#resus writing
Hey everyone, here’s the start of my latest series. I’m aiming for this series to be a little bit shorter than the last one, though given that was over 24,000 words, that shouldn’t be too hard. As usual this first one is mainly setup, but I hope you enjoy it. Comments are encouraged, it really does help motivate me.
***
It was his second day on the job at the little corner sandwich shop. Yesterday he’d been on the counter, clacking away with the rugged old till. It had gone well, especially with the extra business caused by the incident on the river putting the city’s streets into gridlock. Only a half dozen patrons had complained about the wait, and those were quite rapidly shut up by other customers queuing out the door.
Today, he was working in the kitchen. It was still early, so they were preparing the pre-made sandwiches that customers could grab without having to wait. The manager had given him a quick run-down on recipes, most of them quick and easy, a slice of this, a handful of that and a spoonful of the other. He had made good progress, all the Ham Salad and Cheese medley were done, now he just had the Prawn Mayo and the Chicken Mayo left to do. Supposedly the quickest way was to dump a whole load of mayonnaise into a tub, then throw in the punnet of cooked prawns or chicken pieces, depending on the sandwich. He did just that, spooning the mayonnaise from the large blue bucket into two tubs.
His nose wrinkled slightly. He hated mayonnaise with a passion, mainly because almost every store-bought sandwich was almost 90% mayonnaise. Even the ones without Mayo in the name. You see Chicken and Bacon, expecting chicken, bacon and maybe a little bit of mayonnaise for moisture. Instead, you get mayonnaise, mayonnaise, a little bit more mayonnaise, and some extra mayonnaise. Plus a couple of grams of chicken and 3 millimetres of bacon. It was that repeated betrayal that drove the hatred.
He threw in the prawns using the spoon to sit the mixture until they were well coated in the devil’s condiment. He grabbed a different spoon, having been warned about cross contamination, and did the same with the chicken. He reached for the pile of bread and was just about to spoon of some of the prawn mix when his manager walked up behind him.
“Hold on, those need more mayo, won’t stretch far enough otherwise and you do not want to deal with a soccer mom who doesn’t get their sandwich because we ran out.” She said, grabbing the bucket and plucking the spoon from the prawn mayo mix. “Let’s just split the rest of this between them.” She scooped out a spoonful of mayo, without cleaning the spoon, then tapped it hard on the rim of the tub containing the chicken until the spoon was mostly clean. She then added the remaining mayo to the prawn mixture. “There, now mix it up and get those sandwiches wrapped.” She told him before stalking off to the office.
He rolled his eyes discreetly and began to make the sandwiches, never noticing the small pink trails, or the tiny chunk of prawn hiding amongst the chicken. He never realised that that single mistake would ruin someone’s day in just a few hours’ time.
* * *
Anna woke up slowly, gradually slipping from her dreams into the waking world. Her eyes fluttered, with only the soft light peeking past the edges of the curtains giving any illumination to the room. She became aware of Carl’s arm cradling her, and smiled with the memory of last night, letting that sense of comfort and safety fill her once more.
She must have shifted in some small way between waking and relaxing, as she felt Carl stir behind her. She tried to remain still, but it was clear he knew she was awake when he said softly. “Yours or mine?” His arms shifted and then two sets of earpieces drifted in front of her face.
She grinned and rolled over. “After last night, I don’t think it matters.” She pulled him in for a quick kiss, then grabbed the earpieces connected to the steth still taped to his chest, lifting them to her ears while she kicked the sheets back. “I take it this is what you had in mind last night.” She whispered leaning in close, placing her hand on the head of his steth and pressing him back onto the bed as she looped one leg over his waist.
He simply grinned, bringing the other earpieces up. They inserted the earpieces, listening to each other’s hearts as they got faster and faster.
* * *
Two hours later Anna still had a dreamy smile on her face. She sat at the breakfast bar, wrapped in one of Carl’s big fluffy dressing gowns, her still damp hair wrapped up in a towel. She blew gently over her mug of tea, the steamy wisps parting and dancing as they continued to rise. She took a small sip. It was still a bit too hot, lacking a dash of milk that would have cooled it down, thanks to the barren fridge.
The door to the bedroom clicked shut, drawing her attention. Carl was dressed casually, straight cut jeans and a t-shirt featuring a rock band that Anna had never heard of. “So, what do you want for breakfast? Or lunch, I guess would be more appropriate.” He asked as he picked up a jacket and his keys.
Anna shrugged. “Anything that’ll get you back here sooner.” She said, leaving the tea on the counter as she slipped off the stool and pulled him in for a quick kiss, that became a series of them.
“This… won’t….get….me….back…..any….sooner….” Carl said, relenting for a moment before gently extracting himself from her embrace. “I’ll be back as soon as I can.”
“Make sure you do. I’ll be counting the seconds.” She whispered, before letting him go. He smiled at her as her stepped out of the door.
Anna’s smile stayed on her face as she headed into the bedroom herself to get changed.
***
Carl was still smiling when the elevator doors slid open and he stepped out into the foyer of the apartment building. He waved a greeting at the doorman as his long strides carried him towards the front doors, stepping to one side as they swung open and a young man walked in.
“Hey Carl.”
“Hey Joe. Doing well?”
“Yeah, good thanks. Just grabbing a bite for me and Izzy from that sandwich place 2 blocks over.” Jimmy said
“Ah yeah, not a bad place. Not a fan of the prawn mayo though.”
“We’re ok there then. Haven’t eaten a single ounce of seafood since I got together with Izzy.”
“Allergy?”
“Yeah. Super bad. It’s worse than Kryptonite to her.”
“Must be rough.”
Joe shrugged. “She’s more than worth it.”
“I know that feeling, On which note, I’ve got to dash to Lorenzo’s or I’ll have to deal with a hangry nurse.”
Joe laughed and let him go, making his way to the elevators.
* * *
“Hey babygirl! I’m back, and I brought some lunch!” Joe called out as he entered his apartment. It was on the same floor as Carl’s, but was towards the rear of the building. Smaller, worse views, but much more affordable. He hung his coat and keys on the hooks then walked down the small hallway into the main room.
Isabella was astride her exercise bike, headphones in, focussed on a spot on the wall as her legs pumped the pedals. Joe stood leaning against the door frame for a moment, admiring his fiancé’s athletic body, clad in tight fitting sportswear. He could tell she was listening to something fast paced, she always pedalled to the beat of the music.
He waited until her legs slowed, changing to a new song. He cleared his throat loudly, while the new song was still in it’s intro. Isabella jumped, her head whipping around. She lost her grip on the pedals and one of them whipped around and caught the back of her leg. She let out a rapid fire string of Spanish curses.
“Jose! You…” She let out an exasperated noise. “You know not to scare me like that!” She admonished him, plucking out her ear buds and climbing off the bike.
“But it’s so funny.” He said as he walked over towards her. “And I got lunch from that place you wanted to try.”
Isabella reached him, giving him a swat on the arm before she grabbed for the paper bag, which he whipped out of reach. He grinned at her, then pursed his lips. She rolled her eyes, then pulled him close for a kiss. He grinned at her and released the bag into her hand.
She opened it up, pulling out the contents, carefully checking each item’s label before placing them in the correct spots on the table. They sat down opposite each other, ripping open the sandwiches and digging in.
“How was your morning?” Izzy asked between mouthfuls.
“Eh, same old stuff. And probably even more when I get back.”
“No crazy customers or attempted robberies?”
Joe laughed. “Ha, you’ve watched too much TV. At this point the only people who actually walk in the bank are geriatrics who can’t even comprehend the internet.”
Izzy laughed for a moment, then coughed gently. She took another bite of the sandwich.
“How’s the training going?” He asked, nodding at the bike.
Izzy shrugged. “Pretty good. I was up to 32k without even getting near my limit.” She said absently scratching her shoulder. She let out another small cough, frowning slightly.
“Everything ok?” Joe asked, as he saw her cheeks flushing.
She grabbed the wrapped of the sandwich, checking it again, then throwing it aside. She pulled her sandwich apart, spreading the contents. It was definitely chicken mayo. But as she spread it, she saw the little pink trail. “They screwed up.” She wheezed, pushing herself to her feet, stumbling unsteadily.
Joe dropped his sandwich, mind whirring. Chicken Mayo. Prawn Mayo. It clicked and he burst to his feet, at the same instant that Izzy’s legs fell out beneath her and she dropped limply to the floor.
Normally you recieve gifts around your birthday, but I thought I’d give you all a gift instead. Hope you enjoy.
**********
30 minutes after Anna and Carl kissed in front of practically the whole ER, the door to a small flat clicked open, swinging on squeaky hinges. The light flicked on, blinking a couple of times before steadying out. The flat wasn’t a complete dive, it was all up to code and safety checks were performed regularly. But it was cheap, and as a result it was distinctly aged. The neutrally painted walls were faded and the cupboards of the small kitchenette in the corner were a style that was distinctly 80’s.
Anna stepped in first, looking around the small space, glad that she had left it reasonably clean the last time she left it. She turned to look at Carl, who had followed in and was looking around appraisingly as he shrugged out of his coat. Anna felt a wave of embarrassment, a blush rising to her cheeks, followed by a hope that the lingering chill from outside would cover it.
“Where do I…?” Carl murmured, indicating his coat.
“Oh, just behind the door.” Anna said waving at a set of tarnished hooks behind him.
“Ah,” Carl said, with one of his charming smiles. He flicked the closed and hung up his coat, then turn and held his hands up in a gesture of taking her coat. Anna smiled back, spinning her back to him. Carl gently lifted the coat off her shoulders and hung it on the hook next to his own, then turned and looked around the apartment again. “Well, this is a lot better than my first place.”
Anna looked around at him, eyebrow firmly arched. “Seriously?”
“Yeah.” Carl replied, “It had nicotine stains across the ceiling, the hob was permanently greasy no matter how often I cleaned it. And I found a meat cleaver in the drawer that was about 90% rust and blood. For a while I wondered if I was going to get a visit from the cops. Or a serial killer.” He let out a little humorous snort, amused at his younger self.
“No visit i take it?” Anna said, placing her bag on the table and walking over to the cupboard.
“Nah. I eventually figured out a meat cleaver is really not a good tool for murder. And the guy across the hall told me the previous tenant was into traditional cooking, Apparently the smells were incredible, but I think he did some of the butchery himself.”
Anna laughed as she pulled out the large case at the bottom of the cupboard. “He didn’t happen to leave any recipes?”
“I’m afraid not, but he did open up his own takeout place down on Bourneville.”
“Ooo, it’s not much of a detour on the way back to your place.” Anna said as she turned back to see him grinning.
“In that much of a rush?” He said walking over to help her with the case, as she pulled out a second smaller one.
“We did have….plans.” She said, putting on her best sultry voice.
Carl looked at her for a long moment, then his face split with a giggling smile. “I’m sorry…” He laughed. “That…that needs work.”
Anna pouted, rising to her full height. “And yet, I make you weak at the knees.” She replied with a whisper, placing her hand on his chest, grabbing a fistful of his shirt and pulling him closer.
“Oh, you certainly do that.” He said leaning in, his eyes closing, His lips quested forward, finding empty air, until eventually he opened his eyes, seeing Anna’s grin. “Tease.” He breathed out.
Anna stuck her tongue out at him, releasing his shirt and giving him a light pat on his chest, right above his heart. “Focus now tiger. we can get to that when we’re back at your place.”
Carl eyed the suitcases, and the relatively sparse room. “Unless you have an enormous bedroom, it looks like you’re thinking of it as…our place?”
Anna looked at him, suddenly nervous. “Is that… Is that ok with you?”
Carl looked at her, reaching his hand up to brush it gently across her cheek. “I’d like nothing more.” He whispered, his hand easing around her neck and pulling her into a deep kiss.
It lasted a long time, to the point that Anna had to take a long breath when they broke apart. “You can have that one,” her smile clear in her voice, “now lets get these cases packed.”
* * *
Carl settled into the sofa with a sigh, joined a moment later by Anna. She placed the two glasses of wine on the table, then slid onto the sofa, inside the curve of Carl’s arm. “Wow…” She sighed out. “He might leave rusty cleavers when he moves place, but damn that was some good food.” She rubbed her belly. “It’s going to take a lot of exercise to get rid of this food baby.”
Carl chuckled, reaching for his wine and taking a long sip. “A nice accompaniment too.”
Anna looked up at him until she got his attention, then rolled her eyes. “Seriously?”
“What? I’ve learned a thing or two about wine.”
“Not that. I literally just gave you a perfect setup…”
“What do you mean?”
“It’s going to take a lot of exercise…” She trailed off.
Carl’s eyes widened like a light bulb went off. “Oh…Well, perhaps we should get right on that.”
Anna sniffed. “Well, I don’t know now, being slow on the uptake is a bit of a turn off.”
“Oh reeealy.” He grabbed her arms, gently, and pushed her up into a sitting position as he extricated himself from behind her. “Well, perhaps, I have an idea that might just change your mind.”
“And that is?” Anna said, her voice betraying a hint of excitement.
“Ah, that would be telling. I’ll shout up when I’m ready.”
Anna looked at him, giving her best puppy dog eyes.
“Trust me, I think you’ll like it.” He told her over his shoulder as he walked toward the bedroom.
Anna sat back onto the sofa, dropping the act and feeling the curiosity and excitement building. She expected him to be at least a few minutes, so she turned on the tv.
It was still tuned to the local news channel from that morning. They were running an update on the story, this time with a different headline. HERO SERVICES SAVE PASSENGERS. It was showing the clip of Officer Jones running into the cabin of the sinking boat.
“Anna!” Carl shouted.
That was fast. She thought. Did he even set anything up?
Anna drained her wine, and stood up, The curiosity was overtaking the excitement for a moment. With that cupboard of her dreams, filled with all of the equipment she could wish for, what could have taken only a bare minute to setup?
She walked to the door, tentatively reaching out a hand to open it.
* * *
It swung open to reveal Carl standing there. The bed was ready, cover pulled halfway down, pillows plumped up. But she couldn’t see anything else on it. No monitor, no aed pads, no cpr board, nothing. Carl could tell she was looking for something and smiled. His hands were behind his back.
“What do you have for me?” She asked.
He brought one arm out, in his hand a roll of medical tape, the 2-inch-thick kind usually for taping down large bandages.
“Are you planning to tie me up? Or is it you that wants tied up?”
Carl said nothing, but his smile widened. Then he brought his other hand out. In it were two stethoscopes. One of them a professional looking black, with shiny metal work. The other was the one with the sexy nurse bell she had used that first night.
He turned to the bed, not saying a word as he delicately placed the offerings on the bed, then began to take of his shirt. Anna figured out his plan, and immediately started to undress herself. It almost became a race as they both rushed to remove every article of clothing. Anna won, crawling onto the bed, lying on one elbow as she took in the sight of Carl as he turned to her.
“Mmm, I like what I see.”
“Likewise.” He said moving onto the bed next to her. He picked up the bell of the black steth before positioning it on her chest. “Hold it there.” He told her, taking the roll of tape and tearing off a strip. He placed it across the bell, with a decent length on either side. He tore of three more strips, ensuring the stethoscope was securely attached to her chest. He noticed her fingers playing over the tape. She enjoyed the texture and he saw her reaching for the earpieces with her other hand. “Ah ah ah. Not yet my lovely lady.”
He handed her the roll of tape as he picked up the other scope, holding the head in the same position. She didn’t hesitate, tearing off a big strip and attaching it to his chest. Her fingers smoothed the ends of the tape, then lingered, tracing his pectoral muscle before they returned to the tape.
When they each had a stethoscope securely attached to their chests, Anna reached again for the earpieces of the black steth, but Carl beat her to it. “I want your heart all to myself.” He murmured. “And I want you to listen to mine.”
* * *
Anna’s hands trembled slightly in anticipation as she raised the earpieces. She was a nurse, she carried a stethoscope every day and had listened to hundreds, thousands of hearts. But never someone so intimate. Never someone she loved. She took a shaky breath, closed her eyes, and inserted the earpieces.
-Thump. Th-Thump. Th-Thump.
Slow. Steady. Strong. Her fingers quested forward, finding his chest. She pressed her palm to the firm layer of muscle over his ribs.
Th-Thump. Th-Thump. Th-Thump.
She could feel each powerful beat through the wall of his chest. It wasn’t a pounding. That suggested speed, when what she felt and heard was regular, almost measured.
Th-Thump. Th-Thump. Th-Thump.
Anna felt her breathing slow as she listened intently. Beneath the sound of Carl’s she could just make out her own heartbeat.
Th-Thump———–Th-Thump———Th-Thump———-Th-Thump—–
–Lub-Dub—-Lub-Dub—-Lub-Dub—-Lub-Dub—-Lub-Dub—-Lub-Dub
Her eyes opened, Carl was watching her, and listening to her through his own steth. Their eyes met. While no words passed between them, they both understood each other in that moment. They were in a realm of intimacy that was so far beyond carnal physicality that that passed beneath the horizon.
They moved slowly, taking great care not to disturb the heads of the stethoscopes. Carl crept up the bed to rest against the pillows, shifting his arm to create nook into which Anna nestled herself, head resting on his shoulder in a way that wouldn’t put pressure on the stethoscope in her ears. Carl brought his arm around to cradle her, while Anna pressed her left hand to his chest again. Her right hand reached across her body sliding her hand through Carl’s until his fingers rested upon her wrist.
They both sighed out a long breath as they settled. Anna let herself drift, focusing only on the Th-Thump in her ears and under her hand. Strong. Steady. Hers. She felt herself melting totally into the embrace, not just physically but emotionally. She couldn’t remember the last time she had felt so loved. So reassured. So safe. Her heart slowed, gradually, beat by beat.
Th-Thump———-Th-Thump———-Th-Thump———-Th-Thump
-Dub————–Lub-Dub————–Lub-Dub————–Lub-Dub
Two hearts beating as one.
* * *
Carl felt their hearts synchronise. He watched her, saying nothing, doing nothing but imprinting this moment in his mind for eternity. He saw her mouth form into a soft smile that lingered even when the rest of her face became slack as she surrendered to sleep. He remained still for a long time, simply enjoying the sight of the thing that mattered the most to him, enjoying the sound of the heart that beat in tandem with his own.
Slowly he felt the tendrils of sleep tugging at him too. Moving carefully, he gently removed the steth from Anna’s ears, before unhooking his own one handed. He let her head remain on his shoulder. He would probably have a dead arm in the morning. It was a small price, but one well worth paying for such a perfect night.
Sorry for the delay, it’s been a rough couple of weeks but I’m starting to bounce back a little. This probably isn’t my best, but I hope you enjoy it all the same.
Cold Snap : Chapter 1 | Chapter 2|Chapter 3|Chapter 4 | Chapter 5| Chapter 6|Chapter 7
* * *
Carl couldn’t take his eyes off of Anna as they pushed the gurney around a corner. She looked… Amazing. The way she rocked back and forth, compressing their patient’s chest, making her ponytail bounce each time. Her face was a picture of focus, gaze locked on the young woman beneath her as she forced blood through Shona’s ice-cold body. Damn, she was so gorgeous. The way she put her entire soul through her interwoven fingers, into those chest compressions that bent in Shona’s ribs rhythmically. He could see she was doing what he had suggested. Putting her passion, their shared passion, into her efforts.
He took a moment, just one moment, to let a small thrill of pleasure shoot through him. Images flashed through his mind, memories of last night and ideas for when they got home. All the toys they could play with. He took a deep breath, first things first, get their patient back. He let out the breath as they crashed through the doors into Trauma 4.
