CONSULTANT IN CRISIS

by Alison Roberts

  ‘That sounded like a pretty good pre-hospital regime. Kelly’s quite right,’ he told the group that had now gathered and were listening with interest. ‘Treatment has to start before the weight is removed. Hypovolaemia has to be treated aggressively and the hyperkalaemia treated prophylactically.’

  ‘Hyper—what?’ Kyle was trying not to look totally disgruntled.

  ‘High levels of potassium,’ Fletch explained. ‘It gets released by damaged cells and it causes fast, irregular heart rhythms that can lead to an arrest.’

  ‘What’s the rationale for giving glucose and insulin?’ Kelly asked.

  ‘To counteract hyperkalaemia. It’s the insulin that does that. Was it a short-acting form you used?’

  ‘I think so.’

  ‘Giving glucose will encourage the body to produce more insulin further down the track.’

  ‘And the atropine would have been to counter a tachyarrhythmia?’

  Fletch nodded. ‘Sodium bicarbonate would have been useful as well. And calcium.’

  ‘They were the things we didn’t have.’

  ‘Did he survive? Your crush injury victim?’

  Kelly smiled as she nodded. ‘He lost the lower part of his leg but he lived to tell the tale. He’d been trapped under his car for three days out in the bush. It was a helicopter rescue job.’

  ‘You were on the helicopters?’

  Kelly opened her mouth to respond but Tony cut in to call their attention back to their scenario. ‘Let’s save the stories for later,’ he suggested. ‘Everybody else has finished and I don’t know about you guys but I’m starving.’

  Not being able to tell Fletch about the drama-packed events of helicopter rescues was disappointing. Kelly also wanted to know about the chemical interaction between insulin and potassium. For the space of that interchange Kelly had forgotten the past. She had only been aware of how encouraging Fletch’s admiration could be and how stimulating gaining knowledge from him was. The disappointment became more intense as they packed up for the day. Fletch wouldn’t want to talk to her again. Not like that. Not unless she could find a way for other people to initiate a discussion.

  Kelly Drummond had been the only woman who had ever given Fletch exactly what he needed on so many levels. They had shared the same, frequent amusement in often totally inconsequential aspects of life. They had shared a passion for careers that had overlapped enough to allow communication that hadn’t needed background explanations. The mutual physical passion was something Fletch was determined not to remember. And he could have done without the reminder of the intellectual stimulation that conversation with Kelly could spark.

  It would be so easy to talk to her again. Really talk. Their discussion on crush injury syndrome had, briefly, taken him back to a time and place when such an interchange had been a highlight of his day. His interest had been caught to the point when he hadn’t wanted to stop talking. He knew just how eager Kelly was to learn more about the subject and he knew that she would absorb and remember every piece of information she could glean. He hadn’t wanted to stop listening either. He wanted to know about the dangers Kelly had faced working on a helicopter rescue team, wanted to hear stories of lives saved and the type of emergency medical practices currently being used in such a front-line field.

  Dangerous territory. And Fletch was not going to be lured anywhere near it. There were only a few more days left of them being cooped up in close proximity on this course and it should be easy enough to avoid any contact that could run away into personal communication.

  That avoidance was, in fact, even easier than he had anticipated. The next day was taken up with theoretical work and practical demonstrations of shoring techniques and methods of assessing structural safety in partially collapsed buildings. Then there was a day for the protocols of co-ordinated incident management systems and practice using different kinds of radio equipment and data collection. More detailed work on identifying and dealing with hazards followed that and suddenly they were all revising flat out for the final written exam. The course was over and the final paper would give Dave and Tony the chance to collate marks. If they passed they would be issued their personal protection kits on Friday afternoon. They would have their basic equipment and would be available to respond to call-outs from then on.

  It was a long wait after they finished the exam. The questions they had answered were discussed endlessly over a late lunch.

  ‘The signal to evacuate the scene—it’s three short blasts on a whistle, isn’t it?’

