Natural Disaster (Book 2): Quake

by Lou Cadle

  “I wouldn’t say that.”

  “I would. There are plenty of stories. We’re a true blue American small town fighting to stay alive.”

  George’s eyebrows shot up. “Is that what we are?”

  “It’s exactly what we are. They can sell that, and they’ll know it. If we don’t get enough food and water, and soon, this town is going to die. The right person, broadcasting our story, can keep us alive. I need you to find that person.”

  Chapter 13: Bash

  Bash’s day started off on a pleasant note. There was a letter at the receptionist’s desk for him from the Witherspoons, who were catching a ride out on a supply helicopter. They thanked him and left their email address for the baby pictures.

  And then the day started going downhill.

  Nathan came by first thing to tell him that the sandwich shop was entirely out of food and that, under the orders of his boss, he was locking it. He presented a bill for food, for tables, for chairs, all with an apology. Bash thanked Nathan for all his help, and they shook hands. He took the bill over to Dr. Eisenstein.

  “So we have no food. At all?” she said.

  “No. Staff need to bring their lunches, I guess. Patients and visitors? I don’t know what we can do for them.”

  “At least we can evac long-term patients now that the worst of the injured are out.” Absentmindedly, she tapped her stethoscope’s earpiece with a fingernail. “We need to not keep patients around more than eight hours. They’re either serious enough to be evacced, or they go home. If we need to observe, that’s going to have to be our limit, if at all possible. If they’re here for very long, their family can bring them food and water.”

  “If they have family surviving.” They looked at each other hopelessly. “Will the evac helicopters keep coming? Now that the rescue from the second quake is over?”

  “I may have to twist a few arms.”

  “We’ll probably have cardiac and asthma and random injury cases that need evacuation for awhile. Surely they won’t refuse those.”

  “And burns. With more and more open cooking fires, we’re getting more burn cases.”

  Bash had seen one yesterday. “Any bad ones last night?”

  “One three-year-old boy, both hands. He was evacced this morning, just before you came.”

  “So what else do we need to think about?”

  “What I’m more worried about is water. We need it to sterilize instruments with the powdered compound, and we need it to wash, and staff need it to drink.”

  “Do we have enough?”

  “I’ve put in the request several times. It’s your boyfriend who’s running that end of things, I hear. Maybe you can put in a word.”

  “My husband. He knows our situation. I think he’s having a hard time convincing FEMA how desperate it is. And he says they’re focused on the metro area of St. Louis, so that smaller towns are getting forgotten.”

  “People here die just as they do in big cities. It’s as ugly and horrible. Medical help can save the same percentage. The grief of survivors is just as bad.”

  “I know. You don’t have to convince me.” He felt a twinge as his mind scanned, unstoppable, through the images of friends and patients he lost. Meggy, his coworkers. None hurt more than Trevor. He hoped the boy’s mother was holding up okay. Though how could she be? There could be no “okay,” just terrible enduring for her, for years to come.

  The doc was called away and Bash returned to his job, triage once again. He had inadvertently become an expert over the last days, able to push aside his empathy for their pain and quickly prioritize dozens of patients in no time at all. The flow of patients was so slow now, though, that anyone could do it. He had plenty of time to assess, and even precious extra time to offer an encouraging word to patients and anxious family members.

  He had green-tagged a woman with a glass cut on her arm and sent her to the waiting area when a medium-sized aftershock hit. They had experienced a dozen or more like this since the second quake. Always, at first, the catch of breath, and nearly everyone froze in place, waiting to see if it climbed in intensity to another big one. The few who didn’t freeze threw themselves to the ground immediately, taking no chances. Maybe they were the smart ones.

  But this one stayed moderate. After five seconds of it, with the shaking easing off, the cancer clinic building’s curved front wall fell. With a resounding crash, glass flew everywhere, scattering for yards. Bash watched as a full panel of glass bounced like a basketball and flung itself, still whole, into the middle of the street. A car screeched to a halt, just avoiding it. An avalanche of old debris skittered down the slopes of the building on every side. Several people screamed, adding to the noise. You’d think they’d be all screamed out by now, but no.

