by Cari Hunter
“Yeah, you’re sacked.” Meg couldn’t see much of her patient, but judging by the expressions of the Helimed crew, they had had a fraught journey even before they were subjected to the newbie’s driving. It was only when one of the men moved that Meg noticed Sanne sitting on the seat by the bulkhead. She looked pale and shaken, and was dressed in running shorts and a jacket far too large for her. Meg raised an eyebrow at the state of her legs, which looked as if someone had taken a cheese grater to them.
Sanne must have caught her reaction, because she straightened her back and shook her head once, warning Meg not to make a fuss. She took the hand Meg offered, gave it a quick squeeze as she climbed down from the ambulance, and then stepped aside to allow Meg to focus on her patient.
The clatter of the stretcher wheels against the lift prompted Meg to follow her lead. “Shock room please, chaps,” she said, turning to escort the stretcher down the corridor. Her initial visual assessment of the woman had made her hands start sweating in her gloves. With someone in such a critical condition, everything was against the clock.
Due to its helipad and specialist neurosurgery unit, Sheffield Royal had been a designated Trauma Centre for just over a year: ambulances and Helimed routinely bypassed local hospitals and transported the more severely injured patients to the Royal for expert care. Once the woman had been transferred onto the hospital bed, Meg’s team knew to stop what they were doing and listen to the Helimed doctor as he handed his patient over.
He cleared his throat to ensure that his voice carried above the rasp of the vent and the sound of someone moaning in the next bay. “Patient is an unidentified female, found unconscious at the base of a cliff. The exact mechanism of her injuries is unknown…”
Meg scrutinised the woman as she listened, matching the vital signs on the monitors to the physical signs: the rising blood pressure indicating an intracranial bleed; the telltale contusions around her eyes, typical of those caused by a fractured skull; and the slowing pulse and single blown pupil that warned that the woman needed surgery within the next few hours if anything resembling a life were to be salvaged for her. Even though Meg tried to consider the overall picture, the sheer horror implied by the smaller details made them stand out: ligature marks, abrasions around the woman’s lips, torn or missing fingernails, and the filthy underwear that was revealed when the blankets were unwrapped. She was gaunt and dehydrated, with a succession of bruises and track marks over the veins at her inner elbow suggesting repeated injections administered by an inexpert hand. Meg added a toxicology screen to a mental list that was growing longer by the second.
“That’s great, thanks,” she said as the Helimed doctor indicated he had finished speaking. “Sahil, you happy with her airway?”
The anaesthetist nodded. “Tube’s fine, but there’s resistance to the vent, and air entry is poor on her left side.”
“She’s got a lot of bruising on that side of her chest,” Meg said. “Okay, let’s not bugger about waiting for an X-ray series. We’ll get a drain in, see if that improves things, and then get her down for a full CT, ASAP. Any word from Neuro?”
“Thirty minutes,” Liz said, “but that was twenty minutes since. Dr. Maxwell got held up in theatre.”
A clock had been set running at the start of the trauma call. Meg noted its time and added another ten minutes to Liz’s estimate. Neuro were notorious for being late to every party.
“Right.” She rocked back on her heels as she finalised her plan of action. For some reason, the motion always helped her to think. “That gives us a chance to get the drain in, ABG, catheter, and urinalysis. Type and cross for at least six units, and take the usual bloods, including a tox. Shout up if you spot anything Helimed might have missed, and bag everything, please. We have a detective here waiting for the clothing, so remove it in one piece if possible.”
Sanne was at the back of the small room, pressed up against a clinical waste bin and feeling she was taking up too much space even so. When she heard Meg mention her, she stepped forward, arms laden with the evidence bags Nelson had just given her in the corridor. He had offered to do the task himself, but one look at her face had stopped him pushing the issue. The rope she had cut from the woman’s wrists was already sealed and tagged. She set the container where she could keep a close eye on it and opened another large paper bag for the blankets a nurse had collected.
“Fold them inward,” she said, trying to make things easier for the labs. “That’s perfect, cheers.”