They pulled the gurney across, lining it up next to the trauma bed. Carl let Anna maintain compressions, as the rest of the team unclipped the straps of the backboard. It was a small risk, but they couldn’t get Shona into the vest that was spread on the bed while she was still strapped down. The vest was capable of keeping her immobilised, the reinforced back and its own means of being secured doing a close enough job.
“Let’s get ready to move her, nice and easy now.” Carl commanded, watching as his other nurses and the paramedic got in position. The ambubag was disconnected and dropped on the gurney as Dave gets his hands underneath Shona’s shoulders, Kirstie gently supporting her head. Others held her arms and legs, kneeling on the bed so they could reach. “Ok, we’re all ready Anna, we’ll move on your call.”
She nodded, her lips moving, as she started to announce her compressions. “43…44…45…46…47…48…49…50!” She finished, pulling her hands away and rising on one knee, un-straddling Shona’s ghostly white body. Anna helped with the transfer, her hands beneath Shona’s waist and thighs. They moved her over as fast as they safely could placing her on the already warm vest. Everyone could feel the contrast, between the heat of the water filling the ribbed plastic, and the chill of the flesh of the young woman they were trying to save. They all knew it meant they had time, but there was still a primitive part of each of them that was scared by that cold.
As soon as they placed her down Anna stood on a step and placed her hands back on Shona’s chest, resuming her barrage, counting in her head once more, to allow Carl to give his orders. “Let’s ready the combo pads, A/P positions in case we need to pace her, then we’ll get her wrapped up.” Anna kept going with her compressions, in the rhythm enough to be able to look around and watch as Trish tore open some sterile packaging and removed a pair of large square electrodes. Trish peeled off the backing of the first pad, revealing the thick layer of electro-conductive gel. Without being asked Anna raised her hands from the ice-cold sternum beneath them and grabbed the other pad. Like a well-oiled machine, Trish placed the first pad, smoothing the edges to make sure the foam stuck well, a split second before the others log rolled the young woman, allowing Anna to slap the other pad onto Shona’s back, similarly fixing it well.
Shona was rolled flat, and Anna’s hands immediately settled back in their prior position, though the pad was now between her fingers and Shona’s flesh. It had little effect on Anna’s compressions. While flexible, the gel was thick and viscous enough that it held its shape enough to allow the force of Anna’s professional chest compressions to translate straight through to Shona’s sternum, forcing it down and simulating a pulse as her heart was squeezed against her spine. Around her hands Trish was folding in the various panels of the vest and clipping them together, tightening the straps to provide a little bit of immobilisation.
Carl continued to run the code. “Roger, grab me the central line, with the temperature catheter. Kirstie get the monitors changed over; did you get anything from upstairs?”
“No luck on the full ECMO, dialysis machine is on it’s way though.” Kirstie told him, as she pulled the thick lead from the portable monitor, connecting it to the large one that hung above the bed. It instantly began to whine the monotone cry of asystole and was quickly muted. Everyone knew the situation.
Carl didn’t reply to Kirstie as she moved onto the other parts of the monitors. He took in the information, then focused on his next task. He moved around to Shona’s head, Dave shifting out of the way. Roger placed a sterile wrapped pack on the corner of the bed, then retreated to the side of the room, where a dozen IV bags were being kept warmed. Carl took the large wide needle from the tray, lining it up along Shona’s neck. He pressed it against the large jugular vein, barely visible thanks to the girl’s blue skin, then in a smooth motion he pushed it in, sliding the length of the needle neatly into the vein. He wasn’t finished though.
Also on the tray was a 20cm long tube, with a spiral that seemed to twist around the thin core, and a bunch of connectors at one end. Carl grabbed it, feeding it into the large opening on the central line, easing it forward, into Shona’s body, deep down the vein, towards her heart. Her heart that only moved because Anna was still pressing down, rapidly and rhythmically, squeezing the organ that refused to beat on its own.
* * *
Anna was starting to feel the effect of her compressions on her arms as she crossed the 3-minute mark. She reached 100 in her head, then started over again, going for a fourth round. She could feel the way Shona’s chest swelled against her hands as Dave squeezed the ambubag, forcing in air that was promptly forced back out by the actions of her own hands. The thick rubbery temperature vest surrounded the circle left for her hands, Trish having strapped it together, before working on the lower sections until Shona was wrapped up from her neck to her knees.
Anna watched Carl work, seeing his concentration as he slid the catheter into the central line, feeling the way it advanced, making sure it was going in correctly. Eventually the plug where it split into a half dozen connectors nestled into the port that stuck from Shona’s neck. Two of the connectors were attached to a small device that began to circulate warmed saline, the device in turn was linked to the monitoring system and, after a few seconds of calibration, Shona’s core temperature was displayed for the whole team to see.
“Core temperature of just 19…” Carl said, trailing off slightly with a frown on his face. Anna knew that signified he was thinking hard about a decision. It took a few seconds, then he gave a small nod to himself. Anna was pretty sure it was totally unconscious on his part. “Let’s go ahead with the thoracic lavage, Roger, get me 4 chest tubes.” Anna cringed internally, but she knew that it was probably Shona’s best chance. Carl continued. “Anna, switch off after this round, Kirstie, you take over, Trish go ahead with the NG tube and then place a urinary catheter.” It would be needed Anna thought, as warmed saline was being pushed into all of Shona’s IV’s, including the central line via one of the dangling connectors.
As her internal count approached 100, Anna began to count out loud again. “94…95…96” Kirstie stood up on a step on the opposite side of the bed and shared a nod with Anna as she wove her fingers together and straightened her arms. “…97…98…99…Switch” Anna finished, pulling her arms away. She stepped aside making sure she wasn’t in anyone’s way as she shook out her arms, trying to recover quickly. She then set about the task that Carl hadn’t spoken out loud.
In the corner of the room were two tall infusers. IV bags could be hung from the top, like a standard drip, but were instead fed into a console that managed the temperature, pressure and flow rate. Anna grabbed them both, one for each side. She placed them by the head of the bed, then headed for a different corner. There, she grabbed two chest drain units, carrying them to the bed, hooking one on each side roughly in the middle of the bed, just next to Kirstie’s legs as she leaned over Shona and delivered compressions.
In the meantime, Carl had almost gotten setup on Shona’s other side, the small surgical kit laid out on a small metal trolley. Anna stepped forward, unclipping the straps of the vest and opening one side, revealing Shona’s chest. Her skin was still ghostly white, the only visible colour being the soft blues and purples of the bruise forming in the valley between her breasts, caused by the compressions that continued to make her ribs flex inwards.
Roger had been waiting, an iodine-soaked swab on a stick in his hand. A moment after Anna revealed Shona’s chest, he smeared the brown disinfectant across it, from up towards her collar bone, down alongside the soft curve of her breast, and over her lower ribs.
“Kirstie, hold compressions.” Carl ordered, armed with a gleaming scalpel. As soon as Kirstie lifted her hands Carl lowered the scalpel towards the space between Shona’s 2nd and 3rd ribs. He made a few decisive cuts, cutting through the layers of tissue. “Tube.” He held out the scalpel, which Anna carefully took, while Roger slapped the chest tube into his other hand. Carl pushed the tube through the hole he had made, sliding it into Shona’s chest, between her ribs and the front of her lung. It had taken 10 seconds since compressions stopped to get the tube in.
12 seconds later another tube stuck out, this one lower down between Shona’s 5th and 6th ribs, basically on the opposite side of her lung. “Ok, Go.” Carl said, prompting Kirstie to resume her barrage. The ends of the two chest tubes swayed and bounced for a few moments but were soon taken in hand by Anna and Carl and connected into what was effectively a loop. From the infuser warmed saline was pumped through the upper tube into Shona’s chest cavity, washing over and around her lungs, providing warming throughout her chest, before draining out of the second tube into the sealed container. This container then fed back into the infuser, which would be able to keep the saline warm enough to be effective.
Carl monitored the loop until it was running through fully, ensuring the compressions were causing no problems. He nodded, satisfied. “Right, let’s get ready to do the other side, Trish, take over compressions as soon as Anna has arranged the vest.” Anna was already folding the vest back over, lining up the tubes to meet gaps and checking that nothing was kinked. As soon as she was done, she slipped around the bed and took position to repeat the entire process on Shona’s left-hand side.
* * *
Lucy had guided Jones through the triage area, gratefully handing the wheel chair off to a nurse who came to assist. Zainab also approached, having just finished an exam on one of the collared patients.
“Hey Lucy, who do you have for me?”
“Zee, this is Matt Jones. Spent 5 minutes in near freezing water. No signs of inhalation or injury, just moderate hypothermia. He’s been responsive throughout, but I’d recommend a full exam and observation.” Lucy said professionally, despite her weariness. They were guided into an empty cubicle and Jones was assisted onto the bed. Lucy leaned against a pillar relaxing a little as Zainab took a chart and started to note things down. “You might want to give psych a call.” Lucy’s voice carried a joking tone. “I’m pretty sure charging further into a sinking ship falls under crazy.”
Jones smirked a little, leaning back on the bed. “I’d say the crazy one is the one who followed me after being told to get off the boat.” He still sounded tired but was definitely recovering.
Lucy shrugged. “Someone had to save your ass. You’d be at the bottom of the river if I hadn’t.”
“True…True…” Jones smiled faded, his tone becoming a little more subdued. “I just hope it was worth it.”
Lucy nodded, looking at the floor. “They’ll do their best. Just like you did. You gave her a chance if nothing else.”
Jones bit his lip, nodding, but his gaze had drifted away from her, staring at nothing. Lucy knew what he was seeing. A mental image of Shona, pale and lifeless. She felt the same way.
Zainab broke them both out of their solemn contemplation. “We should really get you out of those wet clothes Mr Jones, they won’t be helping you to warm up.”
Jones nodded, groaning as he leaned forward and started to fumble with his uniform. A nurse moved in to assist him. Lucy glanced at him. “I’ll be back.” She told him, before nodding to Zainab and the nurse. Lucy left the cubicle, initially planning to get a coffee, but with her mind she drifting she was a little surprised to find herself standing outside Trauma 4. Her eyes were drawn to the table. Tracy was performing chest compressions on the young woman on the table. The vest covered most of her chest, but Lucy could see the tubes running out through slits to the containers.
She could see the doctor tidying away the surgical kit and giving more orders. She could see Dave, still rhythmically squeezing the ambu-bag connected to the breathing tube, stood at the head of the bed. And she could see the monitor, that constant, unbroken line that proclaimed Shona’s heart was still completely inactive.
Story Index - All my stories in one place.
Chapter 1 | Chapter 2|Chapter 3|Chapter 4 | Chapter 5| Chapter 6
***
As soon as the camera angle changed, presumably someone in the news control room had realised they were showing a possibly dead woman under intensive CPR and had cut away, Anna and Carl started to get prepared. Carl called out for his team to join him in Trauma 4, the other rooms already claimed by those doctors who were scheduled for today. There was fewer of them than normal, a few of the nurses already occupied with minor injuries or the other trauma rooms. Zainab was also occupied by the cubicles, sheer practicality making her more useful with the minor injuries that don’t need a fully qualified emergency doctor to double-check.
Anna and Carl were joined by Kirstie, Roger, and Trish. It would be enough for now; they could also call for additional help if they needed it when their patient arrived. Carl looked at them, figuring out a plan.
“We all saw what we’re dealing with. Cold water drowning, clearly no pulse. Don’t expect it to be any different when they arrive here. Our priorities are maintaining artificial circulation and oxygenation while we warm her up. We need to go fast, but careful. The last thing we need is to trigger rewarming collapse. Kirstie, I want you get in touch with Cardio-thoracics and with Nephrology, I want an ECMO or a dialysis machine, both can heat her blood directly, so either will do. We’ll also need warmed saline, a lot of it Roger, I want to get a warmed gastric lavage going as soon as we can and depending on her temperature, we may need to consider a thoracic lavage too.”
Anna cringed slightly at that. A thoracic lavage would involve sticking tube through their patient’s chest wall. It was brutal, but effective. Carl was continuing.
“Anna, Trish, get the temperature vest set up too, warm her from inside and out. Remember everyone, we have time. We do not give up until she is warm, understood?” The team all nods. “Ok, let’s get ready people.” Carl finished, the others all going about their tasks. Trish went to get the temperature vest from Trauma 1, giving Anna a few moments alone with Carl.
“You sound confident.” Anna told him as they stepped out of the way of the others.
He shrugged. “We have every reason to be. We have the equipment, the skills, and the circumstances favour us. Cold water drowning discovered almost instantly? It’s not a guarantee, but in our line of work? It’s the best damn odds we could ask for.” He looked at her seeing her far off gaze. “Are you doing ok?” He asked.
She nodded slowly, then looked back at him, with a sharper nod. “Yeah. Just doing what you said.” Her voice went quieter, just between the two of them. “Accepting it. Using it.”
Carl nodded slowly. “Ok. Let me know if it gets too much. You can take a step back if you need to.” He told her, keeping his own voice quiet.
Anna slipped her hand into his and they gave a mutual squeeze. Then, Trish came into the room with the bulky vest and Anna went to help her. They laid it on the trauma bed, spread open, ready and waiting for them. To Anna it looked inviting, and she couldn’t help but wonder what it would be like to be wrapped up in it. At this point she would normally feel ashamed and try to bury the thought. This time, she didn’t try to eradicate it. Instead, she filed it away. Something to think about later, maybe…even do later. She thought back to her unit on psychology during nursing school. Using rewards to encourage behaviour. If they succeeded, she would ask Carl if he could ‘tinker’ with one over the rest of the weekend, they were his experiment after all, maybe they could be her reward.
She shook her head, dispelling the fantasy and disguising the small smile on her face, as if she were trying to shake a stray lock of hair out of her eyes while she was setting the control panel on the pump unit, which they had hooked to the end of the bed. The had just finished arranging the hoses so they wouldn’t be an obstruction when a receptionist stuck her head into the trauma room.
“We just got a 2-minute warning on the casualty.” She announced.
“Thanks” Carl dismissed her, looking to the rest of his team. Kirstie was still on the phone in the corner, and she shrugged at Carl’s questioning look. “Keep trying, everyone else, let’s get out front.”
* * *
Lucy kept on rocking her body weight forward and backward, keeping her shoulders and elbows locked, hands planted between Shona’s pale breasts. Each time she leant forward, her hands pressed down the drowned young woman’s sternum 2 inches, squeezing Shona’s stopped heart, pushing blood out of it and around her body. When Lucy rocked backwards, Shona’s ribs sprang back also, releasing the pressure on her heart and allowing it to refill with blood.
Lucy did this over and over and over again, keeping the blood flowing. Keeping hope alive.
She’d heard the driver call out the minute warning. She was aware of Dave hooking things to the gurney and moving around her. She was also aware of the burning in her arms, the lead weight feeling of lactic acid build up. It was a long, excruciating minute. But Lucy never faltered. Shona’s ribs bent inwards 100 times in that minute. Each perfect compression forced her abdomen to roll and her shoulders to pop. Her feet swayed and her head bobbed as the force of the compressions translated through her body. It was brutal, what her body was enduring. But that brutality was the only chance she had.
Lucy felt the entire ambulance tilt as it swung into the hospital grounds, felt the inertia tugging her as the brakes squealed and brought the ambulance to a stop. She ignored it all, maintaining her compressions until she saw the blur out the corner of her eye as Anna mounted the gurney, straddling Shona’s unresponsive body. Just like they had done two days ago, and so many times before, Anna gave a short countdown before Lucy drew back her hands, Anna planted her own, and Shona’s chest continued to be compressed.
The gurney was pulled from the back of the ambulance, Dave squeezing the Ambu-bag regularly, and was rushed towards the emergency entrance. Lucy let them go. She dropped onto the bench, flexing her aching fingers and breathing deeply to pay off the oxygen debt. She shook her arms out, then looked at the man beside her. Jones was still wrapped tightly in the blanket and was staring out after the gurney that had already disappeared around a corner and vanished from sight.
“Come on Jones, you need to get to checked over.” She told him, dragging herself to her feet. She helped him from the back of the ambulance, despite the exhaustion she was feeling, and led him toward the entrance. An observer would have struggled to tell which was helping the other, and Lucy was grateful to the porter who ran over with a wheelchair, easing Jones into it before she pushed him into the busy triage area, leaning heavily on the handles herself.
* * *
The wind had eased to a stiff breeze, though it still cut straight through you, in the hour since Shona had fatefully boarded the now sunk Beetle. Yet, none of the team that had assembled outside the sliding door was shivering. Their collective adrenaline rush banished the cold. There was a tension, but it was that invigorating kind of tension, rather than a panic fuelled one. They knew they were up to the task. Their determination was written all over their faces. So, they stood, filled with an anticipation that grew in intensity as the sirens of the ambulance grew louder. Like the legendary warrior, calmly waiting to enter an arena, their own kind of battle was about to begin, and they radiated the same serenity. The same clarity of purpose. The same capacity to spring into action at a moment’s notice.
The siren reached a crescendo, with an accompaniment of squealing tires, as the ambulance pulled into the emergency bay. Anna waited a beat, then stepped forward, giving Roger and Trish just enough time to pull open the rear doors of the ambulance, before she planted her foot on the step, lined herself up, and vaulted onto the gurney. Her knees made the metallic blanket crinkle as she landed softly and shuffled her knees forward. She gave the countdown, and as soon as Lucy’s hands left the patients sternum, Anna snapped hers into position.
Even through her blue gloves, Anna could feel just how cold the young woman was. Her ghostly pale skin seemed to pull the warmth out of Anna’s hands in an instant. It did not deter the nurse. She began her initial round of compressions. The first press was firm and harsh, to gauge the resistance of her patient’s chest, then those that followed were perfectly judged, pushing in the ideal two inches and drawing back fully in under a second. The gurney moving beneath her had no effect on Anna. She was in her zone. This, this was what she was born to do, and nothing, internal or external, could disturb her rhythm as she put all her effort into delivering the best chest compressions she could to the young woman who lay pulseless between her legs.
As she settled into her task, she became more aware of what was going on around her. She heard the whistling of the flatlined monitor, and she heard Carl say something loudly. He was clearly asking for details, as Anna began to hear the response from the paramedic who was pushing the gurney with one hand, while he squeezed the Ambu-bag that was connected to a breathing tube with the other.
“This is Shona. Trapped and immersed in near freezing water. Immersion resulted in asphyxiation via drowning. Due to the water temperature she’s profoundly hypothermic, skin temperature of just 23C. She’s been in respiratory and cardiac arrest for between 18 and 25 minutes, confirmed asystole for 5 of those, but likely much longer. Resuscitation attempts started 14 minutes ago, with no response. She also has a closed fracture to her left tibia. We cleared her lungs and intubated 8 minutes ago, applied chemical heat packs and warmed saline as much as we could. Throughout she’s had a palpable pulse with compressions, so major internal bleeding is unlikely.”
Carl nodded through the report, and Anna knew he was taking in everything, filing it away in his mind, able to recall every detail at a moment’s notice, to the point that the chart Roger was making notes on would be for later doctors, not for the ER team. At the edges of her vision Anna saw black tarmac turn into the marble effect veneered flooring that ran through the ER and almost every other hospital, school and government building in the western world. During those moments Carl was processing what he had been told, and then he began to give orders.
“Right, let’s carry on as planned. Get her into Trauma 4 and get her in the TMV. I want a central line in addition to those bilateral IVs, and I want wide bore access in one of her legs, ready for extracorporeal warming. Let’s get an NG tube inserted too, bi-directional for the gastric lavage. Let’s get a core temp before we consider surgical intervention though.” Carl briefly held his fingers against Shona’s femoral pulse point, his wrist resting against Anna’s calf. “Good pulse with compressions Anna, keep it up, but let’s also get a Lucas ready, this could be a long one people!” He said, a tone to his voice that instilled confidence and re-doubled their determination.
