by Radclyffe
Sawyer clicked off. The helicopter turned and circled, seemed to slow, and Norton said, “Stand by. Engaging drogue.”
A bump followed by a shudder streaked through the metal decking beneath Dara’s knees, and then nothing but the unrelenting roar of the motor. Across from her Catherine clutched the shoulder straps of her harness, a wide-eyed stare the only sign she was anxious. Phyllis, the seasoned Navy nurse, calmly continued checking vital signs, adjusting lines, and changing IVs. Dara hoped she looked as cool. Hopefully Sawyer couldn’t detect her racing pulse and jittery stomach.
“We’re coming around for a second pass,” Norton reported in a flat, unemotional tone.
Dara realized she was holding her breath and forced herself to breathe. Getting light-headed right now was a really bad idea. The helicopter twisted and turned some more. The shudder and shake kept up. Sweat trickled down Dara’s back. Wasn’t it supposed to be cold in these damn helicopters?
“We’re breaking off,” Norton said, still sounding as if she was reading a phone book. She was nerveless, and that was somehow very reassuring. “Too much turbulence for a safe deployment of the drogue.”
“Copy,” Sawyer said on the comm-wide channel. “Any adjustment to flight plans?”
“Negative, Colonel. We’re heading to Miami,” Norton said. “Mission objective unchanged.”
“Copy, Chief.”
As the Black Hawk wheeled away from the tanker plane, Dara caught a final glimpse of the hose with the basketlike nozzle on the end twisting back into the underbelly of the aircraft. The plane grew smaller until nothing was visible outside the square window but the unrelenting rain.
Dara went back to her routine. No point asking Sawyer whether they’d actually have enough fuel to reach Miami, which she noted Sawyer had not asked about. No matter what happened next, Sawyer couldn’t change it, and neither could she. Expecting Sawyer to be responsible for all of them as well as everything that might befall them simply wasn’t fair. Sawyer didn’t think of it that way, that was clear, and of all the things that Dara admired about her, that was one of the greatest. That sense of responsibility, that willingness to be accountable, was something she’d come to mistrust when her father had betrayed her family. Not everything about that lesson had been bad, and looking back on those last years of childhood after he’d left, she was grateful in a way. She’d learned very quickly the only person she could hold accountable for anything was herself, and she clung to that when she was disappointed or afraid or lonely.
Now, flying into the face of a hurricane, unable to change whatever her fate might be, she was, if not accepting, at least content to know she was here by her own choice, by her own will, and responsible for whatever might happen. She suspected Sawyer would argue the point, reminding Dara she wouldn’t even be here if Sawyer hadn’t allowed it. Dara heard the words in her mind, saw the flash of confusion in Sawyer’s eyes when she laughed at that. As if Sawyer’s permission was necessary for anything she did. Certainly, Dara accepted Sawyer’s command in a crisis, just as Sawyer supported her when appropriate, but personally? When it came down to Dara doing what she believed was essential—no, she followed no one’s orders. Which made it a good thing she wasn’t wearing a uniform. She’d make a lousy soldier. Fortunately, she and Sawyer weren’t likely to clash over those kinds of black-and-white issues—they each had their own fields of battle—for which she was grateful. She could admire and respect Sawyer’s sense of duty and responsibility without being on guard against it. She’d much rather get closer to her. And now there was a thought she needed to put aside for a later time—a much later time.
She might’ve been imagining it, but the helicopter seemed to be rocking and swaying more than it had before. Perhaps her imagination also, the howl of wind rising above the rotors. She couldn’t possibly be hearing that. Memory, perhaps, of the sound of the storm out on the tarmac before they’d taken off. No matter. The wind could scream and the rain could cut at them, and all she could do, all she needed to do, was take care of the young man entrusted to her. She ran his vital signs again. His systolic pressure was all over the place now, up the first time she checked it, down, then up again. His heart rate had climbed to 160. His temp was at 101.5. He was in trouble, and waiting until she was back in the safe, secure confines of the hospital with every modern diagnostic test available to her was not an option.
