by Lou Cadle
“They’re almost done. Look, he’s not squeezing stuff into the patient’s IV any more.” She stood and rolled her neck. “More instruments to wash.”
The other girl spoke softly. “We need more bleach.”
“We’ll tell them,” the bossy one said.
Gale glanced at his watch. When he looked up again, Bash was looking his way. Gale could see him smile, even under the mask. He felt his own eyes go damp and he smiled back, blinking back tears of relief. That was silly. He had been told Bash was okay. But there was something about seeing him with his own eyes.
Then the doctor said something and Bash’s attention snapped back to his work.
Chapter 7: Bash
At sundown, Bash had climbed the debris pile with a bottle of juice from the sandwich shop. He handed it to Suze. She looked like hell, washed out, disheveled, but she also had a stubborn set to her jaw.
He was afraid to say the wrong thing to her, so tried, “Dusk is coming on.”
She nodded, slurping down juice.
“We’re set up for treatment now.”
“I can see that.”
“I’d like to get a better look at your leg.”
“I’m fine.”
He cleared his throat. “The fire fighters are doing search and rescue now. They’ll be able to get up here soon with equipment.”
“I don’t think it’ll do any good,” she said. “How much time has passed?”
“Three hours,” he said.
“It seems like longer.”
“I know.” He wanted to pat her arm or give her a hug, but everything in the way she held herself said not to.
“I haven’t heard a thing.”
“I’m sorry?”
“Here,” she snapped, waving the juice bottle around the remains of the clinic building. “No cries for help, no moans, nothing.”
“Oh, Suze,” he said. “I’m sorry.”
“Are you?”
“Of course. I have friends in there too.”
“Can corpses be friends?”
“Maybe someone is alive but unconscious. With their lights and equipment, the rescuers have a good chance of finding them. But you don’t, not in this light.”
She jerked her head in anger.
“And I want to look at your leg, and get you some aspirin if you need it.”
“Is there an orthopedics guy down there?”
“We only have one doctor, a retired GP.”
“It’s just you?”
“And an LPN with cardiac care unit experience, a hospital aide who was running late to work at the hospital, and an orderly. And a chiropractor, a dialysis tech, and an ophthalmologist, and don’t tell anyone this, but we have a veterinarian taking pulses and temps and BPs.”
She coughed a sound that was nearly a laugh. “You’re not joking, are you?”
“Nope. Everybody is working at the very far end of their training, or beyond. And I’m not the only one there digging all the way back to nursing school to try and remember stuff. If you’re okay, we’ll need you, too. Seriously, desperately need you.”
“I’m fine. I can work.”
“Examination first. And how about checking in at home?”
“I don’t need to. The kid is with his father this weekend. Left this morning for a long hunting weekend. Youth deer season.”
“Where are they?”
“Safe, I think, up in the mountains.”
“Good. That’s one thing off your mind at least.”
She drained the juice and said, “Okay. I’ll come down.”
“I’m right beneath you. Yell if you need help.”
He backed off and crawled down in the waning daylight. When it was obvious Suze could get down by herself, he called to her, “I’ll be right back to check that leg.”
He made his way to reception, which was lit with a variety of flashlights. “Fire department isn’t here yet with our lights?”
“Nope.”
“Going to make it hard to treat patients. Anyone new?”
“In triage.” She waved vaguely behind her.
“Here comes someone,” he said, watching two dim forms approach. Oh! “McKenna, I thought I sent you two home.”
“My mom isn’t there. And the house is a wreck.”
Haruka said. “It’s not safe inside, Mr. Sebastian. We left many notes for her mother.”
“Bash,” he corrected her.
McKenna said. “And we thought we might help. Find more stuff for you.”
“Not in the dark.” He thought, well, why not? Two healthy bodies. Surely he could put them to some use. “I’ll assign you some work. In a second.”
