“I’m not a nutcase,” the man hissed.
Poppy swallowed and used her most neutral sounding voice. “Sit down please, Mr. Smith.”
“No!”
Poppy slowly reached for the phone. As she moved, the man punched the thick glass with his fist, making her jump back. When he began pacing the waiting room, murmuring under his breath, she didn’t hesitate a second longer. She reached for the alarm and pressed. Within seconds, the internal double doors burst open and six security guards surrounded the man, dragging him back through the doors into the main department. Poppy felt sorry for him. If he didn’t cooperate they’d shackle him, sedate him and ship him off to the locked-down psychiatric unit. Poppy knew all about that – growing up, she’d seen it happen to her mother on more than one occasion.
Everyone in the waiting room breathed a sigh of relief and Poppy looked up to see who was next in line. An elderly woman shuffled toward her like a snail, water dripping from her baggy clothes. Four dirty children of a mix of ages and ethnicities trailed behind, leaving muddy footprints on the floor. Poppy glanced through the double doors at the only small patch of gray sky. It was still bucketing down outside.
She smiled politely and for what felt like the hundredth time that day she wished she was back in Australia.
“How can I help you?”
Chapter 7
A plain clothes police officer walked purposefully into the station wearing a serious expression, a black clipboard under his arm. Liam didn’t know the man, but judging from his demeanor and walk, he was a cop. Police and paramedics worked closely together and had a great rapport, but something said this bloke wasn’t here for a pleasant chat about the weather.
When the man got closer, Liam stuck out his hand and put on a friendly smile. “Morning, mate. I’m Liam. Can I help you?”
The officer shook his hand firmly. “Greg Islington. Senior Detective. Your partner around?”
“Maddi?”
The detective checked his clipboard and looked up at Liam, unsmiling. “Madeline West?”
Liam let out a small chuckle. “Yeah, that’s her. But if you want to get on her good side, don’t call her Madeline to her face or she might deck you.”
The detective’s mouth barely twitched.
“So is she around?”
Liam hesitated. He didn’t want to lie, but the truth was Maddi was running late again. She’d called and told him she was at a doctor’s appointment and he was covering for her and praying they didn’t get a call out in the meantime.
“She’s on her way. Why? Is there a problem?”
“You might be able to tell me.”
Liam frowned.
“She been acting differently lately? Anything going on in her personal life?”
No way would Liam admit his concerns about Maddi’s health – that was private and no one’s business, but now that a cop stood in front of him, he had to wonder whether something far more serious was going on. For a week now Maddi had been secretive about her whereabouts and this was the third time she’d been late to work, which was totally out of character.
When he didn’t reply, Greg fixed him with steel-gray eyes. “Who checks your drugs each shift?”
A shiver of alarm ran down Liam’s spine. He hesitated for a fraction of a second before answering but to his ears it sounded like a guilty pause. “Sometimes me, sometimes Maddi.”
“Ever notice any discrepancies?”
Liam didn’t like where this questioning was going. He shoved his hands deep in his pockets. “Nope. Numbers always add up.”
“When you give drugs to a patient, such as morphine or fentanyl, who draws it up?”
Liam frowned. This guy knew what he was talking about. “Depends.”
“Have you ever administered a narcotic and it hasn’t appeared to work?”
Liam’s mind flashed back to the week before when he’d administered intra-nasal fentanyl to the old guy from the nursing home with the fractured NOF. It hadn’t had any effect. Now that he thought about it, Liam realized there were a number of instances over the past few months where the fentanyl or morphine hadn’t seemed to work. He’d put it down to a bad batch of drugs and never given it another thought. He hadn’t considered there might be a more sinister explanation. One that didn’t bear considering.
He pushed his disquiet aside and shrugged. “It happens sometimes. That’s why we have other drugs we can use. Not all drugs have the same efficacy on patients.”
“Have you ever noticed whether the vials have been damaged?”