She scrunched the top of the bag over, recorded the time and date, and added her signature. As she did so, she heard Meg swear, and she looked up to see blood pouring through the wide plastic tube Meg had just pushed into the side of the woman’s chest.
“Bollocks,” Meg said. “If this doesn’t slow, we’ll need to get Cardiothoracic down here.”
“Her sats are improving, though,” the Asian man standing behind the woman’s head said with more optimism.
It took at least another minute before Meg responded, but a smile gradually spread across her face. “Tapering off at about seven-fifty mils, so that’s a bullet dodged. How are we doing elsewhere?”
Sanne listened to the different voices reporting numbers and procedures. The terminology and the significance of the figures were meaningless to her, but Meg seemed to take it all in her stride, not once asking for clarification or for anyone to repeat themselves. Sanne had never seen her working a major trauma before. Thinking back to the previous night’s curry sauce disaster, she was slightly awed by Meg’s calm command over her team.
“Detective?”
The same nurse who had given Sanne the blankets held out the woman’s underwear gingerly. A pale blue bra went into one evidence bag, and knickers that had once been cheerfully patterned went into another. It was a mismatched set probably chosen at random, the woman never imagining it would be seen by a room full of people fighting to keep her alive.
Sanne closed the bags and rubbed a hand across her eyes, swiping at the tears before they could form properly. It was dangerous to let her guard down and think like that. She couldn’t do her job if she fell into that trap. Grateful for the excuse to drop out of sight, she crouched by the door to annotate the bags.
The door nudged against her thigh as someone pushed it open, and a disembodied voice called across to Meg.
“CT are ready when you are, and Dr. Maxwell is on his way down.”
“Fabulous.” Meg peeled off her gloves and reached for a fresh pair. “Tell Max to meet us at the scanner. We’ll be there in five.”
*
Left behind in the shock room, Sanne gathered up the evidence bags and paused, leaning against the wall. Her ears buzzed, and a dull throb behind her eyes warned of an impending headache. She hadn’t drunk enough, she had barely eaten anything, and she had been functioning under constant stress for hours. Just another day at the office, then, but she’d never experienced a day quite like this one. She cradled her left arm where Meg had gripped it. When she had winced beneath the touch, Meg had quickly released her. “Don’t go anywhere until I’ve taken a look at you,” she had told Sanne in a peremptory tone, before leaving to follow the stretcher to the scanner.
Annoyed at herself for wasting time, Sanne pushed open the door with her backside and carried the bags into the corridor. Two uniformed officers came over to help.
“Thanks,” she said, as they added her bags to the pile already stacked on a wheelchair. “Is Detective Turay around?”
“He just went outside to take a call.”
Sanne glanced at the exit with a degree of uncertainty. She wanted to check in with her partner, but she was reluctant to leave her post. Meg had told her the scan would take at least twenty minutes, though, so she decided to take the risk.
“If I’m not here when they bring her back from CT, come and find me,” she told the officers. Their bemused reaction made her pause, and she shook her head, embarrassed. “Sorry, I’m Detective Jensen.”
&n
bsp; “Oh.” The older of the officers flushed to the roots of his auburn hair. “We heard someone had been out on the moors with the vic, but—”
“But you didn’t know to look for a detective in shorts.”
“Exactly.” He smiled, his flush receding a little. “I’ll come and fetch you as soon as she’s back.”
“Ta. Appreciate it.” She was already walking toward the open doors, beyond which Nelson’s voice was just about audible amid the chatter of sparrows nesting beneath the ambulance bay’s canopy. Sanne knew Meg loved those sparrows and regularly flaunted hospital policy by leaving crumbs for them on the bins flanking the doors. As she waited for Nelson to finish on the phone, she found herself scanning the bins for telltale scraps of bread, but all she found were cigarette butts and a discarded piece of gum. She moved closer to the sunshine instead, wishing her day off had turned into anything but this.
