Jack’s voice was low. “But is that actually true? You suspect that this is an unknown strain of meningitis. The first antibiotics tried don’t seem to hit the mark. Now it’s up to the second. Are these boys really safe?”
Amber blinked back the tears threatening to appear in her eyes. “No,” she said quietly. “Particularly when we don’t know if our treatment is the right one. There’s still a chance they could die—or have lifelong aftereffects.”
She could see Jack’s brain was trying to make sense of this all. His natural instinct as an army doc would be to prioritize. For a second there was a flash of something in his face. Something that made her step back. He looked as if he was trying to suppress his urge to take over. It was only the briefest of glances. But it brought back a surge of old emotions that she constantly felt around her father—as if she wasn’t good enough for this. As if she couldn’t possibly be good enough and someone like Jack, or her father, would have to step in and take over.
Her skin prickled. She hated that. Hated associating someone she’d just met with her father.
It wouldn’t be the first time. She’d often met other doctors—particularly surgeons—who had the same old-fashioned attitudes and opinions. People who wanted to be in charge of everything—including her. These were the people she avoided wherever possible. Was Jack one of them?
Even that tiny flash of recognition in her brain would usually be enough to make her turn in the other direction. But in the circumstances, that was hardly possible.
The nurse interrupted her thoughts. “We’re actually going to try and move these guys. They’ve done that in some of the other wards. Most of the corridors and central areas are full—and we have a lot of equipment we need to take. Someone is preparing a space for us down in the basement.”
Jack’s frown deepened. “Okay. We could help here. We should prioritize. Should we really be taking patient histories for close contacts right now when we might have no hope of reaching any of these people in the next few hours?”
Anger flared in her and Amber swallowed. She knew he was right. But she also knew how sick people could become with meningitis. She spoke in a low voice. “Jack, you offered to help. Not to take over. This is my specialty area, not yours. Of course I know this might be futile. But up until a few hours ago the hurricane wasn’t heading in this direction. It might still turn. The prediction could be wrong.”
Jack held his hands out. “Does it feel wrong to you right now?”
She held her nerve. She wouldn’t let him tell her how to do her job. “Maybe not. But what if something happens to one of these guys? This might not be an epidemic yet—but it could be. It has the potential. And we have two young guys who’ve become really sick in only a few hours. What if something happens to one, or both, of them, and we’ve lost the opportunity to find their close contacts? What if we leave those people at risk? We also know this strain is slightly different. This could be the start of something.” She pressed her hand on her heart. “I can’t let the threat of a hurricane stop me from doing my job to the best of my ability. I have to take the histories. I have to collect the antibiotics and I have to try and talk to as many people as I can.” She took a deep breath and her voice gave a little shake. “If the phone lines go down after this we could be in trouble. People might live near to medical centers. We can adapt. We could arrange for them to collect what they need from there.”
His hands were on his hips. For a second she wondered if he was going to argue with her. Maybe bringing him here hadn’t been a good idea after all. What did she really know about Jack Campbell? The army were used to being in the thick of things; maybe he was struggling with a back-seat role?
“I don’t have time to fight with you about this, Jack. What are you going to be, a hindrance or a help?”
She could tell he was annoyed but she didn’t have time to care. He had to do it her way, or no way.
There was a pause, and then he let out a sigh and gave the briefest shake of his head. “Let’s be quick.”
He grabbed a pile of paperwork and walked over to Aaron’s bed. There was no chance of Aaron talking. He was ventilated with the briefest hint of a purpuric rash on his tanned skin. The new antibiotics were feeding into an IV line. If they were going to make a difference they would have to start working quickly.
Jack looked up at Ty. “We’re going to have to ask you questions because you’ve spent the last few days with these guys.”
Ty gave a nervous nod. “Can’t go anywhere anyhow. What do you need to know?”
Amber started firing questions at him. “Where did they sleep? How many other people are there? Do you have names, ages and contact details? Have any left in the last few days? How many are still there? How many people work at the hostel and at the surf school? What have they been doing at nights?”
Once she started she didn’t stop. Every now and then Jack quickly interrupted with the words “And what about Aaron?” ensuring that Ty was answering for both teenagers.
It seemed that there were around twenty people at the surf school. Things were pretty informal. Most had traveled to get there—some from the other Hawaiian islands. The people who worked there were all local. Timescales were important. Two teenagers had traveled back to other states in the USA yesterday, and a third had left for New Zealand in the early hours of this morning.
While all this was going on, hospital staff worked around them, attaching the two boys to portable ventilators that could be pushed out into the corridor with them; oxygen cylinders were attached to the sides of the bed and a portable emergency trolley was positioned near to the door.
One of the hospital administrators appeared and spoke in a low voice. “The patients in Surgical have been moved. The hospital front entrance has been completely cleared.” Of course, it was covered in glass. “Medical CCU is the safest. It’s right in the middle of the building with no windows, but we’ve already moved the sickest of our elderly patients in there. Pediatrics have been moved down to the theaters.”
“Is the basement ready? Do you have the equipment that will be needed?” asked Jack. Transporting these patients would take more than the few nurses that were left in the department.
