It Started at Christmas...

by Janice Lynn

  Over the phone, McKenzie requested an ambulance. Not that there was time to wait for the paramedics. There wasn’t. They had to get out whatever was in the man’s throat.

  Lance tried repeatedly and with great force to dislodge whatever was blocking the panicking guy’s airway. McKenzie imagined several ribs had already cracked at the intensity of his chest thrusts.

  If the man’s airway wasn’t cleared, and fast, a few broken ribs weren’t going to matter. He had already started turning blue and any moment was going to lose consciousness.

  “We’re going to have to open his airway.” Lance said what she’d been thinking. And pray they were able to establish a patent airway.

  She glanced down at the table, found the sharpest-appearing knife, and frowned at the serrated edges. She’d have made do if that had been her only option, but in her purse, on her key chain, she had a small Swiss army knife that had been a gift many years before from her grandfather. The blade was razor sharp and much more suitable for making a neat cut into someone’s neck to create an artificial airway than this steak knife. She dumped the contents of her purse onto the table, grabbed her key chain and a ballpoint pen.

  As the man lost consciousness, Lance continued to try to dislodge the stuck food. McKenzie disassembled the pen, removed the ink cartridge, and blew into the now empty plastic tube to clear anything that might be in the casing.

  Lance eased the man down onto the floor.

  “Does he still have a heartbeat?” she asked, kneeling next to where the man now lay.

  “Regardless of whether or not he does, I’m going to see if CPR will dislodge the food before we cut.”

  Sometimes once a choking victim lost consciousness, their throat muscles relaxed enough that whatever was stuck would loosen and pop out during the force exerted to the chest during CPR. It was worth a try.

  Unfortunately, chest compressions didn’t work either. Time was of the essence. Typically, there was a small window of about four minutes to get oxygen inside the man’s body or there would likely be permanent brain damage. If they could revive him at all.

  McKenzie tilted the man’s head back. When several seconds of CPR didn’t give the reassuring gasp of air to let them know the food had dislodged, she flashed her crude cricothyroidotomy instruments at Lance.

  “Let me do it,” he suggested.

  She didn’t waste time responding, just felt for the indentation between the unconscious man’s Adam’s apple and the cricoid cartilage. She made a horizontal half-inch incision that was about the same depth into the dip. Several horrified cries and all out sobbing were going on around her, but she drowned everything out except what she was doing to attempt to save the man’s life.

  Once she had her incision, she pinched the flesh, trying to get the tissue to gape open. Unfortunately, the gentleman was a fleshy fellow and she wasn’t satisfied with what she saw. She stuck her finger into the cut she’d made to open the area.

  Once she had the opening patent, she stuck the ballpoint-pen tube into the cut to maintain the airway and gave two quick breaths.

  “Good job,” Lance praised when the man’s chest rose and fell. “He still has a heartbeat.”

  That was good news and meant their odds of reviving him were greatly improved now that he was getting oxygen again. She waited five seconds, then gave another breath, then another until their patient slowly began coming to.

  “It’s okay,” Lance reassured him, trying to keep the man calm, while McKenzie gave one last breath before straightening from her patient.

  “Dr. Sanders opened your airway,” Lance continued. “Paramedics are on their way. You’re going to be okay.”

  Having regained consciousness, the man should resume breathing on his own through the airway she’d created for him. She watched for the reassuring rise and fall of his chest. Relief washed over her at his body’s movement.

  Looking panicky, he sat up. Lance held on to him to help steady him and grabbed the man’s hands when he reached for the pen barrel stuck in his throat.

  “I wouldn’t do that,” Lance warned. “That’s what’s letting air into your body. Pull it out, and we’ll have to put it back in to keep that airway open.”

  “Is he going to be okay?” a well-dressed, well-made-up woman in her mid-to-late fifties asked, kneeling next to McKenzie a little shakily.

  “He should be.” She met the scared man’s gaze. “But whatever is stuck in your throat is still there. An ambulance is on the way. They’ll take you to the hospital where a general surgeon will figure out the best way to remove whatever is trapped there.”

  The man looked dazed. He touched a steady trickle of blood that was running down his neck.

  “Once the surgeon reestablishes your airway, he’ll close you up and that will only leave a tiny scar,” she assured him.

  Seeming to calm somewhat the longer he was conscious, the man’s gaze dropped to her bloody finger. Yeah, she should probably wash that off now that the immediate danger had passed.

  “Go wash up,” Lance ordered, having apparently read her mind. “I’ll stay with him until the ambulance arrives.”

  With one last glance at her patient she nodded, stood, and went in search of a ladies’ room so she could wash the blood off her hands and her Swiss army knife.

  Carrying McKenzie’s purse and the contents she’d apparently gathered up, Cecilia fell into step beside her. “Omigosh. I can’t believe that just happened. You were amazing.”

  McKenzie glanced at her gushing friend. “Not exactly the festive cheer you want spread at a charity Christmas show.”

  “You and Dr. Spencer were wonderful,” Cecilia sighed.

  She shrugged. “We just did our job.”

