Night Call

by Radclyffe

  “Shit.” Tristan could see it now. Not only would they have to deal with a critically injured patient, they’d probably have news people crawling all over them, documenting everything they did or didn’t do. It was a PR nightmare, and as the physician on scene, she was going to get all the attention.

  “No kidding,” Linda said.

  “I’ll take a quick look at her airway,” Tristan said, “then you two concentrate on securing the victim, just like you would if I wasn’t there. Anything you need me to do, tell me. I guess you know not to talk to anyone.”

  Linda grinned. “Oh yeah, we know all about that. HIPAA HIPAA hooray.”

  A lot sooner than she expected, Tristan realized they were landing at the edge of a field adjoining the turnpike. The accident scene below pulsed with a life of its own as the lights of a dozen emergency vehicles beat against the night sky. Two other helicopters were setting down simultaneously, hovering like menacing behemoths over the ring of patrol cars, ambulances, and fire engines whose headlights illuminated a jackknifed tractor-trailer and three mangled automobiles. Two forlorn, white-tarp-covered forms lay alone on the oil-stained highway while rescue workers swarmed around the wreckage, tending to the still-living.

  The instant the helicopter touched down, Tristan jumped out behind Linda and Juan. Following Linda’s directions, she helped unload a stretcher and rapidly piled emergency equipment on top. Then she set off running with them toward the scene.

  “We’re from PMC,” Linda called to a man with a lot of gold braid on his uniform cap who Tristan figured was the incident commander. He held two radios and was waving emergency crews in various directions.

  “Over there,” he directed.

  Tristan looked where he pointed. A cluster of emergency personnel knelt on the highway inside a loose ring of state police. Two news vans were angled on the shoulder of the road and a handful of reporters with television cameras strained against a temporary barricade of yellow crime scene tape, trying to get footage. The patient, assuming she was in there somewhere, was not visible.

  “Jesus,” Tristan muttered under her breath.

  Juan cleared the way by announcing who they were, and the crowd parted enough to let them through. When she finally cleared the protective ring of cops and the assorted curious, Tristan saw a woman in her early thirties, unconscious, bleeding profusely from obvious facial injuries. Judging from the victim’s position, Tristan surmised she’d been ejected from a vehicle—probably the overturned Lexus SUV covered with flame retardant foam that was now resting on the median. Her right leg was angulated, a portion of the femur protruding through a long rent in her once-white slacks. With trauma to both her head and lower extremities—bracket injuries—there was a good chance she had internal injuries as well. She already had IVs running in both arms.

  Tristan dropped to her knees by the patient’s head and placed her stethoscope quickly on both sides of the patient’s chest, listening for breath sounds. She heard no air movement on the right. “Pneumothorax on the right.”

  While Juan positioned the backboard next to the victim, Linda opened the emergency equipment box and pulled out a thin trocar with an attached flexible polyethylene tube connected to a syringe. She pushed aside the remnants of the patient’s bloodstained blouse, quickly swabbed a spot below her breast with antiseptic, and pushed the three-inch needle between her ribs. Then she slid the tubing in after it and used the syringe to evacuate the air from the patient’s chest. As Tristan listened, breath sounds returned. It was a temporary measure, but it would do for now.

  “Better,” Tristan said.

  Despite the improvement in airflow, the patient’s breathing was labored. Fractured ribs. Tristan gently palpated her jaw. The mandible shifted beneath her fingers with a grating sensation. Fractured as well, and probably her mid-face too, if the amount of blood streaming from her nose was any indication. With this much hemorrhage and mobile facial fractures, her airway was very unstable.

  “She needs to be intubated.”

  When Tristan glanced up, Juan already had a laryngoscope out and handed it to her. Using the portable suction, he cleared some of the blood out of the patient’s mouth while Tristan inserted the scope’s flat metal blade with a light at the end into the back of her throat. Moving the tongue aside and carefully lifting up on the jaw so as not to move the victim’s head, Tristan squinted into the oral cavity, hoping to find some landmarks. Unfortunately, with the continued bleeding and massive swelling, she couldn’t see a thing. Still searching for anatomical landmarks, she held out her free hand for the endotracheal tube and made a blind pass in the direction of the trachea—or at least where she hoped the trachea was. She really needed to get this tube in, because the last thing she wanted to do was an emergency trach in the field. Too much risk to the patient, especially one with an unstable neck. Tristan eased the tube in a little more. God, she hated blind intubations. Please, baby, come on.