Liam’s throat constricted at the implication. “What’s that supposed to mean?”
“For example, when your partner Madeline draws up a narcotic, do you see the vial she uses? Does she show it to you for checking?”
“Not always. But the same goes if it’s me drawing it up. Sometimes it’s too busy. We’re paramedics. We deal with stressful emergencies. We don’t have the luxury of time to look over each other’s shoulder. I trust her. She trusts me. Why?”
Greg shifted the clipboard in his hands and refused to meet Liam’s eye. “Other paramedics have raised concerns over recent changes in Madeline’s behavior and I understand she’s under a performance review after a recent incident.”
“That recent incident, as you call it, happened because there were no police around to restrain a drug-addicted woman. The woman bashed Maddi senseless then went after her partner. The only reason Maddi’s being reviewed is because of the stress it’s caused her as a result of what happened.”
Greg coughed. “I am mindful of that particular incident. But in addition, there have been concerns that ampoules of morphine and fentanyl have been tampered with. Are you aware of that?”
“Tampered how?” Liam asked the question even though he knew the answer.
There were cases in Victoria and Western Australia where paramedics were caught withdrawing the drug and replacing it with normal saline or sterile water. They were caught and prosecuted. The packaging was changed but it was technically still possible to draw up an ampoule of a drug and put it aside then draw up another ampoule of normal saline and administer that to the patient instead.
Liam ran a finger around his collar. “There’s no way Maddi would do anything to harm a patient,” he said.
“You sure about that?” Greg asked.
“Absolutely.”
“You’d stake your registration on it?”
Liam was about to tell Greg where to shove the rest of his questions when a door slammed.
“I’m here, Liam,” Maddi called out breathlessly. “Sorry I’m late.”
She skidded to a stop and the expression on her face went from apologetic to apoplectic.
Or was that fear?
“Madeline West?”
Maddi’s face turned scarlet and she bit her bottom lip. Liam had never seen her look so vulnerable.
“That’s me.”
Her hands shook.
“I’m Senior Detective Greg Islington. I’d like to ask you a few questions.”
Maddi stared at Liam like he was the fireman and she was the kitten in a tree desperate to be rescued.
Liam gave a small shrug. He couldn’t help her. Anything he said might make her seem guilty of something.
Maddi turned to the detective. “What kind of questions?”
Greg opened his mouth to speak as an alarm sounded, interrupting his reply. Paramedics exploded through the doors and raced to their trucks.
“What’s going on?” Liam called out.
“Check your pager. Truck versus school bus on Old Church Hill Road. All units need to respond.”
Adrenaline cut through Liam’s body like a knife. He yanked open the truck door and jumped behind the wheel in one fluid movement. “Come on, Mads, let’s go.”
Greg waved them on. “Go. We’ll catch up another time, Madeline.”
“There will be no other time,” Maddi muttered and scrambled in.
Liam didn’t miss the
veiled threat but he didn’t have time to analyze it. He pulled out before Maddi even had a chance to buckle her belt. Lights flashing, siren blaring, he sped after the other trucks toward the scene of the accident.
Chapter 8
“The details are sketchy,” Maddi said. She sat forward in her seat alternately checking the computer screen and the road ahead of them. “It sounds like it’s a mini-bus.”
Liam felt momentary relief. A mini-bus reduced the potential number of wounded. But chances were still high that the mini-bus was full of students on their way home from school. And chances were even higher that in a town the size of Birrangulla, he and Maddi knew of the victims.
“Fatalities?” he asked.
“No idea.”
“How many injured?”
“They don’t know yet. Driver of the truck is still trapped.”
They approached an intersection and Liam swore loudly at a car in front of them which wasn’t moving out of their way. He flashed his lights and slammed his fist into the horn. He saw the driver check her rearview mirror before hastily pulling over to the side. It was enough for them to roar through. Afternoon peak hour school traffic was building, hampering their speed, but they made it to the scene in under six minutes.