  “Y’all weren’t at work.” Cecilia held the bathroom door open for McKenzie.

  “Doesn’t mean we’d let someone choke to death right in front of us.”

  “I know that, I just meant...” Cecilia paused as they went into the bathroom. She flipped the water faucet on full blast so McKenzie wouldn’t have to touch the knobs with her bloodstained hands.

  “It was no big deal. Really.” McKenzie scrubbed the blood from her finger and from where it had smeared onto her hands. Over and over with a generous amount of antibacterial soap she scrubbed her skin and then cleaned her knife. She’d rub alcohol on it later that evening, too. Maybe even run it through the autoclave machine at work for good measure.

  Cecilia talked a mile a minute, going on and on about how she’d thought she was going to pass out when McKenzie had cut the man’s throat. “I could never do your job,” she added.

  “Yeah, and no one would want me to do yours. They’d look like a two-year-old got hold of them with kitchen shears.”

  When she finally felt clean, she and Cecilia returned to the dinner theater to see the paramedics talking to the man who’d choked. Although he couldn’t verbalize, the man nodded or shook his head in response.

  As he was doing well since his oxygenation had returned to normal, they had him climb onto the stretcher and they rolled him out of the large room. Lance followed, giving one of the guys a full report of what had happened. McKenzie fell into step with them.

  “Dr. Sanders saved his life,” Lance told them.

  He would have established an airway just as easily as she had. It wasn’t that big a deal.

  The paramedic praised her efforts.

  She shook off the compliment. It’s what she’d trained for.

  “You’re going to need to go to the hospital, too,” Lance reminded her.

  Her gaze cut to his, then she frowned. Yeah, she’d thought of that as she’d been scrubbing the blood from the finger she’d used to open the cut she’d made. Blood exposure was a big deal. A scary big deal.

  “I know. I rode here with Cecilia. I’ll have
her take me, unless I can hitch a ride with you guys.” She gave the paramedic a hopeful look.

  “I’ll take you,” Lance piped up, which was exactly what she hadn’t wanted to happen. The less she was alone with him the better.

  She arched a brow at him. “You got blood on you, too?”

  He didn’t answer, just turned his attention to the paramedic. “I’ll bring her to the hospital and we’ll draw necessary labs.”

  In the heat of the moment she’d have done exactly the same thing and saved the man’s life. After the fact was when one started thinking about possible consequences of blood exposure. In an emergency situation one did what one had to do to preserve another’s life.

  She didn’t regret a thing, because she’d done the right thing, but her own life could have just drastically changed forever, pending on the man’s health history.

  She didn’t have any cuts or nicks that she could see on her hands, but even the tiniest little micro-tear could be a site for disease to gain entry into her body.

  Whether she wanted to or not, she had to have blood tests.

  “Cecilia can take me,” she assured Lance. Beyond being alone with him, the last thing she wanted was to have to have him there when she had labs drawn.

  McKenzie hated having blood drawn.

  Blood didn’t bother her, so long as it was someone else’s blood. Really, it wasn’t her blood that was the problem. It was her irrational fear of needles that bothered her. The thought of a needle coming anywhere near her body did funny things to her mind. Like send her into a full-blown panic attack. How could she be so calm and collected when she was the one wielding the needle and so absolutely terrified when she was going to be the recipient?

  She could do without Lance witnessing her belonephobia. He didn’t need to know she was afraid of needles. Uh-uh, no way.

  McKenzie gave Cecilia a pleading look, begging for her friend to somehow rescue her, but the grinning hairdresser hugged her goodbye and indicated that she was going to say something to someone she knew, then headed out rather than stay for the remainder of the show. Unfortunately, several of the other attendees seemed to be making the same decision to leave.

  “I’m going to the hospital anyway, so it wouldn’t make sense for someone else to bring you.”

  “But I...” She realized she was being ridiculous. One of the local doctors going into hysterics over getting a routine phlebotomy check would likely cause a stir of gossip. Lance would end up hearing about her silliness anyway. “Okay, that’s fine, but don’t you have to finish your show?”

  He glanced back toward the dinner theater. “Other than thanking everyone for coming to the show, I’ve done my part. While you were washing up, I asked one of the singers to take over. The show can go on without me.” A worried look settled on his handsome face. “The show must go on. It’s for such a great cause and I don’t want what happened to give people a bad view of the event. It’s one of our biggest fund-raisers.”

  McKenzie frowned, hating that the incident had happened for many reasons. “It’s not the fault of Celebrate Graduation that the man choked. Surely people understand that.”

  “You’d think so,” he agreed, as they exited the building and headed toward the parking lot. “That man was Coopersville’s mayor, you know.”

  “The mayor?” No, she hadn’t known. Not that it would have mattered. She’d done what had needed to be done and would have done exactly the same regardless of who the person had been. A life had been on the line.

  “Yep, Leo Jones.”

  “Is he one of your patients?” she asked, despite knowing he shouldn’t answer. He knew exactly why she was asking. Did she need to worry about the man’s health history? Did Lance know anything that would set her mind at ease?

  “You know I wouldn’t tell you even if he was.”

  Yes, she knew.