The administrator looked a little worried. “The staff room down at the laboratory has been cleared in the basement. The corridor down there is one of the most shielded in the building.” The lights flickered around them again.
“As long as we don’t have a power cut,” said Jack warily.
“Let’s go,” said the head nurse smartly as the windows started to rattle around them. “I don’t think it’s safe to wait. We’ve packed up the equipment that we need.”
She gestured to the nurses who were left. “You two with Zane.” She looked at Amber. “You go with him too.”
“Myself, Ty and Dr. Campbell will take Aaron down in the other elevator.”
There was only one hospital orderly to assist—the rest obviously deployed to other parts of the building. How on earth did you lock down a hospital and keep all patients safe from a hurricane outside? She didn’t even want to think about it.
They wheeled the bed out to the elevator, along with the portable ventilator, tanks and emergency trolley. The progress was slow; it was almost like a juggling act getting all the equipment they needed inside the elevator.
A few minutes later they arrived in the basement. This time she was familiar with the surroundings and backed out of the elevator first, pulling the bed with her. The lab staff must have been warned because a room to the right had been cleared. It looked as if it had been the large staff room, as a pile of chairs and large table were at the bottom of the corridor. The nurse guided the bed into the space and they quickly connected monitors to plug points and checked the ventilator was working properly.
It was weird. Amber actually liked being back in a hospital environment—even though this was a makeshift one. It always reminded her of why she did this job. Sometimes being stuck in an office
at the DPA was tough. Only communicating with patients and fellow doctors by phone and email wasn’t really how she preferred to work. She liked this. She liked being in the thick of things. She liked to see the patients, talk to them, be on hand when treatments were being tried and tested. A bit more like the role Jack had just done…
There was a weird sound from the corridor. The nurse looked up and frowned as she fiddled with some cables. “Go and check that, will you?”
The lights flickered again as Amber walked swiftly down the corridor. She automatically looked over her shoulder. It was like being in an old-style horror movie—never her favorite kind of entertainment.
The metal doors of both elevators were still closed. Shouldn’t Jack be here by now with Aaron?
The lights flickered once more then went out completely.
Black. Everywhere.
She automatically sucked in a breath and held it.
“Darn it,” came the shout from further down the corridor, followed by the flickering of some kind of light. Must be from a phone.
“You okay, Amber?” shouted the nurse. “We have a backup generator. It should kick in any second.”
Something flooded into her brain. Keeping her hand on the wall, she walked quickly back to the room she’d just come from. The nurse had her phone in her hand and was using the light from it.
“Are the ventilators still working? Do we need to bag him?”
Even though it was dark, Amber moved to the bed, watching for the rise and fall of Zane’s chest. The nurse was at the other side. She shook her head. “We should have three hours’ worth of battery power. Honestly, the backup generator should kick in. Give it a few minutes.”
There was a large thump from the corridor and some muffled voices shouting.
“Oh, no,” said the nurse.
“What?” asked Amber.
“The elevator. I think your colleague’s stuck in the elevator with Aaron.”
Amber’s heart started to thud in her chest. She lifted her hands from the bed. “Okay, you’re okay here? I can go?”
The nurse nodded. Amber pulled her own mobile from her pocket and flicked the switch on as she walked back down the corridor.
The shouts were getting louder. “Jack? Are you okay?”
“Amber? Is that you? The elevator’s jammed and the emergency phone isn’t working!”
Amber ran over to the doors. It was ridiculous. She tried to pull them apart with her hands but it was obviously no use.
Mamo appeared from the lab. “Problems?” He shook his head. “Can’t do much without power down here.”
She pointed to the doors. “We’ve got one of the kids with meningitis attached to a portable ventilator in there.”
Jack shouted from inside. “Is there anything outside you could use to try and pry the doors apart? I can try from in here, but I think I need you helping on the outside.”
There was a strange sound from inside. Almost a whimpering. Oh, no. The nurse inside must be freaking out. Being trapped inside a black box wouldn’t be most people’s idea of a normal working day.
“Hold on.” Amber held her phone up and tried to scan the corridor around them.
Something seemed to flick in Mamo’s head. “Over here. I think there’s an emergency fire ax next to one of the exits. Maybe we could use that.”
Sure enough, on one of the walls there was an ax mounted in a red box behind a breakable panel. Mamo pulled his lab coat over his fist and broke the glass, grabbing hold of the ax.
“Give us a minute, Jack,” Amber shouted. “Mamo is trying to pry the doors from this side.” Something flashed through her brain. “Where’s Ty?”
The reply was slightly muffled. “He stayed upstairs to make a few calls to the surf school. He wanted to check all the kids had been taken to an evacuation center.”
Prying the doors apart was more difficult than it looked. Mamo put the edge of the ax into the gap at the doors and tried to turn it sideways to widen the gap. After a few minutes he turned to Amber. “You keep holding it,” he said gruffly as he slid his hands and foot into the space that was only a few inches apart.
