Prognosis Christmas Baby

by Andrews, Amy

  Charlie donned a pair of gloves and methodically assessed the man as drilled into him during his student years.

  D. R. A. B. C. H.

  Danger. Response. Airway. Breathing. Circulation. Haemorrhage.

  The man was unresponsive. Unconscious. His airway was compromised, his gurgling respirations concerning. He was breathing. Just. He had a pulse. But it was rapid and weak.

  His face was covered in blood.

  Charlie looked at the car and noticed the massive hole in the windscreen. The man must have been catapulted out through the glass, sustaining numerous lacerations. A quick head-to-toe check revealed multiple contusions, bilateral fractured tibias and what appeared to be a major bleed from the femoral artery if the bright, pulsing blood from the man’s groin was any indication.

  Great! He tore the fabric of the man’s jeans, pulled a wad of gauze out of his kit and placed it over the bleeding site, applying firm, even pressure. He needed help. He flipped open his phone and dialled triple zero with one hand and prayed for service in an area that was generally sketchy at best.

  The nearest ambulance station was twenty minutes away.

  ‘Hey, lady, I could use a hand here,’ he shouted into the stillness of the night while he waited for the operator.

  Carrie jumped, snapped out of her daze by the urgency of the man’s voice, strong and commanding despite their distance.

  Of course. She was a doctor, for goodness’ sake.

  But the thought of getting out of the car, of assisting the stranger, paralysed her with fear. The familiar dread descended on her and her heart hammered madly again. He didn’t know what he was asking.

  And anyway...she couldn’t leave Dana.

  Carrie watched him working as he spoke into the phone as if she was watching it on a television screen. Like it wasn’t really happening. He obviously had a medical background. He was calm and capable, with a huge box of medical supplies at his side.

  A strange feeling of disconnectedness draped like a thick, heavy cloak around her shoulders. Maybe it was the residual effects of shock. Maybe his appeal for help had tipped her over. Her hands shook as she thought about getting out of the car and lending a hand.

  She couldn’t do it.

  The mere thought was enough to make her hyperventilate. It terrified her more than the near collision.

  Charlie cursed as he hung up. They were coming, sending two road units and a chopper and alerting the nearby local rural fire brigade, but would it be soon enough? The man’s obstructive breathing sounded loud in the night filled otherwise only by insect song.

  Hell! The driver needed his airway managed as well as his haemorrhage, and he couldn’t do both.

  ‘Lady! Get your butt here now,’ he shouted, turning his head so he could pierce her with a look that was cross between commanding and desperate. ‘I’m trying to save a life here!’

  The man’s demand sliced through Carrie’s panic and touched the doctor she had shut away for too many years. Despite her shaking, despite the dryness of her mouth and the pounding of her heart, something inside responded to the stranger’s urgent appeal.

  She checked on Dana. Still asleep.

  And the, against her will, she rose on legs that felt like two wet noodles.

  Charlie looked up as the woman approached. Oh, hell. She was pale and visibly shaking, looking at the unconscious bleeding patient as if she’d never seen blood before. She looked as if she was going to either faint or vomit. Or both.

  Great. She was going to be as useless as a screen door on a submarine.

  And yet...She’s all you’ve got, Charlie boy.

  ‘Gloves top drawer of the kit,’ he barked.

  If she didn’t snap out of this stupor they were both in trouble. Yes, she’d been through a lot tonight. No doubt she’d thought she’d been a goner at one stage but there was a life hanging in the balance and every second counted.

  He didn’t have time to baby her.

  He only hoped she would respond automatically to his demands.

  Carrie crouched and pulled out a pair of gloves. Her movements stiff and robotic.

  ‘Down here. I need you to put your hand here.’ She didn’t move and Charlie almost lost it.

  ‘I...c-can’t.’ Her teeth chattered violently.

  Charlie bit his tongue and took a deep calming breath. ‘Look, lady, I know you’ve had a shock tonight but this is really, really important.’

  ‘I c-can’t.’

  ‘Yes, you can,’ he said encouragingly. ‘I need firm, even pressure.’

