by Lucy Clark
‘Where are you?’ Alexis asked as Molly connected the call.
‘I’m coming. I’m coming. I overslept.’
‘Were you called in last night? Did something happen I don’t know about?’
‘I’ll be there as soon as I can,’ Molly replied.
‘OK. I’ll let Fletcher know.’
‘Why should he need to know?’ Molly retorted as she tried to climb out of the bed but in her haste ended up with her feet tangled in the sheets.
‘He’s taking ward round this morning.’
‘Is he there?’
‘He’s been here since just before six o’clock. Said he couldn’t sleep so he’s been catching up on the cases he’s going to review.’
‘That’s just perfect,’ she mumbled. Her not-ex-husband was taking ward round on the only morning that she was late! Always the way. ‘I’ll be there as soon as I can,’ she repeated and disconnected the call, now desperately trying to kick her feet free, absolutely hating the sensation of being unable to move. It was part of who she was. Always needing to have a certain amount of freedom. Perhaps it was because she was one of three that she wanted to assert her independence, even if it was in small ways. Cora and Stacey called it her Mollyness.
‘It’s what makes you Molly.’ Cora had laughed.
‘Our Mad Molly,’ Stacey had added, the three of them giggling together.
It was why she’d decided to pursue surgery, why she’d moved to Sydney and why, all those years ago, she’d impulsively married Fletcher. She didn’t like being told she couldn’t do something, she didn’t like other people organising her life, as Fletch had tried to do after they were married, and she didn’t like being restrained, thus the bed sheets ended up in a complete mess on the floor, Molly taking her frustrations out on them.
She quickly dressed in navy trousers and a light blue shirt, then tamed her hair back into a bun, lacquering the sides into place. She felt austere and aloof, wanting her outward appearance to reflect that.
Quickly grabbing her keys, hospital key card and bag, Molly pulled the front door closed behind her and headed off for the hospital at a brisk pace. She could grab a coffee and something to eat at the first available opportunity, which would hopefully be between ward round and the meeting she was scheduled to attend at nine-thirty.
‘How could you have slept in? So unprofessional,’ she chastised herself in a mumbled whisper. All she could concentrate on now was getting to work as fast as possible and hoping that she could just slip onto the end of the round without being noticed. Ha! Of course he’d notice. She was his wife.
The squeal of tyres up ahead stopped her thoughts dead, a sickening feeling rolling in her stomach, which had nothing to do with the fact that she hadn’t eaten anything for breakfast. She stopped walking and listened…waited. Time seemed to stand still, to freeze but then, when she heard the sound of metal upon metal, of people screaming, of more squealing tyres, the world around her seemed to jump into fast forward.
Molly ran towards where the sounds were coming from, the cries for help guiding her in the right direction. She pulled her cell phone from her pocket, dialling Alexis’s cell phone. ‘Hi. I’m going to be much later than originally expected,’ she said before Alexis could talk. ‘Motor vehicle accident, one block up from the hospital. No doubt people have already called the emergency number.’
‘Where are you exactly?’ Alexis asked, concern in her tone.
‘Just crossing the road.’ Molly scanned the area. ‘There’s a bus in the middle of the road, two cars have been hit but it looks as though they were parked. Not sure if there are any occupants of the vehicles.’ She continued to describe what she was seeing as she moved closer. ‘One person on the road. Not moving. Looks like a teenage boy.’ She stopped running and walked briskly through the people who were gathering around, some of them covering their mouths, unsure what to do or how to react to the trauma they were seeing. ‘Bus driver appears unconscious.’ She pushed her way through the few people who were around the teenager. ‘I’m a doctor,’ she told them briskly, her no-nonsense tone brooking no argument.
Molly pressed her fingers to the teenager’s carotid pulse. ‘Pulse is there but thready.’
‘The calls have come in,’ Alexis informed her, then Molly could hear her friend muttering something to someone else. ‘Sister’s on the hospital phone letting the paramedic crews know that you’re already on site.’
‘OK.’ Molly turned her attention to her patient. ‘Can you hear me?’ she called to the teenager.
