Trauma Alert

by Radclyffe

  “Nothing.”

  Bobby leaned an arm against the door, preventing Beau from pulling it open. He leaned close and whispered in her ear. “Bullshit.”

  “Leave it, Bobby.”

  “I’ve known you, what—almost three years? I’ve never seen you lose your cool. Hell, I didn’t think there was anything that could get to you.”

  “Nothing’s getting to me.”

  “That’s why you’ve been pounding the blacktop out here for half an hour.” He opened the door and held it for her.

  “Just needed a little workout.” She shouldered her way inside and he followed.

  “Hey,” Bobby said softly. “If you’ve got a problem, I’ve got a problem. We’re partners, remember?”

  Beau stopped, took a breath, and turned around to face him. “Torveau reported me to the captain. She told me if I let her check me out, she wouldn’t do it.”

  “How do you know?”

  “What?”

  “How do you know she called?”

  “Well why the fuck else would Jeffries get on my case about going in after those civilians?”

  “Everybody saw you, partner.”

  Beau wasn’t convinced. She hadn’t done anything unusual—not for her. “He wants me to pass on the next call.”

  Bobby frowned. “So you take a break. Jesus, no shame in that. That was a tough rescue out there.”

  “I don’t need a break. I didn’t do anything I haven’t done every day on the job for the last three years.”

  “Maybe that’s the point,” Bobby said.

  “What’s that supposed to mean?”

  “You volunteer for every extra shift, you’re always the first one on the truck and the last one to leave the scene. If there’s a tough rescue, you’re in first. What do you think you have to prove?”

  “You wouldn’t be saying this to me if I were a guy,” Beau said, although she didn’t really believe it. Bobby had never treated her like anything other than an equal, but the suggestion would distract him from pushing the conversation places she didn’t want to go.

  “What the fuck?” Bobby glowered. “You’re nuts if you think that.”

  “It’s done, okay? Let’s just forget it.” Beau turned her back on her partner, afraid he might be one of the few people other than Jilly who could actually read the truth in her face. She didn’t want him to know about the specter of defeat that haunted her or the voice in the back of her mind telling her all the things she couldn’t do in her life. She had plenty to prove, more to herself than anyone else. “If the Cap says I sit the next one out, I sit it out. I might as well catch some rack time while I can.”

  The cramped sleeping quarters outfitted with four bunk beds was empty, as she expected it would be in the middle of the day. She climbed onto a top bunk and stretched out on her back, staring at the ceiling a few feet above her head. She hated being sidelined. Her job was more than just a job, it was daily proof she had some purpose in her life. Some reason for being.

  She was angry that Ali Torveau might have cast a cloud over her competency by making that call to her captain, but what hurt was that Ali hadn’t trusted her. She cared about that most of all, and she really really didn’t want to.

  Chapter Six

  “Ready? One…two…three.” Ali and Manny Cameron, the trauma night nurse, slid the middle-aged woman from the treatment table onto a gurney. The patient had been struck by a truck right in front of the hospital after exiting a cab. “Mrs. Hanley, you’ll be going up to the intermediate care unit soon. Dr. Danvers, one of the orthopedic surgeons, will see you later tonight or first thing in the morning and talk to you about what needs to be done for the fractures in your leg. Everything else looks good. Okay?”

  The woman, whose makeup and hair had been flawless when she’d first been brought in mere moments after the accident, now had smudges of mascara under her eyes and her skin had taken on the faint yellow cast of the ill. Groggily, she reached for Ali’s hand. “My husband?”

  “I talked to him on the phone a few minutes ago. He’s on his way. By the time you get upstairs, he’ll be here.”

  “Will you tell him…tell him…” The patient’s voice caught and tears leaked from the corners of her eyes, further destroying her carefully applied face. Neither privacy nor dignity survived the ravages of serious trauma. “He’ll be so worried.”

  “I’ll tell him you’re going to be fine. Believe me.” Ali squeezed the patient’s hand and glanced at Manny. “Vital signs still okay?”

  “Looking good,” the small, muscular man said.

  “Great. Pack her up for transport and let the ICU know she’s coming.”

