Solemn Oath

by Hannah Alexander

  “Don’t try to fool me, Doc. I should’ve caught it, and I didn’t. I was so busy feeling sorry for myself, letting her wait on me and carry food and give me my medicine that I didn’t even know she was getting worse.”

  “You’re not a doctor,” Mercy snapped. “Hush for a moment and let me listen.”

  At the sharp sound of Mercy’s voice, Darlene opened her eyes.

  “Feeling pretty rough?” Mercy asked her.

  Darlene nodded. She opened her mouth to try to speak, but Mercy placed a finger over her lips. “I’ve given you a drug that I hope will help, and we’re waiting for an ambulance.”

  Another reading of blood pressure showed no change. The heart rate did not increase past 140, but Mercy heard no sounds of wheezing, which would have indicated an improvement. The drug wasn’t working yet.

  “Just hold on, Darlene. Keep breathing for us.”

  “She’s been quiet the past few days,” Clarence said, “but I knew she was worried because she was behind with her work, so I didn’t think about her being sick.”

  Mercy adjusted the mask over Darlene’s gray face. “The ambulance will be here.”

  “Take care of him,” came a breathy, whispered croak.

  Mercy jerked back around to find Darlene watching her with tears in her eyes. “Hold on, Darlene.”

  “I’m not going to get through this, am I?” She was struggling for breath, fighting to stay awake, and Mercy could barely hear the words.

  “Yes, you are.” Mercy once more inflated the blood pressure cuff. “We’ll get you to a hospital and get you on a ventilator. Just keep going a little longer, Darlene.”

  Darlene reached up and touched Mercy’s arm, her eyes closing once more. “Take care of my brother.”

  A moment later, they heard the faint, welcome call of a siren.

  Chapter Thirteen

  Lukas winced at the disharmony of strong baby lungs and strident grandma lungs as he pulled off his gloves. He bent down and gently moved Jeremy’s mother aside so he could examine the new father. Her labor pains had ended when her own baby dropped the camcorder.

  The woman scrambled as close as she could to her son’s other side. “He’s bleeding, Doctor. Oh, my…what if he’s got a concussion? Jeremy? Jeremy! Wake up, honey. I didn’t mean those things I said.”

  “What happened?” Melinda demanded from the birthing cot. “Did something happen to Jeremy? What’s going on?”

  A two-inch-long streak of bright blood angled across Jeremy’s forehead where he had connected with the corner of a metal utensil tray that had interrupted his sideways fall. Lukas checked Jeremy’s airway, breathing, circulation, looked in his eyes, and nodded to himself. The man would be coming around any moment.

  “We need to check him out,” Lukas told the others. “He’ll need some stitches, but he fell because he fainted at the sight of his son.”

  An exhausted chuckle reached him from the birthing cot. “Oh, is that all?” Melinda said weakly. “He’ll be okay, then. He gets sick at the sight of blood. I told him he couldn’t take it.”

  The mother’s eyes widened behind her wire-framed glasses. “You’re kidding! The big baby fainted?” She stared back down at her son, her expression metamorphosing from concern to disbelief to disgust. “How typical!” She shook her head and climbed to her feet with a grunt, then walked back over to the bedside. “Oh, Melinda, honey, I’m so sorry,” she said, patting her daughter-in-law’s hand. “This is so humiliating.”

  Jeremy opened his eyes and blinked up at Lukas, then groaned and tried to rise, but Lukas put a hand on the young man’s bony left shoulder and eased him back down. “Just stay put and we’ll all be safer. Someone is on the way down to take you to the emergency room so we can check you out.”

  “Are they okay?” Jeremy asked.

  “Your wife and baby are fine, but I’m not an electronics expert, so you’ll have to get a diagnosis on your camcorder from somebody else.”

  Amanda rushed through the wide delivery room door with a gurney, on which lay a c-collar and spine board. “All right! A new baby! Way to go!” She instantly saw Jeremy splayed out on the floor and lowered the adjustable gurney to make it easier to transport the patient. “Lauren, will you give me a hand? Dr. Bower, as I was on my way in here, we got a call about a bad asthma coming in by ambulance. They’re about six minutes out.”