  As the aftershock trailed off, Bash yelled for stretchers, grabbed his box of triage tags and ran over to the front of the building. He could see a half dozen people injured, one struggling to his feet. Yellow at worst, ignore him. Two sets of legs together, buried from the waist up: aim for that.

  Pulling the biggest pieces of glass aside, he revealed a woman and a smaller body. The adult had fallen over or perhaps leaped onto the child to protect it. Blood pulsed from the woman’s neck. He swiped his glove over the pulse. Location and flow, looked like the carotid. Bash rolled her over. Without full hospital facilities and a vascular surgical team, prepped and ready to sew, she’d be brain dead in five minutes. He didn’t even bother with the black tag.

  Beneath her, the child, a girl, maybe ten, was covered with blood, but as he checked her over, he thought it was mostly from the woman. As he palpated her head with quick fingers, she moaned. Her eyes didn’t open. He lifted the eyelids. One pupil was slow to contract. He rolled the mother off her, slapped a red tag on the girl and moved on.

  Two orderlies came up with a stretcher. “Neck brace this one, take her,” he said, pointing to the girl. Tearing off the old gloves and digging in his pocket for new, he moved on. Citizens were pulling debris off other victims. One rescuer said, “Ow, damn,” and sucked at his hand. On the way by him, Bash said, “get yourself to first aid,” and pointed back at the hospital. “And the rest of you be careful.”

  An elderly victim was being helped to his feet by another person. Bash said, “How do you feel? Can you walk?”

  “I’m okay,” he said, softly. He reached his hand to his head and looked at it. “Am I bleeding?”

  Bash said to the other person, “Support him, please, and walk him over to the field hospital.”

  He heard the old man say, as he was led off, “I was just coming to get my wife.”

  Bash knelt by a group of volunteers uncovering another victim from debris. In his peripheral vision, he could see another stretcher loaded with another person, one he hadn’t checked, off towards the hospital.

  The patient at his knees, a man, said, “Dammit.” Then “thank you,” to one of his rescuers.

  “Don’t move,” said Bash and did a quick exam. “Can you move your arms? Your legs? Does anything hurt?”

  “My arm.”

  As it was uncovered, Bash could see a spike of thin metal had plunged into the man’s bicep. As a volunteer rescuer reached for it, Bash snapped, “Leave it.” To the man he said, “Don’t move,” as he hesitated only a moment before choosing a red tag. He stood and called out, “Stretcher!”

  Bash turned and scanned the scene. He didn’t see anyone else who needed immediate help. A white-smocked person kneeled by the woman with the carotid injury. He walked over and saw it was Suze.

  She looked up at him, holding the woman’s hand.

  “Hey, Suze,” he said.

  She glanced back. “Fuck you.”

  “Did I do something to upset you?”

  “Look at this woman! She’s dying. Why isn’t she tagged?” Her voice grew louder.

  “I hope she isn’t someone you know. But she was beyond our help.”

  “Bullshit. We could have saved her.”


  “No we couldn’t, hon.”

  She leapt up and pushed him in the chest. “Don’t you hon me, you cold bastard!”

  “Suze, shh.”

  She shoved him again. “You don’t care! You don’t care about anyone. You didn’t care about Meggy. You just let them die up there.”

  A small crowd was gathering.

  “It’s okay,” he said to Suze, trying not to take her attack personally. She was exhausted from days of stress. He was exhausted, too.

  “You like this!” She made a fist and threw a punch at him.

  He grabbed her wrist and tried to make his voice commanding. “Stop it. You’re hysterical.”

  She kicked him in the shin, hard. It hurt, and he let go of her wrist. She was sobbing now, and still yelling at him, but her tears made the words impossible to make out.

  Dr. Eisenstein came trotting up. “I have her,” she said to Bash.

