“If you can. I’m not sure I can get my car out yet. We’ve been too busy assessing the situation.”
Her arms held him for a few more exquisite seconds and then she released him and drew back. Her face was appealingly flushed, her eyes moist. “I’ll come back here in case you can’t get the other cars out.”
“Okay, let’s get going.” He kissed her again and then he and Jessica and Lauren helped the injured into his car.
“How bad’s the damage through town?” Lauren asked when she helped the third patient into the car.
“I couldn’t see much in the darkness but at least I didn’t get a flat tire from debris.”
“You took the shortest route here?”
“Yes.”
“Then that’s the way I’ll drive back,” Jessica said.
She kissed him again and was driving away when someone shouted from the building. “Lauren! We need help over here! It’s Norville Webster.”
Archer followed Lauren inside as the siren of an emergency vehicle reached them through the night. Good, maybe help was on the way.
Lauren gasped and his relief dissipated with the wind.
Norville Webster lay in a corner where the backup lights did not reach. John Netz raised his flashlight to reveal a streak of blood framing the right side of Norville’s balding head. Norville moaned.
One of the women cried out and others crowded around.
“He was walking around just a minute ago,” John said. “I knew he’d had a cut or two, but—”
Lauren fell to her knees beside the man. “Norville?” She squeezed his right shoulder. “Norville!”
No answer.
Chapter Five
Lauren kept her voice calm as she gently prodded Norville but her heart raced. What was wrong with her? She never panicked in the ER.
But this was different. She knew this man, went to church with him. The pallor of his skin alarmed her, as did the amount of blood on the floor. His breathing was labored. The hemorrhaging seemed to come from a couple of scalp lacerations, likely caused by flying shards of glass.
As Mr. Netz tried to clear the crowd away, Archer held a flashlight for Lauren to see better.
She checked for glass in the cuts, found none, pressed a towel to the worst cut behind his right ear. “Archer, hold this for me? Keep pressure on it.”
“Got it,” he said. “John, would you hold this light for me? Have you called for an ambulance?”
“Can’t get through right now,” John said.
“I thought we heard a siren a minute ago,” Lauren said.
“It didn’t come here,” John said. “I bet they’re piled up with calls.”
“We need to get this man to the hospital,” Archer said. “Quickly.”
“We can’t wait for them.” Lauren focused on the simple ABCs of trauma management. Airway. “Norville! Can you hear me?”
He moaned again. His lips moved but she couldn’t hear his voice above the chatter of the curious crowd that hovered around them.
“Everybody quiet,” she said in her most authoritative voice. “John, please.”
“Okay, everybody out of this area—now!” John’s voice boomed through the basement. “Can’t endanger a person just to satisfy our curiosity, now, can we?” he said more gently.
As the onlookers around them gradually drifted away, Lauren leaned close to Norville’s mouth. “Please say something, Norville.”
“Yes,” he grunted.
Okay, his airway wasn’t closed off even though he didn’t sound quite right. ABCs. Breathing. She unzipped his jacket and checked the rise and fall of his chest. His respirations were deep and even. She caught sight of the towel Archer held to Norville’s head. It looked as if the bleeding had slowed or stopped.
Why hadn’t she thought to bring her stethoscope? She couldn’t even listen to breath sounds. She felt helpless.
“Is he going to be all right?” John asked, returning from his crowd-control duties.
“I don’t know. Try again to call an ambulance.” She felt at Norville’s right wrist for the radial artery. Pulse fast but strong. Circulation good for now. The ABCs were covered. “Norville, can you still hear me?”
This time his voice was louder but high and strained. “Help me.”
Stridor—upper airway obstruction?
She tried to recall the different causes of stridor. Spasm? Aspirated foreign body?
No. Think trauma.
Laryngeal fracture? What am I missing?
She unbuttoned Norville’s shirt. “Shine the light here, Archer.”
