by Taryn Plendl
The rain pounded me, sounding as loud as a freight train passing right by the window. Faint voices sounded so far away. “Sir? Stay with me; help is on the way.” I closed my eyes. The pain on the left side of my body was excruciating. I tried to shift myself to relieve some of the pressure, but found I couldn’t move at all. I was crushed against the door, almost becoming one with the mangled metal that once was my vehicle. My head felt dark and fuzzy, almost as if I was floating through a dark forest. I couldn’t seem to focus on anything but the cold and the pain. Warm fluid dripped into my eyes. I could smell oil and dirt, and I found myself drifting in and out, catching voices and other sounds, but not quite putting them together. There were sirens and then yelling. I heard the loud motor and crunching of metal, the stench and taste of something metallic and then … nothing.
Chapter 2
Talia
It was a full moon, and that always brought out the crazies. The ER had been packed with mostly minor injuries and sickness up to this point. If my entire shift was going to stay like this, it would be a miserable night. If I find the driver of the crazy bus that keeps dropping off all her passengers at my place of work, I’m going to kick her ass! I sat back with my first, of what would probably be many, cups of coffee.
“Hey, Talia, we have PennSTAR MediVac coming in with a car accident victim. The second victim is coming by ambulance. Can you meet the helicopter and run Trauma One?” my charge nurse, Sara, asked, typing in information at the desk.
I took another quick sip of my lukewarm coffee. “Sure, what’s the ETA?” I asked as I stood up and shuffled into my lab coat.
“Five minutes. Why don’t you head up and wait, and I’ll have Sheila prep the room.” She didn’t look up from the computer. She didn’t have to. She knew I would do what I needed to do. I loved my job, and I was damn good at it.
I had wanted to be a nurse for as long as I could remember. My little brother, Ethan, was diagnosed with Neuroblastoma when he was three. I was only five, but I remembered how kind the nurses were to him. They cared for him and loved him while he was their patient. They also cried and mourned the loss of him after he passed. They were good people with a lot to give. I wanted to be like that. I wanted to make a difference. I loved running trauma. The energy and challenge of it was what kept me coming back. The feeling that came with being a lifeline for our patients—that ultimately I was making a difference—was worth ever second.
“Talia, are you working Trauma One with me?” Dr. Angelo stepped into the elevator with me. I was glad to see him. He was, hands down, one of my favorite ER doctors. He had a level head and rarely missed anything. His technique was good, and he treated the nurses with respect.
“I am. Do you have any idea of what’s coming in?” I asked as the doors closed. The elevator groaned and shuddered as it took us up to the helipad on the roof.
“Pretty serious roll over. Two vehicles. Ours was trapped and needed the Jaws of Life to pry him out. He was unconscious on the scene. Several orthopedic injuries and a head injury.” I nodded. It didn’t sound good.
We could see the PennSTAR Helicopter in the distance. The rain had calmed to a steady drizzle. I rubbed my hands together and waited. I would slip my gloves on when they landed, otherwise they would get too sweaty in the neoprene material. I worked through the motions in my head, as I did with any trauma—what labs we needed, what tests and equipment—going through everything I could think of right up until the helicopter landed.
Dr. Angelo and I met the medical flight team and moved as a unit with the stretcher toward the elevator, listening as we were updated with current vitals and conditions as we ran. Before we knew it, we were pushing through the doors to trauma room one.
I slipped into a gown and new gloves, grabbing fluids and supplies as Dr. Angelo hollered out orders. I cut the rest of the clothing away from our patient’s body, assessing his injuries as I went. His left arm had a compound fracture, and part of the bone was visible. We worked to stabilize it as Dr. Angelo and another nurse stabilized his neck and inserted a breathing tube.
“We need a CT scan and a chest X-Ray, STAT,” Dr. Angelo hollered. I called Radiology to let them know we would be on our way momentarily. In the meantime, the portable X-Ray machine was positioned over our patient’s chest.