  ‘Yeah. And one long blast and one short one to resume operations.’

  ‘I got confused about the timber shoring. Rakers and sole plate cleats.’ Jessica sounded worried. ‘I’m sure I’ve failed.’

  ‘That’s nice-to-know information. I doubt that it’s essential,’ Fletch reassured her. ‘A major scene will have engineers to deal with the technical side.’

  ‘And you can always call the fire department,’ Owen added. ‘We’ve got the equipment and muscle to deal with most of that kind of stuff.’

  ‘A cubic metre of concrete weighs 2.5 tonnes. And steel is 8.2 tonnes.’ Kyle was checking his notes. ‘Yes! I got that one right.’

  ‘I just want to get the results,’ Kelly sighed. ‘It’s been a long three weeks.’

  ‘Hasn’t it just?’ Fletch’s quiet agreement didn’t appear to be directed at Kelly but she could feel the implications. He hadn’t enjoyed being thrown back into her company. Maybe he had found it just as disturbing as she had.

  Finally the wait was over. They assembled in the classroom. Boxes of gear lay in front of their instructors. Overalls and helmets, headlamps, goggles and dust masks. Elbow and knee pads, gloves and whistles.

  ‘The ID cards are temporary. You’ll be issued with formal IDs once your results are processed by the national qualifications authority.’

  The class was silent.

  ‘Wendy? Congratulations, you’ve passed. Come and get your card. When we’ve finished you’ll be able to sort out your kit.’

  Wendy flushed with pleasure at both the result and the applause. She sat down, clutching her card.

  ‘Fletch? Congratulations.’ Dave shook his hand. ‘It’s been a pleasure having you as part of the group.’

  June, Owen, Roger, Joe and Sandy collected their cards. Jessica’s worries had been unfounded. Even Kyle had passed the course. Kelly felt confident that her turn was coming. Surely they wouldn’t announce a failure in so public a manner?

  The pager Dave wore on his belt sounded as Kyle sat down. A moment later, Tony’s pager sounded. The instructors exchanged a surprised glance.

  ‘I’ll ring them,’ Tony said. ‘You carry on.’

  Gerry’s turn was next. Then June’s friend, Pamela. Then Bryan, another fireman. Tony came back and spoke quietly to Dave, who listened intently. They kept talking. Now Dave was looking around the class and nodding. What was going on? The class members exchanged glances. The atmosphere held an unmistakeable air of anticipation. Dave cleared his throat.

  ‘This couldn’t have been timed better,’ he told them. ‘We have a code blue activation under way. There’s been a major building collapse in town. There’s an unknown number of victims trapped and all available USAR personnel are being called in.’ Dave paused for just a second. ‘That now includes all of you. I want you to come and collect your kits and any personal gear you might need, like medications and toiletries. We’ll meet at the bus in fifteen minutes. Let’s go.’

  Nobody moved. Kyle smiled knowingly as he broke the stunned silence. ‘It’s another dummy run, isn’t it? It’s not for real.’

  ‘It’s as real as it gets, Kyle. Let’s move.’

  Dave sounded serious and everybody stood up, albeit reluctantly.

  ‘Funny time for another practice,’ Owen was heard to mutter. ‘I thought we were all going to the pub to celebrate.’

  ‘Maybe that’s where they’re taking us,’ Joe suggested. ‘Let’s play along so we don’t r
uin the surprise.’

  ‘Kelly!’ Dave was calling over the increasing level of noise in the room. ‘Sorry—almost forgot. Here’s your card. Congratulations,’ he added as Kelly reached the front of the room. ‘Make sure you collect all your gear. You’re going to need it.’

  ‘Sure.’ Kelly was quite prepared to enter into the scenario. It was a novel way to end a course. She pulled on her overalls and checked that the helmet she had chosen was a good fit. Jessica was pulling goggles from a box beside her.

  ‘This had better not take too long,’ she told Kelly. ‘I’ve arranged to meet Mum and Ricky at a toy shop in town. Ricky’s going to choose a new toy car as a present for being so well behaved this week.’

