Jennifer purposely didn’t add that it had been an incredibly stressful, unpleasant experience for her.

“Okay, so you know the kind of noise it makes—sort of like a dentist’s drill.”

Like a hundred dentists’ drills.

“I know,” she said.

Jennifer’s jaws clenched at the first screech of the powerful oscillating saw, an instrument whose blade cut by rapid back-and-forth movements rather than by rotation. She had never done well in dentists’ offices. She was a brave—some had even said fearless—nurse, but the noise and knowing what was going on beneath the huge saucer-shaped lights caused her to avert her eyes. Limiting the sterile field with drapes depersonalized things a bit, but this was a person who had come to be like a younger sister to her.

The amputation of Becca’s leg at a spot just below her hip was almost complete when trouble began. Jennifer looked up just in time to see it develop on the monitor screen—extra heartbeats, almost certainly ventricular premature beats. First one, then a pair, then a burst of four together. Her own pulse leaped.

“Bart?” Beebe asked in his surgical voice. “What’s the deal?”

“We’ve got sudden VPBs and a pressure drop. I’m giving her amiodarone.” Jennifer tensed even more. Amiodarone was used to suppress the irritability of Becca’s heart, and to stabilize her suddenly unstable rhythm. The VPBs could just go away, or they could be the beginning of something very bad.

“Janet, call cardiology,” the anesthesiologist said to the circulating nurse.

By the time Jennifer Lowe checked the monitor screen again, the pressure was forty. Becca was crashing—complete cardiovascular collapse. Her heart, compromised by infection, had gone as far as it could go.

“Looks like she’s about to code, Chandler. You’re going to have to close as fast as possible.”

Oxygen saturation plunging.

Pressure thirty.

Extra heartbeats increasing, then suddenly changing into a rapid, totally irregular sawtooth rhythm.

“V. fib,” the anesthesiologist called out. “Call a code blue now. Start chest compressions, get the code cart, and get ready to defibrillate.”

Like a video put into fast forward, the action in the OR increased immediately. From her place on the riser, Jennifer watched transfixed. She was skilled at all aspects of resuscitation, but she was there as an observer, not part of the code team. Much as she desperately wanted to help, she knew that there were more than enough hands. Too many people in a code was asking for trouble. The best thing she could do at this point was to stay out of the way.

But she knew from the moment they called a code blue, that Becca was doomed. In essence, the resuscitation had begun as she was put to sleep and intubated. There was not much to be done that would get at the reason her heart was giving up.