by R L Dunn
"Homeland lost two more of their people."
"Damn, what were they doing?"
"No time to tell me. Brynn never mentioned it. Cassie dislikes her, says she's a cougar."
"That wouldn't be my word, but she does like you." With a hearty laugh, he returned to his office. Checking off a few more things on his list, he headed to the teleconference room for the leadership call.
Inside the room, screens flashed as they connected digital calls to each location head and their seconds-in-command from London, New York, Denver, and San Diego. The DC personnel joined Martin.
With the meeting called to order, Martin’s thoughts drifted to his adult life and how he spent most of his time with these people, some from his Navy days and some through his job. The recent restructuring, creating Chase Security International, promoted him up the chain. The change didn't alter his easy-going demeanor. The men and women in the room understood when action was needed, he was a fierce, unflinching role model.
The meeting covered major personnel issues and staffing shortages.
Karen slipped inside, her expression filled with fear. "I'm sorry to interrupt. Can you step out?" Her hands shook.
"Tony, continue for me. Be right back." He hesitated before leaving the room.
"Your dad called. There’s an emergency." She twisted her wrists.
"Did he say what about?" He picked up speed.
Sprinting to his office, she ran beside him, "Austin," she gasped.
"Marty,” a breathless Dennis Bailey answered.
His voice dropped. "What's happened?"
"Austin was shot. The ambulance is rushing him to Horizon. The chief said it's bad."
"Was he wearing his vest?" he sputtered.
"Don't know. Janey, Mom, Livvy, Mandy, and I are on our way."
"I'll be there as fast as I can. Dad, tell him...tell him I love him." After a stabilizing breath, he turned to his secretary. "Call Esther and have her make my arrangements; I need to go to Iowa."
The discussion quieted when Martin reentered the conference room, bracing himself against the table. "My dad called. My brother Austin was shot at work." He pressed his lips together.
"Don't worry about what's going on here. Go. Be with your family. Keep us posted." Tate Webster gave his shoulder a reassuring squeeze.
A look of concern was etched across Ian's face as he came into the room. "A Gulfstream is on the tarmac at Reagan waiting for you. You'll be there in two and a half hours. Ford, go with him."
"My go bag is in my office. Meet you in the garage." Ford darted from the room.
Chapter Three
Tuesday, July 9th, 1530 hours
Elizabeth stood ready. The adrenaline rush generated by word of an incoming patient with critical injuries sharpened her tired mind and body. The paramedics reported a thirty-two-year-old police officer was in traumatic cardiac arrest after being shot in his chest and abdomen. Violet eyes surveyed the room. "Ambulance is three minutes out. This is a Tier-1 activation. Kathy, as the charge nurse, notify the operating room. Where's the ER attending?"
"On a cardiac in room four," the nurse said.
"Are respiratory and anesthesia here?" Elizabeth asked.
"Anesthesiology, Pietra and I," Warren Chen said.
Each member of the team was identified, and assignments were made. "Kathy, notify security. This is a cop; expect a crowd. Call the chaplain and administration for the family. How much blood is available?"
"Ten units O neg on standby.” The nurse worked readying the tubing as Elizabeth pressed her tongue against the roof of her mouth. "Four units on the rapid infuser. Step back, everyone else; keep your voices down."
"Here they come," the head nurse announced. The doors flew open, and a paramedic performing CPR was straddling a blood-soaked man on a gurney.
"On my count. One, two, three. Cut this uniform off and bag his vest alone. Check his back. Search for other wounds." Elizabeth helped move him to the bed. "Page thoracic."
Her team worked as she watched from the bottom of the bed. An intern suctioned and inserted the breathing tube. "Airway cleared, intubating now." Bloody froth immediately backed up inside it.
Fellow George Keller ran the ultrasound device over his torso. "No cardiac movement. Fluid present in the chest; the right lung is collapsed. Left lung, partial collapse. Blood under the diaphragm filling the abdomen. Should we call it?" The police officer was dead by Dr. Knox’s and all clinical standards.
Not ready to pronounce him biologically dead, she remembered her time in Gaza. Soldiers came back under similar circumstances. Elizabeth hip-checked the bed, causing the heart to jump from the vibration. "See, movement. Pump that blood in. Continue CPR. Cool him down. Put that central line in."