She hadn’t trained for the battlefield, but she was on one now. She slid her gloved hand behind his neck and gently palpated around the edges of the surprisingly small bandage the neurosurgeons had left over the linear incision over his spine. She couldn’t see behind the external fixation frame encasing his head, but she wouldn’t be able to until she got him onto a revolving bed where she could flip his whole body 180 degrees without moving his spine at all. That would be his routine every four hours so the ICU staff could check his incisions and make sure he wasn’t developing pressure ulcers. Now she was left with only her senses, and her fingertips told her the slight sponginess of the tissue around the outer edges of the bandage was normal postoperative swelling. If he was bleeding, it wasn’t there. Lucky for him, so far. Bleeding around the spinal cord could rapidly produce paralysis.
She inched lower, wincing as her knees absorbed the pressure from the unforgiving metal floor, and opened the thermal wrap encasing him from the upper chest down. Myers reported they’d taken the bone grafts from his posterior hip area, where it was easy to reach when he’d been lying on his stomach for the surgery. Dara wasn’t going to be able to see that area now either, but after changing to a new pair of surgical gloves, she carefully worked her hand beneath him. She couldn’t feel much but found the bandage over the graft site, and when she removed her hand, the fingers of her gloves were streaked bright red. He was bleeding through his bandages. How much, she couldn’t tell.
She pressed the button on her headset with a knuckle. “Colonel?”
A second later, Sawyer answered. “Kincaid here. Over.”
“He’s bleeding. I can’t tell how much for sure, but I’m afraid his pressure’s going to drop out any minute. What do you have in the way of plasma substitutes?”
“We’ve got cryo. The fresh frozen plasma would take forty-five minutes to thaw.”
“I know. Get me two units of the cryo. We’ll be on the ground before the FFP would be ready.” She hesitated. “Right?”
“Right.” Sawyer edged around the stretchers in the tight confines, opened a storage container, and extracted two units of cryoprecipitate, a condensed version of plasma filled with blood-clotting agents. She passed one to Phyllis and the other to Dara to plug into his IVs.
Norton said, “Fifteen minutes to the LZ. It’s going to be bumpy.”
Dara said, “Can someone radio ahead and get the OR ready. He’ll need to go back STAT to find out what’s causing this bleeding.”
“Copy that.” A minute later Norton said, “The OR will have a team waiting for us at the hospital LZ. They’ll take him straight down from there.”
“Thank you.”
“Everyone else is stable,” Phyllis said, the first communication from her the entire trip. She’d simply worked economically and proficiently as if they’d still been in the ICU on a normal night. “I’ll stay and help you transfer the rest of these patients to the unit.”
Technically, Phyllis wasn’t covered by the hospital malpractice insurance and didn’t have privileges to practice at Miami Memorial. And Dara couldn’t care less. “That would be great. Thanks.”
The helicopter shuddered and plummeted, taking Dara’s stomach along with it. She grabbed for the nearest thing to steady herself, which turned out to be Sawyer’s arm.
“Turbulence,” Norton said unnecessarily. “We don’t have enough fuel to go around the weather. The ride’s going to get a little rough.”
Dara gave herself a minute to regain her equilibrium, the hard strength of Sawyer’s forearm under her grip an unyielding comfort. When she trusted herself not to
topple over, she let go of Sawyer’s arm, even though a part of her wanted to hold on just for the contact. She wasn’t fatalistic and did not want this trip to be her last.
She’d never been one for meditation, so she had no mental calming tricks in the face of the unknown. Instead, she’d had years of dealing with crisis situations. Panic was not in her nature. Gritting her teeth, she ignored the rocking and rolling and pitching of the helicopter and focused on the patients, checking and rechecking, just as Phyllis and Sawyer were doing.
She caught her breath when the helicopter slammed down, jolted up again, or so it seemed, and slammed again.
“Sorry about that.” The pilot’s voice came through the headset. “Welcome to Miami.”
Dara gasped, almost laughing with relief, and glanced at Sawyer.