“We need an orthopedic trauma consult, possibly a vascular, too!” I yelled when I saw the condition of his left leg. It was mangled beyond recognition below the knee. Tissue and bone crushed together, barely hanging on. I applied a tourniquet to his upper thigh to control the bleeding. I would be surprised if they were able to save it.
“Talia, I need a chest tube.” I grabbed the chest tube and scalpel and handed it to Dr. Angelo. Once we had it placed, and the blood drained out, we were able to inflate his lung again. His blood pressure was low from the excessive blood loss. We were pushing fluids, but we needed to get him blood. “We need three units of O-negative. Take it directly to the OR. Let’s get him transferred to CT,” Dr. Angelo called out as we finished up and prepared him for transfer.
I covered him with a warm blanket as we moved to the elevator. “The OR is prepped and ready,” I told Dr. Angelo as the doors opened, and we pushed through to Radiology. We went as far as the machine and stepped behind the barrier while the scan was in progress.
Dr. Shem, the trauma surgeon, came through to look over the scan. “We’ve got some active bleeding. We’ll do an exploratory laparotomy. We need to see what we have in there, looks like spleen. I’ll see him up there.” He turned and went the opposite direction.
“Let’s move.” Dr. Angelo and I pushed him down the hall and through the double doors into the inner core of the OR. The surgical trauma team came and took over as Dr. Angelo gave them report. As soon as they took him to the surgical suite, we left, making our way back down to the ER to finish up paperwork. My hands shook from the adrenaline, a common after effect of trauma.
“Did we get an ID yet?” I asked as we walked through the stark white hallways.
“Yes, Sara called it up. Thomas Crawford.”
I stopped, grabbing onto the wall for support. I felt like I’d been punched in the gut as the air left my lungs momentarily.
“Talia? Are you okay?” Dr. Angelo stepped toward me.
I felt like I couldn’t breathe. “Did you say Thomas Crawford?” What were the chances? Shit. There was no way. He was out with the others tonight.
“Yes. Do you know him?”
“I don’t know, maybe. I need to see his ID,” I shouted over my shoulder as I ran, leaving Dr. Angelo behind me. When the elevator didn’t open immediately, I took the stairs, slamming through the door and making it back to the ER in record time.
“Sara, I need my patient’s ID.” I was out of breath, gasping. Sara was looking at me like I’d totally lost it. “Please,” I begged as I leaned on the top of the desk.
She handed me the soft, brown leather wallet that she was currently putting into inventory. My hands were shaking as I opened it. I stared down at the smiling face that I knew so well. “Oh. My. God,” I choked out before I slid down to the cold tile floor. In an instant, my life had taken a turn down an unthinkable road. I could hear someone making a sound like a wounded animal, and almost died when I realized that it was me. I curled up against the side of the nurses’ station and cried like a baby.
***
“Thank you.” I smiled weakly at Dr. Angelo as he handed me a hot Styrofoam cup of tea.
“Can you get in touch with his family?” he asked in a soft voice. I scooted to the edge of the stretcher that I was sitting on. I was embarrassed by my reaction in front of my co-workers. I was trained to handle traumatic situations like this, but I guess it had never hit so close to home before.
“I don’t know. I need to call his best friends. They would know.” I grabbed my cell phone and dialed Ava’s number.
“Hey girl!” she answered, obviously knowing I was calling. I could hear thumping music in the background
and realized they must be at the nightclub already.
“Ava ... Ava, its Tom. You guys need to get here now.” I couldn’t contain my tears. Damn it, I seriously needed to get it together.
“What the hell are you talking about?” Her voice was instantly alarmed. I could hear her mumbling to Trevor right before I heard his voice.
“Talia, what’s this about Tom? Where are you?” he asked.
“Trevor, he was in an accident. It’s bad. Get here as soon as you can.” The phone went dead without a response, but I knew they were on their way.
“Talia, go change your scrubs and wait for your friends.” Sara placed her hand on my shoulder. I nodded and headed to the locker room. I stood in front of the mirror, staring at the reflection in front of me. I was covered with Tom’s blood. I tore the scrubs off of me, trying to get away from the images of him lying on that table.