  Charlie kept his voice quiet and composed despite the well of frustration rising inside him. Of all the people in the entire world tonight he was stuck with someone useless in an emergency. But then she surprised him by reaching out a shaking hand.

  Charlie removed his slowly on a rush of relief as she took his place. ‘Firm. Even. Do you understand?’

  She didn’t answer him, just stared with a look of horror at the blood covering her glove as if she’d never seen the substance before. But her technique was good and as long as she kept the pressure applied they could hopefully prevent this man from bleeding to death.

  And it freed Charlie up to manage the airway.

  Carrie didn’t feel the bite of the bitumen into her knees through the thin fabric of her hand-made, cotton, tie-dyed trousers. She didn’t hear the hum of insects or the stutter of her own panicked breath. She didn’t even hear the stranger rooting around in his medical kit.

  The injured man’s blood totally consumed her.

  She could feel its warmth though the thin barrier of latex. She could smell its pungent metallic aroma heavy on the warm night air. Knew that it would be sticky as it clotted around her hands.

  Don’t die. Don’t die. Don’t die.

  The chant helped her keep her mind off the roar of her own blood in her ears, the sweat beading her forehead, the nausea rolling through her intestines. Quickly she grabbed in some air, filling her lungs with it as fast as she could, over and over in time to the silent incantation.

  Don’t die. Don’t die. Don’t die.

  Charlie could hear his helper’s breathing as he applied an oxygen mask to the man’s face. If she kept it up, she was going to need the oxygen. ‘Hey,’ he said, forcing himself to minister to her needs for a few seconds. ‘You’re doing great, OK? Just slow your breathing down. Can you do that?’

  Carrie shook her head, as everything around her spun out of control. Her lips were tingling. Her gloved fingers, covered in blood, were tingling. ‘I can’t...b-breathe,’ she gasped.

  Charlie bit back an expletive. Christ, not now. ‘Yes, you can.’

  His conscience pricked at his impatience. This woman had already been through a lot tonight and now he was asking more. She could have potentially been the victim here and what she probably needed more than anything else was some TLC but instead he was forcing her to do something clearly outside her comfort zone.

  She was obviously one of those squeamish people who didn’t like the sight of blood so it had to be hard for her to help. Frankly, this sort of scene could be difficult for even hardened professionals.

  He sighed. “Look at me.”

  Carrie couldn’t move. She could only see the blood. Her mind started to play tricks. She was getting flashes of another place and time. Another patient. Another life-and-death situation.

  So much blood.

  She squeezed her eyes shut and shook her head to expel them.

  ‘Look at me!’

  Charlie was more forceful this time but it had the desired effect. Her head snapped up, panic flaring her nostrils and dilating her pupils. ‘You’re doing really well,’ he said gentling his voice again, lifting his hand to squeeze her shoulder. ‘The ambulance should be here soon.’

  Carrie felt the warmth of his hand anchoring her in the suddenly spinning world and her panicked thoughts eased momentarily.

  ‘What’s your name?’ he asked.

  ‘C-Carrie.’r />
  ‘Hi. I’m Charlie.’ He smiled. ‘I need you to slow your breathing down, OK? Do you think you can do that?’

  Carrie nodded mutely but she still couldn’t get enough air.

  ‘Come on, Carrie, like this.’ He breathed deeply in and out himself. ‘Breathe with me, like this.’

  Carrie forced herself to slow her breathing. It was hard at first, her oxygen-starved lungs protesting but she clung to the calm timbre of Charlie’s voice, mimicked his deep steady breathing — in and out, in and out. His hand on her shoulder was immeasurably comforting and, slowly, the tingling subsided.

  ‘OK, now. Good. This is good.” He smiled encouragingly. “Much better. Well done.’

  Carrie was aware somewhere inside her jumbled thoughts that he was talking to her like she was a frightened child, the way she spoke to Dana during a thunderstorm. And she was also aware that behind his calm façade his eyes kept flicking down to check the inert man on the ground.

  Their patient was in bad shape and she had to pull herself together.

  ‘I need to keep going here. Will you be OK? Just keep breathing, OK? In and out. All right?’

