The Waiting Hours

by Shandi Mitchell

  “Help is almost there, Devon.”

  She strained to hear the sirens in the distance, but heard only Antoine’s hoarsening calls for help, which abruptly stopped. She thought he might be crying.

  An inhalation, long and thin, keened.

  “Devon, stay with me.” She could hear the caterwaul of sirens. “Can you hear the sirens, Devon? They’re coming for you. They’re so close…”

  The breath caught and gurgled and slowed and slowed and slowed…

  “Devon, you stay with me.” She covered both ears and bowed her head to blot out every other sound. “I’m right here with you. I’m right here.”

  But there was no more breath.

  “Devon?”

  Tamara pressed her hand to her headset, trying to filter out the sirens and Antoine’s frantic cries, We’re here! We’re here! She bent in close to see the boy lying on his side on the grass in the park at night. Sneakers, jeans, and a T-shirt because it was warm, even though it was night. Antoine kneeling over him with his hands on his neck, red soaked…

  Colleen’s voice jarred her back into the room, urging her to let go. “Police and paramedics are on scene.”

  Antoine was screaming. I’m helping! No, no, nooo! I’m doing what she told me to do! His voice was pulling farther away. I did it! I did what you told me to do!

  The line went dead.

  Tamara looked up and the other call-takers respectfully looked away. She removed her headset and passed it to her supervisor. Then, for the first time in her career, she walked into the quiet room.

  9

  Trauma Room 2 was prepped for incoming, and the team activated for the ambulance en route with a Code 1. Male, twelve years old, gunshot wound, unresponsive. ETA one minute. Two doctors and four nurses were watching the clock. Kate put on her gloves. There was no need to talk. They knew their roles.

  Dr. “Spider” Patel, the on-call vascular surgeon noted for his fine stitching, was at the foot of the gurney. His head was bowed and his eyes closed. Kate assumed he was meditating or visualizing the body’s circulatory pathways. His favourite sci-fi film involved a microscopic submarine. She could imagine him peering through tiny portholes at veins and capillaries.

  Beside him, Dr. Savoy rocked side to side. It was a tic not to be misinterpreted as nervousness, but rather was a sign of restless anticipation, much like a thoroughbred at the gate. He earned the nickname Mapmaker for his ability to chart wild medical terrain and locate the true source. Nurses adored him and bemoaned the fact that he was married. He kept a collection of recovered objects that included glass shards, metal projectiles, and a set of crumpled motorcycle handlebars. Some were wins and some were losses.

  The nursing team was positioned around the gurney at head, heart, and feet. Rhonda, the primary nurse with fourteen years’ experience, had the head. She was Kate’s mentor and appropriately feared by the newbies. She always worked the right side of the room. Kate had the heart. Monitors, vitals, IVs, blood, fluids, and meds were divvied between them. Amy, who was always where she needed to be, was acting as relay, replenishing blood and fluid bags, restocking supplies, and manning the defibrillator. The youngest, Donna, detailed and logistics oriented, with only four years on the floor, was scribing. Her documentation of procedures and vitals was unerring and legible.

  The overhead fluorescents hummed. The team practised stillness, breathing in and out. Someone swallowed. Kate made visual checks of the crash carts and trays, taking inventory of the IV bores, sharps, cath lines, tubes, leads, sutures, towel packs, scissors, scalpels, meds, and painkillers. She had never found an item missing with Rhonda as primary. She rolled her neck and loosened her fingers. She was already overly warm in her protective gown, booties, and latex gloves. The siren’s wails bled through the walls, Code Blue.

  “Rock and roll,” Dr. Savoy said.

  The trauma room doors slammed open and a fury of paramedics and a stretcher crashed in. One paramedic was straddling the boy, performing CPR. A police officer jogged beside, guiding the gurney and holding an IV bag above his head. Its line snaked down to a thin brown arm. Kate momentarily registered that it was the same cop who had been in the corridor the previous night. The boy, strapped to an adult-size backboard, was so small that the paramedics were using the bottom half to hold their kit. The lead paramedic was squeezing the Ambu bag with one hand and firmly holding the oversized mask around the boy’s nose and mouth with the other, while leaning in to apply pressure with his elbow to the blood-soaked dressing. His gloves and arms were red. His eyes were dilated, flooded with adrenaline.

