In the corner of his parents’ great room, the TV news continued speculation regarding the sniper’s identity. Film from the news chopper and pics from camera phones were being analyzed. Speculation was rampant regarding the shooter’s possible motive and current whereabouts. The FBI had taken an interest as well, though Sac County was still in charge. House-to-house searches revealed nothing. The news broadcast kept repeating a taped interview with the driver of the school van.
“It’s a miracle there weren’t more physical injuries.” His mother glanced toward the TV for a moment. Her fingers sought the edge of her well-worn Bible. “It could have been much worse. All those people trying to run, get away. Parents protecting their children.”
“There was less panic than I expected,” Fletcher assured her, though he was still surprised by that. “When we ordered folks to get down on the ground and take cover, they did. Cooperated for the most part.” He had an image of Macy Wynn stretched out, her face against the asphalt.
“With the shooter still at large, people will be worrying—those kids from the van and even children who weren’t there will be anxious, sleepless. Parents too, neighbors and families of first responders . . .”
She met his gaze, her concern palpable. But Fletcher knew that it wasn’t only for him. She was thinking about her volunteer work as a community chaplain with California Crisis Care. It had become a passion for her—being there for survivors in the aftermath of personal tragedy. She’d taken the training, spent long hours shadowing another more experienced chaplain, and then finally become certified. When Charly Holt talked about the work she was doing, she lit up. She was convinced crisis chaplaincy was her calling, like law enforcement was his. She felt that her life, even the painful challenges—maybe mostly those—had prepared her for exactly this. Fletcher could understand it in theory, but . . .
“Your doctor said it’s okay to schedule yourself for activations?” Crisis chaplains could be called out in the middle of the night, subjected to physical and emotional stress. Maybe even danger—sometimes they were needed at crime scenes and disaster sites. “No restrictions?”
“I said I wouldn’t take night calls,” she told him. A temporary ploy to appease her husband and son, Fletcher would bet. “But it’s high time I got out there and started feeling useful again.” She rolled her eyes. “Another month at home and I’ll start playing Candy Crush on Facebook. And send invites to you.”
He grimaced. “Can’t have that.”
“The timing is perfect,” she continued, healthy color rising in her cheeks for the first time in weeks. “There’s the Crisis Care gala tomorrow night.” She shot him a look, brows raised.
“I rented the tux,” he assured her, still half-wishing there had been a means of escape. But the evening was important to her. “And set a reminder on my phone.”
“Good. After that, I’ll make sure my name is back on the schedule. I have a feeling we’re going to be busy.” She turned to glance at the TV, which showed images from the News 10 helicopter: the overturned county gravel truck, the school van, Highway Patrol, Fletcher’s patrol car . . . and the vintage BMW with a shattered windshield. “We’ll be needed,” his mother continued, “because this kind of event has a ripple effect. You don’t have to be hit by a bullet to be a victim of the violence.”
“Your tetanus is up-to-date? You’re sure?”
“Two years ago,” Macy promised, trying not to wince as fellow ER nurse Taylor Cabot daubed ointment over the freshly cleaned abrasion on her cheek. “I got one the time I did that impressive kickboxing move and ripped off my toenail.” She caught the redhead’s immediate grimace. “Sorry. Hard to forget.”
“There. All set, tough girl.” Taylor stepped back and surveyed Macy’s face. “It’s going to swell. I’d ice it if I were you.” She glanced through the supply room doorway toward the main trauma room. A distant siren blended with the usual sounds of overhead pages, phlegmy coughs, squeaking machinery, moans, and occasional tension-valve laughter of medical staff. She turned back to Macy, her green eyes filled with concern. “You’re sure you’re okay?”
“Absolutely. Stiff from kneeling on the freeway, then practically kissing it—no fault of my own.” She quickly dismissed an image of Fletcher Holt standing over her with a gun. “Little abrasion. Huge regret at missing a free dinner. The hospital grill is not a legitimate trade-off. But I’m fine. No big deal.”
Taylor touched her arm. “You were involved in a shooting, Macy. That’s a very big deal.”