  While Manny moved IV bags, a portable EKG machine, the pulse oximeter, and other equipment onto the stretcher with the patient, Ali finished her admitting note. She documented Mrs. Hanley’s condition and vital signs on arrival, outlined the steps taken in the resuscitation, noted lab and X-ray reports, and listed the treatments rendered. She checked to see that the nurses’ notes reflected the times various consults were called. Satisfied the events were accurately recorded, she passed the chart along with the preliminary lab results to the clerk who had relieved Trish at three thirty. “Make sure those X-rays go upstairs with her, will you? Ortho will need them.”

  “Sure, Doctor.” The clerk, a premed student by day, gathered the forms and folders and tucked them under the monitors at the foot of the stretcher. When Manny and the ICU nurse wheeled the patient out, he said, “I thought I’d get dinner while it’s quiet.”

  “Go ahead.” Ali briefly thought about grabbing something to eat herself, but the prospect of another hospital cafeteria meal effectively killed her appetite. She closed her eyes and rubbed her face, trying not to think about what the next twelve hours might bring. When she opened her eyes, Wynter, looking exasperated, settled onto a stool next to her at the counter.

  “You said you’d wake me up if things got busy,” Wynter chided. “It’s almost six and I’ve been sleeping all afternoon.”

  “I guess you needed it.”

  “Surgical residents always need it. That’s not the point.”

  Wynter’s tone was gentle, but Ali could tell she was upset. Despite having one child at home, another on the way, and a partner who was also a busy surgeon, Wynter never complained about the long hours or frequent call. She epitomized the mythical modern woman who could juggle family and career with humor and grace. Just the same, Wynter was a pregnant woman who didn’t need to be on her feet all day just to prove she could do her job. Ali was probably being overprotective, but Wynter reminded her of Sammy sometimes. They didn’t look anything alike, and they certainly were nothing alike in terms of what they wanted out of life or how they went about getting it, but they both stubbornly insisted they could do anything, and handle everything, that came their way. Maybe it was just that she cared about both of them, and she hadn’t been able to help Sammy. “We weren’t really busy, and nothing came in that you haven’t seen a dozen times before.”

  “You still shouldn’t be first call. I’m your fellow, after all. I’m here to make your life easier.”

  Ali shrugged. “I was conserving my resources. I wanted you fresh for tonight, so I can go to bed and leave the unit to you.”

  “Oh, that I really want to see.” Wynter leaned close, her shoulder touching Ali’s. “You’re really very chivalrous, you know. Thank you.”

  “You’re welcome.” Ali rolled her pen between her fingers, wondering why she’d been thinking of Sammy so much recently. That had been so long ago. Some hurts never healed, but it had been years since the pain had felt so fresh.

  “What’s the matter?”

  “Nothing,” Ali said quickly. “Sorry, just drifting.”

  “You look tired. Maybe you should try for a nap.”

  “Sure. Maybe.”

  Wynter shook her head, clearly not believing her. “It’s Ken and Mina’s anniversary next Saturday night. We’re farming out all our children t
o Mina’s sister Chloe for the night, and we’re having a party. I want you to come. You need a break.”

  “Ah—”

  “No excuses. It’ll be mostly people from here and some of Mina’s friends.” Wynter shook her head. “Probably pizza. I wanted to have something catered, but Pearce and Ken outvoted me.”

  “Pizza is always a good choice.” Ali smiled, considering the invitation. She liked Ken, an anesthesiologist, and his wife Mina, who lived in the other half of Wynter and Pearce’s Victorian twin. An evening with friends might purge the sadness that seemed to be plaguing her.

  “Maybe you could even bring a date,” Wynter said oh-so-casually.

  When Ali immediately thought of Beau, she mentally backpedaled. “I’ve got a training thing all day on Saturday. It might run late, and I’ll have reports to fill out after.”

  Wynter frowned. “What training thing? I’m not signed up for anything.”

  “Not for the surgery residents. For the TER-OPS paramedics. It’s a field simulation session. Part of the course I’m involved in.”

  “Oh, you mean where you stage some kind of mass casualty situation and they have to triage and all that?”