“Hey, San.” Nelson spoke quietly so as not to startle her. She hadn’t noticed his approach. He tucked his phone back into his pocket. “Where are we up to?”
“Shouldn’t that be my line?” They walked into a shadier part of the bay, and she lowered the hand that had been shielding her eyes. “Was that the boss?”
“Yep. She’s out on the moors with SOCO.”
Sanne licked her dry lips, loath to ask anything else. Forewarned was forearmed, though. “Is she…?” She swallowed and tried again. “Did I—”
“Is she coming here to haul your arse over the coals?” Nelson offered. “No. And you did fine, so don’t look so bloody terrified.” He barely gave her time to process that before he continued. “I uploaded the photos and video from your mobile and sent them to SOCO and the boss. They looked good. You picked out some useful details. SOCO, EDSOP, and a team of uniforms are going over the immediate scene. The boss is planning to get volunteers involved, too, so we can widen the search.”
“The victim was held out there somewhere,” Sanne said. “The state she was in, she can’t have run far.”
“That’s one possibility. The other is an escape from a vehicle crossing the high routes or off-roading,” he countered. “Or, the perp got bored with her, took her out there, and chucked her off the ridge.”
Sanne felt a familiar exhilaration as she weighed up the theories. She and Nelson always worked well like this, bouncing ideas off each other. She had barely had a chance so far to think any of this through, but she loved these first, analytical hours of processing a new case.
“National Trust rangers and Mountain Rescue are helping to pinpoint the closest roads,” Nelson said. “Roads, and any areas with vehicular access.”
She nodded. If her original supposition was correct, the woman’s assailant would have struggled to get her onto the moors, unless she had been hiking out there at the time of her abduction. Which begged the question: was he an opportunist, or had he planned this in advance? Sanne wasn’t sure which was the more frightening answer. She frequently jogged alone up there and had never considered herself in danger from anything but the weather and the terrain. “Are the two lads okay?” she asked, changing the subject.
“They’re upset, understandably, but their parents met them at HQ, and they’ve both managed to give detailed statements.”
“Already?” She squinted at her watch. “God, is that the time?”
“Time for lunch. The boss said to get a statement off you, but I’m sure she meant to say that you were to eat something first.”
Sanne shook her head and tried not to grimace at the pain the motion caused. “No, I can’t do a statement yet. I want to stay at the hospital.” It came out more desperate than she had intended, but to his credit Nelson just nodded.
“How about two ibuprofen and a cup of tea?”
She smiled and leaned into him briefly. “Now you’re talking.”
*
If Meg had been a betting woman, she’d have just won herself a fiver. She found Sanne, as predicted, exactly where she had last seen her, pushed up against the shock room wall, waiting to continue her task, with more empty evidence bags at her feet. She had been scribbling in a notepad, but as the team returned, she lowered the pen and cast Meg an expectant glance.
“Not good,” Meg mouthed. Surrounded by colleagues, she was unable to break the news gently. “Give me a few minutes, okay?”
Ever the professional, Sanne nodded, her face betraying nothing, but her pen slipped unnoticed from her fingers and rolled beneath the bin. Meg turned away, quelling a sudden impulse to wrap Sanne in a blanket and march her into a cubicle for some much-needed TLC.
With perfect timing, someone thrust a Polystyrene box from the blood bank into her hands and motioned that she should sign for it.
“Thanks,” she muttered, crosschecking the contents and scrawling her name. “Max, you want a unit of this up now?”
“Lovely. Yes, please,” Max called back.
The scan results had made this Neuro’s show to run, and they were finalising arrangements to take the woman to theatre. Their plan was to cut into her skull to try to relieve the pressure from the intracranial bleed. They might remove a section of bone to create extra space for the brain or to suck out the clot that had formed, or they might open her up and realise their efforts were futile, that all they could do was try to make her comfortable. The skull was essentially a closed box. Either the swelling from her injury would subside, or it would squash her brain until her vital functions failed. For someone who had survived so much trauma already, such a death seemed particularly vindictive.