A shooting. Macy couldn’t stop the intruding image of that shattered windshield, the hole. When she told Taylor she was stopping by the hospital to check on the little girl injured in the incident, her friend had insisted on coming over. Taylor arrived in her exercise tights, a Sac Fire sweatshirt, and flip-flops, hair still wet from her daily swim.
“Is that why you hauled yourself over here?” Macy asked. “To use me as a guinea pig for your chaplain training?”
“Of course not. Not the guinea pig part,” Taylor amended. “But I saw the news. They’re already profiling the shooter. Tallying up how many people could have been killed.” Her eyes swept over Macy’s face. “I can only imagine how it would feel to be out there, trying to take cover. Or how frightening it would be to have someone you love in that kind of danger.”
Not true. Taylor could do much more than imagine that. Her husband, a firefighter, had been killed just over two years ago. And now she volunteered to throw herself into other people’s pain. It was hard to understand. Maybe Macy was missing that altruistic gene. Or maybe her rugged childhood had squashed it, leaving her simply with the skill to land on her feet. Compliment or not, “tough girl” might actually fit.
“I’m okay,” Macy assured her. “I promise. No tetanus, no trauma.” She gave Taylor a quick hug. “And you are a good person. With really wet hair. You should go home and rest up. We’re back here in the morning. I’ll check on Annie once more and then I’ll go too.”
Macy found the little girl in an exam room, ready to be discharged. Her foster mother was at the desk getting instructions from the nurse-practitioner.
Annie Sims had a Dora the Explorer Band-Aid on her forehead and the beginnings of a black eye. A half-empty pudding cup and a carton of milk sat on the tray table beside her. She clutched the plastic belongings bag holding her bloodstained clothes on her lap; her foster mother had brought clean ones.
“I don’t have to stay all night,” Annie explained as Macy came close. “I thought I was going to have to sleep here.” She shrugged her tiny shoulders, expression far too serious for a six-year-old. “I didn’t know.”
Macy’s throat squeezed, the old ache crowding in. “But you get to go with Helen now.” She knew better than to say “home”—it could mean so many different things to this child. “She’ll be finished talking to the nurse in a few minutes and then you can go.”
“You’re a nurse too?”
“Yes.” Macy smiled, looking down at the jeans and cotton knit hoodie she’d pulled on after shedding her soiled top and skirt. “I don’t look like one now, but I work right here at Sacramento Hope.”
“My real mom is at a special hospital. She’s going to get better. Then she can take care of me. And we can go home.” Annie sighed, hugged the hospital tote. “Can I keep this bag?”
“Sure,” Macy managed despite so many swirling memories of waiting for her own mother, hoping the way only a child can hope. “That bag is yours now.”
“It has handles and could hold a lot. They wrote my name on it too, see?”
“I see that—‘Annie Sims,’ right there.” Macy knew where this was going. Oh, please . . .
“If they send me someplace else, I’ll use this bag,” the little girl explained, running her hands over it as if it were a fine piece of luggage. “My mom said maybe she can come get me this summer. If everybody says that’s okay. I don’t know for sure.”
That was the worst part. Not knowing anything for sur
e. Where you’d sleep, what you’d eat, who was nice . . . or who might want to hurt you in ways you couldn’t even understand. You were never, ever sure. You hung on to hope because it was all you had, but after a while even hope packed up and moved on. You kept your favorite things in a bag you could take with you at a moment’s notice. And you only trusted yourself.
“I want to go home,” Annie whispered, her chin beginning to tremble and her eyes welling with tears. “Really home this time.”
Macy’s arms were around her in an instant, lips brushing the Dora Band-Aid as she rocked the shivering child. “I know, sweetheart. I know.”
6
“LET ME TRY AND GET IN HERE.” Macy struggled to squeeze into the car so she could position the patient’s head and open her airway. An unresponsive fiftysomething woman, at least two hundred pounds, wedged in the backseat of a two-door Honda. The woman’s face was an ominous shade of gray and slick with drool. Macy’s fingers pressed against her ample neck, just below her jaw. A pulse, but . . . “She’s not breathing. We need to pull her out of here. Where’s—?”
