The emergency room colleague rushed out over the phone, "The patient is a newborn transferred from the maternity hospital, less than 24 hours old. The infant has severe cyanosis on the lips and extreme hypoxia. Radiology confirmed it's Transposition of the great arteries."
Transposition of the great arteries meant the two main arteries in the baby's heart were completely reversed.
Normally, the human body's left ventricle connects to the aorta, and the right ventricle connects to the pulmonary artery.
But for a baby with TGA, it was exactly the opposite—the aorta was attached to the right ventricle, and the pulmonary artery to the left ventricle.
This resulted in the systemic and pulmonary circulations failing to connect, depriving the baby of oxygen and causing cyanosis.
It was a highly critical and complex congenital heart defect that required immediate surgery.
Having eaten nothing, a wave of dizziness washed over Wendy the moment she stood up. She barely had time to ask a nurse for a vial of glucose before rushing to the ER.
Walking briskly, she asked the person on the phone, "Why didn't we get an advance transfer notice? Wasn't this caught during prenatal checkups?"
Normally, congenital heart defects diagnosed during pregnancy would trigger an integrated pre-and post-natal treatment plan.
It shouldn't have been dumped on the ER with zero warning.
The phone fell silent for two seconds. "The mother never had any prenatal care."
That explained it.
Wendy picked up her pace.
In the consultation room, the head of radiology and Chief Lawrence from cardiothoracic surgery were already there.
Diagnosis confirmed. They needed to call in the front-line attending physicians.
Wendy said, "I've already called. Dr. Franklin is on his way."
Chief Lawrence checked his phone. "Our second-call shift is arriving now too."
The second-call shift was handled by the deputy directors. There were two in cardiothoracic surgery, and he wasn't sure who was on rotation tonight.
Just as he spoke, Sampson pushed the door open and walked in.
Bypassing everyone, Sampson walked straight to the radiology director and took the echocardiogram report.
The ultrasound indicated: Double outlet right ventricle: Taussig-Bing anomaly, complicated by aortic arch hypoplasia.
This was a severely complex variation of TGA.
Sampson read the report and checked the infant's condition.
The newborn was breathing rapidly, and despite being on oxygen, there was no significant improvement.
The head of anesthesia was already inserting arterial and venous lines into the infant, who weighed barely six pounds. Every single step was incredibly precarious.
"Not feeling well?" Sampson glanced at Wendy.
Above the sterile mask, the man's profile was sharp and deeply sculpted, with only his eyes visible.
For the first time, Wendy noticed that Sampson's irises were a pale, striking shade of amber.
When his lashes lowered and he looked at someone through half-lidded eyes, it gave off an illusion of predatory, cold detachment.
"A little." Wendy forced down her discomfort.
"Then I'll find you in the on-call room after the surgery."
Leaving no room for argument, Sampson turned and walked into the operating room.
Once the surgery began, Wendy's job was done.
On her way back to the on-call room, a familiar sensation hit her.
Checking once she was inside, her suspicions were confirmed—her period had come early this month.

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