"Dr. Reed?" the nervous fellow repeated.
"If you are having issues with my decision to attempt resuscitation, Dr. Keller, step out. Dr. Caine, step in. The time to discuss it is later."
"Thoracotomy tray." The chest saw turned on and off in her hands.
"Operating room is ready. Thoracic is busy. What do you need?" Knox approached the stretcher.
"Opening the chest. Cross-clamp the aorta, and then we roll. Randy, we need to put him on ECMO too," Elizabeth said.
Randy’s face contorted with a scowl, but his expression changed in a flash seeing the remnants of the officer's uniform. “Got it.”
"X-ray!" the technician shouted. Wearing a lead cape, Elizabeth didn't stop working.
"Blood in the urine," Keith Perry said.
A surgical tool spread the ribs apart, declaring the heinous damage from the bullets. Blood poured over Elizabeth's hands. "Heart appears intact. Randy, lift the left lung; can you palpate the aorta?" Pads absorbed the free-flowing blood.
"No." The squishing sounds of Dr. Knox's exploration of the open chest continued. "Wait. Got it, clamping now. Time?"
"15:37," the nurse recorded it.
Tiny fingers continued to massage the cop's heart. "Heart's filling."
A weak vibration bounced beneath Dr. Perry's fingertips held against the base of the patient's neck. "There is a pulse."
"Roll." The group headed with their patient to the OR. "Do we have a name?" Elizabeth's hand squeezing his heart was shrouded with a towel.
"Austin Bailey, Silverton police sergeant," Kathy said.
Elizabeth swallowed hard. Could he be Marty's baby brother? The man she hadn't seen in twenty years. The man she hurt. The man she still loved. Concentration kept Austin’s heart beating, and her own calm as she proceeded to the OR. You can do this.
"Ready?" The nurses helped her into a sterile gown and gloves.
The circulating nurse pulled up the chest x-ray. White dots were scattered throughout the chest and belly.
"Electric knife." The incision extended from the notch of Austin's sternum to his groin. More blood flowed to the floor. "Lap pads. Squeeze that blood in faster," Elizabeth said.
Her business partner and trauma surgeon, Steven Keys, stepped into the room. "Where do you want me to start?"
"The major chest vessels need repair first. Randy cross-clamped the aorta and will set up ECMO. Where the hell is he?" Elizabeth released a shard of metal into a metal bowl. "Be careful; shrapnel and bone are everywhere. A bullet entered through his right armpit. Another penetrated around the fifth rib, and a third entry is above the right kidney. He had to be turning. No exit wounds. The darn things exploded inside him." She kept massaging Austin's quivering heart, moving what little blood was available to his brain while stitching with her other.
Steven removed irreparable fragments of bone that used to be part of the ribcage's right side. "The right lower lobe is a total loss." A mangled lobe of lung plopped into a bucket. "Hold the retractor, Keith. Get me another blood gas, Warren."
"No oxygen-carrying capacity. Acidotic," Warren said.
"Eight minutes since aortic clamp," Gina said.
"There's a tear to the left superior bronchial artery. Trace the pulm
onary artery. Where the hell is Randy?" Another bullet fragment dropped in the container while Elizabeth kept up a heartbeat with her other hand.
"ECMO man is here," the nurse chirped as Knox walked in. An ECMO machine could buy Austin and the surgical team time by taking the strain off Austin's damaged lungs and vessels.
"Leave Randy alone," Pietra Hahn pled for peace. "Blood loss is outpacing gain."
"Duh, Pietra." Elizabeth remained mad. "What took you so damn long? We left together. Damn it, Randy, if he dies because you were slow..." The rest of the comment stayed in her mouth.
"Randy, can you handle putting the new cannula into the internal jugular?" Steven asked sarcastically as he sutured a leaking vein.
"All up to date on the literature, Stevie. Is there a rhythm yet?" Randy squinted. "The blood-thinners will, in the end, make your cop bleed to death."
"He's not my cop; he's our patient. Run the lines. His heart will beat when we give it blood to fill it," Elizabeth grumbled. "Yes, I am aware of what is required for ECMO. Do you have a better idea of how to save this man?"