Sawyer grinned back. “Welcome to the Guard, Dr. Sims. You’re a SAR medic now.”
Chapter Eighteen
Landfall minus 29 hours
When the helicopter doors opened, Chief Norton climbed out and, a few seconds later, signaled the okay to disembark. The engines continued to rev and the rotor kept up its steady whir above Dara’s head, a sound she was going to have echoing in her brain for a long time. A cold wet wind strafed the inside of the Black Hawk, and she reflexively bent over her unconscious patient as she released the clamps on his stretcher and pushed it toward the open hatch. Sawyer jumped out and, when Dara crouched in the doorway to follow, reached up a hand. Dara grasped it and swung down to the rooftop of Miami Memorial. Even through the gloves, she felt Sawyer’s firm grip, and the tension from the chaotic, seemingly endless flight drained away even before her feet planted on the solid surface of the helipad. She had the strange sensation of being home, and for an instant couldn’t distinguish whether it was because she was back at the hospital, or holding Sawyer’s hand.
More questions she had no time to ponder.
“Thanks,” Dara murmured as the OR team hurried across the rooftop toward them. Within seconds she was going to be too engrossed taking care of the transfers to talk, but she didn’t want Sawyer to disappear before she said good-bye. She expected Sawyer to jump back on board, and letting go of Sawyer’s hand took real effort. “Are you leaving?”
“We’ll give you a hand getting all these patients inside. As soon as we get everyone off-loaded, I’m sending the helicopter back to Homestead.”
“What about you?” Dara said.
“I’ll rendezvous with my battalion at the operational command post here in the city. I’ve got to review the provision status in the local evac centers and deploy troops to assist in civilian transport wherever the locals need us.” Sawyer looked out over the city as if she could see through the wall of rain to the streets below, a frown creasing her forehead. For her, that little bit of expression signaled real worry. “At this point, we’re in a support capacity only.”
“Of course.” Dara knew her well enough now to appreciate how hard it was for Sawyer to stand on the sidelines when she wanted to be taking charge. She’d have felt the same way. She had only a second to decide how much she wanted to say. “I know you’re going to be swamped—” She grimaced. “Literally…but if you get a chance—”
“I’ll call you,” Sawyer said with the slightest question in her voice.
“Yes.” Dara smiled. “Not good-bye, then. You have my number?”
Sawyer patted her phone in her shirt pocket. “I do.”
Dara foolishly thought she looked as if she was touching her heart—and the only thing worse than her instant chagrin was the bolt of pleasure that shot straight through her. What was the matter with her? Tired, that was it. Tired and stressed. And out of time as the anesthesiologist and the trauma fellow arrived, heads down in the drenching rain, already reaching for the stretcher with her patient.
“What have you got?” Wen’s senior trauma fellow asked.
“A fresh postop neurosurgical patient,” Dara said as Phyllis and Sawyer lifted the second patient down from the helicopter. Three more hospital staff in scrubs and green cover gowns she recognized from the ICU descended on the next stretcher. “He’s bleeding somewhere. I think his graft site or something in the vicinity. BP’s been bouncing, and he’s got a temp. We’ve given him two units of cryo…”
She jogged along beside them, filling them in on the other relevant details, aware that behind her, Phyllis and Sawyer were seeing to the rest of the patients. Once she’d handed her patient off to the trauma surgeons in the OR, she called Myers. “It’s Dara. You might want to talk to the guys here—we’re taking your postop back to the OR. I think he’s bleeding somewhere around the graft site. He spiked a temp too.”
“Well, hell,” Myers grumbled. “He was juicy when we closed but I couldn’t find anything active. You think it could be DIC?”
Dara’s stomach twisted. Disseminated intravascular coagulation was a disastrous and often end-stage event, frequently related to severe infection. “I don’t know. They’re getting fresh labs now.”
“Okay. Who do I call?”
Dara gave her the OR number and the name of the attending surgeon, then headed to the ICU to check on the other transfers. By the time those five were all settled and she’d discussed their cases with the ICU attending and called Randall with an update, two hours had passed and Sawyer was long gone. She missed seeing her nearby, missed the surety of her presence, missed her fleeting and uncensored laugh. She was just really tired.