She caught her breath at the sight of swelling on the right, below his ear. Dear Lord, help us. “He’s got a neck hematoma.” Blood was swelling his airway shut. “I need ice quickly! We’ve got to get the swelling down. John, any response with the ambulance? We need to get him out of here.”
“They’re out on calls. No telling when we’ll get one.” He squatted. “Helen’s bringing the ice. Looks like this one’s up to you, Lauren.”
***
Grant placed a chart in its slot beside the desk and gestured to the secretary. “Becky, we need to redirect everyone who isn’t injured into the designated waiting room. It’s far too crowded in here.”
She looked up at him, shaking her head and pointing to her headset. “Yes, I understand, Mrs. Harris,” she said softly, turning back to her computer screen. “Try to get a neighbor to bring you in. The ambulances are all tied up right now.”
“Dad?” Beau sidled up beside Grant at the counter, drying his hands on a paper towel. He’d been doing triage and cleaning exam rooms as soon as they were emptied. “Brooke’s in the break room complaining that she doesn’t have anything to do. I won’t let her close to the patients but she’d love to do crowd control.”
“Good. Get her. We need to clear this place. Have you heard anything from the church? Lauren hasn’t come in, has she?”
“I haven’t heard from her. You think she’s okay?”
“I’m sure she’s... I’m sure she’ll be fine.” Liar. He wasn’t sure of anything. He couldn’t stop worrying about her, couldn’t get her out of his mind, especially knowing she would be here by now if she could.
Muriel shoved another chart in front of him. “Bad one in three, Dr. Sheldon. Looks like a concussion, maybe a serious one.”
He glanced at the chart, looked out the glass doors of the ambulance entrance, braced himself for a possible deluge of patients that hadn’t yet hit. “Okay, I’ll be right there.”
***
The ice wasn’t working. Norville’s high-pitched stridor filled the basement with its sound of desperation as his agitated movements—shoulders flexing, head jerking—resembled those of a drunk.
Lauren removed the pack from his neck. The swelling had increased and now Norville’s Adam’s apple edged slightly left of center.
Tracheal deviation.
She looked around at John Netz, who stood watching helplessly a few feet away. “The ambulance?” she asked.
He shook his head.
“Can we get a car?”
“Trees are blocking everybody.”
“Okay.” She forced herself to breathe deeply. She must not panic. “Okay, have Helen find the sharpest paring knife in the kitchen.” And then pray I don’t have to use it! “Have her sterilize it the best she can. If anybody has a lighter, she can hold it over the flame. And have her bring me some of those disposable kitchen gloves from the cabinet below the kitchen sink. And some towels. Quickly, John, please!”
What am I doing? Even Grant wouldn’t try to decompress a neck hematoma. He would do an emergency intubation to protect the airway until a surgeon could get there.
But then Grant didn’t make a habit of practicing medicine in a half-ruined church basement in the wake of a tornado. All Lauren knew was that if she didn’t alleviate the swelling soon, Norville would lose his airway. The carbon dioxide levels in his body would continue to rise until he went to sleep. Maybe fore
ver.
Lauren had no intubation equipment.
She gently placed the fingers of her right hand against the Adam’s apple and slid them to the right side of his neck, searching for the carotid artery. There. She felt it. Barely. She had to avoid that. And stay away from the external jugular. That would be the most superficial and the easiest to avoid since it was now so prominent with the swelling.
“Norville, you still with me?”
He moaned.
“Norville, please listen to me. We may not be able to wait for the ambulance and I might have to do a procedure on you to ease the swelling.”
Even as she spoke his head lolled sideways. There wasn’t time to get him to the hospital even if the ambulance was on its way—which it wasn’t.
“Helen, where’s that knife?” Lauren called over her shoulder.
“Right here,” the older woman said. “Here you go. Be careful, it’s sharp.”
“Good, I need sharp.” Lauren pulled the gloves on and took the knife from Helen. Once again she surveyed her landmarks then she closed her eyes and took a deep breath. Lord, I can’t do this!