  ‘I’m sorry. I’m g-good now. I’ll breathe.’

  Charlie searched her face. She still looked scared but the panic was gone. ‘That’s great.’ He nodded and turned his attention back to his patient.

  What first? He needed a collar to stabilise the patient’s neck before he manipulated it to improve the airway. He didn’t have one. He made a mental note to put a collar in the kit for future use and moved to plan B. He knelt so that the patient’s head was between his legs, his knees and thighs providing support for the head and neck.

  He experimented with some gentle jaw support and chin extension and was relieved to hear the breathing become much less noisy. He reached for his portable suction unit, pushed the mask aside and placed the sucker inside the man’s mouth. Blood slurped into the tubing.

  Carrie startled at the loud mechanical noise. The red fluid tracked down the tubing and she looked away quickly. Nausea roiled through her intestines again and for an awful moment she thought she was going to disgrace herself – more than she had already - and lose her dinner. Her heartbeat spiked and she coughed on a rising surge of bile.

  Charlie glanced up quickly. ‘How you doing?’ He could hear fear in the rattle of her breath as she struggled to keep herself in control. ‘In and out, Carrie. This is nearly over.’

  Carrie nodded, forcing herself to breathe, opening her mouth to ask the question burning through her mind. ‘Do...do you think he’s going to d-die?’

  Charlie was surprised to hear her talk. But that was good. Maybe she needed conversation to distract her from the grim reality of the situation?

  He had two choices. Truth or gloss.

  ‘Probably.’ He’d never much been one for gloss. ‘He’s got a significant head injury and multiple fractures, including probable facial, which is compromising his airway. His pupils are fixed and dilated. He has a major arterial haemorrhage.’

  Carrie nodded. Through the fog of her jumbled thought processes she knew just one of these alone was a significant, life-threatening injury. Combined...?

  ‘But it’s OK, I’m a doctor. I’m not giving up yet.’

  He grinned despite the circumstances, and relief flowed cool and easy through her system. Maybe his confidence was wrong in the face of the severity of the situation but it helped calm her a little.

  The wail of a distant siren interrupted their conversation and they both cocked their heads. Carrie had never heard a more beautiful sound.

  ‘See?” Charlie smiled again. “Not much longer.’

  A fire engine arrived a minute later. It wasn’t quite what Charlie was after but it meant more hands. ‘What happened?’ asked a thin young man in a navy uniform, jumping out of the truck.

  Charlie filled them in. Within a minute the car was being dealt with, a road block was being set up to manage any traffic and Charlie’s request for light had been efficiently dealt with. He even commandeered someone to assist. Second rule of triage — the most experienced person on scene managed the airway.

  But Charlie needed to get a line in and he couldn’t do that from the head of the patient.

  He let one of the crew take his place, stressing the importance of neck stability while he quickly placed an IV in the crook of the patient’s elbow. He hooked up some fluid from his supply and ran the cannula wide open as another fireman held the bag aloft.

  ‘She OK, Doc?’ The human IV pole nudged Charlie.

  Charlie glanced down at Carrie, who had her eyes closed and was rocking her body slightly. Nope. Not really. ‘She’s fine,’ he assured the fireman.

  The ambulance would be here soon and she could be relieved, but in the meantime she was doing a great job with the arterial bleed.

  ‘OK?’ he asked his voice low as he crouched down beside Carrie, squeezing her shoulder. She looked very pale. ‘You’re doing really well. I couldn’t have done this without your help. I’m proud of you.’

  Carrie glanced at him, stunned by his genuine praise. She was a mess and she shouldn’t have been. She should have been a professional. She could have been really useful. Formed a vibrant partnership to save the man’s life. Been an asset instead of a liability.

  But he was complimenting her nonetheless and in this nightmare it really meant something.

  Two ambulances arrived five minutes later, one carrying an intensive-care paramedic, and a chopper thundered overhead minutes after that, landing on the road nearby. Carrie was relieved of her duty, her fingers numb from applying constant pressure. Someone took over and she felt several arms lifting her up and out of the way.

  A paramedic shepherded her towards his rig but she refused to be looked at until she’d checked on Dana. Surely she wasn’t still asleep? But she was. Soundly. Her cherubic pout slack, her blonde locks in disarray.