  “Okay, thanks. Keep me posted.” Lukas took the c-collar from Amanda and placed it around Jeremy’s neck. Together, he and Amanda logrolled the patient onto his side, strapped him onto the backboard, then transferred him onto the gurney. As Lauren and Amanda wheeled Jeremy out, Lukas grabbed another pair of gloves and turned back to his other two patients. The efficient, seasoned OB nurse had already shown the baby to the mother and taken him over to place him beneath a radiant warmer. Melinda, the new mother, needed attention.

  “Oh, and, Dr. Bower?” Amanda continued as they started to push Jeremy out of the room. “The ambulance attendant told us that Dr. Mercy is with them. She was at the scene with the patient when they arrived.”

  Lukas frowned. “She’s in the ambulance?”

  “That’s what they said.”

  Immediately, Lukas knew. Darlene…. Hadn’t he discussed this very thing with Mercy a few days ago?

  “After all that trouble, I hope he didn’t break that stupid camcorder.” Jeremy’s mother once more leaned over her daughter-in-law and dabbed the young woman’s forehead with a wet towel. “My boy means well, even if he is a wimp. He’s just always loved his gadgets.” She glanced in the direction of her new grandson. “How’s that baby doing?”

  “Looking good,” the nurse assured her without looking up from her work. “Great Apgar test scores. He’s got a good strong heart rate, and he’s pink from head to toe.”

  “Now we just have to deliver the placenta,” Lukas said as he positioned himself to complete the job.

  Melinda grimaced. “Jeremy’s going to be okay? Ouch, I’m cramping! Did he even get the baby on film?”

  “Now, now.” The new grandmother continued to pat Melinda’s face with the towel. “He’s going to be fine, just like the baby. Maybe a scar on the forehead will make my son think about you next time you’re in labor, instead of his little gadgets.”

  Melinda’s eyes widened at her mother-in-law. “Next time?”

  Tedi found Abby sitting out by the trees on the playground, watching a last-minute game of baseball before school began for the day. Mr. Walters had been encouraging them to practice for the past two weeks so they would be ready to play the other sixth-grade team Thursday. Tedi dreaded it. She could beat everybody in sixth or seventh grade in a spelling bee but couldn’t control a baseball with a bat or a glove, and she didn’t want to learn.

  She walked over and sank onto the grass beside her best friend. “Why aren’t you playing, Abby? You’re their star hitter.”

  Abby pointed to her bandages. “I don’t have my stitches out.”

  “So? That didn’t stop you last week.”

  Abby shrugged and looked down, ignoring the game. That wasn’t like her, either.

  “What’s wrong?” Tedi asked.

  “Nothing.”

  Tedi knew what it was. “They’re fighting again, aren’t they?”

  Abby pushed her glasses up her nose and nodded.

  “Sorry.”

  “Yeah, I know.”

  The bell rang. Tedi groaned and started to get up, when the bell rang again, and then again, in short bursts.

  “All right!” the pitcher on the mound shouted. “Fire drill! We’re gonna get out of class.”

  Tedi groaned. “That’s silly. Why are we having a fire drill before we’re supposed to be in—”

  Abby gasped and pointed toward the cafeteria at the east end of the long elementary school building. Gray smoke billowed from one of the open windows. “It’s a real fire!”

  The fire alarm continued its blast, echoing across the large grassy playground behind the
building. Wide-eyed with excitement and fear, Tedi and Abby got up and joined the ballplayers at the spot by the flagpole where their class was supposed to stand. They watched kids and teachers and the principal and secretaries file out of the doors of the building and walk toward them, just as they’d done during the drill they’d had three weeks ago.

  Mr. Walters came rushing out from the west exit, herding two other kids in front of him. His slightly chubby belly jiggled over his belt, and his right hand grasped his attendance book. He directed the two kids to join Tedi and Abby and the ballplayers, and as soon as he reached them, he started roll call, just like the other teachers.

  The bell continued its sharp retort. Before Mr. Walters finished calling out the list of kids’ names, a siren joined the jangle of the bell. Another siren soon joined it. The flashing red lights of two blaring red trucks raced toward them down the street from the direction of the fire station.