  Juan pressed his fingers to the patient’s throat, and as Tristan continued to push, he nodded and said, “Feels like it’s going through the cords.”

  Tristan persisted until only a few inches of the tube protruded from the patient’s mouth. Then she took the ambu bag that Linda had connected to the oxygen tank and carefully hooked it to the end of the endotracheal tube. She squeezed the inflatable bag while Linda listened to the patient’s chest.

  “You got it,” Linda announced with satisfaction. “Good breath sounds on both sides.”

  “All right then,” Tristan said. “Let’s get her on the backboard and go.”

  Tristan stabilized the head, Juan placed a cervical collar, and then on Linda’s count, they rolled the patient, slid the backboard underneath her, and strapped her down. While Linda secured the IVs, O2, and other tubes, Juan splinted her leg. Within minutes, they were ready to go. As they worked, Tristan could hear shouted questions from the reporters.

  “Is that Marsha Eisman?”

  “How badly is she injured?”

  “Does the governor know?”

  “Is she going to die?”

  Tristan ignored everyone. She’d have to face the reporters soon enough, but it wasn’t going to be out here. She had far more important things to do than worry about the hospital’s PR.

  *

  Jett checked her gauges in preparation for takeoff while she waited for the medcrew to return with the patient. She hated this part—the waiting. She wanted to be out there in the field, doing something. But her job was to get her crew out and back again as quickly and as safely as possible. She could and had assisted in retrieving the wounded. But that had been under different circumstances.

  “Chief, you shouldn’t be out here! Get back to the chopper.”

  The major had to scream in Jett’s face to be heard above the rattle of small arms fire and the explosion of mortar rounds that came with such rapidity the air reverberated with the continuous roar.

  “The incoming fire is getting worse. We need to get the wounded aboard,” Jett shouted back. She helped the major roll an injured soldier onto the stretcher, grabbed the other end, and lifted. “Another few minutes and we might not be able to get airborne.”

  “If we don’t have a pilot, it won’t matter how long we take.”

  Since the major didn’t actually order her to drop the stretcher, Jett just put her head down and ran for her Black Hawk. They loaded the injured and raced back for more. After that, there wasn’t time for talk. The medevac crew finally cleared the field of injured and Jett somehow got them up and out in one piece. As soon as she’d landed at the field hospital and the wounded were off-loaded, she’d gone back out again. The hours ran together until finally she was off duty and she staggered, weak-limbed and numb, away from her aircraft for some much-needed food and rack time. She slumped down at a table in the mess tent and mechanically shoveled whatever was on the plate into her mouth, not tasting it, not caring, just knowing she needed it if she was going to wake up in a few hours and do it all again.<
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  “Nice flying, Chief,” a dark-haired major a few years Jett’s senior said as she sat down across the table from her. She wore medical insignia in addition to her oak cluster, and Jett figured her for one of the medcrews.

  “Thank you, ma’am,” Jett said, trying to put a little enthusiasm in her voice. She was so tired she could barely see her plate.

  “You ought to stay with your aircraft, though. We can’t spare any of our pilots.”

  Jett recognized her now from the first run of the day, which seemed like a week ago after the night she’d had. “Sorry. I didn’t recognize you, Major.”

  The major smiled, and Jett tumbled into the warm blue depths of her eyes. Quickly, she looked away.

  “But not sorry you put yourself in the line of fire, is that it, Chief?”

  “I was only thinking of the wounded.”

  “I know.” The major extended her hand across the table. “Gail Wallace.”

  Jett took her hand. Her skin was smooth and warm. Warm like her eyes and her smile. Jett couldn’t remember ever seeing anyone so beautiful.

  She jolted back to the present as Linda rapped one hand on the side of the helicopter. “All set, Cap.”