‘Is there any response?’
Molly actually pulled the phone from her ear and looked at it. It wasn’t Alexis on the other end but Fletcher.
‘Molly? Molly?’
‘I’m here,’ she remarked, trying to instil polite professionalism into her tone. It didn’t matter what was happening between them; their private lives had nothing whatsoever to do with this situation. She checked the teenager’s pulse again. At least he was breathing. She called to him.
‘I’m Dr Wilton. Can you hear me?’ She received a murmur; there was no coherence to his words. ‘Mild response,’ she remarked into the phone.
‘That’s something. Is he stable enough for you to check the rest of the area so we have a better idea of what we might find?’
‘Not really. Just a second.’ Molly looked around and it was then she saw a woman in her sixties running towards her.
‘I’m a retired nurse,’ the woman said as she drew closer to Molly, a little out of breath.
‘Great. Can you go and check on cars over there and give me a report?’
‘Done.’ The woman headed off and Molly lifted the phone from her ear. ‘I’m going to put you on speaker,’ she told Fletch and put the phone on the ground so she had two hands to work with. ‘I just want to check his injuries.’ Very carefully, she shifted around the teenager, needing to get a better look. ‘Ribs feel gone on the right side, decreased air intake.’
‘Blunt force trauma. Do you think he might have been struck by the bus or one of the cars?’
‘Given his height and the position of the injuries, I’d go with the bus.’ She kept carefully checking her patient. ‘Right femur and left tibia and fibula feel fractured.’ She felt his ankle for a pulse. ‘No blood loss and weak pulse in his ankle.’
‘So we can assume femoral artery is intact.’
The patient made a sound again and Molly spoke to him. ‘I’m Dr Wilton,’ she said again. ‘Stay still. Help is on the way.’
The retired nurse came running back, puffing. ‘Two adults in the car, one female, one male. Both appear to be unconscious but a woman’s been hit by their car. She’s under the front tyre. She’s dead.’
Molly closed her eyes for a moment and took a breath, shoving this sad news to the back of her mind. She opened her eyes with focus and purpose. She looked up at the nurse. ‘What’s your name?’
‘Vreni.’
‘I’m Molly. We need to get this boy stabilised.’ She directed her words to the phone. ‘Fletch, how long before support arrives?’
‘We’ll be there in two, possibly three minutes,’ Fletcher replied and it sounded as though he was moving briskly.
That stopped her for a second. ‘You’re coming?’
‘Alexis, myself and the rest of the recovery crew are climbing into the ambulance now,’ he told her. ‘Keep the line open.’
‘Vreni, can you stay with him? See if you can get a better response from him but, most of all, keep his head stable. I’m going to try taking a closer look at the bus driver.’
‘OK.’
Molly picked up the phone and took it with her. It wasn’t until she reached the back door of the bus that she realised there were passengers inside. They were trying to get the rear door open, the three of them looking rather panicked as the emergency door release seemed to be jammed.
‘You may need to try the rear window,’ she called to them, pointing to the back of the bus where the emergency
window was located. ‘Lie on the seat and kick the window with your feet. Do it at the same time,’ she called to them. The sound of sirens filled the air. Molly knew that within a matter of ten minutes all the emergency services, fire, ambulance and police, would be on the scene and she would have assistance but for now, if she could get these people out of the back of the bus, she could attempt to get in that way and take a closer look at the driver.
Thankfully, the passengers all worked in unison and were soon climbing out of the rear window.
‘Go and sit over there on the kerb,’ she instructed them. The morning traffic had now slowed to a crawl and down to one lane, the commuters stopping to stare at the emergency for as long as possible. ‘Where are you?’ she asked Fletcher as she put the phone in her pocket.
‘Working our way through the traffic. Give us another two minutes.’
‘Just as well I used to do gymnastics when I was little,’ she commented as she finished climbing into the bus. ‘Driver looks as though he’s trapped, quite badly. Hello? Can you hear me?’ she asked. ‘I’m Dr Wilton. What’s your name?’