Moments later, I was in fresh scrubs and at the entrance of the ER waiting for my friends. The moment I saw Ava running with Nick and Trevor, I started crying again.
“Come on.” I grabbed Ava’s hand, pulling her as we all headed up to the surgical waiting room.
“Talia, what happened?” Trevor asked as we walked into the empty waiting area. I held up my hand for a minute and walked over to the volunteer desk to let them know that Tom’s family was here.
I took a deep breath as I sat down, three pairs of eyes staring at me—waiting. “He was in a car accident. It was bad—he’s in bad shape,” I shuddered, pausing before I went on, not sure how much I should share with them.
“How bad Talia?” Nick asked, his voice strained.
“Bad. He is in surgery. His left arm is broken badly. He had some internal bleeding, and his left leg was so mangled that I hardly recognized it as a leg.” I shuddered again, wrapping my arms around myself.
“Oh God!” Ava put her hands over her face and cried as Trevor rubbed her back, clearly in shock.
“Was he conscious? Did he see you?” Trevor asked finally.
“No.” I closed my eyes. “I didn’t even know it was him the whole time we worked on him. Not until I saw his ID when I came back down.”
“How could you not know, Talia?” Nick asked accusingly. Oh hell no!
I stood up quickly, glaring at him. “Don’t start with me Nick,” I warned. “You weren’t there, you didn’t see him.” I shook my head. “I didn’t even recognize him,” I whispered as I sat back down on the cold seat. How could I begin to explain what he looked like? There was no way I could. I couldn’t do that to them. It was unfortunate enough that I couldn’t get it out of my own head.
“Shit.” Nick shook his head. “For real?” I couldn’t do more than just nod.
“Do you know how to get in touch with his family?” I turned to Trevor.
“He has no family,” he answered simply.
“What do you mean?” How did I not know that?
“His parents died a few years back. He is an only child. Both of his parents were only children also. There is no family. His grandparents are gone, too,” he explained.
“We are his family,” Nick stated, pointing between himself and Trevor.
I nodded. “Okay. We can let them know. Shit guys, I hate to ask this, but do either of you have power of attorney for him?” I looked at the two men who were trying so hard to hold it together.
“Trevor does. It was actually something we discussed right after graduation.” Nick stated.
I let out an audible breath. “Good,” I said, thankful that these guys were smart enough to talk about something like that. Not many twenty-something men would even broach that subject.
***
“Crawford family?” An older doctor stood in the doorway of the waiting room looking tired and disheveled. We all jumped at the sound of his voice. It had been several hours, and we had all long since stopped talking, just trying to get through the waiting.
“Yes. We are his family.” Trevor and Nick walked forward and Ava and I stood behind them, holding hands. The doctor took notice of my scrubs with the hospital logo on them and nodded briefly at me.
“Mr. Crawford is out of surgery, but it is still touch and go. We took a closer look at the scan of his head, and fortunately, there is not currently any active bleeding.” He paused to make sure there weren’t any questions. “Let’s sit down.” He motioned to the chairs, and we all shuffled to them. “We removed his spleen and were able to control the bleeding. He had a pretty significant break in his left arm that we were able to reduce and fix with plates and screws, both internal and external.” I nodded, remembering the fracture I’d noted in ER. “He had some severe damage to his left leg. We were unable to save it.”
“What does that mean?” Nick asked, his eyes wide.
“We had to amputate the leg right below the knee,” the doctor stated carefully.
“You cut his leg off?” Nick stood up angrily, knocking the chair back into the wall with the force. Ava took hold of his arm and whispered something to him, and they walked over to the water cooler.
“I’m sorry; we did what we could, but it was a mess.” He looked to Trevor and me.
“I know. I saw him when he came in.” I nodded in understanding. Trevor looked at me for confirmation. “It was bad Trevor. I told you it didn’t even look like a leg.” He nodded.
“Can we see him?” Trevor asked.