  Jett watched the team lift the stretcher into the aircraft, and when she was sure her crew was secure, she took the helicopter up, Gail’s face still vivid in her mind. She couldn’t remember how many times she’d glanced back to see Gail behind her, tending the wounded or leaning out the door, manning a gun while Jett took off under fire. She didn’t want to think about Gail, not now, not while she was flying.

  Flying had always been her escape. As soon as she was airborne, she was free—free from the memory of her father’s anger, her mother’s misery, her own helplessness. Behind the controls, she was in control. Even in the midst of combat, she felt only exhilaration, not fear. She made choices, and no matter the outcome, she would live or die by them. No regrets. Except one.

  Ignoring the familiar ache in the pit of her stomach, she gave herself over to the strong, steady hum of the rotors above her head, like the heartbeat of a lover in the dark. Even knowing it wouldn’t last, she welcomed the few moments of peace and headed toward home.

  Chapter Two

  Jett circled the hospital rooftop, checking her speed, her angle of approach, and the wind direction. The trauma team ringed the circle of light below, waiting to converge on the aircraft. Gently, she set her aircraft down precisely in the center of the landing pad. The doors flew open and the medcrew jumped out, guiding the stretcher out as the trauma team raced forward to meet them, heads lowered beneath the sweep of the still-turning rotors. Within a matter of seconds, Jett was alone on the rooftop, her job done. Adrenaline still surged through her bloodstream, and her hands trembled as she locked down her aircraft. With her helmet tucked under her arm, she strode to the stairs and hurried down a level to the suite of rooms reserved for the flight crews. She had her own small on-call room and private bathroom. The door from the hall opened into the room on one side and, opposite, another door led to the lounge area where the pilots and medcrews waited until a request came in. In addition to her bed, her room held a dresser, a small TV with only intermittent reception, a single straight-backed chair, and a tall narrow bookcase. She propped her helmet on her dresser, stripped off her flight suit, and draped it over the back of the chair. Then she went into the bathroom, ran cold water, and doused her head and face.

  “Tough flight?”

  Jett lifted the tail of her Army-issue green T-shirt and wiped her face, then turned to find the major standing just behind her. “Hot and dusty.”

  Gail smiled. “Just routine, then.”

  “Yeah.”

  “How long have you been here?”

  “Four months,” Jett said. “This time.”

  “Regular army?”

  “Yes. You?”

  “Sixteen toward my twenty,” Gail said.

  A career Army officer. Jett had thirteen years in herself, but she’d come up a different route. She didn’t often have casual conversations with other soldiers. She talked to her fellow pilots, but mostly about the flights or their aircraft. She’d always been a solitary person; living in close proximity with men and women with whom she couldn’t be completely honest only made her more reluctant to make connections. That’s why it was so odd that she felt comfortable talking to the major. Gail. Her name was Gail.

  “Do you want to grab something to eat?” Gail asked.

  Jett hesitated, uncertain if she wanted to say yes because a little friendly company would help take her mind off the horrors she witnessed every day, or because Major Gail Wallace made her heart beat faster. Because the last thing she wanted was to want something she couldn’t have.

  “I should probably catch some rack time,” Jett finally said.

  Gail studied her silently. “Another time, then.”

  Jett hesitated a beat or two as Gail turned away. “On the other hand, I can sleep later.”

  “Wonderful,” Gail said, smiling back over her shoulder at Jett. “Come on, then. I’m buying.”

  A knock at her door brought Jett upright, icy water streaming from her face. She grabbed a towel on her way out of the bathroom.

  “Yeah?” she called.

  The door opened and Linda stuck her head in. “Do you want to pitch in for pizza? We ordered a bunch.”

  Jett rubbed her face vigorously and shook the water from her hair. “Okay. Sure. I’ll be right out.”

  “Don’t wait too long or there won’t be anything left but the boxes.”