  “But I can honestly say I know nothing about any mayor’s health history.” He opened the passenger door to his low-slung sports car that any other time McKenzie would have whistled in appreciation of. Right now her brain was distracted by too many possibilities of the consequences of her actions and that soon a needle would be puncturing her skin.

  Was it her imagination or had she just broken a sweat despite the mid-December temperatures?

  “Thank you,” she whispered back, knowing her question had put him in an awkward position and that he’d answered as best he could. “I guess I won’t know anything for a few days.”

  “Probably not.” He stood at the car door for a few seconds. A guilty look on his face, he raked his fingers through his hair. “I should have cut the airway, rather than let you do it.”

  She frowned at him. “Why?”

  “Because then you wouldn’t be worrying about any of this.”

  She shrugged. “It was my choice to make.”

  “I shouldn’t have let you.”

  “You think you could have stopped me from saving his life?”

  His grip tightening on the car door, he shook his head. “That’s not what I meant.”

  “I know what you meant and I appreciate the sentiment, but I’m not some froufrou girl who needs pampering. I knew the risks and I took them.” She stared straight into his eyes, making sure he didn’t misunderstand. “If there are consequences, I’ll face them. I did the right thing.”

  “Agreed, except I should have been the one who took the risks.”

  “Because you’re a guy?”

  He seemed to consider her question a moment, then shook his head. “No, because you’re you and I don’t want anything bad to happen to you.”

  His answer rang with so much sincerity that, heart pounding, she found herself staring up at him. “You’d rather it happen to you?”

  “Absolutely.”

  CHAPTER TWO

  LANCE DROVE TO the hospital in silence. Just as well. McKenzie didn’t seem to be in the mood to talk.

  Was she thinking about what he’d said? Or the events of the evening? Of the risks she’d taken?

  When he’d realized Leo Jones had been choking, he’d rushed to the man and performed the Heimlich maneuver. Too bad he hadn’t been successful. Then McKenzie wouldn’t have any worries about blood exposure.

  Why hadn’t he insisted on performing the procedure to open Leo’s airway? He should have. He’d offered, but precious time had been wasting that could have meant the difference between life and death, between permanent brain damage and no complications.

  He’d let her do what she’d competently done with quick and efficient movements. She’d saved the man’s life. But Lance would much rather it was him being the one worrying about what he’d been exposed to.

  Why? Was she right? Was it because she was female and he was male and that automatically made him feel protective?

  Most likely he’d feel he should have been the one to take the risks regardless of whether McKenzie had been male or female. But the fact she was female did raise the guilt factor, with the past coming back to haunt him that he’d failed to protect another woman once upon a time when he should have.

  Plus, he’d been the one to invite McKenzie to the show. If he hadn’t done so she wouldn’t have been at the community center, wouldn’t have been there to perform the cricothyroidotomy, wouldn’t have possibly been exposed to something life threatening.

  Because of him, she’d taken risks she shouldn’t have had to take. Guilt gutted him.

  If he could go back in time, he’d undo that particular invitation. If he could go back in time, he’d undo a lot of things.

  Truthfully, he hadn’t expected McKenzie to accept his invitation to watch his show. She’d shot down all his previous ones with polite but absolute refusals.

  He glanced at where she stared out the window from the passenger seat. Why had s
he semiaccepted tonight?

  Perhaps the thought of seeing him onstage had been irresistible. He doubted it. She’d only agreed to go and watch and so had technically not been there as his date.

  Regardless, he’d been ecstatic she’d said she’d be there. Why it mattered so much, he wasn’t sure. Just that knowing McKenzie had been attending the show had really upped the ante.

  Not knowing if she’d let him or not, he reached out, took her hand, and gave a squeeze meant to reassure.

  She didn’t pull away, just glanced toward him in question.

  “It’s going to be okay.” He hoped he told the truth.

  “I know. It’s not that.”

  “Then what?”

  She shook her head.

  “Seriously, you can tell me. I’ll understand. I’ve had blood exposure before. I know it’s scary stuff until you’re given the all-clear.”

  She didn’t look at him, just stared back out the window. “I don’t want to talk about it.”

  “What do you want to talk about?”

  She glanced toward him again. “With you?”

  He made a pretense of looking around the car. “It would seem I’m your only option at the moment.”

  “I’d rather not talk at all.

  “Ouch.”

  “Sorry.” She gave a nervous sigh. “I’m not trying to be rude. I just...”

  “You just...?” he prompted at her pause.

  “Don’t like needles.” Her words were so low, so torn from her that he wasn’t sure he’d heard her correctly.

  Her answer struck him as a little odd considering she was a highly skilled physician who’d just expertly performed a procedure to open a choking man’s airway.

  When he didn’t immediately respond, she jerked her hand free from his, almost as if she’d been unaware until that moment that he even held her hand.

  “Don’t judge me.”

  How upset she was seemed out of character with everything he knew about her. She was always calm, cool, collected. Even in the face of an emergency she didn’t lose her cool. Yet she wasn’t calm, cool or collected at the moment. “Who’s judging? I didn’t say a word.”