  “Gunshot wound to the neck. Left side. Elapsed time seven minutes from call, eight minutes in transit, fifteen minutes down. No pulse.”

  The team moved in a choreographed dance. “One, two, three—lift.”

  The boy—small, so small—rose into the air. All had miscalculated the weight of his body and for a moment he seemed to rise from their fingertips and they had to pull him back down.

  Dr. Savoy, standing at the helm, took control. “Stop compressions,” he said in a calm voice.

  The paramedic leaned back, sweat dripping from his hair onto the boy’s face. With two slices, Kate cut the T-shirt from the thin body and slit the jeans up the sides. Cardiac leads were applied. Lines and tubes snaked across the body. The finger sensor was clipped on, adjusted to grip the child-size fingertip. The blood pressure cuff wrapped around his arm twice. There was no pressure.

  “Resume compressions.”

  The paramedic leaned in. He smelled sour. Kate located a vein, but the IV bore was too large and she reached for a narrower gauge. It went in.

  Rhonda was still placing the leads. “Take over compressions,” she said.

  Kate leaned in and the paramedic slid back. Her hands spanned the breadth of the boy’s chest. Palms to his sternum, she pressed down, and his ribs bowed. She hummed the count in her head. A hundred beats per minute. One, two, three, four…She played her version of a famous song on continuous loop in the back of her head, Ah, ha, ha, ha, stay alive, stay alive…

  IV lines, cardiac leads, and gloved hands snaked around her. Blood and saline flowed through tubes. Another sharp was inserted in the back of the boy’s hand. Ah, ha, ha, ha…Voices collided, documenting actions. Monitors beeped—heart rate, blood pressure, respiration—all alarming RED. The neck dressing was removed, spraying red. Kate averted her face.

  Behind her, Dr. Savoy’s steady voice guided them. “Stop compressions. Suction.”

  Dr. Patel hunched over the patient, and she could see the thin balding spot on the back of his head. The bullet was a through-and-through. The carotid artery was nicked.

  “Jeezus,” Patel said as he sutured the wound, hoping his web would hold.

  “Resume compressions.”

  One, two, three, four…The wound was reduced to a mere leak.

  “Hold compressions. Intubate.”

  On first attempt, the tube was too large, and Rhonda tossed it to the floor with the growing debris field of discarded packaging, bloodied dressings, and clothing.

  “Do we need a trach?” It was simply a question, with no pressure either way.

  “Let me try again.” Rhonda tipped the head farther back and the tube slipped in.

  “Ventilate. Resume compressions. Charge 40.”

  Kate slipped her hands under the lines that were warm with blood and saline. Oxygen hissed and the defibrillator whined.

  “Push .31 milligrams of epi.” Dr. Savoy raised his hand and halted them. “Stop. What’s his estimated weight again?” He adjusted the dose to .21 mg.

  Ah, ha, ha, ha…Kate’s forearm muscles were tightening and her underarms were wet. The defibrillator alarm shrieked, ready.

  “Clear.” She raised her hands from the boy. The small body twitched.

  “Resume compressions.”

  Amy tossed away an empty blood bag and hung another. Alarms screeched. Kate was looking into the boy’s open eyes. He had brown eyes and blue lip
s.

  “What’s his name?” Savoy was staring at the monitor, as if the answer was there.

  A stranger’s voice responded, “Devon.” There was someone else in the theatre with them. Was it the cop?

  “Charge 80.”

  Kate was puffing and her arms were trembling. Dr. Savoy leaned in, blocking her view. He shone a penlight in the boy’s eyes. “Devon.” When he pulled back, she was looking into clouded pupils. Ah, ha, ha, ha…

  Rhonda said, “Switch,” and Amy took her place. Catching her breath, Kate glanced to the vitals monitor before compressions resumed. The heart rate was flat. The line jumped jagged, one-two-three-four…Amy was counting under her breath. The elapsed time in the room was fourteen minutes. The paramedics were still there and so was the cop, watching their every move. Back the fuck up, her mind growled as she reached for an empty fluid bag.