Amber kept trying to turn the head of the ax wider, while keeping it in the space. Her shoulder muscles ached. Her jaw was tight. From the other side she could see a flash of light. The nurse inside must be using her phone. White knuckles appeared on the inside of the door. She could hear the grunts and groans from Jack. “Grrr…”
After a couple of minutes the doors started to release a little further; both Mamo and Jack stuck their shoulders and body weight in the doors, using their feet to push the opposite door apart.
The elevator wasn’t completely aligned with the floor—probably the reason they’d had so much difficulty prizing the doors apart.
The nurse looked numb. Amber ducked inside and grabbed the end of the bed. “You get the ventilator,” she said to the nurse. “There will be a bit of a bump as we push out.”
Mamo and Jack stayed at their doors, holding them back with their body weight as they guided the bed through between them. The nurse jerked as the bed thudded the few inches to the floor, then steered the portable ventilator alongside. The lights flickered in the corridor again.
“Got everything?” checked Mamo. Jack nodded as he pulled out the emergency trolley and let it roll across the floor. The two of them glanced at each other, then gave a nod and both jumped. The doors slid back into place swiftly just as the lights flickered back on in the basement.
“Thank goodness,” breathed Amber.
Mamo gave a nod of acknowledgment as he glanced at Aaron in the bed. “Everyone okay? I need to go back to the lab and check the machines.”
Amber, Jack and the nurse pushed Aaron into the room in the basement. It only took ten minutes to make sure he was safely set up alongside Zane and that the power supply was working as it should be. The IV infusions with fluids and antibiotics stopped pinging, as did the cardiac monitor and ventilator.
“We’re good.” The nurse nodded. “I’ve phoned one of the ICU doctors and they’re going to base themselves downstairs with us.” She gave a rueful smile. “Don’t worry. I’ve told them to take the stairs.”
Amber walked back over to where she’d abandoned her paperwork. She had to get back on task. Time was ticking.
This was her responsibility and she was in charge. “Jack, how do you feel about making some calls? Let’s do the international ones first. I can give you numbers for the public health agencies in the countries our patients are heading to. Following the patients up will be their responsibility.”
Jack gave a nod. That tiny little feeling she’d had that he might want to take over seemed to flutter away. “Yeah, I’m not sure how long our phone lines will work. Let’s try and do these as quickly as possible. Then we could look at the people who’ve returned to any of the surrounding islands. See if we can get someone local to prescribe and supply the antibiotics.”
She was pleased. He was methodical and logical. Definitely what she needed right now. It was odd to think that last night she’d fallen asleep next to a man she barely knew and now she was working with him in a virtual blackout.
One of the nurses gestured to them. “There’s an office over there. Why don’t you go and try the phones?” She pulled her watch from her pocket. “According to this, we have about ten minutes before the hurricane hits.”
It was like a chill rushing over her body. Should she be scared? Should she actually be terrified? She’d faced plenty of disease disasters, but never a natural one like this. “What happens next? What happens to everyone out there?” she asked the nurse.
“They’ve moved most of the tourists from the beach-front hotels into emergency shelters. Hawaii has a hurricane preparedness guide. Unfortunately we’ve not had the warning time that would normally be in place. Things have changed quickly.”
There was a tiny wave of panic. “Is there anything else I should know about a hurricane?” She hated the fact her voi
ce sounded high-pitched.
“There’s a standard set of instructions.” One of the nurses pulled a leaflet from her bag.
Stay indoors away from windows, skylights and glass doors.
Secure and brace exterior doors. Store as much water as you can.
Close interior doors and take refuge in a small interior room, like a closet or hallway, on the lowest level of your home.
Jack pulled a face. “How do these apply to a hospital?”
The nurse gave a nod. “We’ve moved all the patients away from windows, mostly to the central corridors, and we’ve evacuated the top floor and ground floor. We’re filling the baths and sinks with water to keep the toilets flushing, but the kitchen says it has ample supplies of drinking water.” She closed her eyes for a second. “After that—we pray. This hospital has been standing for thirty years. We’ve had a few hurricanes in that time. We just hope that it will hold together again.”
Amber gulped. “What about the staff? Do you all have to stay?”
She wasn’t thinking about herself. She was thinking about all the local staff that might have families of their own close by to worry about. With the emergency warning coming so late, most of them might not have had time to make plans.
The nurse held out her hands. “We’ll manage. The hospital has an emergency plan. Extra staff get called in as relief. They help transfer the patients and stock the ER. Some of the rest of the staff had to go home to sort out family issues. I came in early to let my friend go home to her disabled mother.” She pointed at the nurse dealing with Aaron. “Nessa only started here a few weeks ago. Her family are on Oahu. She wouldn’t have time to get there, so decided just to lock down here where she could be useful.”
She gave an anxious glance between Amber and Jack. “No matter what your experience, after the hurricane hits, we’ll need doctors. Probably more than you know.”
Jack gave the briefest of nods. His face was serious, but he didn’t seem intimidated at all. “I’d rather be working than holed up in the hotel. Let us sort out what we can about these meningitis cases. After that, put me where you need me.”
Locked Down with the Army Doc Page 6