He jogged back over to the clinic and gave Suze an assist toward the chairs. She could walk, but she was limping. She started to give him instructions on what to look for on her leg. Her Suze-ness was reasserting itself. But he didn’t argue, just got her seated.
At that moment, the fire truck drove up. Two men jumped off and began to unload equipment. A third man — no, a stocky woman firefighter — picked up a small limp form and walked it over. “Where do I put her?”
Bash grabbed a flashlight and shone it back to the treatment area. “Follow me.”
As he walked away, the clerk at reception said “You bring that flashlight back when you’re done.”
“Head injury,” the fire fighter was saying. “Pulse 45, pupils fixed.”
Bash ground his teeth in frustration. One more serious injury they didn’t have to equipment or personnel to treat. “Here. I’ll push these two chairs together and we’ll use it as a stretcher. Has she seized or regained consciousness at all?”
“Not while the rescuers had her.”
“What hit her?”
“They couldn’t say. She had tumbled free of the children’s wing of the hospital. Could have hit her head on the way down.” She set the girl down. “Looks to be about eight. God only knows what she was in for in the first place.”
“Right,” said Bash. Could be cancer or infection or anything at all, something bad enough to have her in pajamas in a hospital. He shone the light on her face. The fire fighter hesitated then said, “I would offer to help, but I really have to….” She sighed as she waved back in the direction of the truck.
“You did great. Thank you.”
“We’ll have your lights set up in no time.” As she walked away, he heard a generator roar to life.
He hoped someone would remember to bring them gas for it from time to time. If there was gas to be had. With no electricity, how do you pump gasoline out of the ground? He pushed away the question. Not his job. His job was here in front of him. Without turning his head he yelled, “McKenna?”
“Geez, I’m right here, you don’t have to scream,” she said, from not four feet away.
“I need blood a pressure cuff, and some tongue depressors, and three sets of gloves. I’m going to teach you two how to glove up.”
“Okay,” she said, and disappeared into the deepening dark.
Haruka said, “I know little about first aid, Mr. Sebastian.”
He didn’t correct the name this time. Let her call him whatever made her happy. “I’m not going to make you do surgery. But I am going to teach you how to soak used equipment in bleach. But you have to pay strict attention to me. No matter what, you stay away from needles. I don’t want you sticking yourself, hear me?”
“Yes, sir.”
“You understand what I mean by needles?”
“Yes.”
“Or anything sharp. You keep the gloves on, and you stay away from needles.”
“Yes, sir.”
“And keep reminding McKenna. I think she’s a little more of a risk-taker than you.”
“I heard that,” said McKenna as she walked up. “Here. And somebody handed me this, too.” She thrust out an otoscope.
“Great. I wonder where they came up with this.” The retired GP had bought a bag, and he had sent his wife out to hunt down more equipment from colleagues. Mayb
e she had returned with much-needed supplies.
Suddenly, the area was flooded with light. Not enough to see this patient very well, but it was a start. The light shifted as they moved the light stands around. Bash waved the girls to either side to move and leave him the best light.
“Watch how I put on these gloves,” he said. “Okay, never touch the gloves with a dirty hand. Never touch a clean glove with a dirty glove.” He pulled on his gloves and examined the girl. “Pulse 45, remember that, Haruka.” He pumped up the ancient blood pressure cuff next. “McKenna, you remember blood pressure 100 over 66. Say it back to me.”
“One hundred. Sixty-six,” she said.
He went on examining the girl, palpating her skull carefully. He found where she had hit her head, and there was a golf ball sized lump. No fracture that he could detect — no displaced fracture, at least. No spinal fluid leaking from the ears. He began to wonder if her unconsciousness might have a cause in whatever condition had put her in the hospital. No chart and no way to know. No parent to ask. He also thought that the last time he had read what to do for TBIs had been over a decade ago. Treatment modalities had doubtless changed since then.
“Can you do anything for her?” asked McKenna. When he turned to look at her, she said, “A hundred over sixty-six. I didn’t forget.”