  He backed away and watched as Suze pointed to the fallen woman. The doc glanced down, where the woman’s heart was barely pushing blood out of the wound in a slow welling. A puddle of red seeped out of the pile of debris, moving toward his feet, like a finger of accusation. She was nearly bled out. By brain function, she’d been dead for a minute or two now. Should he have red-tagged her, gotten her treated first? He felt a moment of doubt. But no, there had been four minutes at best for that woman. He hadn’t the equipment to do anything himself. They weren’t set up for that level of trauma surgery. A minute to get the stretcher, a half-minute to run her back. There’d have been time to make an incision, but then what? A doc might have clamped both ends of the carotid with fingers. Could he have gotten a stent in? Maybe. Just maybe, if everything went exactly like clockwork, they could gotten one in, and have saved her with only minor brain damage, no worse than a mild stroke, recoverable. They probably had some AB blood and plasma in coolers. They might have pumped every bit of it they had into her. Probably used up the whole supply for the day, but they just might have pulled it off if everything had gone perfectly. If anyone else needed blood later, that person would die instead.

  Who would he choose to die instead? The little girl? The metal fragment? The unconscious person? The one on the stretcher?

  The weight of the days of triage grew heavy in his chest. Maybe he had made the right decision. Maybe he hadn’t. How could he know? You can’t run it back and replay it the other way to see how it might come out. She was dead, and that’s all there was to it. Don’t let it eat at you, he told himself.

  But it ate at him.

  He limped back to the hospital and sat down in a chair, checking where Suze had kicked him, probing the wound. It was tender, and there’d be a big bruise by the end of the day. He grabbed an alcohol swab and a bandage and treated himself. He had to get himself ready for more triage.

  The doc was leading Suze past him, and he kept his head down so Suze didn’t see his face. He didn’t want to set her off again. The doc led Suze to a bed, got her up, and said something to a LPN. Within two minutes, the LPN brought a capped syringe over, and the doc gave Suze a shot. She looked around and found Bash, then walked over to him.

  “She’ll be okay.”

  A stab of new guilt pierced him. He hadn’t really been thinking about that. He still didn’t know if he gave a shit. He nodded and fiddled, unnecessarily, with his bandage.

  The doc kneeled down in front of him. “You did great in triage. Nothing she said was real, you know that?”

  He couldn’t meet her eyes. “I hope so.”

  “No, you did fine. She just…broke, I guess. Too many days of the ER life for people not used to it. I’m surprised we haven’t had more psychotic breaks or weeping staff collapsing, or people just not showing up for another day or night of it.”

  “Most of us are doing okay.”

  “We’re doing too damned much with too little in the way of a hospital, but yes. We have every reason to feel proud of ourselves. You, as much as anyone.”

  He squeezed his eyes hard, worried that the lump in his throat would turn to tears. Once he had control, he asked, “What’d you give her?”

  “Diazepam, 10 mg IM.”

  Valium. He could use some himself. “Thanks,” he said to the doctor. “I’ll stay away from her.”

  “That’d be best, I imagine, but I’m sending her home for three days, minimum. Luckily for her, she still has a home. I’ll find someone to drive her.”

  “Okay. I better get back to work.”

  She put a hand on his arm, keeping him from standing. “You haven’t hurt anyone, Bash. The earthquake has hurt people. Buildings have hurt people. Fires have hurt people. You’re doing fine.”

  He nodded, feeling a fractional bit better at the pep talk.

  “Do you want off triage?”

  “No,” he said automatically. Then he thought about it. “I think I’m fine. But if I want to change, I’ll come to you, okay?”

  “That’s great. Do that.” She stood and brushed her hands off. “I have to get back to work.”

  “Yes, me too.”

  As she walked away, he could hear her mutter to herself, “We need fresh staff.”