Meg took her fury out on the tangled IV tubing in her hands, snapping it taut and daring it not to fall into place. The woman’s arm was cold and slack beneath Meg’s fingers, as if her body was already coming to terms with her prognosis and beginning to shut down. The blood ran through the line when Meg opened it up, but there was no miraculous transformation as it hit the vein, no flush of healthy colour or twitch of movement—not that Meg had expected one.
“We’re good to go,” Max told her.
“Right.” She pulled the blanket back over the woman’s arm. “Anything else you need me to do?”
“No, thanks. We’re as ready as we’ll ever be. I’ll give you a call when we’re done, okay?”
“Okay.” She didn’t move as the bed was wheeled from the room. Within a few minutes, most of the team drifted away to clean, restock, or write up retrospective notes. It was only when the last person had left that Sanne approached her.
“Hey,” Sanne said.
Meg let out a shaky breath. She felt weirdly disconnected. She knew she should be doing something but couldn’t figure out what. “Hey, yourself.”
Sanne’s fingers closed around hers. “Come on, love. I’ll make you a brew.”
*
Half a mug of tea and a shortbread finger consumed in the refuge of the staffroom had Meg feeling more like herself again. From behind the rim of her mug, she watched Sanne alternate between tea and biscuit, never using both hands.
“So, where are you hurt?”
In a series of guarded movements, Sanne set down her mug and brushed invisible crumbs from her knees. “Nowhere. What do you mean?” she mumbled, looking at the floor, her ears turning pink.
“Sanne Jensen, you’re a terrible liar. This is why Mr. Kincaid always used to give us detention, because you were bloody useless at telling a simple fib.”
Sanne paused mid-sweep. “I never wanted to take that shortcut! I loved running cross-country. You were the lazy arse who insisted we go across the turnip field.”
The memory made Meg grin. Unbeknownst to them, Kincaid had been lurking on the section of route they had bypassed, and he had rumbled their shortcut fair and square.
“Always such a swotty little thing.” She smoothed Sanne’s unruly hair from her forehead. “You want a hand taking your coat off?”
Sanne shook her head, excuses already tumbling from her lips. “I’m fine. I need to get back to work, start writing everything up. The boss will be
wondering where I am. You’ll have to give a statement—I can ask Nelson to take it—and you’ll phone me as soon as you hear anything, won’t you?”
She tried to stand, but all her strength seemed to desert her. Her shoulders sagged, and tears brimmed in her eyes. She wiped her nose heedlessly on the sleeve of her borrowed coat.
“God, Meg, I thought she was going to die on me. It felt like forever out there before the chopper came, and I couldn’t do anything for her. All I could do was keep her fucking head still and tell her she’d be okay.” She ran out of breath and gave a single sob. “And she’s going to die, isn’t she? So I can tell a fucking lie after all, can’t I?”
She tensed when Meg reached for her, but then she pressed her face against Meg’s neck and let herself be held. Meg rocked her gently, the aimless motion calming them both. It was less than a minute, however, before the sound of voices in the corridor made Sanne pull away. She took the tissue Meg offered her and blew her nose.
“What did the scan show?” she asked, using the same tissue to dry her eyes.
“Multiple skull fractures.” Meg stroked the back of Sanne’s head, surreptitiously checking for bumps. “And a clot from a bleed. Maxwell—the neurosurgeon you saw in the shock room—he’s going to try to remove it, but it was pretty big, San. Even if he’s successful, it may have caused irreversible damage.”
Sanne sat up properly, pulled her knees beneath her chin, and wrapped her right arm around them. She was staring at her muddy trainers when she spoke again.
“Was she raped?”
“I don’t know.” Meg saw Sanne’s confused glance. “There wasn’t time for a rape kit. We’ll need to get someone over from St. Margaret’s to do that. The nurse who catheterised her didn’t note any signs of trauma to her genitals, though—no bleeding or discharge. None of the typical injuries you’d see in a sexual assault, either. No bite marks or bruising to her thighs or breasts.”