“We need to make sure she doesn’t roll off these chairs. And put her someplace where I’ll pass by her from time to time. But no, otherwise, I don’t know of a thing to do.”
“Will she die?” asked the girl.
Bash stood. “I don’t think so.” Not immediately, but she might not wake up with her full faculties. “Okay, watch how I take my gloves off. Remember, never touch a dirty glove with your hands.” He did it slowly while they studied him. “And what do you never, ever touch, Haruka?”
“Anything sharp like a needle.”
“Exactly.” He tucked his dirty gloves in his pocket and pulled out the notepad he charted on. Cauc. Female, approx 8 years old, identity unknown, parents unknown. Moderate head injury. He charted her symptoms. “Pulse,” he said.
“Forty-five,” said Haruka.
“Blood pressure 100 over 66,” chimes in McKenna. “You didn’t say a temperature.”
“I don’t have anything to take temperatures with,” he said. “But she didn’t feel hot.” He finished charting then pulled out the roll of strapping tape and a pocketknife he had gotten from a patient’s husband. He waved it to draw the girl’s attention to it. “Something sharp. A knife. Stay away from it and anything else sharp,” he said to the girls. He cut off the sheet of paper with his charting and laid it on the girl’s chest. “Haruka, you hold that in the center, gently.” Once she did, he cut off two lengths of strapping tape and taped the chart to the girl’s pajamas. It was the safest way, he had decided, to do charting, out where any medical person could see. Any stranger could see it, too, but screw that. This was not the time to worry about such inconsequential things. He had told the staff, anything really sensitive — STD, mental health issue — write on the reverse and put a big arrow at the bottom. That’s how we’ll tell each other there’s more to the story.
What a way to practice medicine.
Then he had the girls put on their gloves while he watched. Gloves were precious, and he didn’t want to dirty several pairs getting this done, and he wasn’t going to have them touch patients at all. Only equipment, used gloves, hemostats, and so on. He coached them through the glove procedure and they did well. “Fantastic,” he said. “Now we’ll find you a trash bag for trash and something to hold what stuff needs to be washed, like my old gloves or any instruments. And when I get a minute, I’ll teach you how to set used instruments and gloves to soak and keep track of the times they are soaking.”
“Just like chem class. We can handle that,” said McKenna.
“I have no doubt you can, or I wouldn’t be asking you to help. Let’s drag one more chair over here to keep the girl from rolling off.” When they had done that, he wound his way toward where he had left Suze.
The chiropractor was finishing an exam of her leg.
“What do you think?” Bash asked him.
“Contusion, not too bad. Under normal circumstances, I’d tell her to stay off it for 48 hours, but now?” He stood up and shrugged.
“I can work,” said Suze.
“I’ll wrap it,” said the chiropractor.
“I’m glad you’re okay,” Bash said to Suze. He wanted to say more to her, to try and forge a better connection with her, but he didn’t know what to say. And there was too much to do.
He turned to the girls. “Okay, before we get more patients, I’m going to show you two what I want you to do and how to do it right. And what’s the number one rule?”
“Nothing sharp,” McKenna said.
“No needles,” said Haruka.
“Exactly. And second most important, don’t touch dirty things with your bare skin. Third, don’t touch clean things with dirty gloves.”
It took only fifteen minutes of instruction before he was satisfied they knew what to do. It’d save professional staff some time, and get some of the pavement cleaned up. There were flecks of gauze and empty wrappers and all sorts of debris lying on the parking lot. If someone saw that, they’d fire him from his job.
Ha. As if there were anyone to take his place.
He went to check quickly on Ms. Witherspoon. Her husband had arrived, catching another ride somehow, and he was sitting and watching his wife as she paced, her hands on her back.
Bash said, cheerfully, “Coming along okay?”
“What the hell was I thinking?” she said. “Getting pregnant?”
“You couldn’t have predicted the earthquake,” he said.
“Man, this is going to hurt, isn’t it? I bet you don’t have an epidural in your bag of tricks up there,” she said.
