The Fellowship

by K. Darblyne

  As if on cue, the loud shrill tones of the Trauma Team pager went off.

  "Trauma Team Page, Trauma Team Page" the crackling sound of the voice being emitted sounded of urgency. "Multiple vehicle accident, three possibly four victims transporting via helicopters with an eight minute ETA. This is a Level One Trauma Team Page."

  "Guess you’ll find her in the trauma room, Doc."

  Garrett nodded her head, "But I won’t need that duffel bag now. Looks like I’m not going to get any sleep tonight."

  In unison the pair turned and headed toward the trauma rooms in the back hallway. The calm, cool demeanor of the professionals that they were was now replacing the laughter they had shared only a few minutes ago. Reaching the hallway, they quickly donned the lead aprons and trauma gowns, each mentally preparing themselves for the worse case scenario before the patient’s arrival. Garrett watched from the hall as Rosie strode off into the second trauma room, the first trauma room being already manned by the petite blonde nurse.

  Scanning over the rooms, Garrett allowed her gaze to settle on Danni. The young nurse, sensing the attention, turned to look at the surgeon. The brief visual exchange between the two roommates as they acknowledged each other, brought the slightest hint of a smile under their protective masks. It was as if they had spoken volumes of words of encouragement as the green eyes locked on to blue.

  The scurry of activity in the hallway increased as the other members of the Trauma Team arrived. Quickly, Garrett sized up the available resources and began plotting a course of action. It was hectic enough when one severely traumatized patient arrived, but now she had the possibility of three or four arriving within minutes of each other. Her chief resident for the night was Kreger, whom she knew to be capable in the trauma setting. He was eager to learn and had demonstrated that to her time and again.

  "Rob," the surgeon called out. "You take the first one, use room # 2."

  Kreger nodded in approval as he moved into the second trauma room where he positioned himself opposite Rosie. He waited patiently for the first trauma to arrive.

  The Trauma Fellow thought about her next move in this game of chess. Her team tonight was not as deep as she would have liked it to be. The experience of the members was not of a surgical nature, and she pondered over the choice of team leader for the next patient. The surgeon thought of Dr. Rene Chabot up in the delivery suite, resigning herself to call upon the impending father-to-be as a very last resort. She viewed members of her team again. The sight of a lone red-haired bespectacled figure came into her view. ‘There’s my answer!’ she thought. The young E.R. attending physician would be able to handle any life threatening emergency until one of the surgeons could break away from their own patient.

  The tall surgeon moved in a path to intersect that of the E.R. Attending physician. She acknowledging her colleague with a slight nod of her head, "Dr. Potter, would you be so kind as to be team leader for patient #3?"

  The physician pushed her glasses up as she grabbed one of the lead aprons that hung outside of the trauma rooms, "Don’t mind if I do." She accepted the surgeon’s offer as she completed her preparations for the job of team leader in the end room.

  Everyone snapped into attention as the loud speaker overhead blared out, "Trauma’s in the department, Trauma’s in the department."

  "Alright, people, let’s do our jobs." The commanding voice of the Trauma Fellow was heard throughout the hallway.

  The first patient-laden stretcher accompanied by the helicopter crew turned the corner and was met by Garrett who motioned them into the trauma room where Dr. Rob Kreger waited. Advancing speedily into the room, the Flight Medic gave a brief report of the patient’s obvious injuries and vital signs. The blood splattered and twisted body belted onto the backboard was swiftly lifted from the stretcher and placed carefully onto the gurney. Each member of the team with his or her own tasks at hand began their work. Garrett watched approvingly from the foot of the bed at the skills that the team leader was demonstrating, her smile shielded by the mask. Dr. Kreger was proving himself in her eyes. His quick assessment of the patient’s airway, breathing, and circulation began to reveal the critical nature of the injuries that the patient had sustained.

  "I need a chest x-ray now," Rob commanded. His eyes glanced over to the trauma fellow at the foot of the gurney. Garrett subtly nodded. In the brief moment that the two surgeons locked eyes, Dr. Kreger had her approval of his actions and an exchange of confidence occurred. She had inspired him from that first day in the O.R. and now he felt as though he had taken another step up on the ladder that brought him closer to being her equal.

  It was obvious to all in the trauma room that the woman was seriously injured. Her breathing was labored, and the large discolored area along the middle of her chest stretching from right shoulder to left abdomen was a sign of significant seatbelt injury, specifically that of a restrained passenger. The chest x-ray would be a guide to the appropriate treatment.

  Rob Kreger decided to utilize the precious time that he needed to see the

  X-ray. "Let’s set up for bilateral chest tubes, type and cross for six units of blood. Alert CT Scan that we will need to scan the head, and chest- abdomen-pelvis."

  Garrett watched the electronic screen as the patient’s chest X-ray appeared. Her eyes turning a steely blue color as she studied it. Her voice came out tense, "Looks like she has a lot of broken ribs and bilateral pneumothorax." She peered at the X-ray again letting her fingers measure out something on the screen display. "The aortic knob looks pretty wide."