Liam had been involved in multiple traffic accidents over the years, but nothing prepared him for the spectacle in front of them. All hell had broken loose. From his position it was almost impossible to tell that two vehicles were involved. The head-on impact had caused the front of the truck to crush into the front of the bus, joining them like Siamese twins at the head. Both vehicles had tipped over and they lay on their sides in a mangled mash of concertinaed metal.
He swore again and tasted hot bile as it rose in the back of his throat. There would be fatalities for sure. No way could either of the drivers have survived the crash. He prayed the kids on board were wearing seatbelts.
Grabbing gloves and the kit he jumped down from the truck. “If they’re making noise, leave them,” he shouted above the sound of sirens.
“I know that,” Maddi snapped back, hot on his heels.
He jogged over to a businesswoman in a suit and stilettos who was performing CPR on a teenager in school uniform who should have been laughing with his mates back in the bus and talking about who was going to win the football on the weekend.
Liam went straight to the businesswoman and knelt beside her. Only when he saw tears running down the woman’s face did Liam realize she was little more than a teenager herself. Her hands worked on the chest of the young boy, performing perfect CPR.
“I think he’s dead,” she said. Her voice cracked and Liam’s heart went out to her. Never in a lifetime would she have expected to be in this situation when she was eating breakfast that morning.
Liam put a gloved hand on the woman’s shoulder and she slumped at his touch.
“Let me check him out,” he said kindly.
The woman pulled away and as Liam began searching for signs of life he heard the unmistakable sound of retching behind him. He didn’t turn to look. In front of him it was obvious the schoolboy was long dead. Liam had no time for introspection, no time to pray before closing the boy’s eyes and moving on to find the next casualty.
“Liam! I need your help here now!” It was Nick, one of the senior paramedics.
Liam ignored the stench of spilt fuel and climbed carefully through the gaping hole of twisted metal into the body of the bus. He shuddered at the sounds and sights in front of him as he made a quick head count. Thank God. Only two students were on the bus. One was a teenage boy who was slumped sideways against the back wall. His open-eyed stare indicated the impact had killed him instantly. Liam checked for a pulse anyway. None. He straightened the boy’s school tie and closed his eyes. What else could he do?
“Go and help Maddi,” Nick said, nodding towards the back of the bus.
Two of Liam’s colleagues worked on the bus driver. The man was talking, which was a miracle. Opposite, in the cabin of the truck, a team, led by Nick, worked on the truckie. He was unconscious but amazingly also still alive. Nick was bagging him but shaking his head. He shouted something about not being able to secure the airway and more frenzied action occurred. Liam winced. If Nick needed to make an artificial airway at the scene of an accident it might not end well.
He turned his attention away from Nick and their colleagues to Maddi and the remaining student. A female. Maddi was holding her neck straight. The girl had a pasty pallor and was crying silent tears.
He touched her shoulder. “Hey, sweetie, I’m Liam. I’m a paramedic. Maddi and I will help you, okay?”
The teenager moaned and started thrashing around.
“You need to lie still.”
With one gloved hand Liam held the girl’s forehead firmly while his other cradled the back of her head while Maddi fitted the plastic cervical collar then held the girl’s head still.
“What’s your name?” he asked.
“Teagan.”
“Well, Teagan, let’s check you over then get you out of here.”
Maddi shook her head and pointed. Liam glanced at the young girl’s legs which were pinned by the seat. He swore under his breath before performing a quick examination of Teagan’s head and upper limbs. No visible injuries or deformities but when he gently palpated her abdomen through the thin cotton of her school dress she groaned. He tried again on the other side and felt her guard against his touch. As well as her legs, she had internal injuries for sure. He couldn’t move her without analgesia.
“I need to get a line in,” he said.
As usual, Maddi was one step ahead of him. She tossed a tourniquet and an IV cannula in Liam’s direction. Liam caught both in one hand. He fitted the tourniquet around Teagan’s upper arm and tore open the wrapper for the cannula with his teeth while he searched for a vein.
