Residual Deficit 2
Morbidity, Mortality, and Mixed Signals
By 7:45 a.m., the neurosurgery residents were seated in the conference room for M&M—Morbidity and Mortality.
Which was less a learning meeting and more a public execution with PowerPoint.
The air conditioner was barely functioning.
A generator hummed somewhere in the background.
Consultants sat in a row at the front like judges.
At the center was Professor Chukwuma Eze, Head of Neurosurgery.
Sixty-two. Ruthless. Revered.
The kind of surgeon who could perform a microscopic aneurysm clipping with hands steadier than most people held a spoon.
And the kind of man who made grown doctors forget how to form sentences.
Tunde stood at the projector.
“Case summary,” Professor Eze said.
Tunde clicked to the first slide.
“Thirty-four-year-old male, brought in following road traffic accident with severe traumatic brain injury, GCS 6 on presentation, anisocoria with left fixed dilated pupil, suspected raised intracranial pressure secondary to extra-axial hemorrhage.”
“Suspected?” Professor Eze repeated. Tunde didn’t flinch.
“Clinically suspected, sir. CT unavailable at time of intervention due to unstable hemodynamics.” A pause.
Then the professor leaned back.
“So you proceeded with decompression blindly.”
Not a question. A statement.
Zainab crossed one leg over the other, expression unreadable.
Kelechi subtly rubbed his forehead.
Everyone knew where this was going.
Tunde answered evenly. “Emergency left temporal burr hole based on impending herniation signs.”
Professor Eze stared at him for a beat too long.
“And if it had been a subdural crossing midline?”
Silence.
Not because they didn’t know the answer.
Because there was no correct answer when a consultant wanted blood.
“Then the burr hole would have been temporizing, sir,” Tunde replied.
A consultant at the end coughed to hide a laugh.
Brave soul.
Professor Eze nodded slowly. “Patient outcome?”
“Currently ventilated in ICU. Hemodynamically improved. Pupils now sluggishly reactive.”
A slight shift in the room.
Not praise. But close enough.
“Proceed,” Eze said.
In neurosurgery, that was basically applause.
After M&M
The team spilled into the corridor, tension slowly dissolving.
Kelechi dramatically loosened his scrub cap.
“One day that man will kill me with eye contact alone.”
“He was easier on you than usual,” Zainab said.
Kelechi stopped walking. “Easier?”
“He didn’t ask if your medical degree was decorative.”
“Low standards.”
Sadiq laughed before catching himself.
It slipped out too naturally.
Too soon.
They all looked at him.
Then, unexpectedly, Tunde smirked.
Tiny.
Barely there. But real.
Sadiq stared like he’d just witnessed a solar eclipse.
“Tunde can smile?” he whispered.
Kelechi gasped theatrically. “Document it.”
4:10 p.m. — Neurosurgery Ward
Bed 12 was crashing.
“Post-op craniotomy, declining consciousness!” the nurse shouted.
Everyone moved.
Patient: female, 52, status post meningioma resection 18 hours earlier.
Now less responsive.
BP rising. Bradycardic.
Irregular respirations.
Zainab was first to the bedside.
“Cushing’s triad,” she said immediately.
Her tone sharpened. “Possible rising ICP.”
Tunde checked pupils.
“Right sluggish.”
“Call radiology for urgent CT scan.”
“No slots till 7,” a nurse replied.
“Then bump somebody,” Tunde snapped.
“No available porter.”
“Of course.”
Nigeria.
The unofficial fifth resident.
Kelechi was already hanging mannitol.
“100 grams IV.”
Sadiq adjusted oxygen.
The patient’s daughter stood frozen in the corner, clutching her handbag like it could anchor her.
“What’s happening to my mother?”
Nobody answered immediately.
Because nobody had time.
And because explanations were a luxury in acute neurological decline.
8:37 p.m. — Outside the Hospital
Against all odds, they made it out.
Kelechi had insisted.
“If we don’t leave this building, we’ll become part of the architecture.”
So now they were at a rooftop lounge on Victoria Island.
Music. Dim lights.
Expensive cocktails nobody could really afford.
A surreal contrast to the day’s blood and chaos.
Zainab had changed into black trousers and a fitted wine-colored top.
Minimal makeup.
Still looked annoyingly composed.
Kelechi noticed immediately.
“Ah-ah. So beneath all that surgical hostility, you are in fact human.”
She sipped her drink. “Don’t spread misinformation.”
Sadiq laughed.
He was slowly realizing these people were funnier outside fluorescent lighting.
Even Tunde came.
Though “came” was generous.
He sat slightly apart, nursing a drink and checking his phone like human connection was a temporary inconvenience.
A woman approached him.
Tall. Confident.
Beautiful in an effortless way that made people else feel underdressed.
“Tunde?” He looked up.
And for the first time that day, he genuinely looked unsettled.
Zainab noticed.
Interesting.
“You know her?” Kelechi asked.
“No idea,” Zainab lied.
But she was watching too closely.
The woman smiled.
“You weren’t answering my calls.”
Ah. Worse.
History.
Tunde stood.
“I thought we were done having this conversation.”
Oof.
Sadiq nearly choked on his drink.
Kelechi whispered, “This is better than Netflix.”
The woman folded her arms.
“You disappeared.”
“I was working.”
“For six months?”
Tunde’s jaw tightened.
That answered enough.
Ex. Or almost-ex.
Or emotionally unresolved disaster.
Same species.
Zainab looked away first.
Not because she wasn’t interested.
Because she was.
More than she should be.
And that irritated her.
11:54 p.m.
Their pagers went off simultaneously.
Four shrill beeps.
All at once.
Like a curse.
Kelechi stared at his pager.
“You have got to be kidding me.”
Zainab downed the rest of her drink.
“Trauma call.”
Tunde was already standing.
Of course.
Sadiq groaned. “Can’t people have brain injuries during office hours?”
“No,” Kelechi said. “That would be considerate.”
They were halfway out before the waiter could even bring the bill.
Emergency Department
“Gunshot wound to the head,” the casualty officer said.
Everything changed.
These were the cases nobody forgot.
The patient was young.
Male.
Early twenties.
Agonal breathing.
Blood soaking through hastily wrapped gauze.
“Entry wound parietal region,” Zainab said.
“No obvious exit.”
Which meant the bullet was likely still inside.
CT was non-negotiable.
If he made it that far.
Tunde examined quickly.
“Decerebrate posturing.”
Sadiq felt his pulse spike.
This was bad.
Very bad.
“Prep for intubation,” Tunde ordered.
Kelechi glanced at him.
“You think he’s salvageable?”
A pause.
Then Tunde answered:
“I think his mother will want us to try.”
That silenced everyone.
Dr. Tunde Afolayan – Final-year resident. Brilliant, controlled, emotionally guarded. Lives for the OR. Hiding burnout.
Dr. Zainab Bello – Third-year. Sharp, composed, one of the few women in the program. Constantly underestimated.
Dr. Kelechi Okoye – Second-year. Street-smart, but deeply insecure about whether he belongs.
Dr. Sadiq Musa – First-year (intern resident). Idealistic, observant, slowly losing his innocence.
Author's Note:
So, what do you guys think about this episode??
Also, the tension between Tunde and Professor Eze…