After careful examination they looked at each other and nodded. This woman was there to check them out, no more. As Jay punched in her data on the computer, the woman insisted on enlightening them that electricity was trapped jinn whom God had enslaved in the wires to serve humans.
As the woman left, Jay stared after her open-mouthed.
Hessuh burst out laughing. “Wait until we go back to Halwan where your patients will make stock-market transactions from their cellphone internet connections while waiting for their CT session, then tell you you made them late for their hegamah and roggiah sessions. The first is the so-called cureall by leeches and bloodletting and the second is the jinn-powered method of warding off the evil eye and extracting malevolent influences.”
Hessuh laughed again as that expression took over Jay’s face on just imagining the incongruities. “I should have my camera ready at all times. Your reactions are delightful.”
“You’re making me sound like a clueless tourist here!”
“Well …” Hessuh spluttered at Jay’s mock indignation. “Oh, you’re just a newcomer. Your wonder is very … refreshing.”
Jay poked her. “That was ‘laughable’, wasn’t it?”
Hessuh giggled again. Jay couldn’t remember when she’d made friends with another person more easily or quickly. Except for Malek.
Malek. How she missed him, ached, burned for him.
God. Everything came back to him. Every thought, every hearbeat, every impulse streaking through her nerves.
It was far worse to see him and suffer his distance and formality after she’d basked in his nearness and spontaneity than not seeing him at all again.
All she could do now was count down the remaining weeks, pray she’d toughened up enough by now that they wouldn’t hurt as much.
Oh, who was she kidding?
“Doctorah Janaan, we have an emergency!”
Saeed! Janaan jerked out of her torment, swung around.
“Here, or are we responding to a distress call?” she gasped.
“A distress call. A cave-in in a quarry around forty miles away.” He rushed to carry her suitcase-sized emergency bag then rushed out after her, giving her that penetrating look that read her down to her last secret. He knew how she felt about Malek, probably even pitied her for the hopelessness of it all.
“Did you alert Ma—er, Sheikh Malek?” Jay asked, remembering that no one called him Doctor, that his sheikhdom superseded his medical status, and that here people called each other by their first name, not their family name, even in formal situations.
“Yes, he said to get you, ask you to organize an appropriate team. He’s organizing the rescue operation.”
And there he was. Malek. Taking charge of the surgery unit. Would he let her work with him again? Would he even look at her?
Get a grip, you pathetic fool. See to your job.
Angry, crushed by longing, humiliated by it, she rushed about, gathering the team best equipped for the emergency.
She jogged to the ambulance as Hessuh caught up with her. Steve and Elaine, her GAO nurses, followed, while one of Malek’s aides took the wheel. Two more GAO nurses as well as Malek’s Lobna and Alyaa went to the other ambulance, with Saeed driving. Then she realized they’d be following a camel-riding messenger!
“That’s a racing camel,” Hessuh said, reading her alarm. “He can do 40 miles an hour, easily keep up 25 miles an hour for an hour. On this terrain, we won’t be able to top that speed ourselves.”
Jay exhaled. “I hope the rescue choppers arrive before us.”
Hessuh sighed. “Sheikh Malek says the quarry is uncharted and only this guy knows the way. Sheikh Malek will relay its position once we arrive—in less than two hours, hopefully.”
Jay felt her stomach knotting. Less than two hours when every minute might mean someone losing their chance to be saved.
She could do nothing but sit and watch their guide prodding his galloping camel, and watch as the endless desert sped by.
She had a feeling this was very much what her life would be like from now on.
An endless desert speeding by.
CHAPTER ELEVEN
MALEK READ THE co-ordinates on his GPS as soon as the quarry came into sight and barked them in his cellphone to the rescue helicopters.
He brought his trailer to a halt as close as he could get and jumped out, his eyes taking in the scene.
A two-hundred-foot-high rock-cutting, gravel-extracting quarry hewn out of Aj-Jalameed mountain, now almost unrecognizable after the the massive avalanche.