They were going to get their patient back. Shona, Anna reminded herself, looking at the girl beneath her, forcing her name into the front of her mind. She had a cute face, even with pale skin and blue lips, that much was clear. The tape holding the ET tube also pulled at the corner of her mouth, forming a grimace, as though she could feel each brutal compression that Anna delivered. Not that Anna was deterred. She was going to do everything she could to get Shona back. To see those lips pink instead of blue. Smiling instead of a forced grimace. She wasn’t alone in those thoughts. The whole team was feeling the same way as they guided the gurney into the Trauma Wing and crashed through the doors into Trauma 4.
A few people have asked for the earlier stories, so to spare folks having to scour back through my blog to find the story they are after, here is a full index, which I will pin and try to keep updated.
Anna Swift:
Barrista’s Bad Heart (Complete)
Chapter 1|Chapter 2|Chapter 3|Chapter 4|Chapter 5|Chapter 6|Chapter 7|Chapter 8|Chapter 9|Chapter 10|Epilogue
Intermission 1 - The Doctor and His Patient Nurse (Complete)
Dead Drop (Complete)
Chapter 1|Chapter 2 |Chapter 3|Chapter 4|Chapter 5|Chapter 6|Epilogue
Intermission 2 - First Fantasy (Complete)
Cold Snap (Complete)
Chapter 1 | Chapter 2|Chapter 3|Chapter 4 | Chapter 5| Chapter 6|Chapter 7|Chapter 8|Chapter 9|Chapter 10|Chapter 11|Chapter 12|Epilogue
Heart to Heart
Shellfish Surprise (In Progress)
Other Stories:
Out Of Body (Occasional Progress)
Prologue|Chapter 1|Chapter 2|Chapter 3
Hope you all enjoy. Encouragement and constructive criticism welcome.
Chapter 1 | Chapter 2|Chapter 3|Chapter 4|Chapter 5|
Dave was stood on the dock, looking out at the foundering boat when it exploded. He was filled with panic and fear for his partner, but soon had to put that aside. The first patrol boat had pulled up and Dave had to lead the response. He spent the next ten minutes in something of a daze, helping people from the patrol boats, checking them over and directing them to an appropriate holding area or ambulance team.
It was only when the last patrol boat, with quite a badly hurt young man was empty that he realised he hadn’t seen any sign of Lucy. The fear came back as he stared out at the larger boat, seeing it slipping into the water, replaced with relief, as he saw one final patrol boat racing across the river towards them, and could make out Lucy’s high-vis uniform coat. He heard the radio call of the parked patrol boat and looked more intently at the incoming one.
As he watched, he saw what Lucy was doing. “Bring a gurney, now!” He shouted to a pair of paramedics who were now just hanging around, with most of the patients dealt with and on their way to the hospital. They jumped, then looked where he was pointing. Even at this distance, it was clear to see the Lucy was performing chest compressions. The paramedics ran over with the gurney, suddenly focused.
The suspense was agonising, as it always was, when they knew a situation was grave but there was nothing they could do right now. They watched the patrol boat get closer and closer, the first made way, and a minute later the final patrol boat finally came to a sudden stop next to the dock. One of the medics jumped into the boat, strapping the body of the young woman to the backboard she was already laying on., then coordinated with Lucy.
As soon as she finished the round of compressions, Lucy and the medic grabbed the back board and lifted it, head up, towards the dock. Dave took the board and along with the other medic they lifted her fully clear of the patrol boat, quickly aligning her with the gurney. Dave immediately began compressions.
Lucy pulled herself up the ladder, with clearly aching arms, handing the ambu bag, which she had taken from a damp looking police officer, to the other medic on the dock. He sealed the mask over the girl’s face, hyperventilating her with rapid breaths. Lucy got herself up, grabbing on side of the gurney. Dave transitioned to one handed compressions, the other medic dropped the ambu bag by the young woman’s head, and between the three of them, they started to push the gurney towards an ambulance.
The last medic was helping the officer out of the boat, trailing along behind as Lucy, still breathing hard started her report.
* * *
“This is Shona, early 20’s. Trapped and drowned in roughly freezing water. She’s profoundly hypothermic and in cardiac arrest. No pulse for nearly 20 minutes at this point. Closed fracture on the right leg, and a minor head injury, both of minimal importance.” Lucy rattled off, giving the important information to the others. The gurney rattled and bounced across the dock as they ran to the ambulance, pulling up just short.
Lucy hopped in first, pulling the head of the gurney into the back of the van, while Dave managed to keep his hand firmly planted between the pale breasts of their patient, pressing down hard but consistently. “Drive.” He said to the other paramedic, not looking, focused on his attempts to keep blood flowing through Shona’s body. He barely noticed when another figure entered the ambulance and was directed to sit down by the last medic, who the closed the doors giving the side of the ambulance a firm slap to alert the driver.
“This is Matt Jones.” Lucy told Dave. “Also hypothermic, and exhausted, but no injuries?” she leaned over, double checking, while she picked up the ambu bag and forced breath into Shona’s lungs. Jones nodded, still shivering sightly. He pulled the blanket a little tighter, settling back into the corner to rest. Lucy watched him for a moment, but the way he shuffled to make himself more comfortable put her at ease. She focused on Shona.
Lucy grabbed an oxygen line, attaching it the ambu-bag and touching some controls, directing heated air into the bulb. She gave some more breaths, then stood, bracing a hand on the cupboards as the ambulance started to move. She pulled open one of them, extracting some chemical heating pads. She cracked them to activate the effect, then started to place them around Shona’s body, starting with one under each armpit. She leaned around Dave, even as continued compressions wordlessly, placing one heat pack across Shona’s bulging abdomen. She dumped the others on the side of the gurney, realising that Shona was still wearing her saturated trousers.
“Switch Dave.” Was all she said. He gave three more hard compressions, then stepped back to the side, giving Lucy access to Shona’s chest, while he grabbed some shears and went to work on the damp clothing. Lucy planted her hands once more, pressing down. It was easier than before. Two minutes of Dave’s more powerful compressions had weakened Shona’s ribs, and now Lucy didn’t to put as much effort into squeezing the young woman’s stopped heart between her sternum and spine.
For now, Lucy ignored the ambu bag, rocking over Shona and caving in her chest at a rate of 100 a minute, while Dave cut away with the shears. After removing the straps of the backboard, he sliced down each leg, then tugged the pants off. He then sniped away her underwear, casting it aside too, leaving Shona naked on the gurney. He grabbed the heat packs, they were already giving off considerable warmth. He placed once between Shona’s legs, being gentle as he manipulated her limbs, considering the broken leg. The last two he draped over her thighs.
With some haste he also took out a splint and wrapped it around the broken bone. Then opened another cupboard. He took out something shiny and metallic, unfolding the mylar blanket and handing it to Lucy as she stopped compressions. Dave slipped his arms under the pulseless girl, lifting her a few inches off the backboard, being careful with her spine, but knowing that re-warming her was more important. Lucy spread the blanket beneath Shona, then Dave lowered her down. They wrapped the reflective blanket around her, then threw a thick woolen blanket over that too, almost creating a cocoon.
* * *
Only a couple of minutes had passed in the back of the ambulance, the two medics working through a whole list of things that needed done, while still keeping up near constant compressions. With the girl wrapped up, Dave took over compressions again, allowing Lucy to focus on the rest. She started two IV’s, one in each arm, hooking up warmed saline to each via thin tubes. Next, she took a much bigger tube, and a metal cylinder with a blade. She slid the laryngoscope between blue lips, into Shona’s mouth, advancing it until she could see her slack vocal chords.
“Hold.” She said, grasping the tube, then sliding it along the blade as Dave halted compressions. “In”. Lucy said, but he had already resumed the body rocking compressions. She inflated the cuff of the tube, pulled the mask of the amub bag and tossed it to one side, then connected the bulb to the blue tip of the 7.0 ET tube. She squeezed in warmed breaths with on hand, dancing a stethoscope around Shona ghostly pale chest, hearing the welcome woosh of air flowing into her lungs. She could also hear the slight gurgling of the residual water.
“Gotta suction her out.” Lucy muttered, to no one in particular. Dave was intent on the compressions, showing no signs of tiredness, and Jones was leaning into the corner, eyes following their actions, but too exhausted to do anything to help. She gave another couple of chest swelling breaths, which Dave could feel against his hands, then unhooked the bag, dropping it again as she dragged a suction unit from one side, threading the small catheter down the ET tube and into Shona’s lungs. The device slurped and hummed as it drew the last bits of water out.
With Shona’s lungs clear, Lucy tore off a few strips of inch-thick tape, wrapping them around the tube then sticking them to Shona’s cheeks, smoothing them gently, almost caressing. She looked at Dave, who was starting to feel the burn in his arms now, after 4 minutes of compressions. He nodded to her, starting to count softly. “45…46…47…47…” As soon as he reached 50 he pulled his arms back and let Lucy slip in front of him to take over. She had dropped the ambu-bag, letting the tube pull Shona’s head to the side. Her fingers interweaved, lowering down to the soft, cold and already slightly bruised skin of Shona’s chest. Her fingers brushed slightly against Shona’s breast as she started to press down again.
Dave concentrated on the monitor, unravelling the leads, attaching electrodes and removing the backing from those electrodes. He then placed them around Shona’s chest, worming his hand under the blanket for the lower two tabs. The monitor came to life, immediately singing the asystolic whine. Neither Dave nor Lucy reacted. They knew there would be no cardiac activity, Shona had been down for long enough and was cold enough that even if she had been in V-fib at first, that would have faded away before they had a chance to shock her.
Dave grabbed other sensors, clipping the O2 sensor to one of Shona’s fingers, and placing a temperature sensor on her chest. It wouldn’t give them a perfect reading of her core temperature, but it would be close enough for them to have a good guess.
“22 C on the surface sensor, with the heating packs, core’s probably 18, could have been down to 15.” Dave said with a sigh, taking a better look at her. Her lips, though covered with tape, were still clearly blue, and her skin was a pearly white. She was clinically dead, and looked it. It was hard to have hope looking at someone in that state. But he had seen it work out ok, been involved in it in fact, back when he was a fresh-faced paramedic like Lucy. They just had to keep working, keep bending her ribs and compressing her heart, pushing bloody through her body. Because as the saying goes, they aren’t dead til their warm and dead.
Once they reached the hospital they would be able to give her more intensive warming and would be better placed to give additional life support. They just had to get there. “How far out are we?” He shouted through to the front.
“Another minute, we’re on a clear run in!” The driver replied.
Dave pumped the ambu-bag, then began to package the gurney for moving Shona into the hospital, where Dave desperately hoped they would be able to save her life.
Chapter 1 | Chapter 2|Chapter 3|Chapter 4|
Jones was starting to struggle. The cold was sapping his strength, his attempts to grab a hand hold on the staircase had failed. He clutched the handrail, but couldn’t pull himself out, not with the unconscious, pulseless, young woman under his arm. It never even crossed his mind to let her go. The water was rising, pushing them closer to the top of the stairs, but not close enough. and by the time it was high enough, they would be unable to escape the doomed boat, not that he could wait that long. He could feel it. The lethargy creeping through his whole body, clawing at him, physically and mentally.
He kicked hard with his legs, shifting his grip higher on the handrail. It was the last of his strength. That would be it. He looked at the girl. He held her with his arm hooked under her shoulders. Her head was tilted back, her face pale and slack, her lips blue.
“I’m sorry kid.” he whispered, his shivers carrying into his voice. His eyelids felt heavy. His grip was on the verge of failing. His eyes drifted shut. With the last vestige of consciousness, he felt his fingers slipping.
“JONES!” He heard the shout. “Damnit Jones come on!” Help was here. They could get out. Somewhere deep inside he found an extra reserve of strength, managing to look up.
* * *
Lucy had braced herself against the door frame at the top of the stairs, letting her reach arms into the stairwell. “Give me your hand!” She shouted at Jones. His hand was just a few inches short of her reach. “You can do it, just a little further!”
It was clearly a struggle for him, but she watched the determination on his face. He kicked his legs, making one last surge upwards. It was enough. Lucy grabbed his wrist in both of her hands. She could feel how cold he was, and knew he was hypothermic. She started pulling, straining with the weight of both Jones and Shona, but he assisted her by kicking, then managing to hook a foot on a bracket holding the handrail to the wall. From there he was able to get his hand up to the edge of the frame, grabbing hold and steadying himself.
“Take her.” He said, almost breathless from the strain as he fought to lift Shona up enough for Lucy. She was able to grab one of the drowned girl’s arms, pulling up a little, then taking her under the armpits. She was light, but the position still made it harder for Lucy and she grunted with the exertion as he lifted her clear of Jones, then dragged her up and over the lip, laying her down on the tilted deck. She thought Jones was cold, but Shona was far worse.
Jones was managing to climb out of the stairway himself, so Lucy concentrated on the girl. A quick pulse check confirmed what she already knew. She gave an experimental breath, causing Shona’s cheeks to puff out, but not much more. Her lungs were too full of water to allow any air in. Lucy didn’t hesitate. She turned Shona’s head to the side, then moved to straddle her, spreading her coat open. She could see the curve of Shona’s lowest ribs easily, thanks to the wet t-shirt that clung to her, and weaved her fingers together before placing her palms just beneath Shona’s sternum. She pushed hard, inwards and upwards, trying to expel the water from Shona’s lungs.
A gush of water rushed out of her mouth and nose, foaming slightly, spilling out over the deck to trickle away. Another thrust prompts a second burst of water, then a third. Lucy’s fourth thrust elicits less of a reaction, but she keeps going until her abdominal thrusts are only forcing a few bubbles from between Shona’s icy blue lips.
By that point Jones had extracted himself from the stairwell, flopping onto his back beside Shona, taking deep breaths and trying to recover. Lucy ignored him for the moment, leaning down over Shona, still straddling her. Lucy pinched her nose, sealed her mouth over Shona’s again, and forced a breath into her lungs, inflating her chest, the breath flowing in easily now that her lungs were cleared.
There was a sudden groaning sound, and a small bang somewhere beneath them, as the water broke into another section of the boat. It reminded Lucy that the boat was still sinking. “Time to go Jones.” She told him, receiving a groan in response, but he did start to pull himself up. “Come on, I need you to help me with her.” Lucy told him. She probably could have managed by herself, but she wanted to keep Jones close, he looked pretty beat.
Lucy looped one of Shona’s arms behind her neck, holding her in a standing position, with Jones taking her other side. The girl was shorter than them, so when they stood properly she was completely off the ground. There was more groaning from the boat as water spread through the lower chambers, heading towards the front, bringing the ship more towards level. It made it easier to head through the cabin, without having to climb uphill, but also meant the boat was getting closer to going under. Lucy could see outside that the water was close to getting onto the deck. Once it did, The Beetle would go under in moments.
Lucy willed them to move quicker, but Jones could only go so fast in his condition. He was only kept upright by leaning on her through Shona. Gradually they did make it to other end of the cabin, and gingerly made their way down the stairs, and out onto the deck. Some waves had already pushed over the side, leaving a thin layer of water that splashed as they carried Shona to the side.
Luckily, the patrol boat was already waiting.
“Quickly now!” Winston encouraged them, waving them over. They reached him, Jones practically collapsing against the side as he handed Shona off to the veteran cop. Winston took her under the shoulders pulling her onto the patrol boat, which was now practically level with the deck of the sinking boat. Her limp legs flopped, banging against the side, before he laid her down on the backboard that he had already placed in the center of the boat.
Lucy helped Jones up, he was running on empty by now, and helped roll into the patrol boat. She splashed across the deck and grabbed her kit bags, tossing them to Winston before she clambered over the rail of the deck, into the patrol boat. Winston stepped up to the wheel and gunned the engine, pulling the patrol boat away from the stricken vessel. Within two minutes it would sink out of sight, but Lucy wasn’t watching. She’d tossed a blanket to Jones, then went to work.
* * *
Every part of him ached from the cold and all he wanted to do was curl up and sleep. Instead, he pulled himself together, and forced himself to open his eyes and sit up. Lucy tossed him the blanket, and he nodded his thanks, but she wasn’t paying him any more attention. She pulled some shears out of her bag, cutting through the still soaking wet material of Shona’s T-shirt, spreading it the sides. Another snip parted her bra, freeing her breasts. Jones watched as Lucy placed her blue-gloved hands between them and started the first round of compressions. Each thrust shifted Shona’s entire body, making her belly bulge and her legs sway.
Jones could hear Lucy counting under her breath. He knew he had to help. He crawled over to the medical bags, checking the tags and pulling open the one marked airway. He tried to shake some life into his fingers, before grabbing what he was searching for. He attached the mask to the translucent blue bulb, then scooted over and lowered it down over Shona’s pale, expressionless face.
Lucy’s count reached 30. “Breath.” She told him. He complied squeezing the bag, watching Shona’s chest inflate against Lucy’s hands, a moment before she started to push down again, bending in Shona’s ribs. The compressions forced small spurts of air back into the mask, as Shona’s lungs were squeezed along with her heart.
Jones heard Winston speaking on the radio.
“Clear that landing, now. We are two minutes out with a patient.” He pauses, glancing back at the others. “Cold water drowning. Resuscitation attempts are underway.”
“27….28…..29…..30……Breath” Lucy said, regaining Jones attention. He squeezed in the lungful of air.
“Is there anything more I can do?” Jones asked, but Lucy simply shook her head, continuing to count out each time she pushed her hands down into Shona’s chest.
* * *
Lucy knew there was no point in replying to Jones question. Right now, there was nothing more either of them could do. The young woman beneath her was so cold that drugs would be pointless, her heart was undoubtably totally still in her chest, meaning the AED in her bag would be pointless.
All Lucy could do was compress Shona’s chest, forcing blood to circulate through her body, a crude imitation of the function of her now stopped heart, transporting the oxygen being pumped into her lungs by Jones. Lucy hoped it would be enough to keep Shona’s brain alive, despite the rest of her being clinically dead. The fact that she was so cold would help, slowing the damage, but she also knew that this could all be for nothing. That all their efforts may fail, that they were putting a poor young woman’s body through an incredible amount of abuse.
Lucy pushed the thought away. If she let it take hold, she wouldn’t be able to carry on, and then Shona would have no hope at all. So, she focused on her compressions, keeping to the 100-a-minute rhythm, pressing Shona’s sternum 2 inches into her chest each time. “Come on.” She whispered. “Stick with us girl.”
Jones glanced at her, but she ignored him, continuing to maintain her perfect compressions. Every 30 compressions she prompted Jones to give another breath, feeling the air enter Shona’s lungs, making her chest swell against Lucy’s hands before she forcefully expelled it. She was unaffected by the motions of the patrol boat, her compressions consistent even as the boat skipped and bounced across the surface of the water, sending the occasional blast of stinging cold spray over them.
Lucy looked up to judge the distance to the shore, realising they were almost there, the two minutes rushing past since Winston’s call. She trusted that Dave would be ready and waiting to begin the next stage of the fight for Shona’s life.
* * *
Anna and Carl made their way to the hospital without saying much. They weren’t quite running, but they made the 10-minute walk in a little under 7. It helped that the roads had jammed up so tightly that they were able to cross between standing traffic without waiting. News had spread about the accident quickly enough that there were only a few people leaning on their car horns.
They entered the hospital as the first ambulance arrived. They ignored it, a team of doctors and nurses were already waiting to receive the first patients, and the fact the sirens weren’t blaring suggested that these weren’t the urgent cases. Instead, they headed straight to the staff room, discarding their coats, before heading back to the central hub.
