Dangerous Waters

by Radclyffe

  Sawyer smiled. “How do you know? You haven’t even read my bio.”

  “I don’t have to.” Dara shook her head. “Unless there’s something in there besides you being one hundred and ten percent soldier.”

  “Not a thing.”

  Sawyer’s expression shuttered closed, and Dara instantly knew there was something Sawyer Kincaid wanted left in the past. Knowing that made her a little more human, even if it didn’t make her any less arrogant and irritating.

  Chapter Seven

  “How about that tour?” Sawyer said.

  Dara almost laughed. Obviously her little show of temper, what she’d managed not to contain, hadn’t fazed the good colonel a bit. Confident was probably too mild a word for her. Or maybe she just ignored what she didn’t agree with and figured when the time came, she’d do whatever the hell she wanted. Well, she’d be in for a surprise if she thought she’d be taking command in this ER. All the same, something about Kincaid’s arrogant charm was appealing, as much as she hated to admit it. She’d always been drawn to self-assured women, in and out of the bedroom. And, whoa, what murky subterranean cave in her subconscious had that non sequitur crawled out of? Sawyer Kincaid and sex did not belong in the same universe. Doing business without fireworks was going to be hard enough, let alone juggling anything personal.

  Full stop. End of that line of thought STAT.

  What had Kincaid just asked? Tour. Like this was an amusement park or something. Okay, now she was just being snarky because the woman had gotten under her defenses and made her lose her temper. Really, she never let anyone close enough to do that. She must just have been taken by surprise. She wouldn’t let that happen again. “Sure, why not. Let me email the ERT—sorry—emergency response team, and set up another meeting. It’ll take at least half an hour for them to get back down here.”

  “Let me guess, administrators?”

  “Most of them, but they’re all highly qualified and serious about their responsibility,” she said, mentally crossing her fingers when she thought about Gretchen, whose interests leaned more toward self-promotion than upholding the hospital’s mission, “but they’re used to taking more time to make decisions than we are. All except Wen, the trauma chief.”

  “I understand,” Sawyer said as they walked out into the hall. “A lot of the people making decisions for the military have never stepped onto a battlefield.”

  “It makes a difference, doesn’t it,” Dara said softly.

  “You mean when you actually get your hands bloody?”

  “Yes.”

  Sawyer nodded. “You have to experience the way time collapses, as if every second lasts an hour and every minute goes by faster than a heartbeat, to understand what it’s like to make critical decisions that mean life or death for your troops.”

  “Or your patients,” Dara said softly.

  “Pretty much the same thing,” Sawyer said thoughtfully.

  “That’s why we do what we do, right? Because we can.”

  Sawyer smiled, a half smile that held as much pain as truth. “Because we have to, maybe.”

  Dara’s breath caught. How could she be having a conversation with a near stranger that she’d never been able to have with anyone close to her, even some of the women she’d had relationships with? Maybe that was why they never lasted very long. “I guess that’s why we need to keep clear boundaries—we each may have tough calls to make, and we can only do that alone.”

  “Believe me, Dr.—”

  “Dara,” Dara said, “since we’re going to be on the same team, more or less.”

  Sawyer grinned. “Then you have to call me Sawyer.”

  “I dunno.” Dara tilted her head, pretended to consider. “I rather like calling you Colonel. It’s all stiff and proper sounding.”

  Sawyer laughed. She didn’t mind being typecast, although the playful note in Sims’s—strike that—Dara’s voice took any edge off the assessment. Dara’s teasing smile was as unexpected as the curling heat stirring in her belly. She liked the smile, wouldn’t mind instigating a repeat. Too bad she probably wouldn’t get much of a chance. Still, she could enjoy it now. “If it suits.”

  “Oh, believe me, it does.” Dara heard the slightly flirtatious tone in her voice and wondered where the hell that had come from. What was she thinking? She never flirted, not even when she’d been young enough and hormonally immature enough to want to capture a girl’s attention. She had just resolutely refused to use one of the tools every other girl she’d known, and a lot of her mother’s set as well, had employed by second nature. Maybe their teasing looks and playful banter had been harmless, but she’d needed to break free of the mold, and the expectations that came with it. At the moment, though, poking a bit of fun at Colonel Sawyer Kincaid was surprisingly enjoyable, especially when Kincaid grinned back at her as if amused, and…pleased. The dancing humor in Kincaid’s eyes and the way the corner of her mouth broke the harsh line of her jaw, softening it in an incongruous, almost vulnerable way, felt like a reward. Dara blinked the vision away. “No insult intended, Colonel.”