  The smell of the smoke reached Tedi as the trucks pulled into the school driveway. More trucks arrived, and men jumped out and unwound huge hoses from their trucks. They connected the hoses to the fire hydrant at the back of the school, and with two men per hose, they shot their forceful streams of water at the fire.

  The smoke turned to sizzling steam as the men shouted to one another and fought the hoses. One skinny man kept running around, tripping over the hoses, until another fireman walked over to him and jerked on his arm. Together they entered the school building.

  “Do you think the cooks are okay?” Abby asked.

  Tedi nodded and pointed toward the school staff. The cooks all mingled with the secretaries at the far end of the group.

  About the time the final wisp of smoke disappeared, Tedi saw Grandma pull her car into the front driveway and wave at them. They’d been dismissed from school for the day.

  That was it? That was all the excitement they were going to have today? No screams, no explosions, no collapsing buildings? Just wisps of smoke and a few fire hoses, and it was finished?

  Tedi sighed and walked toward Grandma’s car. Oh well, at least nobody was hurt. Time to go home.

  In the ambulance, Mercy’s physical tension rose and fell with the sound of the siren above her and the constant beep-beep of Darlene’s monitor. Sitting in the jump seat at the head of the cot, she squeezed the ambu bag with increasing frequency. Darlene had to struggle to take in a breath. This left Connie, the paramedic, free to keep track of the blood pressure and monitor and establish a second IV en route to the hospital. She was just as efficient inserting the second IV as she had been with the first, but Mercy noticed with concern that this time, when the needle pricked Darlene’s flesh, there was no reaction, not even a flinch. And Mercy was having to use more and more force to move air through the ambu bag because of Darlene’s decreased responsiveness and muscle tone. Darlene was too worn-out to breathe.

  Less than four minutes from the hospital, Connie rechecked the monitor and inflated the blood pressure cuff. “Dr. Mercy, I can barely hear a pressure.” She checked for a pulse, then looked up at Mercy in alarm. “She’s in shock. We’ve got to intubate.”

  “Give her fifty milligrams of lidocaine first.”

  “I’ve got it ready.”

  Mercy watched Connie administer the drug through the IV, then she removed the bag mask and changed places to allow the paramedic to do the intubation. “You do it, Connie. It’s what you’re good at, and you do it often.” Mercy was too emotionally involved at this point.

  Connie was smooth, very experienced, and the tube slid in quickly, but too late they saw that in spite of the medication, the tube triggered a sudden bad reaction. The monitor alarm shot through the van.

  “She’s in v-tach,” Connie said, checking the pulse again. “I’m not getting anything.”

  Mercy pressed Darlene’s throat in search of the carotid artery. Nothing. She turned toward the driver. “Bernie, call the hospital. Tell them to call Air Care. Tell them we’re coming in with a code.”

  Lukas stood in the ambulance bay as the code team continued to assemble in the E.R. He had already told the secretary to call the chopper, on Mercy’s instructions. He saw Mercy and Connie bent over someone in the back of the van. He knew for sure it was Darlene Knight before they opened the double back doors and wheeled her out.

  He felt sick.

  He stepped forward to help them. Connie recited the patient summary to him, continuing chest compressions as she spoke.

  Lukas caught sight of tears shining from Mercy’s face, but he had no time to dwell on that. Darlene had crashed hard, and they would have their hands full bringing her back. And they had to bring her back. They had to. Please, God.

  Mercy continued to squeeze the bag as the code team worked over Darlene, and Lukas ordered drugs. She released her position only when Lukas placed the paddles on Darlene’s chest for defibrillation. All stood back.

  “Clear.”

  The body arched, the monitor sang, and then a steady rhythm beeped across the room from the monitor. Mercy felt fresh hot tears—this time of relief. She ducked her head and blinked, scattering the tears over her flexing arms. This was no good! She couldn’t fall apart like this. She felt a hand on her arm and looked up as Lukas gently took over the bagging for her and nudged her aside.

  “We’ve got extra help now, and the chopper’s almost here,” he said under cover of the monitor beep. “Go blow your nose.”

  She went, feeling helpless, inept. After working with patients for more than ten years, she had learned to protect her emotions, to distance herself from the suffering so that she could most effectively help those who depended on her calm judgment. This one had cut deep, had shaken her more completely than her first code blue as an intern, and she hadn’t even run this resuscitation effort herself.