For the moment things were reasonably calm. The first few patients, just a couple of families with a few bumps to heads or cuts and bruises, were taken through either the blue or yellow doors, where they would receive appropriate treatment. A bunch of staff were standing around, waiting to make themselves useful, passing the time by watching a large TVs above the central reception desk. Anna and Carl joined them, nodding at co-workers and returning brief greetings. The TVs were tuned into local news channels, all of which were focused on the current events.
A few had reporters on scene, some of whom were a less than respectful distance away. Behind the talking head Anna could see the paramedics managing triage, judging who was in most need of treatment, while also trying to bring families back together after the staggered evacuation. One boat was behind unloaded slowly, as several patients with neck braces were carefully laid onto backboards before being removed from the patrol boat, the medical teams taking their time now that the main danger had passed.
There was one screen that was more eye catching. It was shot from the same helicopter as earlier. Anna watched as a lone patrol bobbed next to The Beetle despite the empty deck. She wondered what it was doing, before she saw movement by the cabin. It was difficult to tell at first, but the camera soon zoomed in to show three figures, two suspending one between them. Anna watched as they boarded the boat. She could tell that middle figure, a young woman, was certainly unconscious. She was so pale, and her clothing was so wet that Anna could guess what had happened. Her guess proved right as the paramedic began CPR.
Anna turned to Carl, sharing a look. They now knew their patient.
Chapter 1 | Chapter 2|Chapter 3|
Anna walked through into the large living room, turning to the TV. Carl was stood beside the counter, phone to his ear, gaze locked on the screen. A newscast was showing aerial footage from a helicopter. A banner along the bottom was headlined with MOMENTS AGO, and scrolling text described the scene. Not that it needed much describing. The boat was pouring with smoke, people crowded on the fore deck. Anna watched, gasping as the fuel tank explosion sent a gout of flame into the air and shook everyone on board.
“Anna?” Sara asked on the phone.
“I saw.” She gulped, exchanging a glance with Carl. They both nodded. Their plans for the day would have to wait. “We’ll be right there.” Anna told Sara, before hanging up, she headed into the bathroom, grabbing two towels. She tossed one into the sink, soaking it in warm water. She gave her chest a quick scrub to remove the lingering gel, then wiped away as much sweat as she reasonably could. It was an old trick nursing school trick, when you had a short break and needed to freshen up. It would have do. Carl entered the bathroom behind her, and she handed him the wet towel, using the other to dry herself.
They didn’t say anything, both processing what they had seen. Not in the way that someone in shock might have to process an event. They were going over the details they had seen. The footage wasn’t great, but the signs of blood and bandages were pretty clear. There was the fire factor too, and given how cold the river was, hypothermia could be a big complication. Carl’s mind was focused on treatments for the worst case scenarios. Anna thought more about the bigger picture. Triage and dividing her nurses to cover as many bases as possible safely and quickly.
Once dry she slipped around Carl and went to the wardrobe. Grabbing her last set of spare underwear and scrubs. She changed with a sense of urgency, Carl joining her soon after. Anna didn’t waste any time sorting her hair. She ran a brush through it a couple of times, then fixed it in a basic ponytail. She went to the living room and looked through the window, down to the road. Traffic was already slowing down, with the river road likely blocked and emergency vehicles overriding lights in multiple directions. The police department would be clearing routes to the hospital, but none would pass this way.
She heard Carl coming though, dressed and ready. She looked at him and shook her head as she went to the front door. “Walking will be quicker.” He nodded and they both left the apartment.
The kettle finished it’s 5-minute boiling cycle.
* * *
Jones ran towards the back of the boat, waving his arms at one point as the boat rocked, presumably a patrol boat pushing off. It wasn’t big enough to be another explosion. He hadn’t considered the prospect but thought it unlikely. What was left to explode? As he neared the back of the boat, he could feel the tilt getting more substantial as the rear compartments flooded first. A part of him hoped that the luggage area wasn’t one of them. A hope that was dashed when he reached the top of the rear stairs.
The waterline was already halfway up the stairs, which with the tilt of the boat were now almost vertical. It was murky too, not the horribly polluted mess it had been in years gone by. For a city river it was remarkably clean. This was just the standard murk of a natural river, suspended silt and foam, plus whatever dirt was being pulled from the inside of the boat. He couldn’t see any sign of the girl. He would have to go in. He pulled off the life jacket, which would only hinder him here, but grabbed the small waterproof flashlight.
Just looking at the water made him feel cold. He took a couple of deep breaths, gritted his teeth, and jumped in. He did his best to contain a half-scream-half-growl, as the cold water shocked his system. The initial shock over, he swore. Loudly. Then turned to the task at hand. Placing the flashlight between his teeth, hooked a foot under the steps, rotated to face down wards, then pushed off, cutting through the water.
It stung his eyes as he kept them open, looking for any sign. It didn’t take him long. The girl, Shona the kid had said, had long blond hair that was spread out in the water, acting almost like a flag, guiding him to her. She was dead. Clinically at least. That much was obvious. Motionless, blue lips. He didn’t bother checking for a pulse or trying to give her some air. It would be pointless with her lungs full of water. Her only hope was that the cold would prevent any major damage. Jones knew that cold water drowning was one of the best-case scenarios for a full recovery. He just had to get her out and get her to help as soon as possible.
He grabbed one of her arms, pulling on it, hoping it would be simple. But she was trapped. He pushed himself closer, down her body length, to get a good view of the cases covering her legs and waist. He could feel his own air starting to run low, but realigned himself, planting his feet against the floor, grabbing the heaviest case in both hands. He pushed off, taking the case with him, moving it just far enough to roll it away from the girl. He did the same for another case, then, lungs starting to burn, he took a chance. He got one arm around her waist, pulled her upper body closer to his shoulder with the other. Then, cradling her tightly, he pushed off in a smooth firm motion. The was a moment of resistance, as the bags and cases tried to keep hold of their prize, then they relented. Shona was free.
As soon as he felt it Jones kicked off the bottom, but his legs were almost fully extended already and there was no dramatic rush to the surface. He had to swim with his legs, each motion needing more oxygen. He could see the light from the stairs, and swam towards it, spitting out the flashlight, letting it sink away. He felt desperate as he crossed the final few yards.
With a great gasping breath he broke the surface, dragging in few deep lungful’s of air, remembering to breath out steadily and expel the co2 that must have been building. He rearranged the body in his arms, getting a better look at her. In the open air her hair had fallen and clung to her face. He brushed it away, without any tenderness, feeling how cold her skin was. He knew there was absolutely nothing he could do but get her out. And there was the problem. Submerged in the water he had been unable to really sense direction. During the short time he had been under, the boat had tilted further, enough that there was no chance of climbing the steps, not with a pulseless young woman in one arm.
* * *
Lucy watched the cop go rushing off, shaking her head. She wanted to go with him. Help him. But she was the only proper medic on board. And as she had told Jones, Patients come first. She got the splint wrapped around the young man’s arm. She didn’t dare try to reduce the fracture herself. She had no idea how many knocks it taken. Instead, she used the splint to stabilise the bones as they were, loosely wrapping anti-septic coated bandages over the wound. It would do.
She followed it up with a neck brace, then waved over a cop. “I need a spinal board from a patrol boat, and some spare hands.” She requested. The cop nodded, immediately going to do as she asked. She checked the young man’s pulse while she waited. It was rapid, a little thready, but not excessively concerning. The head injury could become a problem, but there wouldn’t be anything she could do if he did have a brain bleed. The best thing would be to get him to a neuro unit as soon as possible, and in the meantime try to reduce his pain and stress levels. To that end she shot him up with a moderate dose of morphine, which seemed to calm him.
The cop returned with the orange board and two others. They should have all had training in spinal boards, it was part of the required first aid course for river patrol, but Lucy coached them through it just in case. They log rolled the young man, placing the board before rolling him back, then they tied down the straps, crossing his body and making everything secure. By the time they were done and Lucy could look around, she could see that they were the only ones left on board.
“Ok, nice and easy.” She said, standing up slowly and in concert with the other three. It was only when she was standing that she realised how badly the boat was faring. Luckily the patrol boat was level with them, so they could shuffle sideways along the tilted deck, instead of having to walk up a 30-degree slope. They reached the edge of the boat and she directed two of them down into it, while she and the other balanced the spinal board on the rail.
Carefully they eased the board down into the patrol boat. Lucy looked out at the river. All the other boats were on their way to shore. She looked at the sinking rear of The Beetle. There was still no sign of Jones. “Do we wait?” A cop asked, clearly tracking her thinking. They were the last boat. The last chance for Jones and the possible casualty. She cursed, looking out over the river avoiding the eyes of the cops. They were putting the decision in her hands. Patients Come First.
She opened her mouth to speak, when she noticed something odd. One boat wasn’t heading for shore. It was making a mad dash in their direction, skipping and bouncing on the waves of the river. “No.” She ordered. “Get this one to shore. Go as fast as you smoothly can.” She said starting to turn away.
“Wait, what about you?” The officer asked,
“Patients come first.” Lucy told him. She rushed towards the cabin without looking back.
I forgot how much I enjoy writing Anna and Carl’s relationship. We get to revist them the morning after their fun. Hope you all enjoy it too.
Anna was already awake, a smile on her face as she watched the screen of the monitor on the bedside table. She let herself slip into the memories of last night. It was almost like a dream. Everything she had imagined and more. She shifted a little, sliding a hand from beneath the pillow, down to her chest. The monitor picked up the increase in heart rate as her fingers brushed across the foam backing of one of the AEDs pad that were still stuck to her skin.
She felt Carl stirring beside her and a few moments later the groaned a little as he rolled over. She felt his warm chest settle against her back, his arm wrapping over her, finding the hand that was brushing the pads. His fingers aligned over hers, and together they traced around the electrode with their fingertips.
“I knew there was something we forgot to clean up…” He commented, his voice rumbling through his chest into her spine. It sent tingles through her.
“I’m glad we did.” She replied, guiding his hand across her chest, circling around her breast and down to the other pad.
“Hmm…” Carl grunted in satisfaction, then he shifted again sitting up slightly and leaning over her. Anna felt a slight tug on the wire of the pads. “Could have done without sleeping on this though.” He said, dangling the hard plastic connector in front.
Anna winced, rolling to look up at him. “Sorry.” She had to suppress a slight giggle, at the way he raised his eyebrows.
“That’s it? Just sorry?” His tone was light an playful. “I think it’s going to take a little more than sorry.”
She pulled him down for a kiss, soft and gentle and still breathtaking. “Good enough?” She whispered when they broke apart.
He looked thoughtful for a moment. “It’s a start at least. I’ll have to think about ways for you to make it up to me.” He told her, before he rolled onto his back, stretching out his arms. “I suppose we should get up.”
“Do we have too?” Anna moaned, pulling herself up to sit against the headboard. “Neither of us are working. We could just stay here, enjoy ourselves for the day. Play with some of the other toys…” She suggested, looking at him in what she hoped was an alluring way.
Carl looked at her, his hand reaching up to brush some of her sleep-messed hair out of her face. “You have no idea how tempting that sounds.” He told her, his finger looping over her ear then running down her jaw. “But the fridge is almost empty. So I was thinking we could go the market, stock up, and maybe head to your place.”
“My place? Why?” She asked, thinking about her own dreary apartment. Cramped, dull and lacking that heavenly cupboard of her dreams.
“Well, erm. I know we didn’t actually get around to announcing…us. But I figured if you were ready for that, you would maybe want to… move in here more… permanently.” Carl said, that nervousness she had seen a few days ago coming back. He really did love her.
She leaned over and kissed him, deeply. For almost a minute they were totally connected, breathing each other in. It natural came to an end, both of them a little breathless. “That’s a yes by the way.” Anna whispered, before pulling away.
Carl grinned. “Great.” He whispered back, then swung his legs out of the bed. “I’ll put the kettle on, if you want to…” He waved at the electrodes, ECG and AED, that covered much of her chest.
Anna chuckled, and nodded, then had to stifle a cringing gasp when Carl stood up. A large red mark from the AED connector stood out like a brand on his side. She couldn’t help but giggle. “Sorry again.”
“Oh…You will be….You will be….” he replied with a low grating voice.
“Seriously? A Yoda reference? Nerd.” She told him.
“And yet you knew it instantly. So who is really the nerd?” He countered, slipping out of the room before she could retort. Anna rolled her eyes, yet couldn’t help but smile as she began to peel off the electrodes. She was slowly peeling off the AED pads, when she heard Carl’s phone ring in the other room. She didn’t think too much of it, but a few moments later, her own began to sound. She ripped off the pad, cringing slightly, then looked around for her bag, spying it on the stool in the corner.
She had to step over the CPR board and other leftovers from last night, grabbing the bag and pulling out her handset. She looked at the name. It was Sara, one of her co-workers. She answered.
“I’m sorry Anna, I know its your day off, but they’re calling in everyone. You’d better check the news.”
* * *
The explosion made the entire boat buck, sending everyone left on the deck sprawling, a plume of fire ballooning into the sky. Shouts and screams rang out, as panic began to take hold. Jones couldn’t let that happen. He winced as he pulled himself to his feet. With a glance to one side he noted that at least the injured had managed to get onto that patrol boat before the explosion.
“Get everyone onto the boats. Now!” He shouted at the nearby officers who had regained their feet. As he walked over to that first patrol boat he staggered a touch, the deck pitching up slightly as the rear of the boat took on water. He peered over the side, relieved to see that everyone was ok. “Cast off, now, carry on as planned.” He ordered, then signaled a different boat to take its place. The other officers were marshalling the remaining passengers, getting them organised and ready for a much quicker exit. It seemed to have stopped the panic before it could cause any problems. Which was just as well, he had more than enough already.
He turned and looked around for that Paramedic. Lucy Branthwaite he reminded himself. She was kneeling down, and he saw blood on the deck. He started to rush over, concerned for her safety, before he noticed that she was crouched over another figure. One he didn’t recognise from earlier. He braced himself on the cabin as he leaned over, taking a quick look. The young man had a badly broken arm, and a nasty cut to his head.
“Miss Branthwaite,” he tried to get her attention, but her focus was on the young mans arm as she flicked a penlight across his eyes. “Lucy! You both need to get off the boat. Right now.”
Lucy shook her head. “I need to splint this arm before we even try and lower him down.” She replied, turning and reaching out for one of her bags. As she pulled it closer and started to open it up the young man stirred, then started to get up. “Woah! Woah. Hold him!” She shouted at Jones. “You need to stay still okay. You’re going to be fine. Just stay still.”
The young mans eyes seemed glazed, roaming between Jones and Lucy, then the suddenly snap into focus, and he started to say something. It was hard to hear over all the other sounds as police officers tried to evacuate all the passengers. Both Jones and Lucy leaned closer. “Help her. Please help her.” The young man was crying, desperate, afraid.
“Help who?” Lucy asked. “Who are you talking about sweetie?”
“Sh…Shona. Please help Shona.” He mumbled.
Another passenger, another casualty, Jones thought. “Where is she? Why didn’t see come with you?” He asked.
“Luggage…Trapped…Couldn’t help her…Please.” He sobbed. “Please…”
Jones looked at Lucy, both knowing what it meant. There was someone else, injured and trapped. At the end of the boat that was rapidly filling with icy river water, water that would soon drag the entire boat under the surface of the river. There was no question about what must be done. “Get that splint on then get out of here.” Jones told her, ignoring her half-hearted but obligatory protest as he turned to a nearby officer. “We’ve got another casualty. You’re in charge. Get the passengers, then yourselves clear, Understood?” He didn’t wait for an answer, turning for the door into the passenger cabin.
Lucy stood in his way. “Be careful.” She told him.
Jones nodded. “Don’t wait. You get clear, as soon as you can.”
“Don’t worry. Patients come first,” She replied.
Jones headed through the door, sprinting up the steps, towards the half submerged rear of the boat, dreading what he might find.
* * *
Shona was still in the luggage area, watching the stairs, hoping to see rescue come for her, when the fuel tank exploded. The noise was like a physical wall, flattening her to the floor. The whole boat seemed to jump, giving a moment of weightlessness. That ended abruptly and prompted the heavy luggage to slam into her again. She screamed as her leg became little more than blinding pain. For an almost endless time, the pain was the entirety of her existence. Until she was pulled back to reality by something even worse
An icy, wet feeling running down her spine, and rapidly expanding.
She gasped as cold gripped her, her eyes snapping open to see the water rushing into the luggage compartment. Desperately she tried to move, her hands splashing in the water that was already rising. Her fingers instantly numbed, and her efforts got her nowhere. Her legs were still trapped, there was no escape.
“Help! Please help!” She screamed, her voice breaking into sobs as the cold began to encase her body. There was already two inches of water in the compartment, it was rising fast, way too fast. “Please…” She whimpered. The cold, pain and shear stress of her injuries became too much. The will to fight left her, her head fell back into the water, already above her ears.
Her breath shuddered as her body shivered, her temperature plummeting in the cold water of the river. Her eyes felt heavy. So heavy. Her head fell to one side, and she shot back to consciousness as water trickled into mouth and was pulled into her lungs. She sat up as much as she was able, her body acting almost entirely on reflex.
The water covered her legs now, which was actually almost pleasant, the water stripping away all warmth but also all feeling, dulling the pain somewhat. There was less pressure on her too, as cases and bags gained a little buoyancy in the water. Not enough to let her free herself, but it no longer felt claustrophobic and crushing. In fact it was almost comfortable. Like a weighted blanket, without the warmth.
She let herself half float on the water as it rose, raising her up to a full sitting position. There was a strange feeling. It was almost like serenity. Even though she arched her neck, trying to keep her mouth out of the water, her panic was ebbing away. Her whole body was so numb that she felt nothing. No pain, no pressure. Even the actual feeling of cold had disappeared. All replaced with a feeling of peace and acceptance, even as the water slipped over her mouth, submerging her completely.
On instinct she held her breath as she descended into the water, all sounds being muted away except one. Her heart became loud in her ears, slowed by the rapid onset of hypothermia, each beat was like a drum, thumping out every couple of seconds. It picked up as her oxygen ran low, as her lungs couldn’t hold her breath in any longer. She blew out a stream of bubbles, then drew in a lungful of chilled river water. Her body spasmed, trying to cough out the water, only to draw more in, leaving her trashing as much as she was able. All of this was automatic instinct alone.
In her mind, she still felt only peace, as her heart slowed once more. Each resounding thump carrying her off. Each thump taking her further, drifting closer to oblivion. With a soft, accepting smile on her face as she slipped away, Shona’s heart beat one more, then came to a standstill.
*******
Dave was driving the ambulance down the towards the river road, approaching from the center of the city, when the call came through.
“All available units, major incident on river ferry, requesting all available units respond to docks nearest Tippers Point and North Inglebank.” There was a pause as the technician dialed in straight to them. “3008, you’re closest. Can you initiate triage protocols on scene?”
Dave looked at Lucy, who simply nodded, then picked up the radio receiver.
“3008 to control. We can do that. Do you have further details?” she asked.
“Not yet. You are to liaise with river patrol and assess the situation on scene. Use your judgement.” The radio goes silent.
“That’s a lot of help.” Lucy sighs. The ambulance reaches the outskirts of the business district, turning onto the river road. Without skyscrapers in the way they can see the expanse of the river, the black plume of smoke clear and obvious, below it the water taxi, limping across the surface of the river. From this distance they could just make out people on the upper deck, waving their arms, and a speedboat, a red and blue strobing light flashing from a pole. Dave guided the ambulance between the traffic, which thankfully relented easily with everyone aware of their destination. He guided it off the road, onto the small dock.