  “None taken. I was about to say, Dara,” Sawyer said, with an emphasis on her name, “that I…” She frowned, dark brows lowering over her eyes. “Hell. I can’t remember.”

  Dara laughed, delighted. At least something could put the stoic colonel off her stride, although she never expected it would be teasing. Did the woman never relax? “Come on, I’ll point you in the direction of good coffee.”

  “For that, I would be eternally grat—”

  Penny rushed around the corner, calling, “Dara! Two level ones coming in back to back. Gunshot wounds.”

  “How soon?” Dara said, already moving down the corridor in the direction of the three trauma bays.

  “ETA two minutes out. They were practically around the corner from us.”

  “What’s open?” Dara pulled off her white coat as she half ran past the receiving area and treatment cubicles, some with curtains drawn, the rest standing open in wait.

  “One and two are both clear,” Penny said. “We’re setting up in there now.”

  “All right, get anesthesia down here and put trauma on standby. Who else is free to take one of them?”

  “Carla has an MI who’s crashing and can’t leave him. Jeremy is just finishing up a lower extremity cast. The resident ought to be able to do that.”

  “Good—get Jeremy into two and find me a resident. We’re good enough for now. Let’s go.”

  She was turning the corner toward trauma admitting before she remembered Sawyer. The double doors from the ER receiving area slid open, and paramedics pushing two stretchers poured through, wheels clattering, monitors beeping, several of them already shouting vital signs to the ER staff who met them in the hall.

  Battle engaged. Everything else would have to wait now.

  Dara grabbed a cover gown and pulled it over her arms, letting it hang loose in the back, as she ran to meet the first stretcher.

  “In one,” she called to the young red-haired paramedic who pulled the stretcher at breakneck speed. The paramedic’s stethoscope jumped around her neck with every stride, a frantic metronome ticking off precious seconds, all that might remain for the patient.

  The patient’s face was obscured by the tape encircling an endotracheal tube and a wad of blood-soaked gauze over his lower jaw and neck, but at a glance he looked to be a young Caucasian male. More blood saturated the sheets beneath his head and shoulders, and a crimson trail of fresh droplets followed the stretcher down the glaringly lit hall like a line of lost children. Bright red blood spurted from beneath the bandage the second paramedic, a burly Latino with a grim set to his jaw, pressed to the man’s throat. Arterial and profuse.

  “GSW to the neck,” the big guy said. “I’m not sure the tube’s in. We couldn’t see a damn thing, too much blood in the airway.”

  Dara cut a quick look at the O2 monitor. Seventy. They weren’t aerating him.

  “We might have a lung
down,” she said, “or the tube slipped out of position. Let me have a look down there.” She caught Kirk’s eye. “Get an endotracheal tube and a trach tray ready. We need to be sure we’re in the trachea.”

  Kirk, the first-year resident who rarely seemed to break a sweat over anything, nodded, his face pale and his quick breaths pulling the cotton fabric of his mask in and out in erratic bursts. He found an intubation tray on a shelf behind them and ripped open the sterile covering. He moved aside as Dara pushed to the head of the table and grabbed gloves from a box on the counter.

  “Hand me some suction,” she said, sliding the lighted retractor into his mouth and toward the back of his throat. Blood and bits of bone immediately flooded her field. “Penetrating wound here. Get trauma down here right now. He needs a trach.”

  “Wen’s on his way,” Penny called.

  “Dara,” a man shouted from the doorway, his voice barely carrying above the din of monitors, ringing phones, and staccato orders. “Patient in two is crashing. Jeremy needs to put in chest tubes and needs more hands.”

  “Kirk—go,” Dara said without looking up from the debris field. If she could just get a clear look past the epiglottis—

  “We lost his pressure and his pulse,” the female paramedic announced.

  “Damn it,” Dara muttered. “We need more lines. Where’s the damn blood? Pen?”