  "That’s what I was afraid of," the team leader shook his head. "What’s her pressure?"

  Rosie looked up at the monitor to her right. "Eighty over fifty and the heart rate is 126."

  Rob’s eyes snapped up to the heart monitor, "Damn, look at those irregular complexes." His eyes quickly fell back onto the chest wall that he was inserting the tube in. "Call the O.R. and tell them to have a room ready for a ruptured aorta." Kreger hurried to finish placing the tube into the left chest and secure it from falling out. Blood now escaped from the chest via the tube as it drained into the holding container. "Damn!" He bit off the word, "No time for the other side to be placed. Call the O.R., we’re coming now."

  As if on cue, the overhead speaker squawked again, "Trauma’s in the Department. Trauma’s in the Department."

  Garrett turned to face the hallway leading from the door to the trauma rooms. Her eyes could barely see the patient through all of the bulky dressing wrapped around his head soaked through with blood. The only thing that she was sure of was that the patient was being assisted in his respirations by the medic that was bagging him. She motioned for the crew to follow her into Trauma Room #1.

  Danni looked at the stretcher with the seemingly lifeless body on it. She noted the small chalky white hand that stuck out from under the cover that the flight crew had used to control his body temperature during the flight. Her heart sank as it always did when confronted with the ravages of trauma on a young person. Her thoughts drifted briefly to her own younger brother and she said her well-rehearsed prayer for his safekeeping. She quickly drew the soft cloth of the trauma gown sleeve across the side of her face, catching the single tear that lingered at the corner of her eye.

  He had always been such a vivacious child, getting into trouble at the drop of a hat. It wasn’t that he was bad or ill mannered, trouble just seemed to follow him around. Matt was with her visiting with their grandfather at his cabin. She would have been ten that year and he had just turned five. Being the older sister, she always felt responsible for him, especially when he got injured. That was the first time she could remember having to tell her parents of Matt’s misfortune. He had fallen out of a tree trying to get an egg out of a bird’s nest. His grip had let go as he stretched out for it, thus resulting in a broken arm. After a while it became standard policy that Danni possessed in her hands a letter of parental consent for emergency care, just in case Matt had to be rushed to the h
ospital. She thought about how it felt to be in charge of her sibling, watching out over him like a mother hen. Perhaps that is when she first felt the urge to start collecting and helping lost, injured or wayward animals. It made her feel important, at least for a little while.

  It was there, in the first emergency room that her brother was in, that she had made her mind up to be a nurse. Not just any old nurse, but the best and most skilled one that she could be. She always thought that she owed her brother a thank you for introducing her to the profession she loved and had brought so much joy to her. In fact, Danni made a mental note to thank him the next time she talked to him, but who would know when that would be. They were older now and with lives of their own. Twenty years had flown by and now they were both adults and living in separate cities. It wasn’t just the years that had them growing apart, but rather Danni’s choice of life at the cabin, out of the reach of all the materialistic goals that her mother tried setting for her, that had lost most of the ties of their teen years. She found the simple life with her Grandfather during the summer months to be so much more enjoyable than the loneliness of the city and her family for that matter. Her mother was always trying to push her daughters into meeting only the most promising young men from well-to-do families, thinking that only money could buy them happiness. She wanted a life of success for her daughters and in her mind that meant running a house and raising a family. Danni’s parents had always gauged their children’s success by the status that they lavished with on the social circuit. Unfortunately, she was never one to rise to the occasion of parties and dating with her classmates. She left that to her younger sister, Breanna, whom was seen as more favorable and brilliant in their eyes with her many interested suitors all vying to wear her on their arms. The bond of sisters was still between them, but each had always listened to their own hearts. Now, they all had grown and gone there separate ways. Matt was with his friends now, all working in law firms, Breanna with her boyfriend Marc who eventually became her husband, fathering her first child on their wedding night and Danni, mostly by herself, always wanting something that would make her feel whole.

  Her mother never approved of her choice in careers, saying that it was beneath someone of her upbringing to be a servant to sick people. Her mother never understood her or her needs: to be giving and compassionate to a total stranger. That would always be a bone of contention between them. Her mother viewed this job as one without rewards or a decent income. Thinking that she needed more time to come into her own with men, her mother agreed to let her go to Nursing School but only if it were at a college that was attractive to the right elements, namely males of good breeding and money. Secretly, she feared that her mother still prayed that it would lead to her rightful position in society, by landing her a well-established physician to marry. Danni could never see herself as the arm piece of anyone, nor would she flourish being treated as someone’s lesser half.

  The blonde nurse was brought back from her thoughts by the voice of the woman across from her, commanding the placement of the patient. Once the stretcher was in position beside the gurney, the Trauma Fellow disconnected the bag from the tube that was securing the patient’s airway. "Okay, on my count," her eyes sweeping the length of the patient for any possible problems with the move. "One, two, three!" The size of the patient was evident by the ease of the move as he was lifted on the long board over to the trauma room gurney. The mechanical act of breathing was again resumed for the patient by the respiratory therapist positioned at the head of the bed.