They jumped out, already hearing other sirens approaching. Dave grabbed his radio, tuning to the emergency channel. “This is 3008, taking control of Inglebank incident.” A properly trained team would be on their way, but that would be ten minutes. “All units report in upon arrival.”
Lucy was looking out the imperiled boat. “I don’t think she’s going down. She’s taken on water, but I don’t think its totally fatal, not soon anywhere.” She paused. “I should go out there.”
Dave looked at her, seeing that she had thought it through, then simple raised the radio again. “Calling all river patrol, please divert 1 to North Inglebank Dock to take on medical passenger.”
* * *
Jones held tight to some of the hand holds on the rim of the patrol boat as it bounced and skipped along the river towards The Beetle. He was able to make out the design of the boat. It was long, with a stepped profile. The passenger compartment rose two levels, to better look out across the river. Towards the front, he could see a wide interior staircase leading down to the proper deck, flanked by doors to the lower level. Towards the rear, a number of windows had been blown out of the lower deck, with smoke billowing forth. The smoke was thick and black, and also running into the upper deck. The product of incomplete burning. If there was a fire, it was most likely just smoldering the oils and grease that must have been within the engine bay. Fuel would be burning much hotter, and would have taken out much more of the boat. That didn’t mean it couldn’t change.
With the smoke filling the interior, all the passengers had escaped to the front deck. It was crowded, and agitated, but not a complete panic. Yet. As the patrol boat eased up next to the taxi, close to an access ladder, Jones threw out a rope to a man in a high vis jacket, expecting it be one of the crew. The fact he immediately tied off the rope was a decent sign Jones was right. Winton was talking on the radio, so he climbed the metal rungs, and pulled himself onto the deck, appealing for calm as he tried to make sense of the situation. He approached the crew member, seeing that he’s an older man, with a white beard and matching hair.
“You are?” He asks.
“The captain, sir.”
“Good. I’m officer Jones, what’s the situation?”
“Catastrophic engine failure. Couldn’t get eyes on but I don’t think it’s fixable. We’re dead in the water.”
Jones bit back a flash of anger. “Is the boat sinking right now?”
The captain sighs. “Yes, but slowly as far as we can tell. My lads are trying to get access, find out more, but as it stands, she’ll stay on the surface for plenty long enough.”
“Ok.” Jones turns to the crowd. “Help is coming, so please stay calm, we’ll get everyone to safety.” He scanned the crowd, seeing plenty of bloodstains and dazed looks, but nothing too major.
* * *
Lucy had made a quick boarding onto the patrol boat that pulled up at their dock. Sirens had been approaching, but she trusted Dave to organise everything on this side. She double checked her bags as they skimmed across the surface, effectively deputising the one of the cops on board the patrol boat. She showed him a set of large colour coded tags. “We tag everyone!” She shouted over the sound of the motor. “Green for no signs of injury. Blue for cuts and scrapes. Yellow for broken bones, burns, anything you would expect to need treated.” She explains each colour.
“Purple for conscious head injury, right?” The cop checked, having been part of major incident responses before now.
Lucy nodded in reply. “Anything worse, you point to me. Those will be priority one, understand?”
The cop gave her an acknowledgment, pocketting the stack of tags, and they made the rest of the journey in silence, both thinking about what they may find onboard the damaged vessel.
A few short minutes later they pulled up alongside The Beetle, other patrol boats backing off to allow them access to the ladder. Lucy climbed up first, not hesitating for a moment. Reaching the deck she saw that things were not as bad as she feared. There were plenty of injuries, but the fact everyone seemed to be sitting or standing, and no one immediately tried to grab her, suggested there was nothing critical.
She waved the cop she had commandeered towards the crowd of passengers, who she noticed were mostly organised into the correct categories anyway. She spied one cop who seemed to have taken charge, on the opposite side of the deck, marshalling kids onto a patrol boat, and headed over.
* * *
Shona’s ears rang. Her nostrils were filled with smoke. Where….What….
Sensation began to return. Her whole body ached with pains and pressure, but one pain kept growing and growing. Her leg. Her leg felt like a constant sharp pain, like a spear was jammed in it. She tried to open her eyes, but her vision swam, and a wave of nausea crashed over her. I took a moment for it to pass, before Shona tried to open her eyes again.
It was better, not by much, but not sickening. She was looking at whitewashed, decades old wooden boards. The ceiling of the lower cabin of the water taxi, and the doorless frame of the luggage compartment. That answered the where.
She started to look around, there was smoke, a lot of it, thick and black, flowing up the stairs. Something seemed off though. The smoke was rising at an angle, heading to the wall first. The boat wasn’t level. It was tilted to one side. Which must mean. Sinking. The boat was sinking.
Instinctively she tried to move, to flee. But the pain seared through from her leg, and the rest of her could barely move either. She looked down, having avoided doing so up to now, only to see a whole luggage rack lying across her legs, pinning her, with smaller bags from the sides scattered over her top half. She could just see which bag was on her excruciatingly painful, almost certainly broken, leg. She almost laughed hysterically. It was her own.
The case prompted more details to came to mind. “Jack?!” She shouted, pushing away a couple of the smaller bags, trying to get a clearer view of the nearby floor. She saw him, crumpled in a heap, not far from her. They must have both been thrown down the stairs when the engine exploded. He wasn’t pinned, but a trickle of blood ran from a cut in his scalp and he was clearly unconscious. “Jack!” She shouted again, grabbing a lighter bag, and throwing it at him. It had the desired reaction, he stirred, moving slightly and groaning.
His groan grew to a shout of pain as he pulled himself up. Shona watched him as he turned slightly, and she saw his right arm. More specifically she saw the bone sticking out of the skin above where he held it. She realised the implication immediately. There was no way he could help her remove all the bags. Especially not her own. “Jack!” She shouted again, trying to get his attention. He looked up, squinting slightly as he looked for who shouted his name. He was clearly dazed, working through things just like she had.
He looked around and Shona could see him piecing things together, before his head snapped back to her direction. “Shona? That you?” His voice was a little slurred
“Yes. Jack. Listen. I’m trapped. I need you to get help, to get these bags off me. I think the boat is sinking, so please hurry.”
He squinted at her, shuffling forward on his knees. “Trapped?” He asked. “I..er…I can.” His voice was off, still feeling the effects of the head injury.
“You can’t. Your arm. Just go. Up the stairs, get help. Please!” Shona pleads, using short phrases in the hope it might help.
It seemed to work. Jack nodded. “OK… OK.” He took a few deep breaths, reaching out with his good arm, grabbing the door frame of the luggage area. He pulled himself up, hissing with pain as he did so. His eyes found hers. “Hold on.” He said.
She nodded. “Hurry…” She whispered. He nodded, then turned, stumbling towards the stairs on the listing floor, but reaching the stairs. He gripped the rail, then began to climb. A moment later he disappeared into the thick smoke, leaving Shona alone.
* * *
“Ok Winston, that’s all the kids.” Jones looked to the small faces, many with tears rolling down their cheeks despite reassurance their parents would be with them soon. “Winston here is going to take and nice and steady for you guys! If you ask nicely he’ll tell you about all the fish he knows!” Jones looked pointedly at one of the older kids, a girl, maybe 15, who nodded at him.
“I think thats a great idea!” She said loudly.“What’s the biggest fish you’ve ever caught Mr. Winston?”
Winston gave Jones a quick salute, before setting the patrol boat in motion. “Well, that is a story! Have any of our been out to west? Into the lakes? It’s be, oh, 10 years ago…” Jones turned away, almost colliding with the paramedic.
“Lucy Branthwaite. You in charge?” She asked, rather abrupt, an annoyed look on her face.
“Apparently. Matt Jones.” He held up a hand, forestalling her. “I know what you’re going to say. We checked them for injuries. Greens and blues only, but i’ve directed them to the triage dock anyway. There should be enough time for your people to give them a once over before we make them busy.”
Lucy’s stony gaze on him held for a few moments, then softened. “Ok,” she said. “What else have we got?”
“Mostly minors, a few bumps to the head though. I want to send those next with your permission, then work our way through the rest. We don’t have safe capacity for everyone in a single go, but the captain says we should have plenty of time, before the boat becomes dangerous.”
“Ok, agreed. Do all your boats have spineboards?” She asked, recieveing a nod in reply, get them all on deck, I’ll assess the head injuries, immobilise those that need it I can have some of your man power.“
"I wouldn’t call them mine, but I’ll spread the…” he’s cut off by a shout, as crew members come running out onto the deck. “Hold!” Jones shouts, bringing them up short. “Report!”
“Fire! Fire in the engine bay, we couldn’t put it out.” The crew member shouted, causing a ripple of alarm through the crowd of passenger.
The captain came closer. “Quiet you fool. How bad is it?”
“Caught a fuel leak sir. We managed to clamp the lines before we got out, but its burning in that direction.”
“Officer Jones, our time just became more limited. If the fuel tank blows we’ll be under within ten minutes.”
* * *
The officer looked at her. It was hidden, but she could see the panic in his eyes. “Can we send the head injuries without immobilisation?”
Lucy ran her hand through her hair, looking at that small cluster of passengers, then she nodded. “I think so.” She pointed to one bag, there’s a dozen neckbraces in there, they’ll have to do. I’ll go with them in one boat, slow and gentle. Can your other boats handle the rest?“
"They’ll have too.” Jones replied. Before turning and barking orders, the air of command returning as soon as the decision was made, getting the less injured onto the first available boat, making best use of time.
Lucy made her way to the head injuries, and began fixing the collars, before handing them off to some officers who were helping them into the patrol boats as gently as they could. Lucy finished with last one, and looked around for Jones to tell him they were going, when she saw a new figure stumbling down the stairs inside. She saw the gruesome spur of bone sticking from his arm and rushed forward, pulling the door open for him. He almost fell into her arms.
“Help her…Plea…”
The fire reached the fuel tanks.
I’m back, again, hopefully a bit more consistently. This time returning to the world of Anna Swift with a story that’s been an idea for almost 2 years but couldn’t quite come together. No resus in this part, just setting up the scene, but I hope you enjoy.
———-
Shona dragged her large suitcase up the ramp and onto the lower deck of the old water taxi. It had become almost like an old friend to her over the last few years, the point of seperation between home and college. She turned and waved to her parents, who stood back on the quay, watching thier daughter leave for the last semester of her college life. In truth she wasn’t going all that far. Only a dozen or so miles as the crow flies, and within the limits of the same greater city area. But while the city had grown and expanded to absorb her old home town as a mere suburb, the city’s transport links had not kept pace. While the rail network ran along each side of the river, it didn’t cross at this end of the city. There were plans for new bridges, but they never materialised. And so, instead of taking a 3 hour trip on the city metro, Shona would take the trusty water taxi that had been crossing the river back and forth for as long as her mother remembered, and be at her dorm within 40 minutes.
A good idea really, she thought, pulling on the suitcase behind her, trying to get it rolling again. She cursed internally at her professors for giving them so much work over the spring break, the suitcase weighed down with what felt like half a library. A gust of cold wind blasted her face, and she thought of another curse, this one at the northern climate. To many, spring break was about running around on beaches nearly naked having parties and getting tanned. To say it would not be advisable here was an understatement. This far north, winter was still clinging on, to the point where snow lay on the ground just a few weeks ago.
Shona pulled her scarf up a little further as she dragged the suitcase toward the door at the rear of the cabin, where luggage could be stowed out of the way. She pushed it open then spun to grip the suitcase handle with both hands and haul it over the small threshold, staggering back a little as the wheels finally rocked over. A gust of wind sucked the door closed with a loud bang and shone flinched, glancing around to see if anyone noticed. Like public transport in most cities, no one so much as glanced at her.
She ducked into the luggage area, and her heart sank. All the lower shelves were full. She walked over, wondering just how she was going to stow the case. She vaguely heard the door behind her, then the sound of rolling wheels that approached and stopped beside her.
“Erm, would you like a hand?” A male voice said. Shone turned to him. He was young, maybe a similar age to herself, with black hair in that intentionally messy style. He raised his hands in a surrendering gesture. “Not infering anything about the strength of your gender…You just looked… and I need to…” He glanced at his own case, similar sized to hers.
Shona shook her head “Sorry, yes that would be great.” She smiled. “We can each lift half.” She commented, prompting a grin from the young man. Together they lifted her bag. Well, Shona steadied it at least.
“Student?” The young man asked, with a slight pant from the effort. Shona nodded, and opened her mouth to reply. “Wait, let me try and guess. Your on this taxi, so you must be studying at Central. That amount of books, over spring break no less, narrows it down. Medical students are already back, my roomate’s doing Chem and says all the natural sciences work is based on their own labs now. And, I haven’t seen you in any of my classes or on my floor of the library, so by process of elimination I’m going to say… History.”
“Impressive.” Shona told him with a grin. “You must be studying literature.” She grinned at his shocked face. “My roommate is in that course. She can almost quote the entire works of Sir Arthur Conan Doyle at this point, and she told me that almost everyone goes through a Sherlock phase in that course.”
He chuckles. “Well played. I must know the name of the lady who bested me.” He said, with a mock bow.
Shona couldn’t help but chuckle too, though it was drowned out by the horn of the water taxi, as it gave it’s last call. Shona felt the familiar rumble as the engine got into gear and began to ramp up in power. “Shona. Shona Smith-Carlson. Yes it’s double barrelled. Ardent Feminist of a mother refused to give up her maiden name.”
“Well theres nothing wrong with that. Though by the look on your face you aren’t too happy it.”
“It’s not that,” Shona shrugs. “She just never shuts up about it. Still loves dad though.” She trails off, the silence starting to become awkward. “What about you?” She re-directs. “I’m guessing your name isn’t actually Sherlock.”
He smiles. “Jack Davidson. Not literally, My dad’s actually called Mark.”
“You must have practiced that line.” Shona said, trying not to laugh at the perfect delivery.
“Maybe once or twice, but it’s a good ice breaker, don’t you think?” He replied with another dazzling smile.
It was a nice smile. The boat jerked slightly as it left the quay and started its journey across the river. Shona rocked a little, Jacks arm moved, lifting a little, not quite reaching out, but ready to steady her if she had stumbled, and Shona suddenly realised he was flirting. Why did this always happen? She fought to not roll her eyes. Her girlfriend was going to rib her again. She would have to let him down gently. She took off her scarf, wrapping it and putting it into one pocket, and then unzipped her coat. She caught his eyes flick down as all men’s do, then slightly to one side, catching sight of the rainbow badge.
He blew out a breath, then nodded with a wry grin. “That’s a good move. I am out played once again. Though I suppose we aren’t quite playing the same game are we.”
Shona shrugged. “Sorry.” She mumbled.
Jack waved his hand. “Don’t be. Not like you can change who you are. How about we get my bag stowed and then we grab a coffee on the upper deck?” Shona looked at him, puzzled. “Your roommate. From what you were saying she’s a year ahead of me. A bit of early information is always good.”
Shona considered it for a moment. He wasn’t being pushy or angry like one of thoseguys. And she was planning on getting a coffee. So she shrugged. “Why not, company is always nice.”
Together they lifted Jack’s case, a little lighter than her own, and placed it in the rack. But as he was checking it was secure, Shona felt a rumble. A different rumble, one that she had never felt before on over two dozen journeys. If she’d been outside, she would have seen a plume of black smoke rise out the tall exhaust stack. If she’d been in the cabin that qualified as the bridge of the boat, she’d have heard voices filled with panic as alarms squarked.
Shona and Jack started up the stairs in front of the luggage compartment, when there was another rumble, and a strange noise filled the passenger cabin as the whole ship vibrated. Shona stopped halfway up the stairs, looking behind her. Jack turned to her, three steps higher up.
“What is it?” He asked
Shona shook her head “The boat. Somethings wr…”
Her voice was totally drowned out by the noise of the engine exploding.
**********
Officer Matt Jones sat on the small river patrol boat, bobbing slightly against it’s mooring. He glanced at his watch. Just another 7 hours and 50 minutes of his 8 hour shift. He sighed, feeling that boiling anger as he rembered getting busted down to river patrol. Not even standard beat cop, river patrol. In March, in this city, where even the foolish wouldn’t think of getting in the river. Only the desperate. But this section of the river didn’t even have any bridges, ruling that out too.
“So…” The old timer, Winston, who was now his partner muttered. “Who did you piss off to land yourself here?”
Jones breathed out slowly, sending the anger with it. “You know Dean Campbell?”
“The head of HR Dean Campbell?” Jones nodded, Winston whistled. “What did you do?”
“I may have pointed out that he was… inadequate for the position. In somewhat more forceful terms. To his face…”
Winston spat into the river. “That would do it. Not that you are wrong of course, that little weasel has done nothing but damage to the department, but, not exactly the wisest decision.
Jones nodded. "What about you?”
“I asked to be here.” Winston replied, prompting a look from Jones. “Coming up on retirement. The last thing I wanted was to be that stereotype. Always liked fishing, figured I’d get some boat time and avoid anything likely to finish me off before my service is done.”
“That’s fair enough I guess.” Jones told him, sipping at the coffee, watching the old water taxi make it’s way across the river. He noticed the black smoke, but thought nothing of it. “Does anything interesting happen here?”
“Wouldn’t have picked this spot if it did.” Winston replied. “Occasionally that floating wreck needs a hand when it breaks, but that’s about it.” He says turning to look. “Speking of which, that exhaust don’t look too healthy.” He said a moment before the radio squarked, lighting up an indicator on the emergency channel.
“This is the Beetle, may-day, may-day, our engine is….” The radio cut off as a gout of thick black smoke burst from the exhaust tube, and the distant boat seemed to lurch. A split second later the sound wave of the explosion reached them.
“Get us moving!” Jones shouted to Winston, as he grabbed at his own radio. “This is officer Jones, Badge number 4582. We have a major incident in progress on the river between….between…”
“Between North Inglebank and Trippers point!” Winston shouted.
“Between North Inglebank and Trippers point. Explosion on a water taxi, we are en-route, unknown casualties, unknown situation, requesting additional backup for evacuation and medical assistance!”
“Acknowledged Officer Jones. Relaying now.”
Winston had gotten the speed boat unmoored, tossing a high-vis life jacket to Jones, before he gunned the motor and they began to cut through the waves, heading for the vessel that was now smoking from more than just the exhaust.
(Edit: Fixed some errors and details. A little out of practice.)
Didn’t really feel like writing much of a resus scene after recent events, but I already had some stuff written so I worked it in where I could while expanding the story a bit more.
************
Jane
The ambulance swung into the emergency bay of the major trauma centre, stopping a few feet beyond an assembled team of doctors and nurses. They were already in blue surgical gowns and with the coordination of professionalism and experience, they spread around the back doors and pulled them open, dragging the gurney out. Dave was still pumping the ambu bag while Jane, her sweat slicked fringe sticking to her forehead, handed over the IV bag and monitor to waiting hands before the team ran inside.
“What have we got?” The trauma lead asked as he ran his eyes across Laura’s restrained body. His eyebrows raised slightly at the improvised chest tube.
“Laura Beckett, 23. Involved in an RTC, sedan vs motorcycle. Fractured femur, query dislocated hip and knee. Fractured wrist as well. Multiple broken ribs and punctured lung, leading to severe haemothorax. Resulted in cardiac arrest, downtime of approximately 25 minutes, reversed after the pressure of the haemothorax was relieved. BPs still low and O2 sat’s barely over 80. Currently sinus tachy at 120.”