  “On it,” Penny replied.

  From beside her, Sawyer said calmly, “Where do you want me, Dr. Sims?”

  Dara looked up. Sawyer was gloved and gowned.

  “Can you get a big line in him?” Dara said after only a second’s hesitation. Right now, the only thing that mattered was the patient, not protocol, and she was short of hands. “He’s bleeding out.”

  “Femoral good enough for you?”

  “Just give me a hose in there,” Dara snapped.

  “Done.”

  Sawyer looked over her shoulder and caught the eye of the nurse who seemed to be everywhere at once. “Cut down tray?”

  “Here you go.” Penny wheeled over a stainless steel tray and tore open the instrument pack. “Penny Arnaux.”

  “Sawyer Kincaid.”

  “What do you want for a line?”

  “IV tubing.” Sawyer made a five-centimeter incision just below the groin crease on the patient’s right thigh. As she worked her way down through the fatty tissue, Dara’s voice overrode all the chaos, issuing instructions, maintaining order, keeping everyone on task. Calm, controlled, certain. Sawyer relaxed into the zone—focused on her mission, confident in the command.

  The femoral vein came into view and she picked a large branch just below the half-inch-wide blue ribbon as thick as her thumb. Beside it, the femoral artery lay pale and weakly fluttering. No blood to pump. Pretty soon his limbs and organs would begin shutting down, then minute by minute, his body would die. Hands steady, she uncovered a major branch off the femoral vein.

  “Get the tube ready,” she said.

  “All set to go.” Penny pressed so close to her side, Sawyer could feel her heartbeat.

  She nicked the side branch, held it open with forceps, and slid the sliced-off end of an IV tubing directly into the vein.

  “Open it up,” Sawyer said. Clear fluid began pouring through the quarter-inch tube directly into the patient’s main blood vessels. It wasn’t enough, he needed blood, but it was what they had. “Got something to tie this in with?”

  “Here you go.” Penny dropped a suture pack into her field. “Pretty work, Colonel.”

  “You’ve done this a time or two yourself.” Sawyer tied the IV tubing in place and straightened. “Thanks.”

  “Run saline straight open in there until we get blood.” Dara slid a new endotracheal tube into the patient’s airway. Blood spurted out the top of the tube and streaked her mask. She quickly suctioned out the tube and hooked it to the ventilator. The readout on the O2 monitor started to climb. “Call the blood bank again, Pen.”

  “I’m on it,” Penny said.

  Sawyer closed the skin incision in the leg with a couple of staples from the instrument pack.

  “Damn it, there’s a lot of blood down there.” Dara suctioned the endotracheal tube again and fresh blood poured out. “Where the hell is it coming from?”

  “Probably hit the trachea on the way through his neck before going up and out his jaw,” Sawyer said. “Either that or he’s bleeding from a branch of the carotid in the back of his throat.”

  Dara met Sawyer’s gaze. She didn’t say what they both knew. If he was bleeding in the mess of torn and swollen tissue in the back of his throat, they’d never find it. They wouldn’t have time.

  “We’re not losing this one,” Dara said. “We’ll just have to keep up with the blood loss until—”

  “What have you got for me,” a cheerful male voice said from behind them.

  Dara said, “Hi, Wen. Gunshot wound to the neck, took out part of his posterior mandible. Blood everywhere. Can’t tell if the trachea’s nicked or not. There’s too much blood in the airway.”

  “Got a chest X-ray yet?” The trauma guy sauntered over to the table, pulling on gloves. He was shorter and lighter in build than Sawyer, but he gave off an air of being much bigger. His cover gown hung loose off his shoulders, his mask untied and dangling around his neck. Cavalier—relaxed. Looking like he was on his way to a party. He glanced at Sawyer, took in the oak leaf on her collar above the gown she’d pulled on, and raised his brows.

  “Welcome to our little corner of the war, Colonel,” he said. “Major Wen Haruke, Army Reserve.”

  “Pleased to be here, Major.”

  “Permanent deployment?” Wen said as he reached for a headlight hanging from a hook above the counter behind them.

  “Short-term placement.”

  “If you two are done bonding,” Dara said dryly, “can we get this guy out of here and up to the OR?”