  “That’s it.”

  “Where is it going to be held?”

  “The university gym on Walnut.”

  “What’s the scenario?” Wynter asked.

  “A campus shooting.”

  “Sad something like that is becoming so common we’re training for it now.”

  Ali nodded. “The one after that will be a subway bombing.”

  “Need any help?”

  Grinning, Ali looked pointedly at Wynter’s belly.

  “Oh come on. So I’m pregnant. I can still waddle around. Besides, it sounds like fun. Pearce is off on Saturday and she can watch Ronnie. I bet you need someone to observe, take notes, that kind of stuff.”

  “Tell me you really want to spend your day off watching a bunch of firefighters resuscitate plastic dummies and med students doused in fake blood.”

  “Come July,” Wynter said fiercely, “I want to be a trauma attending right here. Maybe I’ll be running one of the sections next fall.”

  Ali laughed. “Maybe you’ll have my job in another few years too.”

  Wynter’s eyes sparkled. “There’s a thought.”

  “Okay, come if you want to. If you get tired you can always lie dow—”

  The bio-phone rang and Wynter picked it up. “Trauma admitting. Thompson.” She grabbed a pen and paper. “Uh-huh. Do we know what’s burning? Uh-huh. How many?”

  She pushed the paper toward Ali. She’d written four words and underlined the last two. Refinery explosion. Multiple victims. While Wynter continued to gather information, Ali used another phone to call the trauma unit and request extra nurses. Then she called the ER to have them hold several empty rooms for overflow from trauma admitting. All the less severely affected patients would be shunted to the emergency room. Those with acute inhalation injuries or cutaneous burns would come to the trauma unit.

  As soon as Wynter hung up, Ali said, “How many?”

  “At least six. Some civilians, some firefighters. Petroleum fire.”

  “Call respiratory and have them bring four more ventilators down here. If we’ve got hydrogen sulfide toxicity, we’ll need to intubate them.” Ali ran a mental checklist. “What’s the ETA?”

  Wynter looked at the clock. “Under ten minutes.”

  “Find out which surgery residents are in the house and tell them to get their butts down here.”

  “On it.”

  Ali pictured the acres of refineries, their flaming towers rising against the skyline like a scene from a postapocalyptic movie. They were only a few miles away. Civilians and firefighters, Wynter had said. Ali wondered if Beau’s unit had responded. If Beau was one of the rescuers-turned-casualty. Twenty-five percent of the fatalities from fires like these were first responders. For a second, an unfamiliar sense of fear swirled through her stomach. She had hoped never to feel anything like that again. Another very good reason to stay away from women who lived on the edge.

  *

  Beau was in the midst of transporting a twenty-year-old woman with multiple facial fractures to a local ER when the first call for the refinery fire went out. She and Bobby had gotten split up when she’d had to sit out part of the shift, so she wasn’t in the first wave of responders with him. She didn’t arrive on scene until the second and third alarms went out. By then it was pretty much controlled chaos with engines, ladder trucks, and ambulances everywhere. She didn’t see Bobby but found Jeffries, who sent her to the medical command center to triage. A few of the civilian refinery containment personnel had major flame injuries, and those she routed directly to the burn units at Crozier and St. Agnes Hospital. Many of the firefighters, despite their protective outer gear and SCBAs—self-contained breathing apparatus—had enough exposure to high concentrations of chemical agents that they were exhibiting early signs of toxicity. She triaged anyone with evidence of neurologic compromise or respiratory insufficiency to UHop. When the line of injured trickled to a halt, she left the cleanup to several other paramedics and checked in with her squad.

  “What’s the status?” she asked Jeffries, watching nearby firefighters spraying flame retardant foam over areas of chemical spills.

  “We’re pretty much contained.” Jeffries completed a few more status checks, then said to her, “You can head on over to the hospital with the next ambulance. I’ll be there as soon as we close this down.”

  “What for?” Beau asked, a bad feeling creeping through her chest.

  The captain’s expression grew solemn. “A couple of our first-on-scene guys got a big dose of that crap.”

  “Bobby?” Beau asked, but she already knew.