Just imagining the effect it had had on flesh and blood, that there were people below that rubble, dead or dying or even only injured, in pain, trapped in horror for the long hours it had taken to alert them and bring them here. His blood boiled.
He hadn’t known this quarry existed. And neither had any officials. This was an unsanctioned project, erected with no safety protocols. Those responsible for this exploitation of workers and resources would answer to him in person. But that would come later. He had to save their victims first.
And for that he needed Janaan with him.
He swung around to the two ambulances that had stopped behind him, found her jumping down from one, followed by the other personnel, rushing towards the scene. Not towards him.
And why would that wrench out his heart?
He’d told her he’d keep his distance, his implication that she must do the same loud and clear. And—ya Rahmaan ya Raheem—she’d done worse than that. She’d vanished. Only the evidence of the incredible job she was doing told him that she was still around.
He spent his days going insane, her scent filling his lungs, her voice ringing in his ears, her eyes and smile emblazoned on his retinas. He saw her everywhere, only to find her nowhere. Nowhere but on his mind, indelibly engraved. Then had come the nights. Soaked in delirium, his body convulsing with need, his heart corroding with hunger for one smile, one twinkle of her precious eyes.
He missed her with every breath. He missed her every breath. Nothing, not even preoccupation or exhaustion, lifted the longing, the gnawing. And she was there, within reach, and he couldn’t reach out and take all the joy and ecstasy her essence and passion could bring him.
You’re not important, ya moghaffal. Get to your casualties.
He ran after her towards the casualties who were strewn on the ground like broken toys. Gaunt men, working in inhumane conditions, for a pittance no doubt, now covered in rock powder, as if they’d been exhumed from their graves.
Could they be Damhoorians? Were any of his people in such a depth of need they’d debase and endanger themselves to that extent for crumbs? Or were they Ashgoonians? Or maybe Nussoorans?
He’d get to the bottom of this. And he’d put an end to it. But first those men.
Janaan and her team were already all around them, emergency bags open, supplies lined up and gurneys ready to transfer the most badly injured to the ambulances or to OR.
Saeed caught up with him, a dusty, scared man stumbling in his wake. “That’s the foreman. He says his men pulled out those twelve with their bare hands. Two are dead. Twenty-four remain buried.”
Before Malek could ask the first thing that burst into his mind, Janaan asked it. “Those men—how long were they buried?”
Saeed translated her question to the foreman. The man stammered out the answer. From one to three hours.
“And how long ago were they rescued?” she pressed.
The answer was the same.
She reached the same conclusion he did, announced it to her team. “We have to assume they developed crush syndrome.” At the hesitant looks from those whose specialties had nothing to do with trauma, she elaborated, “After being crushed for more than an hour, on being released, crush syndrome develops, resulting in severe hypotension, renal failure and irreversible shock.”
“So they might have only managed to kill them by pulling them out?” Steve Mittman asked. Malek didn’t like th
e way the big, blond man was looking at Janaan. Didn’t like it at all.
Janaan nodded. “Rescuing people from underneath rubble, without initiating aggressive fluid replacement during or right after the rescue, is termed ‘rescue death’.”
“At least we’ll be right here when the rest are being pulled out.” That was Hessuh, his pride and joy, prototype of the new breed of female Damhoorian doctors. She’d gotten so close to Janaan, gotten to share her trailer, breathe the same air. He envied her so much, he couldn’t bear looking at her.
And there was Janaan, exchanging that look of unspoken understanding and camaraderie with her, not with him!
“For now, regardless of other injuries,” Janaan said, “some may be beyond reach if the six-hour window when the syndrome becomes irreversible has passed. So here’s the treatment plan.” She rose to her feet, still not looking at him. “Pick a patient, then bilateral peripheral lines, glucose-saline, two liters over the next hour, two more over the next two, twelve in all today. Then airway management, ventilation and examination.”
Then she fell to her knees between two of the casualties.
She behaved as if he wasn’t there. Was she abiding by his order, or was she punishing him for it?