‘Jerry,’ he managed to say, his breathing uneven.
‘OK, Jerry.’ She felt his pulse. ‘Just keep real still for me.’
‘I can’t move my legs.’
‘Right. Let me see if I can have a look,’ she said, bending down to carefully shift a bit of the dashboard that seemed to have curled around the driver’s legs. She took the phone out of her pocket and spoke to Fletcher. ‘Are you still there, Fletch?’
‘I’m not going anywhere,’ he told her and at the moment she was extremely comforted by his words.
‘Driver has sustained an injury to his legs. I can’t shift the debris but I can see beneath it. Part of the steering wheel has broken off and is lodged in his upper thigh. Other than that, he’s stable for now so long as he stays still.’ She stood and put her hand on Jerry’s shoulder. ‘You’re going to stay nice and still for me, aren’t you?’ she said with a smile in her words.
‘Whatever you say, doc,’ he replied.
‘That’s good news. I need to leave you now but crews will be here soon.’
‘We can’t get through any further at the moment. Cars are banked up,’ Fletch told her. ‘I’m climbing from the transport now and bringing the kit with me. We’ll probably need the helicopter to lift the patients out.’
‘Get Alexis to sort that out,’ Molly stated as Jerry told her where to find the emergency lever to open the front doors of the bus. This she did and, with the phone still to her ear, she returned to where Vreni was monitoring the teenage boy.
‘I can see you,’ Fletch called and within the next second he’d hung up. Molly looked in the distance and saw him running towards her, dressed in bright retrieval overalls with the word ‘Doctor’ emblazoned on the back and front.
Molly shoved her phone back into her pocket and looked to Vreni. ‘Any change?’ she asked.
‘His breathing is still raspy but he’s managed to tell me his name. It’s Davis.’
‘Hello, Davis. I’m Dr Wilton. We’re going to get you all sorted out now.’
Within another moment, Fletcher was kneeling down beside her, opening the large medical backpack to retrieve some gloves. He handed some to Vreni and to Molly, the paramedics coming alongside them and carefully stabilising Davis’s head and neck in a brace.
Molly took a stethoscope from the bag and immediately listened to Davis’s breathing. ‘His air intake is definitely decreased on the left side.’
‘Pelvis is unstable, pulse is still good in both legs,’ Fletcher remarked as he ran his hands over Davis’s lower injuries, checking them. ‘Let’s get a drip into him and some pain relief. Pass me the portable monitor,’ he stated to another one of the paramedics. Together they worked to hook Davis to the monitor that gave them an ECG read-out as well as monitoring his blood pressure and oxygen saturations.
By the time they were done, Molly looked up and it was then she finally became aware of the other emergency crews. The fire-brigade crews were busy cutting away the driver’s side window of the bus to allow the paramedics easier access to both sides of the driver. Alexis was with Jerry, helping to stabilise him. Several of the other paramedics and emergency doctors were with the passengers of the car and she saw the one police officer covering the deceased woman’s body with a blanket until they were able to successfully move her to a more suitable resting place.
‘OK,’ Fletch remarked as he monitored Davis’s output. ‘He should be OK to stretcher and move. How long until the helicopter arrives?’ He asked the last question to the paramedic, who immediately pulled out his two-way radio to confirm these details.
Just after they’d successfully transferred Davis to the stretcher, one of the paramedics using a bag to ensure Davis received enough oxygen, the portable machine that was monitoring his vital signs began beeping.
‘Sats are falling,’ Molly remarked.
Fletch immediately hooked a stethoscope into his ears and listened to Davis’s breathing. ‘He’s going bradycardic.’
‘Pressure’s going down,’ Vreni said.
‘All signs are pointing to tamponade,’ Molly added.
‘We’re going to need to open him up and find where he’s bleeding,’ Fletcher stated firmly.
‘Here?’ Vreni stared at him as though he were completely insane. ‘On the street? He might die.’