“Transport gurney’s right behind you,” Taylor confirmed. “There’s a flat to slide her out on. Ronie’s got the tank and an Ambu bag.”
“Let’s . . . try it.” Macy suppressed a groan of exasperation. Car extrication shouldn’t have been part of this. Why hadn’t the woman’s son called 911 instead of screeching to the curb outside the ER and running wild-eyed into the waiting room trying to find a wheelchair?
“Hurry! C’mon—can’t you do that faster?” he pleaded, observable anxiety making his deep voice turn shrill. “Are you sure you know what you’re doing?”
“Yes, they do, sir,” said the familiar, calm voice of one of the ER security guards. “Now please, step back and let these folks do their jobs.”
“No! I’m not going anywhere. That’s my mother in there. I have to be sure they’re doing the right things. I have to—”
“Drop the gurney. Get in close!” Macy shouted over her shoulder to a waiting tech. She grabbed the Ambu bag and leaned back inside the car, ducking her head to avoid the elbow of another tech as an octopus of arms worked frantically to slide the woman onto the transport flat. “Make sure that O2 is on high flow.” Macy positioned the plastic mask and squeezed the Ambu bag, delivering an oxygen-rich breath into the woman’s lungs. “Okay now, let’s slide her out of here.”
“What did they do to her? Why are you giving her oxygen?” the son shouted, eyes wide, as they strapped his mother onto the gurney, jerked it to an upright position, and began hustling toward the ER doors. He lurched forward, jogging alongside them. “She said she had a headache, a bad headache. Not trouble breathing.”
“I’ve got the bag,” Taylor told Macy, taking over the rescue breaths. She nodded toward the son. “If you want to get some history . . .”
“Right.” Macy was grateful to see the two security guards flanking the coded-entry doors from the ambulance bay to the ER. She’d learned the hard way that people under stress were highly unpredictable. “Mr. . . . ?”
“Harrell,” the man puffed, a mix of confusion and horror on his face as the gurney carrying his mother clattered through the open doors. His body tensed. “I need to get in there, not stand here talking.”
“Please,” Macy told him as gently as she could. “In order to help your mother, we need some infor—”
“Her insurance card’s on file. Darlene Harrell—look it up.” He stepped close enough that she caught a whiff of panic-induced body odor. His teeth ground together, making his words hiss. “Money. It’s always money first.” He jabbed a finger toward Macy’s face. “You’ll get paid, if that’s what you’re worried about.”
“It’s not. Not at all.” Out of the corner of her eye, she saw one of the security guards move discreetly closer. Macy kept her voice calm. “The only thing I need from you is some basic history of what happened with your mother today. It helps us help her. We’re trying to help her, Mr. Harrell.”
He pulled his hand back, anguish in his expression. “I’m sorry . . . Oh, man. I’m sorry.” He jammed his hands in his pockets, stared at the ambulance bay doors. “I’m worried. That’s all.”
“Of course.” Macy made a mental note to page the hospital chaplain once she got through those doors. “We’ll get you in to see your mother as soon as we can. I promise. But right now you can help her best by telling me how this current illness started. Did you say she had a headache?”
“That’s right. She gets headaches, but nothing a couple of Tylenol can’t handle. Ma’s tough. She raised six boys, kept us all fed by driving a correctional facility bus—doesn’t take anything off anybody. Doesn’t complain either.” The man swallowed. “But she called me about an hour ago and said this was the worst headache she ever had in her life.”
“I see.” Macy nodded, wishing he hadn’t just voiced the classic symptom of a catastrophic brain hemorrhage. She gleaned what additional information she could and then jogged back toward the trauma room.
Less than five minutes later, Darlene Harrell’s body stiffened with a seizure, and the respiratory therapist moved in with a suction catheter to clear her airway. The ER physician, Andi Carlyle, steadied the woman’s twitching face between her gloved hands. The overhead exam light gleamed off her small cross-shaped pendant. Everyone knew Dr. Carlyle’s faith was as much a part of her practice of medicine as the stethoscope slung around her neck.
“Seizure’s over,” Macy noted, relieved.