  ‘We’ll probably just go around the block,’ Kelly said. ‘I don’t think they’ll be going to too much trouble to make this realistic.’

  Kelly had to revise her opinion as the bus passed a third intersection without indicating any turn that might take them back to the classroom’s location or a nearby tavern. She wasn’t the only person to notice the police car that shot past them a short time later at high speed with its lights and siren blazing. At the next intersection she could see the build-up of slow-moving traffic, but it was a Friday afternoon. Traffic in town always got heavier when schools finished for the week.

  Traffic didn’t usually come to a complete standstill, however. Or get blocked by a barricade of police vehicles. And there was never the sound of so many sirens approaching from different directions. And Kelly had never seen a pall of smoke that hung over the suburban mall she knew lay at the end of the main road they were on. The same mall they had visited only a week ago.

  ‘Oh, my God,’ she said aloud.

  Heads turned and necks craned to see what Kelly had spotted from her window.

  ‘What is it, Kelly?’ Wendy called from the far side at the back of the bus.

  The silence was expectant. Kelly swallowed hard.

  ‘This isn’t a dummy run,’ she told them. Her voice trembled slightly. ‘I think Dave was telling the truth. This is as real as it gets.’

  CHAPTER THREE

  THE unimaginable had to be faced.

  Awareness of the enormity of what lay ahead came in stages. After the initial shock accompanying the realisation that the incident was genuine, a stunned silence permeated the bus. Its passengers stared silently through the windows, absorbing whatever information they could gather. The queue of traffic slowed to a crawl as they were allowed to pass the police cordon, still several blocks away from the mall. The sensation of unreality was as marked as the silence. Only a week ago this same group of people had travelled in this bus towards the same destination. Then they had been anticipating a convivial social occasion at a popular restaurant and bar. The anticipation now was so different it was incomparable.

  Through the front windscreen of the bus Kelly could see the convoy of army vehicles ahead of them. The open backs of the trucks revealed large numbers of personnel, dressed in army fatigues. They looked young and keen to reach their destination. It was probably the first time they had faced involvement with anything more than a dummy exercise and Kelly could remember that kind of excitement. When she first joined the ambulance service any priority call would start the adrenaline flowing. Who knew what she would have to deal with at the end of the run? The sound of the siren advertising the importance and urgency of the mission only added to the expectation.

  They could hear sirens now. The bus had to pull over and halt as an ambulance edged past. Kelly watched as Kyle stood up on the other side of the aisle, craning to follow the emergency vehicle’s progress through the traffic. His stare was intense and remained unbroken despite the jerk that forced him to sit hurriedly as the bus resumed its forward motion. The smile on his face was probably unconscious. Kyle was as caught up in the excitement as any of the young army personnel. Fletch was also watching Kyle from his position in the seat in front of Kelly. He turned his head.

  ‘He’s got a lot to learn, hasn’t he?’

  ‘Mmm.’

  They knew. Kelly and Fletch had faced countless emergencies and dealt with human tragedies they would never forget. They had both faced challenges that could provide enormous satisfaction when successful and sometimes devastating emotional repercussions when they weren’t. They knew. And Kyle Dickson had absolutely no idea. It gave Fletch and Kelly a bond that was unavoidable. Kelly found herself smiling gently as she responded to Fletch’s comment. The bond was welcome. What she was about to face was bigger than anything she had faced before and she was only too aware of how hard it might prove to be. It was comforting to know that someone else understood.

  The smile tugged at something deep within Fletch. It spoke of a bond that needed no words to reinforce the understanding between them. More than that even. It indicated a bond that linked them in a way that couldn’t be broken. A connection that Fletch had never even found a hint of with anyone else and one that would be there for the rest of his life even if he never saw Kelly again. And that was precisely the core of the pain their separation had caused and it was still able to stir a grief that even anger couldn’t obliterate. His fleeting response to Kelly’s smile was unconscious and was more a surprised reaction that such a deeply personal emotional reaction could occur in circumstances such as they were in right now.