  Carrie allowed the paramedic to give her a once-over by her car. Someone thrust a warm drink at her and someone else draped a blanket around her shoulders. She was grateful to be away from it all, her heart rate settling but the feeling of unreality persisted.

  Her neck ached and she rubbed each side absently. Her knees ached also. She looked down at her ruined trousers, torn and frayed at the knees.

  She watched Charlie work in tandem with the paramedics to help stabilise the patient, admiring his confidence, his self-assuredness. She’d practically fallen apart, almost vomited all over the patient.

  But not him.

  He had saved the man’s life. His insistence that she help, while difficult beyond words for her, had been the right call. Not that she’d been capable of much.

  Thirty minutes later the patient was gone. Dana finally woke up as the chopper lifted noisily. Carrie got her out of her car seat and snuggled her against her chest, wrapping the blanket around both of them.

  ‘What happened, Mummy?’

  ‘There was a car accident, sweetie.’

  Dana yawned. ‘It looks like a disco. Can I dance?’

  Carrie smiled. Dana was right. The scene did look like a roadside discotheque. Flashing lights from the multiple emergency vehicles strobed across the scene, reflecting the pieces of broken glass scattered like diamonds across the road surface. ‘No, sweetie, no dancing tonight.’

  Dana gave her a cute sleepy smile and snuggled her face into Carrie’s neck. Carrie hugged her closer, inhaling the sweet smell of her daughter.

  Charlie approached, surprised to see a mop of blonde hair peeking out of the top of the blanket. Carrie had a kid? No wonder she’d been reluctant to get out the car.

  ‘Is this your daughter?’ When she nodded he continued. ‘I’m sorry, I had no idea...’ Maybe that’s why she’d been so shaky? She’d probably still been reacting to the potential consequences had the red car hit hers head on.

  ‘It doesn’t matter.’ She shook her head. ‘Dana slept through it all.’

  ‘Who are you?’ Dana’s hi
gh voice broke into their conversation.

  Charlie was captivated by a pair of big blue eyes fluttering behind heavy lids. ‘I’m Charlie.’

  ‘Were you in the accident?’ Dana asked sleepily.

  ‘No, Sleeping Beauty, I just helped out.’

  Dana giggled. ‘Mummy, Charlie thinks I’m Sleeping Beauty.’

  Carrie smiled down at her daughter. ‘Go to sleep, then, Sleeping Beauty.’ She dropped a kiss on Dana’s forehead. They both watched as Dana shut her eyes.

  ‘How are you doing?’ Charlie asked.

  ‘I’m fine,’ she assured him, despite the persisting tremble of her hands.

  ‘I’m sorry, I was probably a bit forceful back there.’

  ‘You were just trying to help him,’ she said dismissively.

  ‘You did well.’ Charlie leant his hip against her vehicle.

  Carrie laughed. ‘Sure.’

  ‘It’s not everyone’s cup of tea.’ He shrugged.

  Carrie decided it was best he didn’t know about her qualifications. The chances that they’d ever meet in a professional capacity were fairly negligible. He was obviously an emergency medicine specialist and she was firmly ensconced in management.

  ‘Are you going to be right to travel home?’ he asked. ‘Your car still goes?’

  Carrie looked at the dented rear side panel. It did, but she doubted whether she could drive again tonight, she was too shaken up. ‘I’ll get one of the tow-truck drivers to take it away and arrange to have it fixed first thing tomorrow. It’s a bit of a pain but, considering I thought we were going to die tonight, it’s an inconvenience I can live with.’

  Charlie chuckled. ‘You heading back to Brisbane? Can I give you a lift home?’

  Carrie watched the traffic accident investigation squad put yellow markings on the road. They’d promised her a lift back into the city but they didn’t look like they’d be finished any time soon.

  She regarded him steadily, taking notice of his looks for the first time. He was tall, a good head taller than her. He had nice eyes, grey eyes. A nice face, actually. Calm. Serene.

  Confident.

  Even when he’d been snapping orders he’d been completely self-assured.