She slipped down the stairs to the ER back entrance, cowardly avoiding the main desk and the rack of pending case charts, and hid out in the break room to have a cup of coffee and catch up on the last twenty-four hours’ worth of messages.
She’d taken one sip of fresh hot coffee—praise all the powers that be—and before she could even open her mail, her phone blared with its emergency message tone.
1:05 p.m.
Florida State Disaster Management Division
Evacuation Update
Storm tracker models now predict Hurricane Leo will make landfall in the direct vicinity of the Miami metropolitan area. Mandatory evacuation orders are now extended to all Zone A, B, and C regions.
Dara’s breath caught. The new evacuation orders changed everything and, really, nothing at all. Her job remained the same—to coordinate the emergency medical relief efforts between civilian emergency response teams, the National Guard, and Miami Memorial. But the hospital was also filled with patients and staffed by hundreds of individuals, all of whom were now in immediate danger. In addition, many had family in the evacuation zone. The protocols for this crisis situation weren’t open to debate, and she didn’t plan on wasting time with more meetings. She texted the department heads in a group message:
Per the latest state mandate, an emergency evacuation order is now in effect. Any patient deemed medically stable should be discharged within the next twenty-four hours. Elective surgical, interventional radiology, and diagnostic procedures are immediately canceled. Non-mandatory personnel duties are suspended as of the end of first shift today.
The hospital would go to minimal function over the course of twenty-four hours. The emergency room would remain open, as would all critical care units—medical, cardiac, surgical, trauma, and neonatal. Staff members covering those units would most likely be working double or triple shifts until the emergency situation resolved.
As Dara finished the text, exhaustion swept through her like a dull gray curtain dropped over her senses. She sipped the coffee, leaned back, and squeezed the bridge of her nose. She was running on less than four hours’ sleep in the last several days, and she’d need to crash soon to catch up before further rest became an impossibility.
“You ought to get out of here,” Penny said, sliding into a seat across from her.
Dara jumped, sighing wanly as she opened her eyes. “I was just thinking the same thing myself. I’ll try in a little while.”
“How was the helicopter trip?”
Dara grimaced. “Rough ride with no
parachute. Not something I want to repeat right away.” She smiled a little, remembering the sense of being part of something unique, of the teamwork—of being challenged and winning. “Although, I have to admit, now that it’s over, parts of it were fun.”
“The part having to do with the super-hot colonel?”
Dara blushed and knew it. “I certainly won’t deny she’s hot.”
Penny snorted. “Well, yeah. Anyone with eyes could see that. How was working with her?”
“Oh, she’s good. An excellent medic, cool in a crisis, and knows how to lead.”
“Sounds like your kind of woman.”
“I think I just described a highly skilled professional, so, yes. The kind of associate I respect.”
“And that’s it?”
“What more were you looking for?” But she knew. Penny wanted her personal opinion—did she like her, enjoy her sense of humor, find her interesting, attractive. Yes, yes, yes, and very much yes. So she kept quiet. Too soon to say all that out loud.
“She watches you, you know.”
“How on earth would you know that?” Dara asked.
“I only had to see the two of you together for about thirty seconds. No matter what she was doing, you were on her radar.”
“Penny,” Dara said, pleased but disbelieving, “we were dragging patients out of the helicopter across the roof into the elevator in a torrential downpour. There was hardly any time for…anything.”
Penny shook her head. “You obviously have not dated in too long a time. You can’t even read the signals anymore.”
“Sawyer is not the kind of person to send signals,” Dara said. “For God’s sake, Catherine Winchell—” She frowned. “Where did she get to?”
“The blonde?” Penny said. “I noticed her with a camera. I think she went up to the OR, but I’m not sure. What was she doing with all of you, exactly?”
“She’s a reporter for Channel 10 on assignment with the National Guard. She’s following the storm preparations and breaking weather developments. She joined us at Homestead and went with us to Key West.”
