by Radclyffe
“I had hoped we could talk logistics.” She cleared her throat, which was suddenly dry. “I don’t want to get in your way, Dr. Sinclair—”
“You’re already in my way.” Sax pulled her T-shirt over her head and replaced it with a navy scrub top. She moved deftly around the redhead to her desk, found a pen, and stuck it in her chest pocket. Leaning her hip against the edge of the desk, she regarded her visitor warily. Jude Castle’s stance and expression made her determination very clear. With a sigh of exasperation, Sax said, “I’m stuck with this, aren’t I?”
Jude shrugged. “’Fraid so. I’ll try to make it as painless as possible.” She wasn’t sure that levity would get her anywhere with the aggravated surgeon, but she needed to do something to take her mind off how damned attractive Sinclair was. It wasn’t like her to be quite so affected by a pair of deep, brooding eyes and a mane of black hair that begged for fingers to run through it. She tried to ignore the faint flush of heat in her limbs. This was work, not social hour.
Sax pushed away from the desk, strode rapidly to the door, and jerked it open. She looked back over her shoulder and called, “Well, come on, then. You’ve got twenty minutes to fill me in.”
“Thirty.” Jude hurried after her. “Make it thirty, and I’ll buy the coffee.” She didn’t get an answer, but she could have sworn she saw a hint of a grin. It was a small victory, but she’d take it for now.
Chapter Two
June 30, 6:20 a.m.
Jude was used to running while on the job. She’d filmed almost everything there was to film at one time or another except actual combat—though she’d been close enough to the front in Kosovo that she’d needed to sprint to avoid being flattened by falling debris during bombing raids. She was practically racing now to keep up with Sinclair as they rushed through the halls. As she started to turn right at a corner clearly marked with a sign indicating the cafeteria, Sinclair grabbed her arm and pulled her in the opposite direction.
“Where—” Jude started to ask.
“Some things are essential in this business.” Sax fished a handful of bills out of her shirt pocket and pushed through the doors that separated the main lobby from the clinical areas. “Good coffee is one of them.”
She led Jude toward a tiny kiosk tucked into the corner of the large admissions area waiting room. The top of a brass and chrome espresso machine was visible behind a stack of cups and a plastic bin of pastries.
“Ah, I see,” Jude noted. “A real coffee drinker.”
Sax leaned over the counter and peered around the cash register down the narrow aisle beyond. “Terry! Coffee—quick!” Glancing at Jude, she inquired, “What’ll you have? Terry’s making me a red-eye.”
“Perfect.” With a grateful sigh, Jude accepted the cup of coffee with an added shot of espresso a minute later. When Sax started to pay, she caught her hand. “I’ve got it, remember?”
For a second, they both stared at Jude’s hand on Sax’s wrist. Jude stared because her fingers were tingling, and that made no sense at all. She hadn’t a clue what the surgeon was feeling, because her face was expressionless.
Sax pulled her hand away from Jude’s. “Sure. Thanks.”
Carrying their coffee, they walked across the lobby level public seating area toward the stairs.
“So,” Jude began, anxious to take advantage of every minute with her reluctant subject, “I need to clarify a few details of the shoot with you.”
“I gathered that,” Sax responded dryly. She held the stairwell door open, a little surprised at how easily the director had maneuvered her into discussing something she wasn’t at all sure she wanted to happen. She was usually not so susceptible to persuasion, but she had to admit that the redhead had a subtle charm that was hard to resist. To take her mind off that disconcerting thought, she said, “I have an orientation meeting with new staff in forty minutes. We can talk in the conference room before everyone arrives. That’s probably the only time I’ll have free all day.”
“Fine.” Jude sipped her coffee as they climbed the stairs. “Oh yeah. Nice.”
Sax heard her faint groan and grinned in spite of herself. “Definitely.”
When they were seated in the small meeting room adjoining the hospital cafeteria, Sax leaned back in her chair and regarded Jude seriously. “Preston Smith told me last night that you want to film a documentary in my trauma unit.”