“I’m going to die,” Teagan said, tears streaming down her face.
“No, you’re not,” Liam assured her. “Not on our shift. Too much paperwork.” As soon as the words were out, he grimaced. She wouldn’t know he was only joking – that joking was his coping mechanism in situations like this. Luckily she didn’t appear to have heard him. Maddi had though. He could tell by the scowl on her face. He’d apologize later.
Teagan stared down at her legs. “I can’t feel my feet.”
“That’s because they’re stuck right now,” Maddi said. Her voice was calm and reassuring.
“What if I never walk again?” Teagan cried out. “I’m a dancer. If I can’t dance you might as well let me die now.”
Hysteria was mounting and Maddi spoke softly to distract her while Liam slid the cannula into her vein, flushed it and secured it with a dressing and tape.
“Teagan, are you allergic to anything?” he asked.
She nodded more calmly. “Bees. I’m anaphylactic. My EpiPen is in my school bag.” She moaned. “Can you give me something for the pain? My stomach really hurts.”
“Morphine or fentanyl?” Maddi asked.
“We’ll go with morph,” Liam replied.
Maddi reached into the bag behind her while Liam attached the blood pressure cuff to Teagan’s arm and pumped it up. He listened carefully with this stethoscope and wasn’t surprised her blood pressure was low.
“Ten milligrams in ten mills,” Maddi said as she handed the syringe to Liam.
He almost asked to see the vial of morphine but decided not to. Now wasn’t the time to go around second guessing his colleague, regardless of what that detective bloke had insinuated.
He pushed five milligrams of the drug into Teagan’s vein and took the second syringe from Maddi’s outstretched hand. This one would be normal saline for the flush, but there was no way of telling – both syringes contained clear fluid.
Liam pocketed both syringes and sat back to wait for the drug to take effect.
“What else do you need?” Maddi asked.
“I need more hands in here. We need to see if we can cut t
hat seat away.”
The pulse oximeter beeped. “Sats and resp rate are dropping,” Maddi said.
“Is it a poor trace?”
Maddi shook her head. “Trace is good.” She felt for Teagan’s pulse. “Thready. She’s clammy too.”
“Morphine and shock,” Liam said. “Hand me a bag of fluids and some O2.” He touched Teagan’s shoulder and her eyes fluttered open. “Won’t be long now. How’s that pain now? Easing? I’ve given you some morphine.”
“I still can’t feel my legs.”
Liam attached a bag of intravenous fluid to a line and primed it before connecting it to the IV in Teagan’s arm. He spiked the bag on a piece of metal sticking out above them and opened the line so it ran full bore into her vein. “We’ll get you out as soon as we can,” he said. No way was he going to mention anything about her legs. Maddi fixed an oxygen mask over Teagan’s face.
“You guys need anything?” Nick called out from outside.
Liam took a second to take stock of his surroundings. While he and Maddi had worked on Teagan, both drivers and the deceased boy in the back had been removed from the bus. He’d been concentrating so much he hadn’t noticed.
“How long until someone can come and cut this seat away?” Liam asked.
“They’re about to do it now. She stable enough to move?” Nick asked, pointing to Teagan.
Liam screwed up his face. “Probably not,” he said softly. “She’s got internal injuries as well as the legs. She’ll probably go into shock the minute we shift her.”
“Righto, let’s get going. We’re set up out here to tube her if we have to.”
More people crowded around Liam and Teagan and soon the small space was filled with the sound of grinding metal as the seat pinning Teagan was cut away. Liam administered another five milligrams of morphine and tried to ignore the beating of his heart when it didn’t seem to be taking any effect. He attached monitors to her chest and re-checked her blood pressure. Still low. She needed more fluids and more pain relief. He looked around to ask Maddi to draw up some more but he couldn’t find her anywhere in the commotion.
Critical Condition Page 5
