by Lucy Clark
‘Do you have anything in your kit for pain relief?’
‘Yes, of course.’
‘Perfect. I can’t see any medical alert chains so we’ll presume he’s not allergic to anything.’
Marty drew up the injection while Natalie rechecked the abdomen. ‘He has a small gash on the lower part of his abdomen, his pants feel wet around the top of the leg so he’s voided.’
‘Bladder rupture?’
‘Most probably, and that’ll be just the beginning, I’m sure. Pass me a large bandage and we’ll get this abdomen stabilised. You’re doing good, Sammy. Real good. Sammy?’ she called. ‘Can you hear me?’
He coughed a little and she turned his head just in time. He vomited onto the road but there wasn’t much. ‘It’s all right, darling,’ she told him when he started to whimper. She checked his pulse again. It was stronger than before. ‘Good boy. That’s it.’
Marty administered the injection. ‘Double-check his fractures, Nat.’
Natalie did as he’d said, carefully running her hands over the small bones. ‘Dislocated hip, fractured tibia and fibula.’ She shook her head. ‘Poor baby.’
‘He’s lucky to be alive.’
‘You’re not wrong. Sammy, we’re going to get you to hospital real soon.’ Carefully, she turned his head in case he was sick again before pulling the blanket over him.
‘Natalie?’ Beth called, and Natalie smiled down at Sammy, even though the little boy still had his eyes closed.
‘I’ll leave you with Dr Marty for a while, but I’ll be back.’ She glanced at Marty. ‘I’ll have someone come and stay with him, which will free you up.’
‘Thanks.’ He looked at her and their gazes held. A lot was said in that one moment. An emergency like this put life into perspective and although they were still facing a lot of problems, she had the feeling they’d slowly work their way through them. ‘Get going,’ he said after a moment.
Natalie stood and picked her way carefully through to where Beth was standing by the last car.
‘What have you found?’ Beth asked, and together they compared notes. ‘Sammy’s stable?’
‘For the moment. If we can get someone to sit with him, that’ll free up all three of us, but he needs to be monitored until an ambulance arrives.’ Natalie told Beth what she’d found and how at least one of the cars didn’t appear to have any casualties.
‘The first car has two elderly people—male and female. Looks as though the man had a heart attack. He’s dead and his wife, although her pulse is fairly strong, is still unconscious. Second car has two people, male and female, in their late teens, early twenties at best. They’re both completely trapped in the car and will need to be cut out. We could possibly get in through the back to monitor or set up a drip so there’s that option but no way of seeing exactly what type of injuries they have.’
‘And this car?’ Natalie asked, pointing to the one they’d parked behind.
‘Two adults, two children. The twin girls in the back have asthma and when I just checked them, they were both starting to wheeze heavily.’
‘Right. I’ll deal with the girls,’ Natalie said. ‘Get Marty to check on Sammy’s mother.’
‘Yes. I’ll take another look at the woman in the top car and then check on the teenagers.’ She shook her head. ‘I’ll send someone to relieve Marty,’ Beth said, and Natalie thanked her while she changed her gloves, grabbed the stethoscope and found the asthma medication and spacer Beth kept in her kit, before heading to the car.
‘Hello. I’m Natalie Fox,’ she told the parents.
‘Can we get out?’ the father asked.
‘If you can give me a minute to get the girls under control, I’ll check you both. It’s just better for now if you can stay where you are.’
‘That’s what the other doctor said,’ the mother replied.
Natalie managed to get the rear passenger door open, giving her access to the girls. ‘Hello,’ she said to the two crying girls, who were dragging air into their lungs. They were dressed identically, their blonde curls tied up in pigtails. Apart from their screwed-up faces and the loud noise they were both making, they looked adorable. ‘I’m Dr Natalie. How old are you both?’ No response.
‘They’re almost three,’ their mother answered for them.
‘Right.’ Natalie hooked the spacer together, showing the girls what she was doing and explaining. ‘Have you ever used one of these before?
‘Both of them have.’ Again the information came from their mother, just as Natalie had known it would.