“Beckett?” The doctor asked, not asking the question out loud. Jane simply nodded. “Ok, lets get her inside, fast beep radiology we need to get a full trauma series ASAP. Let’s get a proper chest tube in, get her on the vent and pack the rapid infuser with TXA, platelets and 2 units of O-neg.”
“She’s A-positive.” Jane cut in.
“Good, lets get 6 units of that up from the blood bank. Get in touch with cardiothoracics, orthopaedics and neuro for consults.”
The rest of the team confirmed their orders as the gurney was pushed into the primary trauma room. After a 3 count Laura was lifted across onto the table, a flurry of action surrounding her as doctors and nurses perform the assigned tasks. The lead eased Jane back.
“We’ve got it from here Jane.”
She shook her head defiantly, but her voice came out in a whisper. “I’m not leaving her.”
“You’ve done your job. And done it well, but you can’t help her in here. Go get cleaned up, you’ll be the first to hear when we have any news.”
Jane lingered for a moment, gazing at her sisters body as nurses rapidly stripped away her clothes, discarding them into a bloody heap in one corner of the room. Then her shoulders slumped and her head bowed as she retreated from the trauma room, discarding her gloves into a bin.
Dave tried to catch her attention, but she ignored him, heading towards the ladies restroom while pulling out her phone.
Ashir
Ashir sat at his desk, much of the room shrouded in the late-night darkness. The desk itself was lit by a powerful lamp that starkly highlighted thin tendrils of smoke as they were drawn into the small extraction unit mounted in the window. He peered through the microscope, gently applying more solder to the electronic circuit board he was working on. It wasn’t work that needed to be done right now, but he needed something to occupy his mind. He made a satisfied grunt and shifted the microscope out of the way. He leaned back, stretching and rubbing his eyes, while spinning on his chair.
His gaze fell on the other desk in the room. Laura’s desk. It was cluttered, stacks of newspapers, photographs and journals were strewn about in a system that Ashir couldn’t recognise, but his journalist roommate seemed perfectly at home with the mess.
The pin board hung on the wall behind the stacks was a different story. It was laid out like a true conspiracy theory board. Over a dozen profile pictures formed the centres of different sections and various colours of string linked articles and reports in a web that looked chaotic at first glance. Looking closer, and with only a small amount of guidance, it began to come together into a cohesive whole.
Ashir sighed. He really hoped his roommate was wrong about all this. But even he had to admit the evidence was compelling when presented in the way she had laid it out. That was part of what worried him. She should have been back by now. Or at least have dropped him some form of message. At least she’d told him where she was going. He’d been able to get his own backups into place. She’d probably kill him if she knew about them.
As that thought crossed his mind his phone began to ring. He let out a relieved sigh as he prepared to make his concern clear. That was when he saw the caller ID. His hand trembled as he answered.
“Ash you were right. She’s in over her head.” Jane’s voice was tight.
“What happened?” Ash was already on his feet looking for his keys.
“She’s hurt Ash. She’s really hurt.”
“I’m coming down there.” He pulled on his jacket then flicked off the light.
“Hurry Ash.”
Laura
I heard the noises first. Alarms sounding. Orders being given. I opened my eyes, once again struck by seeing the world in that strange brightness. A nurse was above me, rocking backwards and forwards, her ponytail flicking to and fro with the motion, until she paused for a brief moment. I followed her arms, down to her hands that rested in the slight valley between my breasts.
“Still nothing, resume compressions.” Someone said. The nurses hands suddenly disappeared into my chest. CPR, I was getting CPR again. My heart had stopped once more. The way the nurses compressions passed through my ethereal form was still incredibly disconcerting, so I sat up and looked around. Doctors and nurses surrounded me, but there was a gap at my feet. I managed to scooch past them without passing through anyone, then turned to look my body.
I was naked on the table. And I didn’t look good. My chest was heavily bruised, with tubes sticking out of either side, Jane’s impromptu effort having been replaced by a proper chest tube, an identical one mirroring it. My broken arm and leg had both been splinted and bandaged, though the bandages were already stained through. A urinary catheter had been placed. I was slightly glad I hadn’t seen that happening, someone touching me in such an intimate place.
A large bore IV was in my leg, with other lines into my arms and another one near the base of my neck. Blood and saline were flowing into my body, though as I watched, a nurse pushed some drugs into the central line.
The ecg wires trailed across my chest, leading to a monitor that hug above the trauma table. The line on the monitor was flat. I looked down at my chest, seeing my lifeline still strong and thick. I also saw that my ghostly form was naked too. I instinctively tried to cover myself, despite no one being capable of seeing me.
I looked around for my clothes, shredded and discarded into one corner. I reached out to them, but of course my hand passed right through them. But there was something. A strange feeling, almost like a memory of sensation across my whole body. I reached out again, letting my hand linger within the bundle. The sensation became stronger, growing steadily, and it was almost like I could feel the clothes on me.
I took a deep breath, recalling the meditation techniques my therapist had taught me years ago. How visualising a result can help it happen. I had no idea if it would work, but I’d rather not walk around naked, even if no one could see me. I tried to hold on to the memory of my clothes as I pulled my hand out. I could still feel the clothes on me, and focused on that feeling, blocking out everything else. Slowly, I let out the breath and opened my eyes, looking down at myself. I was clothed. My dark grey t-shirt and similar coloured pants were whole, despite their real counterparts being little more than shreds before me. My black hoody was also on me, unstained by blood like the genuine article.
“We’ve got V-fib.” Someone shouted, dragging my attention back to my body. The alarm had changed, it was familiar enough that I knew what was going to happen next. A doctor, fully gowned and masked, held a pair of black paddles down against my chest. “Clear!” He said, a moment before my naked body jerked on the trauma table. I cringed at the way my legs spread slightly.
“No change. Let’s do another minute of compressions and shock her again.” A nurse immediately had her hands back on my chest, pressing it down, seemingly quite easily. Given how petite the nurse was, my ribs must be really soft.
It was almost enough to turn my stomach, and I instinctively took a few steps back. There was a momentary feeling of resistance, and suddenly I couldn’t see anything. I paused, realising that wasn’t quite right. I could see, there just wasn’t anything too see. Except the papery texture of the back of the plasterboard sheet in front of me, and the treated timbers that were the drywall studs. I was insidethe wall. I took another step back, emerging into a corridor.
It was a quiet corridor, empty except for a cleaner at the far end. Yet I could still hear a voice. Quiet, but clear. It was counting. “15…16…17…18…” I grimaced slightly, then plunged back through the wall. The nurse was still pressing down on my chest, and she was mouthing the words, but more to herself. She wasn’t shouting by any stretch, in fact I would be surprised if her words would even carry to where I stood.
So, I can still hear what is happening to my body.Helpful. I glanced down, concentrating slightly to look at my lifeline. It was still strong and steady. How far can it stretch? I remembered Keith telling me to stay close, but the lifeline was thin then, insignificant compared to the almost cable thick line I could see before me now. I made up my mind. I strode across the room, towards the doors, unable to stop myself from hesitating just slightly before I walked through them. Again that slight resistance, more a reminder the wall was there, than something really stopping me, tugged as I passed through. And then I was in a different corridor, busier, but still quiet.
I looked around, hoping to see Jane, but she was not there. I walked down the corridor, trying to figure out precisely where I was, or where I should go. I glanced at the signs, but most of them were mainly just numbers, hanging in front of cubicles or other offshoot corridors. Coloured lines were on the floor, branching out down the corridor behind me. Presumably,I thought, they must all come together at one starting point. I followed them back, dodging a nurse pushing a young man in a wheelchair, a large boot on his foot. Neither of them payed me even a sliver of attention.
“Ok, that’s a minute. Let’s shock her again.” It was the voice of the doctor working on me. “Clear” he said a moment later. I stopped walking as I wondered if I was about to be wrenched back into my body. “Still no change. Load her up with epi, bicarb and amiodarone.” I considered going back, but my lifeline hadn’t changed. I was close enough to see the name plate on the nearby doors, ‘Reception’. Seemed like a sensible place to look for my sister.
I passed through the door and immediately sidestepped out of the way of a porter. It was much busier in here. I retreated to an out of the way corner and looked around for Jane. I couldn’t see her anywhere and was beginning to wonder if she had abandoned me and gone back to work when I saw a high-vis jacket come around the corner. It was her partner. Dave. I remembered. He held two coffee cups, putting them on a counter before reaching for his radio. I crossed the room, weaving around nurses and patients, cringing when a small girl ran through me.
Dave was already mid conversation. “…anks for sorting it. I’ll tell her then I‘ll run the rig back to base.”
“How’s she doing?” A voice said from the radio.
Dave blew out a breath between clenched teeth. “Honestly, not good.” He seemed to stare across at a pair of doors across the room. Toilets. “I mean, it is her sister after all, how many of us would be alright after seeing someone we love in that …” I left him behind as I crossed the room and plunged through the wall into the ladies restroom.
Jane stood there, leaning over a sink. Her high-vis jacket lay on the floor at her feet. Her knuckles were white as she gripped the edges of the sink. She was murmuring to herself, enough to earn a sideways glance from another woman who quickly scurried out.
“…stupid. Stubborn. Why couldn’t you just listen to me. I begged you. ‘Don’t go after him.’ But you didn’t listen. You never listen.” As I stepped closer, I could see her aura. There was a bubbling of red, but it was mostly that sickly green. As the door swung shut behind the fleeing woman, Jane let out a great shuddering sob, and tears began to fall from her face. I reached out, but my hand passed through her shoulder.
I could still hear the distant sounds of the attempt to resuscitate me. A third shock delivered. “Back in asystole. Ok, hang another round of blood products and chase up the surgical consult, if we don’t get anything back in two minutes we open her up down here.” That sounded just delightful. I glanced down at my lifeline, but it didn’t look like it had diminished.
That’s when I noticed the traces of red in the sink. Blood. My blood. As if to distract herself, Jane washed out the bowl of the sink, tears still dripping as she took deep steadying breaths. I’d seen her do it before. Fighting to assert an iron control over herself. It had always driven me crazy, especially after what had happened to Mum and Dad. But then, something happened that I had never seen before.
She lost.
Her whole body was wracked with sobs as she sank to the ground against the wall. Her hands covered her face and she drew her knees up tightly. I didn’t know what to do. So I sat down beside her. For just a moment I passed into the wall, but I grabbed that moment of resistance, held it my mind for a few seconds, and suddenly the wall felt solid. I leaned back against it, looking at the ceiling.
“I’m sorry. I’m so sorry.” I whispered. As expected, she didn’t respond. She continued to sob, and I could see tears leaking out. I sighed. “It was him. If you can hear me at all, hear that. It was him. Patterson. I was right. He’s a murderer, and he tried to kill me. Just like he killed them.” I could feel the anger building. I turned to look at her, as she lowered her hand, her sobs easing. “It was never your fault Jane. It was always him. He had mum and dad killed.”
Sorry for taking so long to get back. A bad year followed straight after by a pandemic hasn’t been great, but i’m slowly getting back to my old self and another recent return inspired me to start trying to write a little bit more. I’ll be honest this part isn’t totally new, I did post it somewhere else around the time of the first chapter, but i noticed I hadn’t updated it on here. I’ll probably do a bit more on this story before going back to Anna Swifts stories. Anyway, it’s been nearly 2 years since chapter 1, so you might to check out the previous parts.
********
Once I was strapped down on the orange back board, my broken leg packed into a splint, Dave moved down to my feet, positioning himself to lift me into the ambulance. The cop was still compressing my chest as Jane squeezed another breath into my lungs. “After this round, we move. Grab the gear.” She said to the cop.
“27…28..29…30” The cop finished with a nod, immediately shifting back and pushing himself to his feet. Jane and Dave had already lifted me into the air. The cop hurried to pick up the monitor, the leads stretching close to their limit before he made up the ground.
I followed, too caught up in the rush to even notice when my legs passed through the wreckage of my bike. The ambulance doors stood open, the bright lights spilling out across the road. Keith was already standing there, even though I hadn’t seen him move.
“I think I’ve blown your mind enough for now. I’ll explain later.” He glanced down just in front of my chest. “Lifeline’s looking fragile. Best to stay close for now.”
He was right. The thread was thinner than before, more wispy. I climbed into the ambulance as the back board was slid onto the gurney. Jane took the monitor from the cop. “Drive.” She commanded as she placed the monitor in its dock. The cop hesitated for a moment, before Jane’s glare seemed to pierce right through him. He spun and headed for the cab, grabbing his radio, telling his partner what he was doing.
For a second, I was concerned about his partner, but realised that Patterson was not that stupid. His plan was in place. I would die, he would spin the story into a tragic accident and spread some tale of how he tried to save me and the people of the city would eat it up. Dave pulled the doors closed and took up position on my left, commencing compressions without Jane saying anything. She was hooking up a saline bag to the central IV, along with pushing in some syringes, and giving me regular breaths with the ambu bag. I sat down on the bench across from my feet, watching my sister as she danced her steth across my bruised chest.
***
In the bright light of the ambulance I could clearly see the deep purple, almost black, bruising fade through to the pallid grey tone of my flesh. After a cycle of compressions Dave grabbed a pair of shears and snipped off my bra. A smaller bruise was starting to form in the valley between my breasts. As soon as the cups were spread to either side, Dave’s blue gloved hands returned to their position and started thrusting down into me. I could see the wave of each compression translate through my abdomen and down my legs, my feet rocking gently despite the straps of the board and the leg splint.
Jane gave me another breath then grabbed her radio. “304 to control. We are en-route to City Hospital with an RTC, severe left chest trauma with collapsed lung, multiple limb fractures and currently in full cardiac and respiratory arrest. Resuscitation underway.” She didn’t wait for a reply as she gave me another breath the said to Dave. “One more round then I’ll intubate.”
There was a sudden rumbling as the cop brought the ambulances engine to life, followed by the sound of the sirens as the vehicle began to accelerate away from the scene. I glanced back to see Keith’s upper body sticking through the back door.
“Could you please not do that?” I asked. In response he shrugged and seemed to drift into the back of the ambulance.
“Sorry, you get used to it after a while.” He sat down beside me, careful to keep himself from interposing with Dave’s legs.
I shook my head, focusing my attention back on the efforts to save my life. Dave counted out each compression, then once he reached 30 he straightened up. Jane had already prepared the intubation kit. The neck brace already held my head in the proper position as she slid the blade of the scope into my mouth. She followed it up with a size 7 ET tube, pushing it down until only a few inches stuck out between my greying lips, and inflated the cuff. Tossing the mask from the ambu bag to one side, she attached the bag to the tube and gave me a few breaths as Dave listened to my lungs.
“You’re in, but I’m barely hearing anything on the left. Suction her out again.” He told her before looping the steth over his neck and restarting compressions. Jane simply nodded and disconnected the ambu bag, laying it next to my head. The suction tube was threaded down the tracheal tube and began to draw out more blood from my lungs. While the suction tube cleared my lungs, Jane taped the breathing tube securely, two thick strips going from each side of my chin, around the tube, and up onto my cheeks towards my studded ears.
The suction tube ran dry, so Jane pulled it out and resumed bagging while she studied the monitor. I leaned over to see what she was looking at. The line on the monitor was perfectly flat.
“Epi going in.” Jane said, hoping the drug would stimulate my heart into at least a shockable rhythm. She also attached an oximeter to the ring finger of my right hand. It was brief, but I noticed her squeeze my hand. Dave completed his most recent round of compressions, panting slightly, and turned to look at the monitor. The alarm changed from the persistent whine to something more two tone. “V-fib. That’s it sis, now come on back.”
“Sis?!” Dave exclaimed. “I figured you her but…”Jane didn’t answer, she just forced him out of the way, bringing the paddles down onto the orange squares. After a quick glance to make sure Dave was clear she pressed the buttons. The shock slammed through my chest, the straps of the backboard holding me down as muscles around my chest suddenly contracted. The only thing that didn’t react was my heart. “No change.” Dave said quietly.
Jane didn’t even look at him as her thumbs manipulate the other buttons on the paddles. “360. Stay back.” The defib signalled its readiness a moment before another shock jolted my body. The monitor began to whistle before I was even still. Jane cast the paddles aside, her professional façade starting to crumble as she began rapid, almost frantic compressions.
The way her body rocked over my chest I could finally see her aura clearly. The fear had grown, almost over-riding everything else. The anger was there, but different, not directed at me, but inward. The gold of determination was little more than a thread, and it was fading, as was my lifeline.
I looked at Keith. “Can’t you do something?”
He frowned, biting his lip. “I…”
“You can clearly do something. Please. Please do it.” I begged.
“It’s not so simple. It takes a lot of energy. I’ll need to return to my source. I won’t be able to guide you.”
“That won’t matter if I’m dead!” I had gotten to my feet, clipping through the gurney where my body rocked. Dave was bagging me with one hand, while his other held a penlight, running it over my eyes.
“Pupils are sluggish.” He said with a sigh.
Keith mirrored the paramedics sigh. “Ok. It’s not a guarantee, I can’t take control or give her any ideas. All I can do is reinforce an emotion. Then it’s up to her. Just stay close to yourself. I’ll find you when I can.”
I nodded and watched as he stepped up right behind her. He reached out, his hands on either side of her head. I tried to figure out what he was doing, but all I could see was the thin gold thread strengthening. It grew rapidly, crowding out the other emotions. As it grew, Jane’s compressions became steadier, her face more focused. Then, with a flash, Keith disappeared.
***
Jane, almost glowing with determination, finished her round of compressions and grabbed the orange gel pad from my left side. She ordered Dave to take over compressions as she started to root around in one of the cupboards.
“What are you doing?” He asked, as she placed a sterile cloth on the bench beside the ethereal me. She didn’t reply as she placed a scalpel, some gauze, a bottle of iodine and an uncuffed size 7 ET tube with a stylet on the cloth. “You aren’t planning on…”
She cut him off. “She needs a chest tube, or she dies.” Jane dabbed the gauze with iodine and began to spread it over the side of my chest.
“You’re not qualified Jane! We don’t even have the proper equipment!” He reached over for the ambu bag and squeezed it twice, before Jane shunted him to the side. “If you screw this up you’ll kill her!”
Jane turned on him, a blaze of anger, scalpel in hand. “She’s been down for 20 minutes Dave. We’re 10 away from the ER. She’s already dead, unless I do this. I won’t lose her too.” With that last whispered statement, she leaned down over my lifeless body and started using her fingers to count down my ribs. I didn’t realise I’d moved until I watched my ghostly hand pass through her shoulder.
“That wasn’t your fault.” I whispered, even though she couldn’t hear me. “You were 15.”
“4th intercostal space.” Jane muttered as she lowered the scalpel toward my flesh, her hand steady. With one smooth motion she sliced through the skin, a trickle of blood running down my side. She quickly sterilised her finger with the iodine and pushed through the hole, nodding to herself. She grabbed the tube and eased it in alongside her finger, keeping a close eye on the depth indicators along its length.
There was a sudden rush of blood into the tube, held in by the cap of the insertion stylet. “It’s in!” Jane shouted with a grin. She grabbed a carboard spit tray and held it underneath the end of the tube before pulling out the stylet. The blood flowed out of the tube for about 10 seconds, gradually slowing to a trickle. “Give her a breath.”
Dave squeezed the ambu bag my chest rising in response. When it did, it rose evenly. Jane let out a long breath. “That’s it Laura. Start compressions Dave.” He complied, beginning to press down on my battered chest once more. After a dozen compressions Jane clamped the chest tube to prevent it from drawing air back into my chest and began to prepare some more syringes of drugs. She scooted around Dave and pushed the drugs into my system.
