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Spring 1998
To Save Two Lives
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At 5:25 p.m., Busuttil, two other surgeons, two anesthesiologists and two nurses begin operating on Andrew in O.R. 1, a high-ceilinged room bathed in light. All are dressed in pale blue scrubs; the surgeons wear custom-made glasses with magnifying lenses. On a table next to them, neatly arranged in rows, are dozens of surgical instruments, a metal bowl and countless squares of white cotton gauze. A monitor near Busuttil keeps watch on Andrew’s vital signs. The team crowds around the boy tightly, as if protecting him. Someone puts in the first CD; music plays softly in the background.

Andrew is covered by a sea-blue drape, his tiny shape barely taking up half the table. Occasionally a straw-blond patch comes into view at the end of the table. It is the top of the boy’s head.

Busuttil uses a yellow, pen-like cauterizing tool to burn away the abdominal wall and underlying tissues; the terrible smell of burnt flesh saturates the room. As he works inside Andrew, Busuttil scarcely moves. He doesn’t banter with the other physicians. The only time he speaks is to request an instrument, or to ask Dr. Randy Steadman, an anesthesiologist, how the patient is doing. At 6:10 p.m., Elvis is heard crooning “My Way.” An assistant hands Busuttil instruments, while a surgeon suctions fluid out of Andrew’s abdominal cavity. A big metal tub on the floor is already full of blood-soaked cotton cloths.

“How’s the baby’s head?” Busuttil asks Steadman. “Is the baby’s head OK?”

Steadman, a muscular man with reddish hair who wears wire-rim glasses, is the chattiest member of the large team. Whenever someone new enters the room, he grins and calls out hello. He stands near Andrew’s head, monitoring the baby’s heart rate, blood pressure and other crucial measurements, adjusting the medication in his IV lines and supplying blood as needed.

By now, Busuttil has worked his way through the abdominal wall, and is nearing the liver. “Hold this back here,” he says. “OK. Let’s see what we’ve got.”

Surgery Andrew had as an infant will complicate the transplant. “That’s the difficulty with these babies. They have these earlier operations and develop all these adhesions,” Busuttil explains. “The intestines get all matted up in a big ball.”

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