“I’ll tell everyone to keep an eye out.”
“Yeah, that sounded hopeful.”
“I’m sorry.”
“Women had babies before epidurals, honey,” said Mr. Witherspoon.
“You want cancer and be missing all your teeth?” she snapped.
He grinned wanly at Bash. “She’s in a little mood.”
Bash winced, readying himself for the response to that, but she must have thought better of it and kept her reply to muttering. He kneeled by Mr. Witherspoon. “You feeling okay?”
“The nausea is pretty much gone from today. I’m tired, is all.”
“I’ll find you a blanket and you can lie down, if you don’t mind lying on the ground.”
“I think I’ll stay up for now. Be with Melba.”
“The two of you went through delivery coaching classes?”
“Oh yes, we did. So I can help her breathe and rub her back, if she ever lets me near her.”
Ms. W’s mumbling got louder. “Help me breathe as if…” and then it faded as she paced away again.
Mr. W said, “She’s been saying she’s hungry.”
“Hungry!” Bash smacked himself on the forehead. “I have just the thing. I’ll be back soon.” He went up front, calling for McKenna and Haruka.
He found them in the stacks of equipment, watching over soaking pans of gloves and various small instruments. “Fantastic,” he said. “And the ground is all picked up already. You two are great.”
“I’m bored,” said McKenna. “You said we have to wait a half hour with this stuff.” Haruka held up her cell phone where a stopwatch app was ticking down the time.
“Deglove, without touching dirty gloves remember, and add those to the gloves soaking,” he said. “And then I have something else for you to do.” He coached them again through safe degloving, then praised them. They were being so sweet, willing to work and willing to learn. He loved kids. He thought, not for the first time, that Gale and he should have adopted or found a surrogate in LA.
“Pizza,” he said, when they were done.
McKenna snorted. “I don’t think we
can feed your cravings now.”
He grinned. “But you can. I have a stack of pizzas in my car, a few hours old. I want you to get them, and get a slice each to the couple back there, the Witherspoons, she’s the pregnant lady in a temper. And then hand them out to staff, a slice each. But no other patients until medical staff says so. Not everybody is okay to eat.” He handed over his keys and told them how to find his car.
“Bash,” called the receptionist. “We have new staff.”
He smiled at the girls and turned to greet his new staff. An occupational therapy assistant, who could surely do temps and pulse and assist, and best of all, a plastic surgeon, a Dr. Shah.
“You’re the surgeon,” Bash said.
The man looked puzzled.
“I mean, you’re our only surgeon. You’re going to have to do it all.”
“I see.”
“You up for it?”
“I don’t see as we have another choice.” He had a faint British accent.
“Great.” Bash did triage in his head again, thinking of his red-tagged patients and who would benefit most.
“I need a surgical assistant or nurse, of course,”
Bash looked around. Well, shit. “I guess that would be me for now, but I’m not at all expert.” Suze couldn’t stand for that long. An LPN wouldn’t do. He wished he could clone himself. “Okay, first, I think we have a compartment injury, both legs, and I don’t know that much about them.”
“Nor do I,” said the surgeon.
He led the man around the parking lot and let him re-examine all the red-tag patients and decide for himself who he could help and who would go first. McKenna came up to him with the stack of pizzas, now only three boxes tall. “You said not to feed patients until you could go with us and tell us who can eat,” she said.
He wished he could clone himself in three.
The night got busier as both the fire department and individuals uncovered trapped people. The good news was, they uncovered some medical workers who needed minimal care and were at least able to sit and take vitals, though with head bandages and a sling in one case, so a couple of staff looked as bad off as their patients. A pediatrician in private practice had arrived, unhurt and ready to work. When he got some time, Bash would try and foist medical director duties onto him. They’d added two dentists to the team, too, who were perfectly capable of giving injections and dressing wounds. For surgery, though, they had only the plastic surgeon and Bash to function as nurse.