“Let us get him settled in the ICU, and then you will be able to see him one at a time. Give us about an hour, and we will come and get you.” He stood.
“Thank you, doctor.” Trevor shook his hand and walked back to Ava and Nick.
“You work in the ER?” The doctor asked me.
I nodded. “I didn’t even recognize him. The entire time we ran the trauma. Not until I saw ID.”
He nodded, understanding what I meant. Tom had not looked like himself when they brought him in. He was swollen and covered in blood. I was so focused on doing my job that I didn’t even actually look at his face. It was better that I didn’t recognize him anyway. I’m not sure how I could have done my job had I known.
“Thank you for everything,” I said and turned to join my friends.
Chapter 3
Trevor was the first to go in and see Tom. I tried to prepare them for what they might see when they went in. I was sure he would look pretty grim, and I didn’t want them to freak out.
Ava, Nick and I sat in the waiting area of the Surgical Intensive Care Unit. We were told that Tom was in a drug-induced coma and would remain that way for at least a few days. I assured them that this was normal as we sat in the cold and sterile waiting room. It never occurred to me how uncomfortable our hospital waiting rooms could be, until I was sitting on the other side.
The light green walls made the room feel uninviting. The carpet was industrial and the seating was hard and uncomfortable. The smell of cleaning products was prevalent in the stagnate air. People wandered by all day, without even glancing at us. I would kill for just a hint of normalcy right now.
“We need to figure out who is going to stay with him,” Nick spoke out loud, still trying to wrap his mind around everything.
“We can take turns,” Ava said softly, squeezing his hand.
“I am working nights for the next two weeks. I can be here during the day while you are all at work,” I suggested.
“Talia, you can’t do that. When will you sleep?” Ava asked me.
“I’ll see if they will let us set up a bed in his room. I’m not sure they’ll go for it, but it’s worth a try,” I shrugged.
Trevor rounded the corner, looking slightly pale. “Your turn man,” he said to Nick as he sat down between Ava and him. “He’s pretty bad, Nick. He doesn’t even look like himself right now,” Trevor warned him. Nick just nodded and walked around the corner.
“Hey, are you okay, Trevor?” I placed my hand on his shoulder as he buried his face in his hands.
“Shit, Talia. I couldn’t quite grasp how you didn’t know it was hi
m the minute you saw him in the ER, but shit …” he tapered off as Ava rubbed his back. “He’s a fucking mess!”
“I know.” I didn’t know what else to say. I had been beating myself up over not knowing who he was, but deep down, I knew it wasn’t my fault. In the ER, we see people at their worst. They are battered, beat up, and generally a mess. We did everything right for Tom. His trauma ran as well as we could have expected.
“Trevor, I’m glad I didn’t know it was him. I wouldn’t have been as much help if I’d fallen apart on my team.” I shrugged.
“I know, Talia. Thank you for being there.” Trevor gave me a small smile and laid his head on Ava’s shoulder.
***
I situated the small roll out bed and walked over to where Tom still lay unconscious. The only sounds in the room were the beeping of the monitors and the sound of the ventilator that continued to push air into Tom’s lungs.
His beautiful face was swollen and bruised. Days of growth covered his chin. There were speckled cuts across his cheeks and neck where the glass had hit him. His head had a bandage on the left side where they stitched up a large gash. His dark hair peeked out from under the white bandages. His left arm was in a cast from just below his elbow with an external fixation device to stabilize the bones.
I gently lifted up the blanket covering his legs and sucked in air when I saw the stump on his left leg. They had removed the mangled portion right below the knee joint. It was wrapped and clean. I know they were worried about infection. It was another reason I didn’t want to leave him. I trusted the staff of nurses and doctors immensely, but I still felt as if I needed to be there—to watch over him myself.
Tom and I had become good friends over the past few weeks. I truly enjoyed spending time with him, so much so, that I couldn’t remember the last date I’d been on. Whenever we all went out, Tom and I paired off to dance. I had become so comfortable with him. Actually, it was more than that. I liked him … a lot.