She felt a hand on her shoulder and looked up to see Archer hovering over her. “I’ll be right here to help, just let me know what you need.”
“Straddle his chest and hold his hands so he can’t fight me. John, I need you to hold his head perfectly still. And pray.”
“You’ve already got that.”
She nodded. Norville’s movements had slowed considerably. She had to do this now.
She pressed the knife to Norville’s throat, rechecking her landmarks. She held her breath and made a short vertical incision.
A little blood dribbled down his neck but nothing major. She would have to cut deeper.
“Jessica’s back with the car!” someone shouted from the doorway.
Lauren withdrew, her hands trembling.
“Don’t stop now,” Archer said. “You can do this. Come on, Lauren.”
She swallowed hard, steadied herself, and extended the incision, pressing a little more deeply.
Blood spurted. Archer pressed a towel against it and Lauren took it from him. She handed him her knife and checked the wound. Blood continued to spurt. Dark clotted blood.
“Got it!” Lauren cried.
A siren echoed in the distance as the swelling eased in Norville’s neck. His breathing returned to normal with encouraging rapidity.
“I need more ice,” Lauren called over her shoulder. “And another towel, please.” Thank you, Lord!
She leaned over Norville. “You’re going to be okay.”
***
“Norville Webster’s a lucky guy,” Becky said softly as they listened to the ambulance report at the central desk. “Thanks to Lauren.” She turned and grinned at Grant. “Have you been teaching her the tricks of the trade?”
“Not me. Don’t forget she’s been in the ER for a lot of years.” Grant couldn’t be more proud—or relieved.
He gestured to Eugene, the night RN who had arrived to help out barely five minutes ago. “Let’s set up for our incoming patient in two. I might have to intubate. Also, the patient in eight is ready for discharge.”
“I’m already on it, Dr. Sheldon,” Eugene said. “Lester’s setting up the intubation equipment. Will you have time to see the guy with the swollen ankle in six? He needs an x-ray.”
“Yes, I’ll check in on him.” He took the chart from Eugene, then turned and nearly collided with his daughter.
“They’re out, Dad.” She brushed the long dark bangs out of eyes that glowed with excitement. “There’s nobody back here now that doesn’t have a good reason. I’d make a good bouncer, don’t you think? Got anything else for me to do? I can’t leave—Beau won’t let me take the car, and—” She glanced toward the door. “Oh great, what’s she coming in for?”
Grant followed Brooke’s line of vision and saw Mayor Jade Myers entering the ER from the reception office. “She came to see about her uncle.”
“Oh, sure, and she’ll find some reason to corner you and—”
“Retract your claws, Brooke. She’s a nice lady and a good—”
“She’s after you, Dad.”
“She’s dating Norville.”
“So? That doesn’t—”
“Settle down. I don’t have time to argue with you. Go back to my call room and get a set of scrubs from the cabinet. Take them to room five. I’m releasing Mr. Mourglia and he needs something to wear home.”
“Got it, Dad.” She rushed off like an eager puppy, obviously pleased to be in the thick of the excitement and unaffected by the trauma of the tornado.
“Heads up!” Becky called from the central desk. “Incoming. They’re here with Norville.”
***
Lauren helped Christy and Bill unload Norville from the ambulance as she glanced at the shattered glass and ruined waiting room. The ER proper appeared intact. She turned to find Grant walking out of the ambulance doors to meet them. Some of her night-long tension dissipated at the sight of him. To her relief, through the window she saw Beau rushing past the central desk and Brooke carrying what appeared to be a pair of green scrubs down the hallway.
Safe. They were safe. Thank God.
As Christy gave report, Lauren followed the retinue. The place was packed and more were coming. She’d be busy here for a while.
“There you are, Lauren McCaffrey. I’ve been looking for you!” Gina Drake caught her as soon as she entered the department. Gina’s red hair fell in disheveled curls to her shoulders—she’d been growing it out. She touched Lauren’s arm, tugged at her shirt. “Where’s your Superwoman outfit? Everybody’s already heard about the emergency surgery you performed. Way to go, girl!”