  “I’ve got blood,” Penny said, dropping six units of whole blood onto the bed. She read off the name on each one: John Doe, patient number 20144479. “All match.”

  “Go ahead, Pen, hang it,” Dara said, and she hooked a bag to the right arm IV. “Sawyer, can you hang one in that leg line?”

  “Copy that.”

  With three units of blood pouring in, his pressure crept up.

  Wen edged the paramedic aside, replacing his hand on the bloody gauze, and peered underneath at the neck wound.

  “Yep, that’s a gusher,” he said, as if describing the weather. “Must’ve just nicked the external carotid, or he’d have bled out by now. Put your finger back on there, buddy.”

  “I’ll take that, Major.” Sawyer put pressure on the wound. The artery beat feebly beneath her fingers.

  “Thanks.” The paramedic stepped back, sweat streaming down his face, and let out a long breath. “Man, it’s going to be a long day.”

  Sawyer wished a long day was all they faced, but then, that’s why she was there. The battle was just beginning.

  Chapter Eight

  Landfall minus 5.5 days, 2:30 p.m.

  Dara pulled off her cover gown, wadded it into a ball, and tossed it into a laundry receptacle by the door. She stood in the doorway of trauma bay one, pulse racing, skin as sensitive as if an electric current raced beneath the surface, listening to the clatter of wheels and receding jumble of voices as Wen, Penny, and one of Wen’s trauma fellows pushed the patient’s stretcher down the hall toward the elevator. Behind her, the housekeeping staff had already begun the task of gathering the discarded package wrappers, empty IV bags, and bloody sponges littering the room before mopping and disinfecting the bloody tile floor. She’d always thought of the aftermath of an alert like the abandoned battlefield, and conscious of Sawyer beside her, wondered if she’d even been close to imagining the reality. How could she really know?

  “Was it anything like what you’re used to?” she asked.

  “In some ways,” Sawyer said from beside her. “You’d do well in the theater, Dr. Sims.�
��

  Dara snorted. “I’m not sure about that, not if people were shooting at me at the same time.”

  “Sometimes they are,” Sawyer said. “Other times, you’re in the belly of the Black Hawk, the gunners are firing, the air is rushing through the open ports, and you can’t hear anything except your own heart beating in your ears.”

  “That must be terrifying,” Dara said.

  “It probably should be, but there’s just no time for fear in the middle of a firefight.” Sawyer shook her head. “That comes later for most of us, if we’re lucky. If you wake up in the middle of the night afraid of the next callout, that’s bad for everyone.”

  “If you falter, someone dies,” Dara murmured.

  “Yes,” Sawyer said.

  Dara pictured what they’d just been through taking place in a helicopter, surrounded by smoke and fire and death on the wing. What kind of training would it take to enable someone to ignore their fear, to disregard the possibility of their own death and make critical decisions under those conditions? Or did only those who already kept their emotions under lock and key ever make it that far? She’d always thought she’d chosen emergency medicine for its immediacy—for the satisfaction of solving a problem, administering treatment, and bringing closure to the situation. Endings were important to her—clean and sharp and certain. Maybe she’d been fooling herself—maybe she chose to live with death as a sign of her failure because somewhere in her past, she’d closed off the part of herself that wept for loss.

  Dara rubbed her eyes. What did it matter, after all this time, why she was here? All that counted was that she did what needed to be done. “I need to check on Jeremy and the other trauma patient.”

  “Sure.”

  Dara stuck her head into trauma bay two. Jeremy Gold was an experienced ER physician, ten years her senior. She trusted him to handle just about anything, but every patient who came through their doors was ultimately her responsibility. “Everything under control, Jer?”

  “All good.” Jeremy—tanned, blond, buff, and looking for all the world like a stereotypical beach bum—stepped away from the table and pulled down his mask. He looked as fresh as if he’d just arrived, not having just ended a grueling alert. Only the patina of sweat on his forehead revealed how hard he’d been working. “He’s probably got a perforated lung. Lotta blood coming out of the chest tubes, but his pressure’s holding and the O2 sats look okay. They’re getting another trauma room ready for him upstairs. Angie Eastwood is on her way down.”