“Last night? You just found out yesterday?” Jude could not hide her surprise. She also felt a small shock of anger to find herself placed in the position of ambushing the one person she wanted on board from the start. “We’ve been negotiating with the hospital for months about this, and I was told that everyone involved was on board. Why didn’t he tell you before?”
“Probably because he knew that I would refuse,” Sax offered mildly, watching her companion over the top of her coffee cup. So far Jude had been unflappable—confident and capable, but surprisingly nonconfrontational. An iron hand in a velvet glove. Sax was impressed, and she didn’t impress easily.
“Really?” Jude commented just as placidly. She thought she understood some of the surgeon’s resistance now. She could hardly blame Sinclair for being aggravated if she’d just been informed about the project, and that also explained why she hadn’t been able to get an appointment with her sooner. Sinclair’s secretary had probably thought Jude was just another media hound looking for an interview and had put her request for an appointment on the bottom of the pile. But she sensed something else beneath the other woman’s opposition—something more personal than bureaucratic conflicts. “Mind telling me why you’re opposed to it?”
“Because you and your cameras don’t belong in a trauma unit. It’s an invasion of privacy to film what might be the most intimate and personal moments of someone’s life.” Her concern about patient confidentiality was true, even if it wasn’t her only objection. She had no intention of disclosing her own aversion to publicity.
Jude was used to fielding these kinds of objections. “We’ll get releases for anything that we air,” she pointed out reasonably. “We can block the patients’ faces electronically if we need to.”
“And what about the ones who can’t give consent—the comatose, or the moribund, or the children?”
Jude was about to give another stock answer, but something in Sinclair’s voice made her stop. There was an edge of anger, of protectiveness, that intrigued her. She sat forward, meeting Sinclair’s intimidating gaze head on. “What if I guarantee that every precaution will be taken to protect individual privacy? I’ll be there myself the entire time that the cameras are rolling. I’ll talk to the families personally if there’s a need. No one will be filmed without consent.”
“Your presence is going to interfere with Deb Stein’s training. She’s going to be more worried about looking good for you than about learning to make decisions and exercise good judgment.”
“I thought the trauma fellows took call with a senior attending who supervises them,” Jude stated.
“That’s true. They do. Deb Stein will be on duty with me most of the time.”
“And you’re concerned that...what? She’ll pay more attention to me than to you?” Jude’s voice rose in a way that suggested she was trying not to laugh.
Sax was forced to grin again. The dynamic director was proving hard to resist. “She’ll be distracted at least.”
Jude regarded Sinclair intently, aware that this confrontation could spell success or failure for the project into which she had invested all her energy and considerable resources for six months. She could do it without the trauma chief’s cooperation if she had to. The signed contract from the hospital would stand up in court if it came to that. But if she went that route, going over Sinclair’s head to get the job done, it would make the work hellishly difficult. And she didn’t want this woman as an enemy for a lot of reasons, not the least of which was that she found her obvious lack of concern for diplomacy refreshing.
“What is it that r
eally bothers you about all of this?” she asked quietly.
“There are some things people don’t need to know, maybe don’t even want to know,” Sax said, surprising herself. I don’t even know this woman, and she has me admitting things I wouldn’t say to a single living soul before now. “What happens in that unit—not always, but often enough—in those few seconds when life hangs in the balance are not events to be exposed for the sake of curiosity. These patients aren’t just naked and defenseless—they’re helpless. And sometimes what we do in there is not pretty.”
“You’ve just described human drama, Dr. Sinclair—real life. Don’t you think that the public can appreciate that and understand how special it is?”
The public’s right to know—the relentless pursuit of the story in the name of truth—is often just a convenient excuse for invasion. Whatever happened to preserving a person’s dignity and privacy when they can’t speak for themselves? Sax merely shrugged and answered flatly, “I don’t know. I’m not a sociologist—I’m a surgeon.”