  “Reports are sketchy, but it sounds like he had some kind of seizure. He’s at U—”

  Beau didn’t hear the rest. She didn’t need to. Her partner was in trouble, and she needed to be with him. She should have been with him all along. She should have had his back, and if she hadn’t been forced to miss part of the tour, she would have been with him. This was her fault. She couldn’t shake the monkey on her back that made her put the ones she cared about the most in danger.

  *

  Ali left the nurses to apply sterile saline-soaked dressings to the burns on the chest and shoulders of a thirty-year-old man. He was stable, and a general surgery resident was on the way to admit him. She moved to the next patient, a firefighter, identifiable by the yellow bunker pants he still wore. His face was obscured by an oxygen mask.

  “Manny—get his clothes off,” she said while she quickly scanned the flimsy chart. “Bobby? How are you feeling? How’s your breathing?”

  “Not…so good…Doc.” His voice was weak, his breathing labored, his skin gray.

  “Kash,” she called to the clerk seated at the tiny workstation in the corner, “do you have his blood gas back yet?”

  “Just a second.” Kash pulled a sheet from the printer and hurried over, the paper in an outstretched hand. “Just got it.”

  Ali scanned the printout. O2 sats in the red zone. The CO2 was climbing and he was acidotic, hovering on the brink of respiratory collapse. She set the report aside and did a quick peripheral neural exam. His reflexes were depressed, sensory levels altered. All consistent with central nervous system toxicity. She leaned over the table so he could see her face.

  “We may need to intubate you—give your breathing a little assist until your body can clear the chemicals.”

  He nodded, too breathless to speak.

  “If I paralyze you to put the tube in, you’ll still feel the tube in your throat. It’ll be a little irritating, but you’ll feel a lot better when we can get some oxygen into you. Okay?”

  He closed his eyes, then slowly opened them. “Where’s…my…partner?”

  Ali frowned and checked the chart again. She didn’t see a contact person listed. “Girlfriend? Boyfriend?”

&nb
sp; Bobby shook his head and pulled his mask aside. Struggling for another breath, he gasped, “Beau.”

  “Oh,” Ali said, ignoring the frisson of anxiety that shot along her spine when she recognized Beau’s partner from that morning. “Was Beau in trouble out there? Is she hurt?”

  “Don’t know. Can we…wait?”

  “I’m sorry, Bobby. No. We need to do this now.”

  Bobby nodded wearily.

  Straightening, Ali motioned to Manny. “Let’s set up to intubate. And get an amp of Pavulon. If he figh—”

  “Bobby!” Beau barreled through the doors, skidded to a stop next to the stretcher, and gripped Bobby’s shoulder. “Hey? What the fuck, man. Can’t I leave you for a minute?”

  The tightness in Ali’s chest eased a little. Beau still wore her bunker pants, the suspenders stretched over the subtle swell of her breasts beneath her dark, sweat-stained T-shirt. A faint indentation creased her forehead where her helmet had rested. Her hands were smeared with oil and soot. Despite her disheveled state, she was breathtaking.

  Bobby tried to speak, but his words died on a rattling gasp and his body shook violently.

  “Okay, that’s it. Let’s go,” Ali said sharply, striding to the head of the table. She opened a curved metal laryngoscope and cupped Bobby’s jaw, pressing down with her thumb to open his mouth. She slid the flat edge of the half-inch wide blade over his tongue and swept it aside so she could visualize his vocal cords. “There’s a lot of edema. I can’t see the cords at all. Let me have a number eight. I’ll have to go blind.”

  “Here you go,” Manny said.

  “Watch his O2 sats.” Ali struggled to keep the small window of larynx in view. “If I don’t get it after a try or two, we’ll have to trach him. Find Wynter.”

  “I’ll page her,” Kash called. “She answered the code in X-ray.”

  “Never mind, then.” Ali slid the endotracheal tube into the posterior pharynx and advanced it in the general direction of the vocal cords. When she felt resistance she pushed gently, hoping the swelling hadn’t progressed to the point that the airway was completely occluded. She felt a little give and waited for the resistance to ease. Pink frothy fluid bubbled up around the tube.