  And what about Clarence? She’d left him slumped on the front porch of his house, frantic about his sister, and grimacing in pain from pulled muscles.

  She did as she was told and blew her nose and wiped her face, but she would not leave the E.R. After rechecking the progress on Darlene, she turned to watch through the plate-glass windows for a helicopter to appear in the sky. She listened for the pulsing thrusts of echoing blades that would be her first assurance that help was arriving.

  Instead, she saw Buck Oppenheimer wheel into the ambulance bay in his big red pickup truck. He wasn’t supposed to be doing that. What was going on?

  Then she saw Clarence Knight riding shotgun, his massive bulk taking up half the cab.

  Mercy ran into the E.R. proper and grabbed their sturdiest wheelchair. When she stepped out with the chair, she saw two more cars pulling up behind Buck’s pickup. Altogether, five men climbed out.

  Buck jumped from his truck and came around the front. “Hi, Dr. Mercy. I heard about what was happening over the radio. I drove over to check things out, but you had already left with Darlene. I saw Clarence sitting on the front step of their porch.” He shrugged. “I was off duty, so I rounded up a few friends. I think he’s pulled some muscles in his right leg, and his lower back is hurting pretty badly, but as far as I can tell, he’s okay otherwise.”

  “Thank you, Buck. Is he complaining of pain anywhere else? Is his breathing—”

  Clarence shoved the door open and leaned out, his big body nearly toppling from the truck as the men rushed forward to catch him. His hair and beard were wet from perspiration. He wore his usual short pants, covered by a huge ragged T-shirt that barely covered his torso, and the worn pair of black house shoes Mercy had seen many times before—the only ones he owned.

  “Where is she, Mercy? Is she okay?” He allowed the men to help him squeeze into the big wheelchair, but his deep brown eyes held Mercy’s, and he reached toward her. “Tell me she’s still alive!”

  “We had to resuscitate her, Clarence, and we’re airlifting her to Cox South in Springfield.” She spread her hands helplessly. “Lukas is working on her now. I’m sorry, but she hasn’t regained consciousness.”

  “B
ut she’s alive?”

  “She’s alive.” Who knew how long that would last?

  “I’ve got to see her. Please let me see her.” He let his arms fall over the sides of the wheelchair and looked down at himself, at the men struggling to push him into the E.R., and his face contorted. Tears filled his already reddened eyes. “What have I done? I let this happen. What have I done?”

  Mercy put a hand on his shoulder.

  He leaned back and moaned as the men wheeled him through the doors.

  Mercy bent over him. “Clarence, are you having pain in your chest?” His numbers had been good the past few weeks, but—

  “It’s not my heart. It’s just pulled muscles.” He laid his head back. “Please let me see Darlene.”

  They pushed him to the broad door of the first trauma room. Lukas and Lauren worked with two nurses from upstairs as they continued to watch Darlene and take her vitals and help her breathe.

  Clarence’s gaze shot immediately to the monitor. “Is she awake, Doc?”

  Lukas shook his head. “No, Clarence, not yet, but we just got word that the chopper’s getting ready to land. You could probably hear it if you were outside.” He gestured toward the group of men who encircled Clarence’s wheelchair. “We’ll have to clear out for them to come in and get her.”

  Mercy stepped forward. “Let’s put Clarence in room three, guys. There’s a sturdy Stryker bed in there, and I want to do an assessment on him and take care of some of that pain.”

  “I’ll take him, Mercy,” Lukas said as the rotor echo of the helicopter reached them and the shadow of a huge bird darkened the landing pad outside. “I’ll be with him as soon as they take Darlene. You’ve got patients in Labor and Delivery.”

  Connie came rushing over to them from the central desk, where she’d been working on her ambulance-run sheet. “We just got word that there’s been another fire.” She glanced at Mercy and grimaced. “Sorry, Dr. Mercy, but it was at your daughter’s school, in the kitchen.”

  The breath left Mercy’s lungs as if she’d been kicked. As the flight team trooped through the automatic doors to collect their patient, and Buck and his buddies unloaded Clarence into room three, Mercy rushed to the nearest desk phone to call the school.