  More compressions, more shocks, more drugs. The bags were emptied again and more blood was rushed in. Beyond the trauma doors, she glimpsed a huddle of police officers and paramedics. Their heads turned, awaiting word. In that moment, she hated them for expecting her team to do more. The dressing around the boy’s neck was sopping red again. Ah, ha, ha, ha…

  “Charge 80.” Dr. Savoy’s arms were crossed. She pressed the charge button on the defibrillator and its whine shuddered up her spine. Amy was counting louder. A rib cracked and they pretended not to hear. Rhonda touched Amy on the small of her back, a touch that said It’s okay, and took over compressions.

  Savoy asked, “Is the family here?”

  The cop answered, “The mother’s en route.” From his hand dangled one sneaker. The other was still on the foot.

  “Clear,” Savoy called, and hands lifted. She pressed the paddles to the still chest and fired. It was the tenth one.

  “Stop.”

  The doctors stared at the monitors for the smallest blip. The nurses did not. The machine said heart dead. But Kate had known that before she applied the first compressions. She had looked in his eyes. The alarms squealed. There was blood on their hands, blood on the floor, blood on the boy.

  “I’m calling it.” Dr. Savoy’s voice was calm, but she could see the hand hidden behind his back and the tremble of his fingers. He had two sons, ten and thirteen. Only he and Donna looked to the clock.

  “Time of death, 2:26 a.m.”

  Latex gloves were snapped off, alarms silenced, oxygen shut off, and IVs shunted. Dr. Patel touched the stitching over the carotid as if feeling for a pulse, searching for anything else he could have done. He closed the scalpel incision with clean, tight stitches, and Rhonda dressed the wound with fresh white dressing.

  Kate cleaned the face and neck. Someone closed the eyes. A clean sheet, folded in half and half again, was draped over the body, up to the neck. The cleaners arrived and the aftermath was swept into bags.

  The paramedics had left, but the cop was still standing in the corner. He looked older than he did last night. His shoulders were slumped and his vest was stained like his hands.

  “You should wash up,” she said, and their eyes met.

  His eyes said, I don’t know what to do.

  Hers said, Get out.

  She was standing between him and the boy. He stepped around her and laid the sneaker on the foot of the gurney. His boots squeaked against the polished floors. The door swung shut behind him and the space felt bigger.

  * * *

  —

  Kate accompanied Dr. Savoy to the family meeting room. Security was stationed outside. A small woman sat alone at the head of the overbearing, cheap boardroom table. Her bare arms, lean and muscular, were crossed tight, protecting her heart.

  Dr. Savoy explained in a neutral voice what had happened and what had been done. He kept his folded, calm hands on the table. The woman appeared to be listening, but Kate wasn’t certain that she was hearing. She didn’t look up. The doctor waited patiently for questions, and when they didn’t come, he said what he needed to say. “I pronounced him dead at 2:26 a.m.”

  This was when the silence usually broke. It was the one word families waited to hear—despite all the other words that meant the same thing. But the woman didn’t cry out.

  “I want to see him,” she said. Her voice was as dead as her boy.

  * * *

  —

  The mother noiselessly followed Kate down the corridor, past the security monitors and the rooms with the sprained ankle, kidney stone, and blistering sunburn. Kate’s fresh scrubs rubbed stiffly against her legs. Her skin felt raw from the antiseptic soap, and her ponytail elastic was pulled too tight at the nape of her neck. The handle of the trauma room door was cold. The boy’s mother didn’t falter as she entered.

  The room had been cleaned and the harsh overhead light had been partially dimmed. It was eerily silent. The boy was still hooked up to the muted machines, a practice intended to help families understand the enormity and finality of the moment. But Kate didn’t think they needed that help. The woman, who was looking down at her son, didn’t make a sound. Only when she reached for his hand, where the IV was still connected, did she hesitate.

  Wordlessly, Kate cut the tubing below the shunt. She couldn’t remove the IV, because there would be an autopsy, so she taped the line to his forearm, adhering it with the gentlest paper tape to mask the adhesive tugging at his skin. She had to remind herself that she couldn’t hurt him. She pulled up the sheet and tucked it over the IV to hide it from view. She did this for the mother. The mother took his hand in hers.