  The smile was so brief it almost hadn’t happened. It was easy enough to dismiss the imagined sadness in the expression as Kelly chose the same moment as Fletch to turn away. He was probably just feeling the same sense she was of the daunting enormity of all this. Kelly looked through the rear window of the bus. They were being followed by a huge truck loaded with supplies of timber. Behind that was a four-wheel-drive vehicle emblazoned with the logo of a major television channel. An ambulance passed them, going in the opposite direction, travelling carefully with its beacons flashing. The lights in the cabin were on and Kelly could see someone adjusting the flow of IV fluids.

  ‘I wonder how they’re coping at Headquarters?’ Joe leaned towards Kelly from two rows down the aisle. ‘I imagine it’s chaos.’

  ‘I’d like to know what Emergency is like,’ Fletch responded. He frowned. ‘I should be there. We’ve just set up new strategies for dealing with major incidents. It’s my job to co-ordinate them.’

  A tow truck went past. Another one could be seen unhooking a car to join a line of vehicles blocking a side street.

  ‘They must be emptying the mall car park,’ Joe observed, ‘to make room for emergency services.’

  So where were all the people who had been unable to drive their cars away? Were they injured or dead? Or were they trapped and waiting for rescue? How many people were missing? And how soon would the passengers in this bus be allowed close enough to the scene to start trying to help? Questions tumbled around the vehicle. Speculation provided conversation but the answers were unavailable despite Dave’s and Tony’s constant telephone communication with whoever their commanding officers were. As they entered the vast car park still being emptied of private vehicles, Dave stood up.

  ‘Stay on the bus once we’ve stopped,’ he instructed.

  Police officers wearing bright reflective jackets were directing them to an area near where the army trucks were parking.

  ‘Tony and I will report to scene command and find out what’s happening,’ Dave continued. ‘We’ll get back and brief you all as soon as possible. I suggest you check your gear and make sure you have all your personal protection equipment ready to go.’

  Kelly could see the fire engines flanking the main entrance to the mall with ladders extended to the second storey. Someone was being carried down. She could see the huge ambulance triage tent that had been erected. Scene command vehicles from the police, fire service, ambulance and civil defence were grouped together and there were people moving everywhere. It looked totally chaotic at first glance but closer attention revealed the purposeful direction of human traffic. The fire crews were focused on an area just out of
sight round the corner from the main entrance. Hoses and equipment were being handled and moved with professional efficiency. An ambulance was being loaded with two stretchers outside the triage tent. A second ambulance was backing in slowly ready to take its place.

  Fletch was clearly frustrated at having to stay where he was. ‘They’ve got ED doctors working in the tent,’ Kelly heard him inform Ross. ‘That’s where we should be right now. Doing something useful.’

  ‘We may be more useful inside,’ Ross responded. ‘We’ve got skills now that they don’t have.’

  ‘It’ll just be the surface casualties they’re treating right now,’ Joe added. ‘People that were able to walk out or be accessed easily.’

  ‘And if there’s this many, it’s highly likely that a lot of people are still inside,’ Kelly said quietly.

  ‘It doesn’t look that bad,’ Jessica commented.

  ‘It’s a huge mall. The main damage is probably further in,’ Kyle said confidently. ‘It must be bad. Look at all the extra equipment they’re bringing in.’

  Trucks carrying generators and lighting systems were being unloaded. Another vast tent was being erected and they could all see the huge crane that was slowly approaching the scene. They made themselves as ready as they could. Kelly tied on her knee pads and checked the lacing of her boots. She pulled the band from her ponytail and began braiding her hair tightly to keep it more securely out of the way. Jessica followed her example and tried to pull her auburn curls back to confine them with a scrunchy.

  ‘Dave and Tony have been gone for half an hour.’

  ‘I saw them with a group of people near the main entrance.’ Wendy had been at the front of the bus for a while. ‘I think they all went inside for a look.’