‘Excellent. First of all, I’m just going to listen to your chests.’ Thankfully, with the appearance of a stranger half in and half out of their car, their crying had dropped to a whimper along with the gasping of air into their lungs. The twin on the left seemed slightly worse so she decided to start with her. ‘What’s your name?’ Both were still strapped into their car seats and she silently thanked their parents for properly restraining their children.
‘Liesel,’ the mother replied. ‘The one with the pink bow is Lillian. I’m Lauren and my husband is Lawrence.’
Natalie smiled. ‘Cute. All right, Liesel. I’m going to loosen your seat belt then have a listen to your chest.’ Natalie did just that, closing her eyes to concentrate as she placed the bowl of the stethoscope on Liesel’s chest. She listened intently, moving it around. ‘Try and lean forward for me, darling,’ she said soothingly, moving the child a little. She managed to get the stethoscope down the back of Liesel’s top, glad it was summer and the girls weren’t dressed in layers of clothes. Again she listened and this time when Liesel coughed, she shook her head. ‘Good girl.’
She shook the medication they were about to have before connecting it to the spacer. ‘All right, Liesel. Remember what you need to do? Nice, slow, deep breaths.’ Liesel seemed to calm a little at the routine and as she’d stopped crying, Lillian followed suit. Once Liesel was a little more settled, Natalie turned her attention to Lillian, listening to her chest and administering the medication.
‘All right, girls.’ She shifted a little. ‘I’m just going to see how Mummy and Daddy are. Just relax.’ Both girls looked too tired to move yet both sets of big blue eyes followed every move she made.
Natalie extracted herself from the car and went around to the driver’s door, which didn’t appear to be as badly mangled as the passenger door. ‘Lawrence. Where’s the most pain?’ she asked, crouching down beside him.
‘My neck. My back. My ribs. It hurts a little to breathe.’
Natalie nodded. ‘Can you move your feet? Your legs?’
‘Yes.’
Natalie watched as he moved his feet and legs. She had him squeeze her hands and checked he could shrug his shoulders.
‘I can wiggle my toes, too,’ Lauren assured her.
‘Good. Let me just listen to Lawrence’s chest. I’m just going to undo your seat belt which will give me better access.’ He’d no doubt hit his chest on the steering-wheel and although his skin was pale, he didn’t appear to be having too much difficulty breathing. She listened to his chest and was pleased to hear no obstruction. In one place where she put the stethoscope, Lawrence winced.
‘Hurts there, does it?’ Natalie wished for more light but checked the area out, pressing it gently. Lawrence winced again, more strongly than before.
‘You may have fractured a rib. Keep still, concentrate on relaxing and deep breathing. Once the ambulance arrives, we’ll get you off to hospital for X-rays.’
‘Can I move yet?’ Lauren wanted to know. ‘I feel so helpless, just sitting here unable to do anything.’
‘I’m trying to figure out the best way to get to you, Lauren. I can’t open your door and I think the best way is to come around behind you.’
Lauren undid her seat belt. ‘I can climb out through the back seat and you can examine me out of the car.’
‘No.’ The word held urgency but was also a command. ‘I will get to you but you can’t move until I’
ve checked you.’ Natalie came around the car again and climbed in the back seat. She smiled at the girls and was pleased they were both breathing more normally, although they would need extra salbutamol to keep the asthma under control.
She squeezed around until she was between the twins’ car seats, facing the front and kind of squatting on the floor. ‘All right.’ She slipped her arms around, careful not to elbow Lawrence in the head, and took Lauren’s hands in hers. ‘Squeeze my fingers.’
They went through all the other checks and only once Natalie was satisfied did she let Lauren move. ‘If you could continue to monitor the girls and their breathing, that would be good. Lawrence, if you start coughing up blood, I need to know immediately.’
‘Will that happen?’
‘I doubt it, but at least you’ll know what to watch for. Otherwise just stay as still as you can. We’ll need to get a neck brace on you and you’ll need some analgesics before you can be moved.’
‘You have other people to see to,’ Lauren said. ‘Go. I’m used to taking care of my family.’
‘All right, but call if you have the slightest doubt or worry.’ Natalie met the other woman’s gaze.
‘I will.’ Lauren promised.