‘If we don’t try, then he’ll definitely die,’ Fletcher remarked, pulling different pieces of equipment from the medical kit. He looked to the paramedics. ‘I need lung spreaders and a full surgical kit, stat.’
One of the paramedics headed off to fulfil the request. ‘We’re going to need some screens around the patient,’ Molly said to a nearby police officer. Within a matter of minutes, Fletcher was ready to proceed with the emergency surgery.
He looked at Molly, his blue gaze intense but filled with absolute confidence. She drew strength from that. ‘Ready to do a thoracotomy?’
She nodded once. ‘Ready.’
‘Scalpel,’ he said and she placed it into his hand. He made a neat incision on the left side of Davis’s chest, Vreni ensuring that the teenager’s left arm was out of the way above his head. Molly had the blunt scissors ready for when Fletcher needed to cut through the muscle tissue. They inserted the spreaders, which gave them a bigger area to find out what was causing Davis to fail. The paramedic was still squeezing the bag with a regular rhythm so that Davis’s lungs received oxygen. Vreni was supplying gauze and packing to mop up the blood surrounding the wound, trying to keep it as clear as possible. ‘Feel around, Molly. See if you can locate that bleeder.’
She did as she was told. ‘Found a clot. There’s a hole in the right atrium.’ She held out her hand. ‘Clamp.’
Vreni reached into the surgical kit and quickly handed Molly a clamp.
‘Careful. It’s as thin as tissue paper,’ Fletcher stated as he carefully cut through the pericardium to reach the heart. He went to reach in to massage the heart but stopped.
‘I’m on the wrong angle and my hands are too big.’ He took the clamp from Molly and she immediately put her hand around Davis’s heart.
‘Quality massage but don’t kink it. Keep it level,’ he reported. After a few moments, when there was still no output, he shook his head.
‘I’m going to give him some adrenaline.’ He pulled a shot of adrenaline from the emergency medical kit and inserted the needle straight into the heart.
‘Still nothing,’ Molly said, trying desperately to keep the concern from her voice.
Fletcher flicked the heart. Nothing. He flicked the heart again and this time Davis’s body responded but not in the way they’d hoped.
‘He’s going into ventricular fibrillation,’ Vreni stated.
‘Let’s close up his chest. Get the pads on him. Shock him.’ Molly and Fletcher were working quickly, putting on first one pad, then the second.
‘Stand back.’
Th
e paramedic who was bagging Davis waited until the last minute to remove the bag from the tube that was in the teenager’s mouth.
‘Clear!’
The shock was administered, Davis’s body jolting for a split second but it was enough.
‘He’s in sinus.’
‘There’s an output,’ she confirmed.
‘Right. Let’s get him into the helicopter and back to the hospital. Molly, you’re with me, we’re taking him straight to Theatre.’
They left Alexis, Vreni and the rest of the emergency team to deal with the remaining casualties. As they climbed into the helicopter, monitoring Davis as they made their way back to the hospital, Fletcher was on the headset, talking to the theatre sister, giving her a debrief and letting her know what sort of equipment they’d require in order to ensure Davis had every available chance at making a full recovery.
By the time they came out of Theatre, Molly was exhausted. She leaned against the wall and closed her eyes, knowing there would be more emergency surgery to follow. The bus driver would need their attention when he was finally free from the wreckage. They’d been kept appraised of the situation while they’d been patching Davis up but, now that the young teenager was stable and being watched over by the recovery staff, Molly just needed a few minutes to draw some strength from somewhere.
‘Have you had coffee this morning?’ Fletcher’s words broke through her thoughts and she opened her eyes and straightened up. Before she could answer, he looped his arm around her waist and led her to the doctors’ lounge. ‘It doesn’t look like it. Come and sit down. I’ll make one for you.’
‘Fletch, it’s all right. I’ll be fi—’
‘Shh. Doctor knows best. Now, do as you’re told.’
‘You always were bossy,’ she murmured as they entered the small deserted room. She sank gratefully into a chair, giving in to his suggestion.
‘Hmm, not bossy but perhaps…direct. Sometimes too direct,’ he clarified softly.