"Calm your tits, Beth. No lost time. Sheesh, you need to get laid. Hell, if you want, I'll sleep with you, baby. Think of it as a mercy fuck. My charitable contribution for the year. An orgasm might mellow you out," Randy said flippantly, waving his hand.
Then he continued, “Well, Wonder Doc, if you must know why I'm late: Dufour asked about you and the Maxwell kid and poaching my jail patient." Hal Dufour was the vice president at the facility and her father's friend. "Told him I couldn't talk because the officer needed my attention."
"Knock off the crass comments, Knox," Steven's voice rose.
"Randy, how the hell can you go from being a decent surgeon to asshole in two seconds? Officer Bailey is no different from Arthur Maxwell, yet you had no problem extending the resuscitation attempt here. Why, because Arthur was Black, or because this patient is a cop?" Another fragment pinged into the pan. "Your jail patient, as you call him, had a moderate liver laceration that failed embolization. It was your fault you didn't scrub in. It’s also not my problem you missed two pages. Where were you then?"
"None of your damn business, Wonder Doc."
"Here's the deal, Dr. Arrogance. Call it when you are in charge. Now pay attention to this surgery. The bean counters would approve: thirty-two years old at the height of actuarial viability. For all that is holy, if I wasn't up to my elbows inside Officer Bailey's..." The heart started beating weakly between her fingers. "Pulse?"
"Faint, Beth," the nurse said.
"There you go, Randy. Spontaneous circulation," Elizabeth snapped.
"Push more blood products and antibiotics. Release the clamp."
Alarms rang. All his organs appeared like a sprinkler hose charged with water. She returned to massaging his heart.
"Pack-off the bleeders. Start running the bowel. Check for any small wounds. These bullets fragmented; they don't make big holes."
Steven slid through the tacky mess on the floor. Lifting a small shard of metal, an arc of blood sprayed across his mask. After a toss into the basin, he reached for the next one. This was going to be a lengthy operation for them all.
July 9th, 1942 hours
Martin and Ford made their way through the chaos at the hospital entrance. A cop shot was big news. They reached the small second-floor waiting room where Martin's mom, Fay, ran into her son's embrace.
Ford introduced himself to Dennis Bailey. "I'm sorry about Austin. Ian Chase sent me to be of any service to you and your family."
"Thank you. Now all we can do is wait. Almost four hours now," Dennis said.
A pregnant woman clutching tissues sat in a chair surrounded by Martin's sisters. He squatted in front of her. "Janey, how are you holding up?" Her pregnant belly and tear-stained face made a sorrowful impact. "Do you need something to drink? Do you need to put your feet up?"
"We’re doing the best we can, Marty. Livvy, Mandy, and your mom are taking care of me. They sent someone for my folks."
"Honey, we will get you through this." Martin placed his hands on hers. His dad, his brothers-in-law, and his sisters’ shoulders were stiff.
Ford whispered into Martin’s ear, “I’m going fishing. He attached his Homeland credentials on his belt.
A short time later, Ford returned to the waiting room and jacked his head to catch Martin's attention. "Any news?"
"No, but I guess it's a good sign." Martin’s posture slumped.
"Chief is protective of his turf. Austin took at least one shot to the armpit while investigating an injured child. Chief isn't forthcoming with anything more. Blew off Iowa's DCI. Doesn't make sense. I called in and requested Bravo team to perform our own investigation."
“Thanks.” Martin ran his hand through his close-cropped blond hair.
Chapter Four
The minutes on the clocked ticked by. “Could you find someone to help you get food and drink for everyone? It looks like we’re in for a long wait, and I’m worried about Janey.” Martin’s gaze circled the room.
Ford waved over Shaun Murray, who had been introduced as Austin’s best friend. “Martin, are you alright? Can I do anything? His words were frenzied.
“Shaun, this is Ford Cox. We work together. I was wondering if you could pick up food for everyone?
"I’m so sorry, I should’ve thought. Want anything particular?"
"Janey is pregnant, so something healthy for her and fresh, strong coffee. Other than that, no." Ford provided him his credit card. "Feed everyone here well."