Jane gently squeezed the ambu bag every few seconds, keeping one eye on my chest to make sure my lung inflated properly. Between each breath she looked at the monitor, whispering something to herself. After 2 rounds of 30 compressions she held up a hand. I leaned forward to get a look at the monitor. The previously flat trace bounced erratically, and an alarm blared in the confines of the ambulance.
“She’s back in Vfib!” She grabbed the paddles and twisted the dial to 360 as Dave replaced the second gel pad, placing it just beside the improvised chest tube. “I’m all charged, stand clear. Shocking!”
The shock hit my body, my chest convulsing. I fell still, and for a moment silence reigned. No monotone scream, no blaring alarm. Then there was a bleep. Followed by another. And another.
“Sinus! She’s back with us!” Jane exclaimed, her aura washing through with something that must have been happiness. Or relief. Then I felt a hard tugging on my entire ethereal body. I glanced at the lifeline, broad and practically buzzing with strength. Then it tugged on me again much harder, pulling me towards the broken but alive body on the gurney. I got one last look at Jane, a tear rolling off her cheek as she whispered into my ear, before everything went black.
I’m going to be taking a brief hiatus until I’m feeling better, but I knew I couldn’t leave hanging. So here it is, I hope you enjoy.
***
Part 1 : https://intubatedangel.tumblr.com/post/184652041622/first-fantasy-intermission-2-part-1
Part 2: https://intubatedangel.tumblr.com/post/184830189037/first-fantasy-intermission-2-part-2
***
The springs of the bed squeaked softly as Anna’s chest was compressed against the hard CPR board that lay atop the mattress. The monitor whistled, the line sliding across the screen. With eyes cracked open and head fallen to one side, Anna could see that another section had started flashing, a number ticking down. Her hand held a small device that bristled with wires and buttons, and she was glad she had found the right one.
“O2 sat’s dropping, we need to secure her airway!” Carl shouted, pulling his hands away from Anna’s chest. Anna heard some rummaging, before a hand gently turned her head to face the ceiling, tilting it back. She felt fingers trace her jawline, almost caressing it before they applied enough pressure to thrust her chin forward, fully opening her airway.
Something white flashed just out of focus, heading towards her mouth. She felt the plastic guedel airway slide into her mouth until the distal ring came to rest against her lips. The airway had been cut down, Anna and Carl agreeing that actually inserting things into her throat on their first play was probably not the wisest move. That didn’t mean they couldn’t have some form of intense breath play.
Anna watched, barely reigning in her excitement, as the large mask descended towards her face. Carl held it tightly over her mouth and nose, squeezing the bag and forcing air through a length of flexible tubing, into the mask and then into her body via the guedel. The breath filled her chest easily. She hadn’t noticed the two rubber straps when she was carried into the room, but now Carl grabbed the ends from behind her head and used them to secure the mask tightly. Anna took an experimental breath, barely able to draw anything through the valve of the new mask. Carl was now in complete control of her lungs.
As if on cue, he used that control to give her a deep, steady breath from the bag, then gave her a quick round of compressions. Anna could feel the pressure build in the mask as air was pushed from her body by each press on her sternum. Another breath filled her lungs, a moment before the monitor stopped whining. Instead it began a two tone alarm.
“Look’s like she’s in VF.” Carl announced. “Charge the paddles to 200.”
Anna couldn’t see what he was doing with the mask in the way, but she did hear a slight splurting noise. And then the paddles landed on her chest, avoiding the AED pads that were still stuck to her skin. The thick layer of conductive gel leeched heat from her flesh as it squeezed out around the paddles.
“Charged at 200. All clear. Shocking!” He pressed the paddles down hard for a brief moment, releasing the pressure as Anna spasmed with the imagined shock, her jaw clenching slightly on the white airway that was acting as a bite block. The alarm persisted, and Carl’s fingers pressed into her neck. “Still no pulse. Come on Anna, come back to us.” He whispered. Then, louder, “One minute of compressions then let’s hit her again.”
His hands found her sternum again, but he pressed lighter than he had before. Anna figured her chest must be starting to get a bit too bruised for his comfort. She was more concerned with oxygen. Having had no new breath since the defib, and only being able to draw in a small amount from the mask, by the time Carl pressed on her chest for the hundredth time she was getting very lightheaded. Even though her lungs were begging for breath, it felt amazing.
Her lungs were sated with a deep squeeze of the ambu bag, then the paddles were on her chest again, smearing the lingering traces of gel. “Charged to 300, everyone back. Clear!” Another quick dig from the paddles caused Anna to jerk, her feet bouncing on the bed as her legs kicked out.
“Nothing. Charge again. Jump it up to 360 this time.” Carl ordered the empty room. “Push an epi and get back on her chest.” He gave her a short breath to keep her topped up before resuming the gentle compressions, his hands pushing almost sideways, compressing her breast more than her sternum. Anna found that she didn’t mind the drop in realism too much. Despite being mostly inactive the whole time, 30 minutes of being worked on was tiring. Probably because her heart had been thundering along at over 100 bpm for the whole experience.
“Come on Anna, give me something babe.” Carl begged her. “360 charged, everybody clear.” The paddles returned to the thickly gelled points; Anna’s thumb shifted ever so slightly. “Shocking!” Carl shouted, before pressing the paddles into her again.
Anna put all her ecstasy into that last shock, her back arching from the bed, neck craning, toes pointing from in turned feet. Her back slapped against the cpr board as she dropped. She was unable to supress the shuddering that ran through her body. Her thumb twitched. The alarm stopped.
Beep. Beep. Beep.
“Sinus!” Carl shouted, his fingers plunging into her thigh feeling more than just her flesh. “Good strong pulse.” She could hear the grin in his voice. Her chest heaved slightly, trying to draw breath through the tight valve of the mask. “Looks like she’s making some respiratory effort.” Carl said as he gave her a breath before panic could set in. Her mouth was soon freed from the tight mask and she could take deep, shuddering breaths of her own. She smiled around the airway as she felt the stethoscope dancing across her chest.
She lay there, recovering while Carl took the simulator control from her hand. The monitor went quiet for a moment, then began to beep again, this time her heart was the one on the screen. She let herself relax to that rhythmic noise, allowing Carl to clean her chest of the gel.
He reached for the corner of an AED pad, but she grabbed his wrist. She didn’t want to take them off just yet. He looked into her eyes, then leaned forward and kissed her over the airway. It started out as a kiss, then became a steady lung-filling breath. She felt his teeth on her lips as he gripped the airway between them and gently slid it out of her mouth.
“How was it?” He asked, his voice husky.
Anna stared up at him, her hands running across the AED pads, brushing the ecg electrodes that dotted her chest. “Take me now.” She whispered.
It was all he needed to hear. In seconds his pants were on the floor, his hips straddling hers. The cpr board was still beneath her as two became one, the springs of the bed squeaked softly for a different reason. The monitor started to alarm and was completely ignored. It was unable to tell the difference between something dangerous and something far more pleasurable.
Sorry I’ve been slower updating the last few weeks. Life has been rearing it’s head and leaving me with very little energy. I’ll do my best to keep going with regular updates.
****
Part 1: https://intubatedangel.tumblr.com/post/184652041622/first-fantasy-intermission-2-part-1
***
Carl rushed out of the bathroom, giving Anna a few moments to get her breath back and push back the dizziness. She shivered slightly on the floor, partly from her body cooling as the water clinging to her skin evaporated, and partly because she was so excited about what was coming next. She had to consciously keep her hand from drifting. She focused on remaining still, doing her best to portray her role of pulseless drowned young woman.
Carl returned after a few seconds, in his hands a large bag and a smaller plastic case. He placed them on the tiles, a second later his hands were back on her sternum, pumping down and compressing her heart ever so slightly. Her breath huffed out in small involuntary spurts.
“27..28..29..30” He finished the counting chant, a moment later his lips pressed against hers and he inflated her lungs. She couldn’t resist the shiver that ran down her spine and felt his lips twitch into a smile. He pulled away, turning to the plastic case. “Need to get the pads on her.” He said.
She couldn’t see what he was doing, flat on her back, only able to see what was above her. But she knew he was opening the AED, unravelling the pads. Something small was pressed into her hand, the remote for the training device. She was in control.
Anna heard the plastic backing of the combo-pads being peeled off the pad. Her heart fluttered with excitement as she saw it descending towards her chest. Carl pressed it firmly above her right breast, smoothing out the foam as Anna revelled in the feeling of the conductive gel of the pad, cool and slightly sticky against her flesh. The second landed on her ribs beneath her left breast. Anna could feel the ecstasy coursing through her, her eyes closing to enjoy the feeling. Carl turned on the AED, giving her wrist a quick squeeze to indicate she could start using the remote.
“Analysing heart rhythm. Do not touch the patient.” The monotone voice called out. While it did so, Anna heard the zipper of the bag, a hand rifling though the contents. A moment later she felt the plastic mask around her mouth and nose. With a whoosh, air was forced from an ambu-bag, through her airway and into her lungs. Her heart thrilled. It wasn’t the same sexy as the air from Carl’s own lungs, but the cool slightly clinical tasting air ticked one of Anna’s boxes. Most of her own fantasies had revolved around a hospital setting.
Her chest fell, air flowing from her lungs as the mask was removed. The AED chimed in. “Shock advised, charging.” The bathroom was filled with a rising tone. Anna was filled with anticipation. Another breath was forced into her lungs as the AED ‘charged’, the tension building throughout Anna’s body. “Do not the touch the patient. Press the flashing button to shock.”
Carl said one word. “Clear.”
Anna released all the pent-up anticipation, her back arching in pleasure as she imagined the jolt of electricity passing through her chest, through her heart. She dropped back to the tiles, her back impacting the floor with a thud that was barely reduced by the beach towel.
“Shock delivered.” The AED said, waiting for her instruction, while Carl pressed his fingers into her thigh, on her femoral pulse point. Anna almost wanted to break the roleplay there. Instead her thumb moved by memory and pressed a button on the remote. “Resume CPR.”
The AED began to beep out the rhythm while Carl’s hands settled in between her breasts and started the half-compressions again. Anna desperately wanted to draw a deep breath, to recover from that one intense moment of the imagined shock. But she was determined to play the role and it would have been difficult to breath anyway with the compressions forcing air out of her lungs.
Anna was thankful when Carl counted out the last few compressions. “98..99..100.” He grabbed the purple ambu-bag and forced a full, wonderful breath into her lungs. A second followed it as soon as her chest fell. The ambu-bag was dropped next to her head, rolling slightly to rest against her cheek. Carl’s compressions resumed, Anna feeling much more comfortable with a lungful of air to support her. She let herself relax into the motion of her chest dipping and her abdomen bulging. In her mind her heart was fluttering in her chest, her little pump fibrillating gently. Carl’s hands were pushing deeper, squeezing the organ and forcing blood through her body.
The AED chimed in that it was analysing. While it did so, Carl gently pulled open her eyes, flashing a light across them. He shook his head. “Sluggish.” He muttered. “Come on Anna, come back to me.” The AED proclaimed that another shock was required. It made the charging whine again.
“Pressed the flashing button to shock.”
“All clear. Shocking!” Carl shouted, his finger stabbing the button.
Anna jerked, not the arching back of her first ecstatic shock, but a more subdued, more realistic little spasm. She let her head drop to one side, pushing the ambu-bag with her nose. She pressed a button on the remote and made a sign with her other hand. Her imaginary self had become asystolic, her heart completely still.
“No shockable rhythm. Resume CPR”
“No, no, no. Need to get some epi in.” Carl muttered. He grabbed her arm, a moment later her was taping an IV catheter to the back of her wrist. She watched, eyes still hanging half open, as he pressed the plunger on the syringe. He dropped her hand, she let it fall limply. After a quick breath from the ambu-bag, he started compressions again.
They were starting to hurt, the relentless battering had already formed a small bruise between her breast. And yet, they felt so good. Carl’s warm, firm hands, pressing into her chest. His fingers brushing the side of her breast. The way he stared so intently at her, his compressions never slowing. She didn’t want it to end, keeping her hand as steady as a flatline.
“Still isn’t working.” Carl sighed. “Need to try something different.” Anna heard some shuffling beyond her field of view, then Carl’s arms slipped underneath her shoulders and knees. He lifted her limp body easily, the equipment bag slung over his shoulder. He quickly carried her from the bathroom. Anna’s head stretched back, giving her a view of the bathroom, then the living room where the blinds had been drawn, then finally the bedroom.
Carl carried her round the room, she saw the monitor still on the beside table, the blue plastic of the cpr board laid on the bed and a scattering of other equipment. He lowered her onto it, her head tilting back thanks to the board that pushed her chest up, her body bowing slightly over the blue block. She remained limp, letting him manipulate her body into the perfect position. A different ambu-bag was waiting, this one blue, and he gave her a breath before her went into compressions. He pushed down harder this time, putting a real amount of force into his compressions. If the bed hadn’t been as yielding, her heart would be getting crushed against her spine.
Anna took the compressions like a pulseless patient would. The board helped to force her stretched abdomen to bulge even more than before. She could feel everything displacing slightly, her arousal surging each time her chest was pumped. She didn’t know how much longer she could deny the desperate needto be taken.
She lost herself again for a few moments, descending into her fantasy. She was on the trauma table, nurses all around, everyone desperately trying to bring her back, to get her heart to beat. Hands drifting about touching her body in all sorts of places, attaching electrodes, establishing IV’s. Air being forced into her chest, while hands crush it down. The monitor squealing beside her head. No, that part is real.
Anna returned to the present, Carl was standing over her, pressing her against the cpr board. The monitor beside her was showing a barely wavering flatline, screaming a loud monotone alarm. A corner of the screen flashed with red, highlighting the three letters ‘ASY’.
Carl had started to speak, as if he was handing over a patient. “…26. Drowned in the bath. Unknown if it was drugs, exhaustion or pre-existing condition. She’s been down for 20 minutes, asystolic for 5. 2 shocks and 2 rounds of epi administered.” His stethoscope danced about her chest, the head cold enough to make her supress a shiver. It might not have been the head of the steth. “Let’s give another epi, then continue compressions.”
***
Barista’s Bad Heart: https://intubatedangel.tumblr.com/post/183863814312/baristas-bad-heart-collected-links
Intermission 1: https://intubatedangel.tumblr.com/post/183900250412/the-doctor-and-his-patient-nurse-intermission-1
Dead Drop: https://intubatedangel.tumblr.com/post/184651985732/dead-drop-collected-links
Part 1: https://intubatedangel.tumblr.com/post/183971918377/dead-drop-part-1
Part 2:https://intubatedangel.tumblr.com/post/184106937832/dead-drop-part-2-version-2
Part 3: https://intubatedangel.tumblr.com/post/184162594552/deap-drop-part-3
Part 4: https://intubatedangel.tumblr.com/post/184201839977/dead-drop-part-4
Part 5: https://intubatedangel.tumblr.com/post/184290950412/dead-drop-part-5
Part 6: https://intubatedangel.tumblr.com/post/184398037347/dead-drop-part-6
Epilogue:https://intubatedangel.tumblr.com/post/184514166472/dead-drop-epilogue
Anna sat in her office as the last few minutes of time on her shift ticked away. They’d sent Linh up to the ICU shortly after her heart had recovered and gotten stuck in with the rest of the day. The resus-suites had remained mostly empty, their only patients the victims of a t-bone crash. Thankfully none of them had been critically injured.
Most of the staff, Anna included, had been kept busy in the other wards. An outbreak of Norovirus had struck a geriatric home in the city, so they’d all pitched in to deal with that literal mess. Throughout the day Anna’s sense of shame had subsided slightly, the harsh edge that dug at her being smoothed away. She’d spent the last hour of her shift here, in the office she shared with another AVN, catching up on paper work.
In grooming her for more responsibility, she’d been put in charge of a sub-group of student nurses. Which meant stacks of reports to double check, weekly assessments to sign off on and all sorts of boxes to tick. She now felt sorry for the senior nurses who had filled in the same paper work during her student days. All of her students were progressing well, and it was late enough in their placement that they rarely bothered her for anything.
She signed off on the last progress report, sighing in relief that she was finally done. There would be no reason to disturb her during the weekend off, at least not for petty matters. She closed down the reporting software, glancing at the time in the corner of the screen. Just five minutes left. There was a knock at the door. Carl had come to have that talk.
He opened the door softly, smiling at her. “ICU called down. Linh’s stable. Still sedated but she’s out of danger.”
“That’s good.” Anna replied, staring down at her keyboard, the shame rearing its head again.
She saw Carl’s shadow cross the room as the door clicked closed. “I know how hard it is at first.” His voice was low, tender and caring. His hand rested on her shoulder.
Anna turned to look at him. “I feel so…wrong.”
Carl sighed, giving her shoulder a squeeze, then nodded to the sofa. “I did too, at first.” His arm slipped around her shoulder as she rose from the chair and they moved over to the couch. “You handled it better than I did.”
Anna glanced at him as she settled into the curve of his arm on the soft couch.
“Seriously. I completely froze up. The lead sent me out of the room. I nearly threw up that day, I was so disgusted with myself.” He grimaced. “It was tough.”
“How did you fix it?”
“I didn’t. Not really.” He chewed on his lip for a moment. “At first I tried to just force it away, keep it locked down deep inside. It worked for a little while, but not long. It didn’t get rid of that self-loathing.” He let out a long breath. “I nearly quit.”
“But you didn’t, you got through it.”
“In a fashion. I decided to use it. Accept it was part of me and use it to make me better at the job. That was the key. To accept that yes, it does arouse me, but to focus that into saving lives.”
Anna nodded. Could she accept that part of herself? She’d buried it so deep for so long.
“It helped when I started to explore my interest.” Carl continued. “Running through scenarios on chat programs. It was like a release. And slowly, I was able to separate the two. When you give it the time it demands, it stops intruding.”
They sat in silence for a while. Anna had never seen him freeze during a resuscitation, never seen even a hint of the interest they shared. Maybe he was right.
“I understand if you need time to think about it. If you don’t want to try it tonight, that’s fine.” Carl said. There was no disappointment in his voice, and when looked up at him his expression was the same one of concern she had seen earlier. That was what made up her mind.
“No, let’s do it.”
***
Part 1: https://intubatedangel.tumblr.com/post/183971918377/dead-drop-part-1
Part 2:https://intubatedangel.tumblr.com/post/184106937832/dead-drop-part-2-version-2
Part 3: https://intubatedangel.tumblr.com/post/184162594552/deap-drop-part-3
Part 4: https://intubatedangel.tumblr.com/post/184201839977/dead-drop-part-4
Part 5: https://intubatedangel.tumblr.com/post/184290950412/dead-drop-part-5
Part 6: https://intubatedangel.tumblr.com/post/184398037347/dead-drop-part-6
*
Barista’s Bad Heart: https://intubatedangel.tumblr.com/post/183863814312/baristas-bad-heart-collected-links
Intermission 1: https://intubatedangel.tumblr.com/post/183900250412/the-doctor-and-his-patient-nurse-intermission-1
“We’ve got a rhythm!” Zainab’s shout followed the second bleep of the monitor. She let out a long deep breath, her shoulders slumping in relief.
“Check pulses.” Carl cut in, holding up a placating hand to Zainab. “Nice work Zee, I’ll take it from here.”
Anna reached over to Linh’s inner thigh, her fingers pressing a point close to Linh’s smoothly shaved vagina. She stared at the monitor, barely feeling the pulse of blood that followed each spike. “it’s there, but it’s weak. Too weak.” She said.
Carl nodded. “Attach the combo pads, A-P positions, we may need to pace her until her potassium is back up. We’d best get a 12 lead and echo. Make sure her heart is physically intact.”