  “The buzzer is here if you need me.” She took care to shut the door behind her so it barely clicked.

  The howl began as she reached her nurses’ station. It tore from the belly and ripped the throat and raged through the walls. The sound didn’t match the juvenile charts of grimaces and clenched lips used by nurses to identify pain on a scale of 1 to 10. This pain shuddered up spines, bristled hair, gutted souls, and devoured hearts.

  Kate checked the clock. It was 3:05:21 a.m. 3:05:22. 3:05:23. Ah, ha, ha, ha…

  We take care of them, her mind reminded her. We don’t care about them.

  The call buzzer sounded for the patient in room 4. Her charge. We take care of them, her mind snarled. We don’t care about them. Sedatives would need to be prescribed. She paged Dr. Savoy. The woman with the shattered heart was scaring the other patients. Someone had to do something, but no one was moving. The charge nurse, Momma Jo, finally made the long walk. The trauma room door opened and shut, and the unnatural sound stopped.

  Room 4 buzzed again. Mr. Blue Pill. Male, sixty-six. Racing heart, sustained erection. DFB—dick for brains. In the corner, his much too young red-faced girlfriend wanted to know why someone wasn’t helping him.

  “It shouldn’t be long now.” Kate used her softest, most reassuring voice. She noted the patient’s clenched lips, furrowed brow, and twitching cheek. A five on the pain scale. “Are you cold?”

  Her stomach growled. She was ravenous for a burger, salty fries, onion rings, too much ketchup, a chocolate milkshake, and hot fudge sundae. She would settle for a bag of plain chips from the vending machine.

  “I’ll get you a warm blanket.”

  * * *

  —

  Kate sat in the parking lot with the window down. The air smelled dew green. Doctors and nurses, with coffees and bagels in hand, disappeared from view behind the sliding ER doors. A new crop of casualties was already lining up for triage. Her eyes wandered the brick building, counting the floors. She couldn’t find her mother’s window. Zeus shuffled in his crate, sated from his early run, water, breakfast, and hugs. He spun around and settled down for another nap. She started the engine.

  The bandage on her palm was limp and lifting at the edges again. Adhesive stuck to the steering wheel. She peeled it off. A flash of pain flared up her arm and set her chest, throat, and eyes on fire. Hot tears streaked her cheeks. She gagged on the choking grief, but not a sound escaped her lips. Zeus scrambled up, whining and pawing. She ra
ised her wounded hand to shield her face from the security cameras.

  “I’m okay.” She wiped her cheeks dry. The night was over.

  Zeus remained standing, stiff and alert, staring at her flooded eyes in the rear-view mirror, until she had to look away.

  10

  The morning sun was blinding, and night hadn’t brought any relief from the heat. Bluebird Taxi was waiting for her, though Tamara had forgotten to call. The driver stepped out and opened the back door. She wanted to protest that he didn’t need to do that, but her feet were stepping forward. The door shut softly behind her.

  The air conditioner hummed. White noise plugged her ears. The vinyl seat was cool against her back and legs. She noticed the cabbie’s ID was now displayed on the back of his seat, at her eye level. Hassan Ahmad. He looked younger in the black-and-white photograph. She looked into the rear-view mirror and met his eyes. They were soft and patient. Brown like hers.

  “Fasten seatbelt, please.”

  She secured the belt around her waist, surprised that she had forgotten.

  “Stay on the main street, please.” She rested her forehead against the chilled window. Iron railings flickered past, blurring dark leaves, heavy with dust and drought, and flashes of old headstones glinting in the rising sun. She looked to the sky. It was going to be another relentless scorching day. She missed the rain. The railing abruptly ended and the trees thinned, giving way to sidewalks and school crossing signs.

  The cab slowed. Up ahead, several vehicles were stopped, though it was just after seven and well ahead of morning rush hour. A barricade blocked the road: LOCAL TRAFFIC ONLY. Hassan shifted in his seat, placing his hands at ten and two on the steering wheel. Chilled air wafted into the back seat, carrying the faint scent of his underarm deodorant.