  Extending her arm, Garrett arched her body overtop of the now patientless stretcher as she adjusted the earpieces of her stethoscope listening for lung sounds to assure her that the breathing tube was in the proper place. She moved the sensitive device from one side of his chest to the other.

  "I want a chest X-ray now," the surgeon bellowed out as she rose to her full height. Stepping back slightly to allow the flight crew to depart with their equipment, she caught the harried pace of Dr. Kreger and his patient being moved briskly through the hallway to the elevators. Their eyes met for a second. The silent exchange was acknowledged by the slightest of nods on each of their parts and each one’s attention quickly returning to their own patient at hand.

  Garrett moved closer to her patient as she reached over to the neck area to check for a carotid pulse. She glanced over to the tracing on the heart monitor, assuring herself that the weak pulse she felt under her fingertips was indeed the patient’s and not her own. "Let’s get blood hung on the rapid infuser." The surgeon’s gaze riveted to the medic at the end of the bed, "What the hell happened?"

  The exasperated medic snapped back, "He was a rear seat passenger, that was partially ejected through the windshield of the SUV. It was a head-on with a tractor trailer, that’s what stopped him, doc." The medic grew pale as he gulped and continued. "We had to get his head out of the truck’s grille."

  An eyebrow arched high under the dark hair of the tall surgeon. "Karen, get me…"

  Her words were cut off; "I have neurosurgery called already."

  "Then get me a…"

  "Scanner’s ready and waiting, doc." The charge nurse motioned to the CT Tech standing patiently in the hallway outside of the trauma room.

  "Chest X-ray is out," the technologist informed.

  Garrett stepped back, "finish up on that blood work. X-ray, get me a lateral C-spine and abdomen." She turned and walked into the hallway and then over to the electronic viewer. She carefully studied the chest x-ray that was displayed on the screen. ‘The tube is in a good location, no apparent fractures or pneumothorax,’ she pondered. She sidestepped and looked back into the trauma room.

  "Dr. Trivoli," the experienced CT Tech tried to get her attention.

  "HMMMM," she muttered as she turned her head toward the voice, while her eyes remained observant of the activity around the patient.

  "Head, chest and abdomen scans?" She asked staring up at the doctor’s face, full of concern.

  Nodding her head in agreement, "Yes, but that may change after we see the head."

  "Okay, doc, whenever you’re ready."

  "Just give us enough time for those X-rays and we’ll be right over," the surgeon glanced over at the technologist who was walking back to her scanner. ‘It’s nice to have experienced people to work with,’ she thought as her eyes moved between the two nurses in her room.

  The sound of the loud speaker again was heard, "Trauma’s in the Department, Trauma’s in the Department."

  Within seconds of the announcement, a stretcher was whisked around the corner and toward the beckoning motion of the E.R. Physician in front of the third trauma room. Jamie Potter, red hair flaring out from around the mask/shield combination that she wore, stood there waiting for them to transverse the distance to her. The young doctor’s attention stayed solely on the patient lying on the stretcher. Her assessment began with that initial moment. The experiences that she had gained in the few short years of being an attending in the metropolitan city hospital setting were evident. Her attention was on the patient as she absorbed the exchange of information from the medic. The cries of pain not only attested to the anguish of the patient’s torment, but also assured her that his airway was patent. With the blanket removed from the lower extremities, Dr. Potter could see the evidence of trauma to the man’s legs. The odd angularity of his right ankle caused her to wince at the sight of it.

  "Call Ortho down," she commanded as she readied the team for the careful transfer of the injured patient. "Okay, nice and gentle now. One, two, three."

  The patient was settled on the gurney, as a string of curses rolled off of his lips that would make a sailor blush. The anger and the intensity of his pain were fully realized by the facial expressions that he displayed to convey his emotions. His hands reached out as if to soothe and steady his aching limb, only to find them restrained by the belts that secured him to the long board he was lying on. Breathing hard and ragged in an effort to control his pain, th
e patient’s right hand grasped the gloved hand of the nurse as she released the board; his terror-filled eyes shifting to lock onto hers.

  "Give me something for the fucking pain, will you! You’ve got drugs here."

  His gaze seemed to burn a hole through the insecure nurse as she attempted to remove her hand from his grasp. Lori looked over to Jamie, her eyes silently pleading for help.

  The physician leaned into the patient’s line of sight to get his attention. "Sir, we know that you are in pain, just give us a minute to find out what all hurts. I need to know where you hurt first before I can give you something to take the edge off that pain." Her left hand slowly traveled down the man’s arm until her gentle touch conveyed her sincerity as she held on to his hand. "Now let us do our jobs. Okay?" She asked.

  With that the man’s grip weakened, allowing the slender hand to withdraw. The tall blonde nurse gently rubbed her hand trying to forget the memory of the vice-like grip that had held on to it.

  The tension and strain of the situation was evident on the faces of the Flight Crew, as they made their way back down the hallway to finish their report. The short, thin medic walked over to the Trauma Fellow who was now studying the X-rays displayed on the viewer.