“Yes,” Jude agreed, thinking that Sinclair was much more than that. “And it’s your trauma unit. But can we agree to give it a try?”
“Do I have a choice?”
“I’m sorry,” Jude said, to her surprise meaning it. “No.”
Personal Project Log—Castle
June 30, 7:50 a.m.
Sinclair stood up at 7:00 a.m. on the dot, and every person in the room grew quiet. There were a dozen people present—six senior staff, the first-year trauma fellow, two general surgery residents, and two medical students. I was the only outsider—the only non-physician. She walked to the front of the room, leaned against the edge of the conference table, and folded her arms over her chest. She looked relaxed in just a scrub shirt and pants—as if she didn’t have a care in the world. She never said a word until every eye was on her. I felt like I should jump up and salute. I thought one of the younger residents might. God, she looked tough.
I expected a speech. She didn’t give one.
She laid out the ground rules instead. [Note: Title first episode “Rules of Engagement.”] Twenty-four hours on, forty-eight hours off—except on high-volume holidays like the one coming up, when everyone works more frequent shifts. Rounds in the trauma unit at 8:00 a.m. and no one goes home until they’re over. Which by my calculations turns out to be somewhere in the range of thirty hours straight without much sleep. I lost track of what she said after that, because I was trying to imagine that kind of schedule. I’m used to working hard, sometimes days at a time when a story is breaking. But I’ll be the first to admit I don’t function at my peak the whole time. And I’m not cutting into people.
She got my attention again with the very last thing she said—the only direct order I can remember her giving. She said, “Some will die in the field, and there’s nothing you can do about it. Those, you let go. But if they come into my trauma unit warm and with a pulse, you’d better not lose them.”
*
Jude caught up to Deborah Stein just outside the conference room. “Deb,” she called, drawing even with her as they started down the hall.
“Hey, Jude,” the blond, two-time basketball Olympian answered with her trademark effervescent grin and sparkling blue eyes. “Good to see you again.”
“What happens now?” Jude asked as they double-timed down an intersecting corridor off the main hallway. Doesn’t anybody walk at a normal pace around here?
“You heard the chief. Rounds in the trauma intensive care unit in five, and then we wait for a trauma call. I’m assigned to the admitting unit this month, so I don’t have any floor responsibilities.”
“Gotcha.” Jude mentally reviewed what she remembered from the all-too-brief synopsis the surgical department had provided her. She had a feeling, however, that Sinclair didn’t adhere to any script. “So once the patients are transferred from the trauma intensive care unit to a regular floor bed, you don’t have any responsibility for them?”
“Well, I’ll be involved in that aspect of things during the weeks I’m not taking trauma call. It’s an either-or kinda deal because you can’t really do both at once.” Deb held open the heavy gray windowless door with the red rectangular sign announcing the TICU—Trauma Intensive Care Unit. “Grab a cover gown. I’ll get you some scrubs later so you don’t have to worry about your street clothes getting ruined, and you won’t have to keep covering them up every time we go in and out of the units.”
“Thanks,” Jude replied absently.
Standing just inside the door, she scanned the length of the brightly lit rectangular room. A U-shaped counter area to her right was empty save for a few swivel chairs left askew in the middle of the space, a plethora of charts scattered over the countertops, and a misshapen box of fossilized donuts. What captured her attention were the ten beds lined up along the opposite wall, separated from each other by a few feet of space and featureless curtains on ceiling tracks that were all pushed back to expose the occupants to anyone who happened to be looking.
Almost every Spartan, steel-railed adjustable bed contained a genderless, nearly naked form dwarfed by the dispassionate machines of modern medicine. Free-standing ventilators the size of dishwashers flanked every bed, delivering a predetermined volume of gas, ten to fifteen times a minute, through the hard plastic breathing tubes jutting from the vicinity of every patient’s mouth. Arms were strapped to extremity immobilizers or tied by soft cotton restraints to the bed rails. Tubes of all sizes ran from every orifice, delivering salvation in the form of antibiotics and liquid nutrition or removing the waste of injury and decay. Monitors occupied every available space, metering out lifetimes in a steady series of monotonous beeps and flashing pinpoints of light.