"Black card? Chase Group? Austin mentioned Martin, and I guess you work for them.” The exclusive card with no credit limit rested between his fingers.
"Thanks for getting the food." Ford did not comment further.
Thirty minutes later, the officers returned with ample food and drink, including fresh coffee. Shaun passed Ford his card. "Wanted to return this."
"Thanks. Mind talking with us for a few minutes? What was Austin checking out?" Martin asked.
"C'mon, let's take a walk? Maybe a little fresh air might help the wait,” Shaun said.
Inside the operating room, the surgery was going on its sixth hour. A VIP patient in the ER with appendicitis requested Knox. "Where are we at?" A needle driver guided Steven’s sutures. "More suction."
"Replaced Mr. Bailey's blood supply three times. Clotting factors are getting harder to manage; he needs you to finish. Pietra and I can't hold his blood pressure much longer." Warren adjusted the gauges again.
Two fresh nurses took over at 19:00 hours. "Please put out a call for more blood,” Dr. Reed asked of one. “The second we touch that kidney, he'll hemorrhage again." Another bone fragment pinged from Elizabeth's forceps into a pan.
The disembodied voice of a nursing administrator filled the OR, "Can I give the family an update?
"Yes, tell them he's still fighting. It’s slow going. We have him on ECMO for his lungs." A blood-soaked pad around his kidney held her attention. "We’re running out of AB positive." A clamp clattered from her fingers to the floor.
"Find some hand warmers. Beth's fingers are numb." Steven's tiny, shivering colleague smiled when the nurse placed a warmed blanket on her shoulders. Melanie handed her another clamp. The OR was a cold place.
"You know, Steve, we’re all cold." Pietra hung a unit of plasma.
"No offense intended, Pietra, but Beth's teeth are chattering. Find a warm blanket for Dr. Hahn," Steven asked the nurse, his eyes rolling.
When a corpulent woman wearing a lab coat walked into the tension-filled waiting room, the anxious family stood. "I'm nurse administrator Henrietta Krump. Sergeant Bailey is still in surgery. Dr. Reed and Dr. Keys placed him on a machine to support his lungs. The extent of Austin's injuries has Dr. Reed requesting blood donations. Austin is type AB positive."
"How much longer will the surgery be?" Janey wrapped the blanket around her tighter.
"I wish I could tell you more. I promise I’ll be back with any infor
mation as soon as it becomes available. Is there anything you need?"
"No. Thank you," Fay Bailey spoke for her daughter-in-law.
Shaun and Ford followed Henrietta into the corridor. The door to the room was slow to close, letting those inside hear both offer assistance setting up the blood donations. Henrietta also mentioned needing to rush handwarmers to the OR.
Waiting was killing him. "Excuse me, I'm Austin's brother, Martin. I overheard your request for handwarmers."
"Austin's surgeon is a petite woman, and her fingers are losing sensation. Your brother is chilled down to preserve organ function. I need to have some delivered to the OR."
The name of one of the surgeons had disturbed him. "One more question: what are the surgeon's names again?"
"Dr. Steven Keys is assisting Dr. Elizabeth Reed. She's a gifted critical care surgeon with extensive trauma experience, including Johns Hopkins and war service with Doctors Abroad." A fake smile followed a well-practiced political speech. Martin stood statue-stiff. "Mr. Bailey, I can assure you, Dr. Reed is quite capable."
Martin snapped out of his trance. “I'm sorry, Ms. Krump; I’m not against a female physician operating on my brother."
Elizabeth Reed. His heart pounded against his ribs. The last time he saw her was the night before he left for boot camp, twenty years earlier. She shattered him by breaking promises of forever love.
His sisters, Amanda and Olivia, met him in the corridor. "Um, Marty." Any chance of it being a different Elizabeth Reed dissipated with Amanda's alarmed expression. She showed him her phone, open to Horizon's website. The violet-blue eyes that still haunted his dreams stared up from the screen. Shiny red hair was tied behind her, and a demure strand of pearls circled her neck. "Marty?"
"I'm fine. She better save Austin.” He stomped over to the elevator. Outside the emergency room, Martin sat on a bench as painful memories pelted him like a barrage of bullets.