  The door swung closed and Jett sank down on the side of her bed. In the six weeks she’d been at PMC, she hadn’t gotten friendly with anyone. The first few weeks she’d spent riding with other pilots to get used to the system and the crews, rotating shifts until her mandatory probation period was over. For the last few weeks she’d been on a regular rotation and flew with the same crew more often than not. Without the division of rank, the civilian crews were more relaxed and informal than she was used to in the military. Until now, she’d been able to avoid a lot of the socializing that went on, but she couldn’t keep ducking the people she worked with without being rude. As much as she wanted to stretch out on her bed with her eyes closed and just wait, with her mind blank, until the next call out, she pulled the door open and stepped into the lounge. She could pretend to enjoy herself for a few minutes of meaningless conversation. She was good at pretending.

  *

  Tristan piled her beepers and the rest of her gear on the dull brown metal cabinet that served as a bedside table in her on-call room. After calling the page operator with her extension, she kicked off her running shoes and socks, and crawled under the sheet, still in her scrubs. The adrenaline rush was tailing off, and she was hovering on that edge between exhilaration and exhaustion. She needed to get some sleep, but her mind was racing.

  More reporters had been waiting when Healthstar arrived back at the hospital. Apparently someone at the scene had called the hospital’s powers that be, too, and the chief of anesthesia had been rousted from bed and had met them on the roof with the trauma team. He was in the OR doing the case right now. Tristan wasn’t insulted that she’d been bumped, since she would have had to call in backup if she’d gone to the OR. Considering the extent of the patient’s injuries, she’d have been in the operating room all night long. Unfortunately, Tristan had been delegated to feed the reporters something so they wouldn’t begin gnawing each other’s arms off.

  After fielding questions for fifteen minutes, she’d finally escaped. The state police had verified that the woman was indeed the governor’s daughter-in-law, which meant this story was going to be top news for the foreseeable future. If she was lucky, someone else would have to deal with the press after tonight. With a sigh, she closed her eyes and tried to relax. She could feel her pulse racing, and with nowhere to divert all those jumbled hormones, her body channeled them elsewhere. She felt a familiar stirring between her legs. Great
. Wired and horny.

  If she’d been reasonably certain she wouldn’t be interrupted, she might have been tempted to do something about the insistent thrum of excitement in the pit of her stomach, but the last thing she wanted to do was get even more worked up and then get called before she could finish. She’d just have to tough it out, and sooner or later, her mind would shut down and she’d fall asleep. She was just on the verge of drifting off when the phone rang.

  “Holmes,” she said.

  “Hi, Dr. Holmes. It’s Mary up in L and D. We need you up here right away.”

  “I’m on trauma call—I think maybe you want Jerry Edwar—”

  “Nope, we want you. Dr. Maguire specifically asked for you if you were in-house.”

  “Quinn?” Tristan thought Quinn was still in Vegas. “What’s she got to do with it?”

  “Dr. Blake has been in labor since late last night. She might need to be sectioned and—”

  “I’m on my way.” Tristan dropped the phone into the cradle and rolled out of bed. After pulling on her socks and running shoes, she clipped her beepers back to her waist and took off at a jog. Labor and Delivery was all the way on the other side of the hospital and up two floors. The obstetricians needed their operating rooms near the newborn nursery and neonatal intensive care units. The doctors and nurses in obstetrics had very little to do with the other hospital staff, with the exception of the pediatric intensivists, who camped out in the neonatal intensive care unit taking care of the critically ill preemies.

  Honor Blake is about to deliver. Jesus. Tristan tried to remember how far along Honor was in her pregnancy. Honor was chief of emergency medicine, but Tristan knew Quinn Maguire, Honor’s partner, far better. Quinn was now the trauma chief at PMC, but before that she’d been a trauma fellow at the same hospital in Manhattan where Tristan had been an anesthesia resident. Tristan had been surprised along with everyone else when Quinn didn’t stay on at St. Michael’s in a staff position, but then she’d heard Quinn had fallen in love and settled happily in Philadelphia. Tristan had met Honor a few times when she’d been called to the emergency room. The ER at PMC handled surgical as well as medical emergencies, including trauma. Whenever she was on call, Tristan was down there at least once. Honor was smart and easy to work with, and the last time Tristan had seen her, very pregnant.