No—that would be manipulation and by now he was sure she didn’t have a manipulative cell in her body. Maybe she knew they could deal with this, that his expertise would come later.
“Let me help.”
Steve. With his boyish good looks and hot eyes. Advancing on Janaan, offering assistance, declaring interest. Hunger.
Janaan looked up, gave a tiny smile. A smile. Of acceptance, encouragement …? W’Ullahi ma beyseer!
By God, he wouldn’t let it be. He fell to his knees by her side, growled up at Steve, “If you don’t have a patient, help in the rescue efforts. The helicopters will be here any minute.”
He dismissed Steve from his focus, turned his eyes on Janaan. Her face was still averted, scrunched up in … was it concentration? She cut off her patient’s sleeves then reached for IV giving sets. He closed his hand over hers, taking one from her hand.
Her gasp blasted through him like a hot desert gale, her soft, capable hand going limp in his and letting both sets fall.
Still keeping her eyes off him, she withdrew her hand, turned to the others. “Elaine, Alyaa, Miguel, place catheters, then monitor urine output and pH. If it’s dark brown or red then it has myoglobin. To flush it out to keep the kidneys working, we need to achieve a diuresis of at least 300 millilitres per hour with a urine pH of more than 6.5.”
They nodded, got to it at once. They clearly considered Janaan their triage officer, even in Malek’s presence. Janaan had really won his team’s unswerving respect and obedience during the past two weeks.
And how couldn’t she? Her knowledge was extensive, her work ethic impeccable, her people skills inimitable. Everyone recognized that and was giving each talent and asset its due.
He felt her eyes darting to him now, or rather to his hands, felt their gaze along his every nerve ending as she took in that he’d already started fluid replacement on one patient.
He looked up at her, needing that gaze to mesh with his, needing the connection. She didn’t look back, turned to the other patient. He gritted his teeth, kept on working.
Ten minutes later, resuscitation was over and everyone reported the condition of their casualties. Then the helicopters were there and Janaan rushed after Malek to organize the airlift.
He directed his men’s efforts while she directed their medical team in resuscitation before extrication.
It took over three hours of grueling work, and not a few accidents, the worst resulting in one of his men fracturing his femur, to get everyone out and resuscitated.
With triage sorted out, they loaded casualties on gurneys in preparation for transferring them to the ambulances or OR. Rafeeq went to ready the anesthesia station.
Janaan stood there taking stock. He approached her, needing some contact, some response. She still refused it.
Suddenly she asked, “Who will you start with?”
He didn’t answer right away. Not because he hadn’t made a decision but because he needed to bring the debilitating spurt of joy and relief at her acknowledgement of him again under control.
“This man.” He pointed to the moaning man on the second gurney from where she stood. “His crush injury is the worst.”
Her nod told him she thought so too. So had she only been making sure his judgment was the same as hers? Or had she been trying to initiate conversation?
No. Janaan didn’t resort to things like that. That had been a legitimate question. To which he hadn’t given a complete answer.
He had to add, “I may have to amputate.” At her gasp, he rushed on, “I won’t know until we have him on the table. But I just need you to be ready for the possibility.”
She nodded, her color at high level. And he couldn’t deny his need. He needed her with him.
“Will you assist me?” he rasped.
Her eyes swung up to him, letting him in again, blazing her relief to be included, her eagerness to be of help. To be with him again?
“Hada abbi.”
Both Malek and Janaan jerked around at the adolescent voice, found a boy of no more than thirteen standing two feet away from them, covered in the yellowish dust, as if he too had been pulled from the rubble, undernourished, underdeveloped, swaying.
Malek took a stride towards him, his hand held out to support him, and the boy hiccuped a sob and stumbled back.
“Aish beeh? Aish rah t’sa’woh b’abbi?”
Malek closed the gap, took the boy by the shoulders, gently, carefully, talked to him, low and soothing. And the boy’s sobbing escalated into all-out weeping.
“Malek?”
