. “She’s crashing!” Maya screamed. “Aris, I don’t care about the statute! It has to have a medical exception for the mother’s life! It has to!”
“Not without committee approval!” Aris scrambled backward the moment he was free, clutching his bruised neck. “Not unless it’s a documented, undeniable certainty that the mother will die without intervention, and even then, legal has to sign off in writing!”
“She *is* dying without intervention!” Maya yelled. “Look at her pressure!”
The wall-mounted emergency phone blared, a harsh, synthetic ring that sliced through the chaotic noise of Trauma 3. Aris lunged for it like a drowning man grabbing a thrown line. He yanked the receiver off the cradle, nearly ripping the coiled cord out of the wall.
“Aris,” he panted into the mouthpiece. “Yes. Yes, I’m holding. I’m complying.”
He slammed his palm against the speaker button and slammed the receiver back down. A crisp, disembodied voice echoed through the trauma bay, utterly detached from the blood-soaked reality of the room. “Dr. Aris, this is Richard Vance from Risk Management. You are on a recorded line.”
Maya glared at the speaker base on the wall. “Vance! We need him to operate! Patient is a twenty-eight-year-old female, twenty-six weeks pregnant, massive abdominal trauma, profound hemorrhagic shock!”
“Nurse Maya,” Vance’s voice was devoid of any urgency. He sounded as if he were discussing a supply order. “I am reviewing the chart intake now. The trauma was sustained via a ballistic incident?”
“It was a misfire at the parade staging area!” Maya screamed, her knee slipping dangerously on a slick patch of blood that had pooled onto the linoleum floor. “A blank round shattered a prop casing! She’s a Guard medic, she was trying to clear the jam for a high school cadet!”
“Regardless of the heroic origin,” Vance said smoothly, “the hospital’s preliminary legal assessment categorizes this as an unverified ballistic trauma. Under Section 4 of the new mandate, surgical intervention that actively risks fetal viability is strictly prohibited until a magistrate grants an emergency waiver. Have you secured a magistrate’s waiver, Dr. Aris?”
“No!” Aris shouted at the phone, pressing his back against the frosted glass of the sliding doors. “No, I told her that! I haven’t touched a scalpel! I haven’t even scrubbed!”
“Good. The hospital’s legal exposure here is catastrophic if you proceed. Maintain supportive care only. I am paging the ethics committee, but it being Memorial Day, the relevant members are scattered at various civic events. It will take time.”
Maya couldn’t breathe. The sheer, suffocating absurdity of the conversation pressed down on her chest like an iron weight. She was watching a decorated soldier bleed out on a gurney because a team of hospital lawyers couldn’t get a judge on the phone during a holiday parade.
The fetal monitor dropped to seventy. A slow, agonizing, sluggish rhythm.
“Supportive care isn’t stopping the internal bleeding, Vance!” Maya shouted at the speaker, blindly grabbing a fresh stack of lap pads with her free hand. She shoved them under her palm, the thick white cotton instantly turning a saturated crimson. “She needs a vascular clamp! She needs an ex-lap right now!”
“Nurse, if you continue to pressure a physician to commit a felony on a recorded line, I will have hospital security remove you from the premises,” Vance stated flatly. “Dr. Aris, do not open that patient.”
The line went dead with a sharp click.
Maya stared at the phone, then turned her frantic gaze to Aris. The surgeon had finally taken his hands out of his pockets. He was holding them up in a gesture of absolute surrender, inching toward the exit. “You heard him, Maya. I can’t do it. My license. My family. I go to jail.”
“You took an oath,” Maya snarled, her voice shaking with rage.
“I took an oath to do no harm. The law says operating on her right now harms the fetus.”
“Not operating kills them both!”
The parade outside swelled, a massive marching band passing directly by the emergency room’s exterior wall. The deep, thudding rhythm of the bass drums physically rattled the loose surgical instruments waiting on the stainless steel Mayo stand. It sounded exactly like a funeral march.
Sarah shifted weakly on the gurney. Her pale lips parted, dry and cracked. Maya leaned down, putting her ear close to the soldier’s mouth, ignoring the blood that smeared against her own cheek.
“Save… the baby,” Sarah whispered, her breath smelling strongly of copper and cellular decay. “Cut… me.”
“I can’t,” Maya whispered back, hot tears finally stinging the corners of her eyes. She felt utterly isolated, trapped in a brightly lit room that had suddenly transformed into a legal cage. “The doctor won’t do it. The hospital won’t let him.”
Sarah’s heavy, hazy eyes rolled toward the surgical tray. The sterile blue paper wrappers remained untouched, perfectly folded. She looked back at Maya. There was no fear left in the soldier’s gaze, only a hollowed-out resignation and a fierce, desperate plea. “You… do it.”
Maya froze. She looked past Sarah to the gleaming steel tray. She wasn’t a surgeon. She was a trauma nurse. She had assisted in hundreds of emergency laparotomies over the last eight years. She had handed over the scalpels, held the retractors, tied off the bleeders. She knew the exact anatomical landmarks. She knew the steps by heart.
But doing it herself? That wasn’t just breaking hospital protocol. It was practicing medicine without a license. It was aggravated battery. It was an instant prison sentence.
The fetal monitor let out a sharp, continuous wail. Severe bradycardia. The baby was suffocating as Sarah’s blood pressure bottomed out.
“Aris, please!” Maya begged, her voice breaking as she looked at the cowering man. “Please, just clamp the artery! I’ll document that I forced you! I’ll take the blame!”
Aris shook his head violently, his face entirely drained of color. He reached backward and slapped the wall switch for the automatic doors. The heavy glass panels slid open with a soft hiss. The normal sounds of the ER-ringing phones, chatting orderlies, the distant wail of an ambulance siren-flooded into the room, a jarring reminder of the world continuing outside.
“I’m going to find the charge nurse,” Aris said, his voice trembling so hard it cracked. “I’m formally recusing myself from this trauma code due to legal conflict. Do not touch that surgical tray, Maya. That is a direct order.”
He turned and sprinted down the hallway, his white coat flapping behind him like a flag of surrender. He left Maya completely alone with a dying soldier and a flatlining monitor.
Maya stood over the gurney. The heavy pressure dressing was failing completely, the warm blood running down her wrists and soaking into the blue fabric of her scrubs. The marching band outside hit a deafening, triumphant crescendo. The overhead monitor flashed a blinding red warning, Sarah’s systolic pressure dropping into the forties.
Maya reached out with a trembling, blood-slicked hand. She rested her fingertips lightly against the edge of the sterile blue wrapper covering the scalpel tray.