Natalie headed over to check on Sammy, who was being watched by one of the teenagers from the end car. ‘The other doctor just came and checked him,’ the teenager said.
‘Good. How are you feeling?’
‘Scared. What if something happens to him and I don’t know what to do?’
‘Come and get one of us if you think there’s anything different in his condition.’
‘I get scared with all these cars going past and I want the ambulance to hurry up and get here,’ the girl whimpered.
‘I’m with you there but your dad is going a great job of making them go slowly and, besides, everyone likes to slow down so they can have a look at what’s happened. At least, in that respect, it makes them go slowly.’
‘A few other people have stopped to help.’
‘That’s good, but sometimes too many helpers can make things more difficult. Still, I’m sure your dad has everything under control.’
‘He’s a Wing Commander in the Air Force,’ the girl said.
‘That explains why he has everything under control.’
‘Yeah. I’ve never seen him like this…you know, in action before.’
Natalie smiled, realising that although the teenager didn’t have any life-threatening injuries, this night would not only change her perceptions but would mould her in years to come. ‘I need to go and help. You’re doing a good job with Sammy. Just keep talking to him and checking that he’s breathing.’
‘What if he talks back?’
‘Then that’s a good sign.’ Natalie headed over to where Marty was still dealing with Sammy’s mother.
‘We’re almost there, Chrissy. That’s good. Just breathe.’ Marty had just finished bandaging Chrissy’s arm where it had been cut. He glanced up at Natalie, speaking softly. ‘Any word on the ambulances?’
‘My phone’s in Beth’s medical kit.’
‘They should be here soon, though?’ His words were said with purpose and Natalie looked at Sammy’s mother.
‘Absolutely.’
‘Chrissy, this is Natalie. She’s a doctor as well.’
Chrissy opened her eyes and gazed unseeingly at Natalie. ‘Where’s my boy? I need Sammy.’
Natalie wondered why Marty wasn’t letting Chrissy see her son, but there was obviously a reason.
‘I’ve just checked on him and he’s doing fine.’
‘This man…’ Chrissy hit out at Marty, who managed to move out of the way just in time ‘…won’t let me see him.’
‘I need you to stay still, Chrissy,’ Marty tried to reassure her. He’d fashioned a neck brace from a few bandages, as well as putting a gauze pad and bandage around Chrissy’s head where it had obviously been cut.
‘I tried to grab him.’ The anger Chrissy had just displayed towards Marty now turned into a fresh bout of tears. ‘I saw Sammy go through the window and I tried to grab him but I couldn’t.’ She closed her eyes in shame and Natalie realised that was how her arm had been cut. Marty stood so he could talk to Natalie.
‘She can’t move her legs and I’ve even done a pinprick test. No feeling.’ He looked down at the ground and shook his head. ‘Her car’s been hit the most, first from the initial car, then the Wing Commander’s and then from the car with the twins. If I leave her, she’ll try and get out of the car, and although she may not physically be able to move her legs, she may still find a way of getting to her son. She’s too unstable to be left without proper supervision.’
‘And we can’t even bring him to her.’ Natalie felt desolate. ‘I’m checking on those ambulances. We need oxygen, we need bandages, we need plasma—we need more than we have.’ She stalked towards where Beth was and found the medical kit. She picked up her phone and punched in the number.
‘This is Dr Fox. I called in an accident.’ Again, she gave the particulars. ‘Where are the ambulances? We need the equipment here now. Please, check how far away they are.’ Natalie closed her eyes as she waited, feelings of helplessness and anger coursing through her.
‘Natalie!’ The call came from Beth, who wasn’t that far from her.
‘What’s wrong?’
‘I need you.’
‘One more minute, Dr Fox,’ the emergency operator said, and Natalie disconnected and dropped the phone, quickly changing her gloves.
‘Hurry,’ Beth called. She was leaning over the smashed bonnet of the car through the windscreen, which was broken, and breathing into a young man’s mouth, the protective face shield in place.
‘See if you can get in. Try the back doors, the boot. Anything. He needs CPR.’