  Ouch. He wondered, was he losing it as much as Suze, but in his own way? If he wasn’t good at his job, he should back off. But then who would do it? They only had fifty or so staff, including aides and orderlies and dentists and vets, most of them emotionally and physically wiped out after long hours, some of them in bandages and splints themselves, most of them short on rest from sleeping on the hard ground through increasingly cold nights. He was better off than most, having a roof and a bed and no dead family to mourn.

  He had to pull himself together, forget this moment, and soldier on. Rain started, a patter that quickly picked up. Just great.

  Down where the glass had fallen, he saw two orderlies by the carotid woman, unfurling a blue body bag. Bash walked a few steps towards them, watching. He sent a silent apology to the woman: if I screwed up, I’m sorry. An apology didn’t do any good for either of them. He thought about the girl, probably her daughter, possibly an orphan now, and felt guilt anew.

  An ambulance pulled up and he forced himself to go over to it and start triage again.

  The day didn’t get any worse after that, but it didn’t get much better. The rain continued, relentless, and patients came in soaked and shivering. The hospital didn’t have enough blankets. The weather cooled further as a cold front followed the leading edge of the rain. It was going to be a nasty night for those sleeping outside on the ground.

  He skipped lunch, not having thought to bring food from home, and saw the afternoon’s patients. They were getting nearly every sort of case an ER or a acute care clinic might get, plus doctor’s office issues, too. He saw a patient who had contracted what sounded like crabs. He wondered if people out there, bored with no TV or internet, were having more sex. A population like the tent cities, STDs could sweep through the sexually active people in no time at all.

  As Dr. Eisenstein had predicted, he saw two new burn cases, neither worse than second degree. There was a chest pain, a mental health case, and countless contusions, abrasions, and sprains. Three broken bones — a foot, an ulna, and three fingers. Two of the patients from the wall collapse this morning were evacuated by helicopter: the little girl, identity unknown, and the old man, who had grown increasingly confused and disoriented. He needed a brain MRI or CT, far beyond their level of technology here.

  By six o’clock, the rain still hadn’t let up entirely, the sunlight was almost gone, and Bash was more than ready to go home. Hunger gnawed at him. He walked to his car, got in, and only then remembered.

  He was supposed to pick up the girls at 3:00 from school.

  Panic swept over him. Were they okay? It was three hours too late. Where would they be? If they were hurt, he’d never forgive himself.

  He drove up to the school site, but no one was there. He drove home, taking the route he thought they might have walked. No one was at the house, eit
her. Had something happened to them? What if they had been assaulted or worse? It would be his fault.

  Driving up to the Walmart, he thought it was his last reasonable hope, that they were somehow with Gale. He drove into the parking lot, surprised by the sight of the swimming pool in his headlights — what the heck was that about?. He parked and walked to the tent, looking around for Gale or the girls. Lanterns threw dim light around the area. There were sleeping bags and bundles of blankets piled under one tent’s edge. A few people were at a table eating. Others were bent over paperwork or talking in small groups. He wove through the crowd, anxiety pushing him on.

  And saw the girls, sitting on a blanket, playing with a toddler. They were laughing.

  He started shaking, his legs feeling weaker and weaker until he just sat down where he was, cross-legged, on cold damp grass. His breath was coming so fast he thought he might pass out, but he forced himself to slow it down. In a few minutes, his head cleared. But his hands were still quivering.

  “Bash?” It was Gale’s voice.

  He looked around.

  Gale’s eyebrows shot up and he came over, squatting by Bash. “What’s wrong with you?”

  “I forgot the girls,” he managed to say. “I forgot totally to pick them up.”

  “It’s okay. They walked back here.”

  “Oh Gale, I can’t believe it. They could have been hurt.”

  “They weren’t, though. They hung with some other high school kids for a while, and when you didn’t show, they came back here. We all figured the hospital had gotten crazy and you couldn’t get away.”

  Bash shook his head, ashamed. “I just forget.”

  “It’s okay, really,” Gale said, concern on his face. “It’s not like we had kids last week. This instant family thing is a little confusing. Looks like you’ve had a rough day.”