“Thanks but—”
“No time to talk, we’ve got patients to see. I volunteered to help out here for a few hours, and I’m going to follow you around for a while to orient. You did come here to work, didn’t you?”
“Of course but—”
“Come this way. The triage area is now a regular exam room, and they’re setting up for triage in the conference room. Got it? The waiting room’s not habitable.”
“I saw that.” Lauren tried to keep up with her firebrand friend, the respiratory therapist-turned-ER-aide. “Who’s following whom around?” she teased. “How are the boys?”
“They’re loving the excitement. They’re at the neighbor’s, where we rode out the tornado in the basement. Levi’s disappointed that nothing happened on our street except one tree got uprooted.”
Someone gasped behind them. Lauren turned to see the town mayor, Jade Myers, approaching the entranceway to the second trauma room, her intense dark eyes filled with shock, the slender fingers of her right hand covering her lips as she watched Grant and the others working over Norville.
“Uh-oh,” Gina murmured. “Guess she just found out about Norville the hard way.”
Lauren squeezed her friend’s shoulder. “Why don’t you go on to the triage area and start taking vitals. I’ll be right there.”
“Okay but be warned we’re doing lots of urgent care tonight. Lots of cuts and bruises, scrapes and panic attacks, and we only have two docs. You’re going to have to play nurse practitioner.”
Lauren nodded, still watching Jade. The woman obviously cared a great deal about Norville. “It can’t be any worse than what I’ve already had to do,” she said softly. “I’ll just check on Jade and be right there.”
Gina went on without her and Lauren stepped to Jade’s side. “He’ll be okay,” she said softly. “They’ll take good care of him.”
Jade looked at her. “I didn’t know... I came to see about Uncle Ernest and then this... what happened?” The woman’s customarily rich commanding voice trembled. “I tried calling him at home and couldn’t reach him.”
“He came to the church,” Lauren explained. “He was running out to herd some kids to safety when it appeared a sliver of glass hit him.”
“Wher
e did it hit?”
“A vein in his neck. The blood built up and cut off his airway momentarily but he should be fine. Dr. Sheldon will call a surgeon if he needs to.”
Moisture filmed Jade’s eyes. “You’re sure he’s going to be okay?”
“Don’t worry, it looks worse than it is now. I think he’ll be fine.”
Jade nodded and straightened her shoulders. “Then I’ll stay out of the way and let them work. I need to see about Uncle Ernest.” She patted Lauren’s arm as she turned to walk away, all business once again. “Thank you.”
Lauren felt much more comfortable with the woman now that she appeared more attached to Norville and less interested in seeking out Grant’s attention. All would definitely be well.
Chapter Six
At one o’clock in the morning Grant Sheldon signed a final chart and placed it in the slot where it belonged. Muriel would take it from there. Eugene had gone home over an hour ago, as had Beau, Brooke, and Mitchell Caine. Together, Mitchell and Grant had ordered enough x-rays and sutured enough flesh to match a typical full week at this ER. They’d used the last suture tray in the department at eleven-thirty and they’d been forced to borrow two from the surgery department.
Grant leaned back in the chair and sighed. Except for the sound of Muriel’s voice as she discharged the one of the last remaining patients, there was no other activity. He looked around the department for Lauren and was disappointed he didn’t see her. Had she gone home without saying goodnight?
They had received word well before midnight that Norville Webster’s surgery had gone well. The surgeon had identified and ligated the bleeding vessel and removed the glass. Except for the vessel no other vital structures of the neck had been damaged.
Grant yawned. Time for food. He was starving.
He found Lauren in the break room resting her head in her folded arms on the table beside a cup of coffee that was likely cold by now. He tried to open the refrigerator without waking her but she straightened at the barest sound.
She still wore the overalls and shirt she’d been wearing when she first arrived and her hair hung in waves around her shoulders.
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