Natalie immediately went around the car and tried the rear doors. Jammed. She looked around for something to smash through the rear window in the hope she could get in that way, but couldn’t find anything. ‘I can’t get in. Can I go through the front?’ She came around the car again but Beth had the only position that looked safe enough. ‘The doors are jammed, the rear of the car’s been hit as well.’
‘Crowbar?’ It was the Wing Commander, walking towards her with the tool she would need.
‘Brilliant.’ Natalie walked around the car with him and he jimmied the crushed boot open.
‘Stand back,’ he said and climbed in, feet first, then kicked the rear seats down so Natalie could slide through.
‘Thank you.’ She went in head first just as she heard the wail of sirens getting closer. She exhaled, saying a silent prayer. The cavalry had arrived.
‘Natalie!’ Beth’s tone was urgent and breathless.
Natalie knew what she had to do and crawled on her elbows through to where she needed to be. She carefully pulled herself as upright as she could and leaned through to the front. ‘There’s just no room, Beth. I can’t get to his chest properly.’ She felt around for a button or lever to release the seat to make it recline. ‘Got it. Beth, I’m going to wind it back. You’ll need to come further into the car to continue until I’ve got him.’
‘OK. Start winding,’ Beth said between breaths. ‘Pulse is still absent.’
Natalie’s hands started cramping as they were squashed around the side of the seat, trying to manoeuvre the dial. Beth kept going for as long as she could.
‘I hope you’re lying on something or that glass is going to cut into you.’
‘I’m on a blanket the Wing Commander gave me.’
‘Yay for the Wing Commander.’ Natalie shifted around. ‘All right. I’ve got him.’ She began CPR on her almost supine patient, silently counting. Beth carefully extracted herself and Natalie continued with the EAR when it was required, checking desperately for the pulse.
Natalie continued, concentrating on what she was doing. Hopefully, this young man had the will to live because right now she needed all the help she could get. Although the first ambula
nce had arrived, it would be used to transport Sammy and probably his mother to the hospital. She had no idea how the elderly wife of the deceased driver was doing and knew Beth was probably seeing to her now.
‘Nat?’ The call came from Marty. She gave two breaths into the young man’s mouth and felt for a pulse before beginning the next round of CPR.
‘Here,’ she called.
‘Where?’
She counted in her head. ‘In the car.’
‘You’re in the car?’ Marty stopped short, his chest tightening in pain. She was in the car! That car was basically crushed. How on earth had she got inside? His breathing increased and he swallowed over the dryness in his throat. The woman he loved had put herself in danger and suddenly he was a mass of jelly. What if something went wrong? What if she couldn’t get out? What if she got hurt?
His stomach churned and he was astonished at how sick he felt. Was this what loving her was going to be like?
CHAPTER NINE
MARTY raked his hand through his hair, desperately trying to pull himself together. Natalie needed his help right now as a colleague and he wasn’t about to let her down.
‘Nat.’ He stuck his head through the crushed windscreen of the car. ‘The cavalry has arrived.’
‘I need a soft bag resuscitator, if there’s one. The girl here needs to be checked out but she still hasn’t regained consciousness. Is the fire brigade here yet? We need to cut these two out as soon as possible.’
‘I’ll check it out.’
‘How’s Sammy?’
‘Being taken care of. I’ll be right back, honey.’
Natalie breathed into her patient’s mouth and checked his pulse again. It was there and she felt weak with relief. ‘Marty!’ She called, her fingers still on the man’s carotid pulse.
‘Yeah?’
‘I’ve got it.’ She smiled at him through the shattered windscreen.
He returned the smile and her insides began to turn to mush. ‘Looks as though it’s your night for reviving. I’ll be right back.’
Natalie looked down at her still unconscious but breathing patient. ‘We’ll get you through this,’ she promised, before trying to shift around so she could check the other passenger. ‘Now, don’t you go getting any ideas and stop breathing.’ She pressed two fingers to the teenager’s pulse. ‘Good.’ Although she didn’t have a medical torch, she lifted the woman’s eyelids. With the small amount of light that surrounded them, the pupils dilated a fraction and that was enough for Natalie. ‘Can you hear me?’ she called, but received no response. It was probably best if the girl stayed unconscious because if she could see where she was, trapped in a squashed car, she might start to panic.