“Good girl,” Dr. Carlyle whispered, giving Mrs. Harrell’s cheek a gentle pat. “That’s enough of that.” She pulled the intubation tray closer and glanced at the nurse near the crash cart. “Let’s draw up some Versed—better if we’re dealing with elevated intracranial pressure. There’s no gag reflex. But if we need to, I’ll use etomidate and succinylcholine. I’ll want labetalol for that blood pressure. I’ll need to talk with the stroke team. But first things first.” She nodded to the respiratory therapist. “Hyperventilate her; we need to get this tube in. From the sounds of those lungs, this good woman’s aspirated a lot of stomach contents.”
“I’ve got the IV line,” Taylor reported. “And the blood for the lab. Chest X-ray and brain CT ordered.”
Overhead, the operator paged for a chaplain to come to the ER.
“Blood pressure’s 208 over 114,” Macy reported, watching the monitor. “Sinus rhythm at 54. Pulse ox on the high flow . . . 96 percent.”
“Glucose 92,” a tech added. “I’ve got the Foley cath here when we can do it.”
“My tube first, then yours.” Dr. Carlyle’s smile showed a glimpse of dimples. Those dimples, combined with her eager smile and diminutive stature, plus her penchant for Crocs with brightly patterned socks, contributed to countless questions from patients and family regarding her age and experience. But Andi’s enviable skill assuaged every doubt. She lifted Mrs. Harrell’s lids gently. “Darlene, I don’t like the look of your pupils, my dear.”
“Her son wasn’t aware she’d stopped breathing,” Macy explained, imagining the poor woman’s struggle. She’d been too far gone to protect her airway. “Someone said the drive from her house to the hospital must have taken at least fifteen minutes.”
“Let’s hope she was getting air for most of that time.” Andi squinted down her patient’s throat, laryngoscope in one small hand, endotracheal tube in the other. “Brain’s compromised enough already, and . . . Here we go, folks.” She threaded the plastic tube deftly, removed the scope, and then nodded to the respiratory therapist to inflate the balloon that would seal it against the woman’s trachea. “Looks good. Let’s have a listen to her lungs.”
“Don’t tell me to wait outside. I need to see her!” a too-familiar voice shouted outside the code room. “What are they doing to her? Get the doctor out here. I’ve got to talk to—”
“Mr. Harrell, sir.” The chaplain’s voice. “If you’ll come this way . . .”
Taylor shot Macy the dreaded u
h-oh look. They both knew that it didn’t take long before fear and panic turned to hostility. They’d seen it countless times. Fortunately Andi also had great skill when it came to her patients’ families.
“All righty then . . .” Andi Carlyle rose on the toes of her Crocs to stretch farther over the gurney as she finished listening to her patient’s lungs. “Let’s get that portable chest,” she said calmly. “I’ll write the orders for the labetalol. After it’s onboard—and we slip in that Foley cath—we’ll get this lady down to the CT scanner.” She reached for the white coat she’d hung over an IV pole. “Meanwhile, I’ll go out and talk with Darlene’s very worried son.”
“Be sure you have security with you,” Macy advised, remembering those few seconds when the man poked his finger toward her face. He’d apologized, but—“Best to play it safe.”
“Good going, Houston. You sure know how to pick ’em.”
Fletcher responded with an offhand shrug as a fellow deputy exited the popular south Sacramento grill. There was laughter as the man joined his partner outside the door. This was about the thirtieth time since his shift began that someone felt the need to point out his obvious stupidity.
“It’ll die down. Stay cool.”
California Crisis Care chaplain Seth Donovan swiped his fingers across his lips, catching a stray shred of purple cabbage from his taco. “You’re fresh meat, Fletcher. Everyone new starts off as a slab of rump roast in butcher paper. Maybe worse for you, since you’re a lateral transfer. Didn’t go through the academy here—and didn’t get a copy of the local who’s who. Not likely you’d know that Elliot Rush is the brother-in-law of a sitting US senator . . . who’s tight with the county higher-ups.” His brown eyes were warm despite rugged features and a world-weary manner that sometimes belied his age—just nearing his fortieth birthday. “I wouldn’t lose sleep over it.”
By Your Side Page 3