Janaan’s trembling whisper touched him before her hand did. He first called Saeed, gave him orders, turned the boy over to him then turned to Janaan.
“This man is Aabed, Nabeel’s father. Nabeel told me he was standing next to him when the cave-in happened. He pushed him away at the last moment. Nabeel has six younger brothers and sisters and he said he’s too young to be the man of the family.”
That vast compassion flared in her face, burned him. “What did you tell him? What did you tell Saeed to do?”
“I told him he has nothing to fear. I told Saeed to take care of him. Now we’ll take care of his father.”
“Is he under yet, Rafeeq?” Malek asked.
Rafeeq adjusted his anesthetic/oxygen delivery then raised his eyes. “Go ahead.”
“Administer cephalosporin, please, Rafeeq.” Malek raised his head at the moment’s silence that greeted his order. “Yes, now, and tetanus toxoid. Infection with the state of circulation in his leg is taking root as we speak. We can’t be too aggressive or too early in treating it.”
He returned his eyes to the field of surgery, Aabed’s left leg. It was blue, cold and pulseless. Not to mention grossly swollen up to the groin.
Jay eyes followed Malek’s, the only thing she could see of him now, and shivered at the terrible intensity that prowled in their depths, like a caged lion pondering a way out.
She couldn’t bear it. “What will it be, Malek?”
Malek was silent for a moment more. Then he exhaled. “I’ll start with a fasciotomy. If we don’t get definite distal pulses at the end of the procedure.”
He’d have to amputate. Then Aabed would lose his ability to stand on his own two feet, his only means of supporting his family. And Nabeel would lose his childhood to the struggle of keeping his family from starvation.
“He won’t.”
Her heart fired at Malek’s whisper. Had she muttered her fears out loud?
As Malek held her gaze, she knew he only shared her thoughts, was reaching out with the promise. Nabeel, like Adham, would get the best chance at life. He’d make sure of it.
Then he moved his eyes back to his task, made a transverse incision across the thigh,
dissected the subcutaneous tissue to expose the iliotibial band, made a straight incision through it in line with its fibers. She carefully reflected the fascia for him, exposing the intermuscular septum, watching the poetry in his every move, the genius and healing flowing from his fingers.
“Cautery, please, Janaan.”
His baritone sent its gentleness through her on an almost un-containable wave of longing. She clamped down on the tremors, coagulated all vessels in the now pale, spongy muscles. She withdrew, fell back into the reality of his nearness, the feeling that he seemed to be seeking her again, still afraid to believe it, expecting it to end at any moment.
She watched his every move as he made a two-centimeter incision in the fibrous septum, releasing the building pressure in the muscle compartments of the thigh which were now cutting off circulation and causing the starting necrosis of the whole limb.
“Metzenbaum scissors, please, Janaan.” It was in his hand as he uttered its name. He used it to extend the incision. “OK. Anterior and posterior compartments released. Please measure pressure of the medial compartment.”
She did, bit her lip. “Elevated,” she rasped.
He inhaled, nodded, made another incision to release the adductor compartment. After two minutes he said, “And now?”
She measured again, felt her heart boom at the reading.
“Pressure within normal limits,” she gasped.
He let out a long exhalation. Relief made audible.
“Your turn,” he murmured.
She jumped in, making sure she didn’t leave one bleeding artery uncauterized.
“That’s perfect, Janaan. Now feel for distal pulses.”
She felt for the pulse in Aabed’s foot as Malek felt for the femoral and popliteal, bracing herself. A flutter tickled her fingertips. She moaned. “Oh, God.”
He came around her, felt where she had then dragged off his mask. “Pack the wound open, Janaan, and apply a bulky dressing.”
“You mean.”
He turned heavy, full eyes on her. “Yes. This is a supreme case of guddur w’luttuf. God decreed adversity but was merciful with it.” He turned his eyes to Aabed’s leg and her eyes gushed with their loss, with fear he’d resume his distance, her deprivation. She blinked tears away, got to work.
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