The nurses scuttled around, readying the equipment. Anna stepped down the floor, shaking her arms out for a moment as Jess tore open the package of combo pads. Carl stepped up beside her, releasing the straps of the backboard, and together they rolled Linh towards them, Sara taking the rectangular pad from Jess and placing it just slightly to one side of Linh’s back, between her shoulder blades. They rolled Linh back, and in seconds the round pad was placed into the valley between her breasts, her heart sandwiched between the two electrodes.
Trish was dragging over the ventilator from its unobtrusive location in the corner. After fiddling with the controls for a few seconds she motioned Kirstie away, swapping the ambu-bag for the end of the vent hose. Carl looked at the control panel, making sure the values were ok. He nodded and turned to Jessica. “Let’s go ahead and start pacing, initial output of 50 mili-Amps at 80 beats.”
They all watched as the pacing started, Linh’s chest twitching gently as the defibrillator sent the small shocks through her heart. They waited ten seconds, each little shock on the monitor failing to produce a beat. “Up to 60.” Carl ordered, glancing at his watch. More twitching, more downward spikes on the monitor, still no capture. “Anything in her femoral?” He asked Anna.
Anna fingers returned to their previous position. “Nothing. PEA?”
Carl cursed with a sharp nod. “Back on her chest, give her one round then we’ll step it up again. Push an amp of atropine.”
Anna stepped up, her hands falling on the round foam pad. She started to push down, hoping that Linh’s heart wasn’t damaged. That it was just the imbalance of electrolytes that was preventing the young woman from surviving on her own. Her gaze shifted to Linh’s head, her compressions forcing that head to rock gently from side to side.
Anna counted to 30 then pulled back. The pacer was upped by 6mA, but Linh’s heart was still not responding. Anna resumed compressions, other hands moving around her own as additional ecg leads were attached. After another 30 the pacer was increased once more, to 72mA. Anna’s hands hovered slightly over the pad, Linh’s breasts shaking gently as she was shocked repeatedly.
“I think we’re getting somewhere.” Carl murmured, drawing Anna’s attention to the monitor. The small spike of each pacing shock was now being followed by a wide wave that roughly resembled a standard QRS complex. “Do we have a pulse?”
Anna pressed her fingers into Linh’s thigh, feeling the surge as Linh’s heart contracted with each pacing shock. “Yeah, I’m getting a good pulse. I think we have capture.” The tension in the resus-suite dissipated, they had managed to get Linh’s heart beating properly. Anna crossed her fingers, hoping they could keep it that way.
“Good.” Carl said, a slight smile playing on his lips. “Let’s go ahead and get that echo. Jess get a urinary catheter in, I want to know her kidney function. With any luck she won’t need dialysis, but let’s get that base covered. Trish, take a fresh sample to the lab, all the usuals. And chase up the tox panel, we need to know if we’ve missed anything. Kirstie, could you call neuro? That initial seizure was more intense than opiate’s or potassium deficiency usually present. Ask them to check for epilepsy when we get her upstairs.”
Anna settled with stepping back out of the way. Her arms tingling slightly. She watched intently as Carl took the echo probe and held it tight to Linh’s chest, just below her breast. The intensity of the resuscitation, and the wave of relief that was flowing through the room, served to lower her defences for a moment. In that moment she yearned to have that probe up against her chest. To have her heart visible on the ultrasound screen. She felt it, felt that little pump flutter in response. It caught her off guard.
No. Now is not the time. Shame welled up within her and she closed her eyes tightly. She’d always kept her special interest buried deep. Now it had shown itself twice, in the space of two days. She clenched her hand tightly, digging her nails into her palm and turning her knuckles white. She should be able to control it. Needed to be able to control it.
“Heart looks good, I can’t see anything that looks like permanent damage. Cardiology will probably want to work her up anyway given the arrest.” She heard Carl talking, then the rustle of paper towels. A few seconds later she heard the paper towel being thrown into the trash beside her, then a hand settled on her bare arm. “I know what you’re feeling.” Carl’s voice was kept low, just between them.
“How do you control it?” She whispered, opening her eyes. She was surprised by the concern that was evident on Carl’s face. He grimaced slightly, taking a breath to answer, but was cut off.
“Doctor, labs are back.” Zainab was stood by the large screen, fresh results flashing to draw attention.
Carl glanced back, sighing softly. “We’ll talk about it later.” He gave her arm a squeeze, then turned away heading for the screen.
Anna retreated to the wall, crossing her arms defensively as the internal war raged on. In the corner of her vision Linh continued to twitch rhythmically with each pacing shock. She could feel her own heart slowing, back under control. She noticed the glances cast her way, rubbing her arms to try and convince them that she was merely recovering from giving compressions. She didn’t know how effective it was.
She watched, remaining in the background, as the lab results were discussed. An ET tube was eased through the i-gel, into Linh’s lungs. The i-gel was then removed, leaving the ET tube in place. After a few minutes they began to reduce the intensity of the pacer. Anna felt another wave of relief as they managed to wean Linh off the pacer, her heart successfully beating on its own.
“Great work guys. Let’s package her up for the ICU.”
***
Part 1: https://intubatedangel.tumblr.com/post/183971918377/dead-drop-part-1
Part 2:https://intubatedangel.tumblr.com/post/184106937832/dead-drop-part-2-version-2
Part 3: https://intubatedangel.tumblr.com/post/184162594552/deap-drop-part-3
Part 4: https://intubatedangel.tumblr.com/post/184201839977/dead-drop-part-4
Part 5: https://intubatedangel.tumblr.com/post/184290950412/dead-drop-part-5
*
Barista’s Bad Heart: https://intubatedangel.tumblr.com/post/183863814312/baristas-bad-heart-collected-links
Intermission 1: https://intubatedangel.tumblr.com/post/183900250412/the-doctor-and-his-patient-nurse-intermission-1
There wasn’t enough of them actively engaged to allow Anna to climb on the gurney to perform compressions. There were plenty of on-lookers, but they had already settled into that slack-jawed paralysis known as the bystander effect. So instead, she went to the head of the gurney to give Linh oxygen with the bag, while Carl used his longer arms to provide one handed compressions from the side of the gurney.
They didn’t have the time to waste taking the gurney around to the dedicated entrance to the resus-suite, so instead they charged towards the main entrance of the trauma centre. Thankfully a couple of people had the presence of mind to hold open the sliding doors, allowing them team to head straight inside.
The reception area was thankfully quiet. Less than a dozen heads turned to look at them as they raced across the room, the gurney rattling loudly. Anna noticed a mother covering her child’s eyes and ears as they charged on through. Anna understood the reaction, but this was a clean resuscitation by all accounts. No blood or gore, all the young woman’s vomit had ended up in her own lungs, then the suction device. And the gurney was high enough that anyone sat down would be unable to see the track marks in her arms, the pattern of bruises from the beating, or her exposed genitalia.
“Hold the door!” Carl shouted at a nurse that was coming out of the central triage room. His voice carried such a thick current of command that she didn’t even hesitate, it boomed loud enough that a porter on the other side of the doors grabbed the other half and pulled it out of the way quick enough that they didn’t even have to slow down.
They swung to the right as they passed through, lining the gurney up with the black panelled double doors that led to the resus suite. Roger and Trish appeared from the staff lounge, still straightening their uniforms, and bolted through the doors, holding them open for the gurney. “2.” Was all Roger said as they passed, but they all knew what he meant and targeted the 2nd Resus suite. Almost like performing a three-point turn, they moved slightly beyond the door, then pulled back, Anna leading the way into the room so that everything was the correct way around.
“Let’s get ready to move her.” Carl said, halting his compressions and moving from between the gurney and the trauma table. Roger dived in to take over from the other side as people grabbed the ends of the backboard. “1..2..3.” They moved her over smoothly, Trish already in position on the step of the trauma table, keeping the cpr mostly un-interrupted. “Zee, what’s the play?”
The Junior Doctor suddenly looked up, like a deer in the headlights. “Errr…” Her mouth opened and closed like a feeding goldfish. She jumped slightly as the suite’s door opened, Kirstie and Sara rushing in. Anna nodded Kirstie over and handed off the Ambu-bag, knowing that she’d have to do some of the more complex work. She quickly checked Linh’s pupils.
“Pupils are pinpointed.” Anna announced.
Carl nodded his thanks, then returned his attention to the Junior Doctor. “Doctor Patel! What is the next move?” He stared hard at her, the nurses all averting their gaze slightly. It was Carl’s strategy, one that had taken some time for the nursing team to get on board with. He would throw the Junior doctors in at the deep end, while also making it as one-to-one as possible, almost like an exam. The student response would kick in, but then nurses would actually follow the orders. It worked surprisingly well, giving them confidence that they knew what to do and they were in charge, exactly the qualities needed in emergency medicine.
Anna knew without looking that Zainab had taken a deep, steadying breath, “We need to hook her up to the monitors.” She said.
“Who?” Carl pressed.
Zainab glanced around, trying to decide. “Sara.” She blurted out.
“Ok, What next?”
“Pupil constriction and respiratory depression suggests an opiate overdose, so let’s go with a nasal dose of Narcan while we get access.” She nodded to Jess who acknowledged the order. “Is there a good vein on that arm?” She asked Anna, who swung around the bed to get a closer look.
“Veins are all shot here.” She replied.
“Ok, let’s go with a tibial IO, we can put a central line in after trauma assessment.” Anna complied, pulling the nasty looking IO gun from a drawer and loading it up with a needle. Carl was nodding along as Zainab’s voice lost the edge of nervousness. It wasn’t quite the authoritative tone he managed, but it was the tone of a doctor. She stepped forward and palpated Linh’s abdomen “I want epi in there immediately. Get me the FAST scanner, abdomen isn’t firm, but I want to rule out a bleed.”
Carl grabbed the ultrasound, bringing it over and readying the device as Anna swabbed the area just below Linh’s left knee with iodine, then positioned the IO gun on the bone. She’d never liked the device, as useful as it was, and cringed slightly as it forced the wide bore needle through the bone and into the marrow. She removed the gun, attached a syringe, and pulled a sample of blood. “Good placement.” Anna stated.
“Good, get the sample to the lab. I want the full set of tests, including tox.” Zainab told the porter, turning to study the monitor as Sara finished attaching the various devices. “Still asystolic, or near enough, BP’s low.” She continued as Carl handed her the ultrasound probe. “Ok, hold compressions.” She probed Linh’s abdomen, getting a good look at her organs. Anna inserted the Epi, Zainab murmuring an acknowledgement as she studied the display. “I’m not seeing any free fluid; spleen looks a little swollen but there’s no rupture.” She looked up, nodding at Trish to resume cpr, then looked at Carl. “Could be the infection,” she indicated the angry red rash on Linh’s arm, “either way, she’s not bleeding out, so we don’t need surgical down here.”
“How do you want to proceed?” Carl asked, looking down at Linh, her bruised belly bulging with each of Rogers hard compressions. Zainab considered for a moment.
“We should assess the neck and head, establish a central line in if it’s suitable, then get saline and broad-spectrum anti-biotics going, secure her airway, and continue cpr while the epi circulates.” She says. Carl nodded, not taking his eyes off the young woman in front of them. “Did I miss something?” Zainab asked, the nervous student peeking out once more.
“Huh,” Carl looked up, shaking his head slightly. “Sorry, no, you’re doing fine. I would add a vasopressor though, should bring her pressure up and help perfusion.” Zainab nodded at his recommendations, biting her lip and clenching her fists at her minor mistake. “Keep your head in the game Zee, you’re doing great so far.” Carl’s reassurance seemed to have the right effect, the junior doctor relaxing slightly.
“Anna, can you get the pressor in?” Anna nodded to Zainab, taking the drugs from the crash cart. Roger, who had taken on his usual role of recorder, flashed the chart at her. Anna quickly double checked everything, nodding her approval.
“Vasopressor in.” Anna announced.
“Neck seems fine, I think you’re good to go for the central line.” Carl said to his Junior colleague, who had the kit in hand. He stood back enough to not be looming, but close enough to have a good view, and watched as Zainab got the IV catheter into the vein on Linh’s neck. “Good. Let’s do a pulse and rhythm check.”
The doctors and nurses all probed the various pulse points as Trish stepped away. Nobody felt anything, most of them turning to the monitor. Anna, down by Linh’s feet, instead took a moment to get a good look at the young woman. The silk smock was still looped over her arms, half pinned beneath her. The straps of the backboard still restricted her arms and legs. Anna felt a pang of sympathy for the woman. It was clear she’d been terribly abused. She was covered in bruises, her crotch was scarred, and the track marks in her arms took months to get to such a stage. She hoped someone could find a way to help her if they successfully saved her life.
“That’s VF!” Zainab’s excited shout snapped Anna’s attention up. The monitor showed the coarsely bouncing line. “Let’s get ready to shock her at 200.”
***
Part 1: https://intubatedangel.tumblr.com/post/183971918377/dead-drop-part-1
Part 2:https://intubatedangel.tumblr.com/post/184106937832/dead-drop-part-2-version-2
Part 3: https://intubatedangel.tumblr.com/post/184162594552/deap-drop-part-3
*
Barista’s Bad Heart: https://intubatedangel.tumblr.com/post/183863814312/baristas-bad-heart-collected-links
Intermission 1: https://intubatedangel.tumblr.com/post/183900250412/the-doctor-and-his-patient-nurse-intermission-1
Anna and Carl sprinted towards the figure who had just dropped onto the tarmac. The van roared away, the back wheel just missing her foot. Anna could see the faces around the entrance, all struck dumb by the sudden appearance of the van. It wasn’t too surprising. While Memorial received dozens of ‘drops’ every year, they usually happened late at night. Not in the early morning.
“Get the drop kit!” Carl shouted, pointing at a porter who was stood by the doors smoking. “Now!” The authority in his voice prompted the porter into motion. Anna saw him go through the door and knew he would be hitting the alarm that activated the drop protocol, before grabbing the gurney and equipment that was stowed in a bay behind the door.
In the few feet before reaching the body on the floor, Anna shrugged out of her coat. She quickly folded it, dropping it on the floor as she sank to her knees. Carl had done the same opposite her.
“Hey, just stay still, ok, stay still.” Anna told her, noticing the victim was still conscious. She gently pressed on the girl’s shoulders, keeping her held down. “What have we got Carl?” She asked, scanning the bruised body between them.
“Track marks, probably heroin. They’ve become infected on this side, we could be dealing with a sepsis element. Bruising as well, looks like she’s been beaten.” His voice was harsh. Angry. He looked over towards the door, but the porter hadn’t freed the gurney yet.
“Can you tell me your name sweetie?” Anna said, leaning close and placing a steadying hand beneath the Asian girl’s head. She could see the lack of focus in her eyes. And the fear.
“L…Linh…” She heard the girl whisper.
“Linh? Can you tell me what happened Linh?” Anna felt a hand against her leg, weakly grasping. She stopped holding her down, she could already feel the woman becoming weaker, and took the hand in her own. “She’s slipping Carl.”
“I know, resps are becoming depressed.” He felt for a pulse in the wrist. “Pulse is tachy and thready.” He looked towards the door, the porter was finally on his way, flanked by Jessica and Zainab. “Get over here quick!” He shouted.
Anna felt the hand she was grasping shudder, an unco-ordinated twitching. “No, no, no. Stay with me. Stay with me.” Anna whispered, staring into the girl’s eyes. “Stay with me.” Those eyes lost focus as the tremors intensified. “Argh.” Anna gasped, as the girl’s hand clenched tight on her own. She tore her hand free as the girl descended into a full on grand mal seizure.
Carl scooted around to grasp her head, preventing it from cracking off the tarmac. Anna could only stare as the girl’s chest bucked and shuddered. Her breath a weak gurgling sound that rapidly became worse as foam spurted through the gaps her teeth. “Shit, she’s aspirating.” Anna shouted over the rattling of the approaching gurney.
Carl tried to keep her head tilted back, tried to open her airway. “She’s clamped up tight.” He looked up at the team that was almost there. “We need Diazepam now!”
Anna grabbed the steth from around Carl’s neck, inserting the ear buds and slipping the head under the silk smock. She had to press hard to counteract the twitching of the seizure, sure it would leave a clear circle, not that it mattered with the girl in this state. As her fingers brushed the girl’s flesh, she could feel the protruding ribs, sticking out clearly in her half-starved state. Anna could hear the rapid thrumming of the girl’s heart, and the harsh struggling attempts at breath. “Airway’s compromised.” She told the team.
The gurney had been lowered, Zainab trying to get an IV line into the girl’s arm. “Veins are blown, I can’t get the line in.” She said shaking her head. Jessica already had the diazepam prepared.
Carl grunted, reaching over to grab the needle from the nurse. He slammed it into the Linh’s thigh. She continued to thrash, arms and legs spasming without rhythm. Anna knew the girl was slipping away. She grabbed the smock and tore it down the middle, the silk put up some resistance, but it was old and worn, Anna’s strength enough to rip the fabric. “Pass me the monitor.” She told Zainab.
Anna stuck the 5 ecg tabs onto the paling chest of their patient. The monitor screen came to life, the trace extremely erratic due to the seizure, which still shook Linh’s body. Linh’s lips had started to turn blue, hypoxia setting in. “We need to get an airway.” Carl said, trying once more to pry open Linh’s clenched jaw, to no avail. “Jess, run and grab a trache kit. If this seizure goes on much longer we’ll have no other option.”
They couldn’t do much else as Jessica ran back toward the hospital, merely make sure the young woman seizing before them didn’t cause any more damage in her thrashing. Slowly, the diazepam took effect. The thrashing eased; sporadic twitches as opposed to full body jerking. “That’s it girl.” Carl said, as he was finally able to unlock Linh’s jaw. “I need suction, she’s aspirated a lot of vomit.”
Zainab handed him the pump as Anna grabbed a geudel airway. She slipped the airway between Linh’s teeth, pushing it deep into her throat. Carl then followed it with the thin suction catheter, drawing the vomit out of her lungs. Anna watched Linh’s chest as the blockage was removed, hoping to see it rise with a breath. There was nothing, her chest remained still. Nobody had thought to look at the monitor, but it grabbed their attention as it began to alarm.
“Heart rate’s tanking, extreme bradycardia.” Anna reported.
Zainab had her fingers on Linh’s wrist and neck. “I’m not getting a pulse. It’s non perfusing.”
Anna immediately placed her hands in the centre of Linh’s chest and began to press down hard, squeezing Linh’s heart and forcing blood to pump through her body.
“Let’s get her on the backboard.” Carl ordered. “We don’t know the extent of her injuries.”
Anna kept up compressions as Carl started to inflate Linh’s lungs with the clear ambu-bag. Zainab and the porter were prepping the backboard, undoing the straps and laying it next to Linh’s body. “On 3.” Anna said between compressions. “1…2…3” She stopped compressions, log rolling Linh with Carl and Zainab. Jess returned just in time to help the porter slide the board underneath the mal-nourished woman.
They rolled Linh back, Anna resuming compressions as soon as the board was flat. The others quickly strapped her down, then, after another 3 count, they lifted her onto the trolley. They checked the monitor and pulse points.
“She’s asystolic.” Carl announced, he gave Anna a hand up onto the gurney so she could continue compressions. “Let’s get her inside and get her back!”
***
Part 1: https://intubatedangel.tumblr.com/post/183971918377/dead-drop-part-1
Part 2:https://intubatedangel.tumblr.com/post/184106937832/dead-drop-part-2-version-2
Barista’s Bad Heart: https://intubatedangel.tumblr.com/post/183863814312/baristas-bad-heart-collected-links
Intermission 1: https://intubatedangel.tumblr.com/post/183900250412/the-doctor-and-his-patient-nurse-intermission-1