The trauma intensive care unit, one of the triumphs of medical technology, was a cold and impersonal place. Jude shivered.
“You okay?” Deb Stein asked.
“What? Oh...yes, I’m fine. Sorry.” Jude dragged her gaze away from the silent tableau. She searched the room, trying to shake the eerie sensation of having stepped into a nightmare. Finally, she found something to occupy her attention.
Sinclair stood at the center of a group of rapt personnel in white coats or rumpled scrub suits who were crowded around the bottom of the first bed. Her foot was up on the seat of a rolling chair, one arm propped on her raised knee. She held a long sheet of paper in her hand and her attention was sharply focused on the figure in the bed as she listened to what a young man next to her reported.
“Let’s go,” Deb whispered urgently. “Sinclair’s already started.”
“Will I be able to film in here?” Jude interjected, because she wanted this on tape. Sinclair, with every eye on her and every expression expectant, looked like a commander surveying a battlefield.
“Probably,” Deb said as they approached the people clustered around the trauma chief. “We’ll figure it out later—after rounds.”
Jude had no choice but to agree, because she could see that she couldn’t interrupt what was underway. Besides, she wanted to watch this. No one seemed to object or even particularly notice that she was there.
Nurses moved efficiently between the beds, going about the business of administering meds, adjusting fluid pumps, and drawing blood. X-ray techs threaded their way through the residents and staff blocking the aisles, slid rectangular film plates under the patients, then shouted “clear” with complete disregard for what was happening nearby. At the sound of the technician’s warning, everyone shuffled behind the nearest person wearing a lead apron to shield themselves as much as possible from the radiation, waited for the tech to shoot the X-ray, and then moved back to their places with barely an interruption in their cadences.
A deep commanding voice caught everyone’s attention.
“How high is his intracranial pressure?” Sinclair asked the fair-haired young man standing just in front of Jude.
“Thirty-eight.”
“Up ten in the last two hours?” There was a faint
edge to the trauma chief’s voice.
“Yes.”
“And what does that indicate to you, Dr. Kinney?”
Jude craned her neck to see Sinclair, whose blue eyes were fixed, laser like, on the young man’s face. He was a first-year surgery resident according to the ID badge clipped to his pocket. His voice was taut with strain as he replied.
“It means that something is causing the pressure to rise inside his skull.”
“Such as?” The edge had progressed to razor sharp now.
Jude thought she could hear him swallow.
“Uh...cerebral edema, subdural hematoma, uh...epidural bleed.”
Sinclair set down her foot from the chair and straightened to her full height, her fierce gaze still on the younger physician. She seemed taller than Jude remembered, but she knew that they were very nearly the same height. It had grown very quiet, although activity still teemed around them.
“Are any of those conditions surgical emergencies?”
The resident blanched. “The subdural and the epidural bleeding.”
“Then why don’t I see the neurosurgeons in here looking at him?”
“We called...they said they’d be by,” he offered tentatively. He glanced right and left as if looking for assistance, but his fellow residents studiously avoided his gaze. He was on his own.
“And if he herniates his brain stem while we’re waiting? Who will be responsible for that, Dr. Kinney?” Sinclair turned her head a fraction and met Deborah Stein’s eyes. “Call neurosurg. Tell them I want them here now. Contact radiology and let them know we need an emergency head CT on this guy. Check the chart and find out who signs the consents for his procedures, but don’t call the family until we know for certain he’s going to the OR.”
“Right,” Deb answered briskly and moved off toward the nurse’s station on the far side of the room.
“Okay, who’s next?” Sinclair asked, already stepping to the neighboring bed. Someone pushed the rolling chair over to her. She absently propped one leg up on it again and leaned forward to study the patient in bed two while a different resident began to give his report.
