Moving to a new city had been a brilliant idea. After graduating from nursing school, this was her chance to have her dream career and a fresh start. After all, how many women got a do-over, much less three, and soon to be four in a row? Tiffany was beginning to loosen up and see that sometimes problems were just opportunities in disguise. She refused to waste her life constantly looking over her shoulder and worrying about tomorrow.
Sneaking a quick peek in the mirror on the way out, she hardly recognized herself. All in all, she hadn’t done too badly. Her long, dark hair and blue eyes were definitely her best assets. Scratch that, it was her snarky personality and ability to persevere. Live one day at a time. Taking her mother up on her outstanding advice was becoming easier by the day.
Excited about her shift at the local ER, she threw the two bags containing all her worldly possessions in the back of her SUV and headed to work without further consideration of her circumstances. At this point, she was on automatic pilot.
The city’s busiest emergency department offered a thrill a minute for people with the personality to appreciate it. Challenging herself to deal with whatever man and Mother Nature threw at her was proof positive that she was strong and capable. In some irrational way, it validated her ability to make tough decisions and find success in an environment very few medical professionals could tolerate.
Tiffany had fallen in love the minute she walked into the building. She often wondered if it was the action and adventure that drew the “new and improved” her to the work. Or maybe it was the work that drew out and validated the new qualities she saw in herself. Either way, she felt privileged to find a position helping others in their time of need. Helping others filled a hole for her.
Pulling into the hospital parking lot, she immediately craned her neck to catch a glimpse of what was waiting in the loading zone. Excitement rolled through her gut as she observed five ambulances waiting to unload. The light was also flashing to indicate that they were on diversion. Smiling, she knew that meant they had a full house. Her shift would fly, rather than crawl by. This was good since it was her last before moving on.
On account of a recent expansion, the emergency department had grown to double its normal size. Yet the place was somehow still heaving. Reading the whiteout board, she noted her assignment before going straight to her section.
Feeling the excitement thrumming through her body, she headed back to take report from her illustrious predecessor with a spring in her step. Her ability to compartmentalize the various segments of her life truly astounded her at times.
Skidding to a stop in front of a tiny podium, she noticed the woman sitting there appeared tense, frustrated, and exhausted.
Because they were on familiar terms, she knew Stephanie would enjoy the attempt to lighten the mood.
“Busy day at the office, Steph?”
Looking up at her, Stephanie offered a faint smile before blowing out an exasperated breath. “You cannot even imagine, girl. We’ve had a multi-car collision on Jefferson Avenue, a house fire that spread to a warehouse, and some sushi restaurant gave a bunch of people food poisoning. In short, we’ve been up to our elbows in burn victims and vomit all day.”
“Sounds rough.”
“Oh, and we got another gentleman from the geriatric high-rise across the street with urinary catheter complications.” Stephanie made little quotation marks in the air when she spoke the last three words.
Anger boiled in Tiffany’s blood. “You had better not tell me he had a non-deflated cath stuck in his urethra.”
“I’d love to be able to tell you that, but I can’t.”
Closing her eyes and counting to ten, she shook her head. “How difficult is it to deflate a catheter before you pull it out?”
“Not hard at all. I get so frustrated seeing geriatric patients in pain over generalized incompetence. Then again, his dementia is pretty severe, so there is a chance he pulled it partially out himself.”
“Either way, it evidences poor quality of care. We both know they get paid top dollar to see that things like this don’t happen.”
“All I know is Dr. Cole is on the warpath about it. He claims their rate of catheter complications is three times the national average.”
“That sounds like a fair assessment to me. What else do we have going on?”
Flipping through her notes, she frowned. “Air Life Line dropped a critically injured patient off earlier this evening. He’s built like a bodybuilder, covered in tattoos, and supposedly a real terror. The medics reported that they had to tranquilize him in order to provide basic lifesaving care while en route. Naturally, I assumed they were exaggerating, as they are prone to do. Then I read their report stating they had to sedate him not once, but twice during the flight. That was an imprudent choice for someone with a traumatic head injury, but I guess if your only other choice is them tearing the chopper up, you do what you’ve gotta do.”
“That sounds a little dramatic. Couldn’t they just strap him down?”
“I wasn’t there, so I don’t know. Mark my words, you are going to have your hands full with that one. He’s been unconscious thus far, but he’s due to wake up anytime. If I were you, I’d try to stay out of his reach.”
Tiffany nodded, appreciating the advice despite the obvious complication it presented. “I’m certain what you’re saying is true. However, it’s difficult to provide adequate care if I don’t get within arm’s reach. I need to be close enough to take vitals and administer medications. Speaking of which, does he have an IV?”
Looking down at her notes again, Stephanie answered succinctly. “IV therapy dropped a line as soon as he got here, so he’s fully hydrated. I noticed he’s been restless, so I’m betting it won’t be long until he wakes up.”
“Okay. I’ll be careful not to get myself mauled by him. Did his chem panel come back yet?”
“He’s negative for drugs, with the exception of marijuana.”
Typical. “Great. At least there is no danger of an amphetamine induced psychosis. You know those are always fun times.”
Her friend grinned at her off-color remark, knowing she meant just the opposite.
“He’s just one of several complex cases you’ll be facing tonight. You still have five other patients who are all fully conscious, and a couple of them are fairly demanding. We don’t have any beds open, so you’ll have every single one of them until they’re discharged or we find another hospital to accept them.”
Tiffany nodded. “At least we’re on diversion until further notice, and hopefully, it’ll keep them from cramming more in on us.”
Tiffany flipped through the charts, listening as Stephanie gave her a brief, incisive report on each of the remaining patients. As soon as her counterpart left, Tiffany got to work quietly visiting each of her patients, taking vitals, dispensing medications, and changing out bandages.
As the beginning of the shift wore on, doctors visited each patient, wrote orders, and the lab techs came to draw blood. One of her patients had a gunshot wound to the arm and a blood alcohol level of point ten percent. Handcuffing him to the bed was a safety precaution taken by the local law enforcement officer who brought him in. Charged with stabbing his wife during a domestic dispute, Elmer Oliver was clearly not only dangerous but a flight risk.
No matter how any times she asked him to refrain from yelling, he didn’t listen, as he was apparently hell bent on patching things up with his one and only true love. Barely resisting rolling her eyes, Tiffany stayed focused on writing her nursing notes, ignoring the rowdy man. The ER was always an exercise in patience.
In no time at all, Elmer’s drunken voice had gone from serenading his love to taking about how much he missed her. He was irritating and totally oblivious to everyone around him as he called for the woman in question.
“Eloise. Elllooiisseee. Answer me, woman.”
“What?” a sharp, raspy female voice answered, resonating off the walls, sounding less than pleased at being forced t
o answer him in such a public setting.
Once the woman spoke, Tiffany could discern some slurring of her words. Of course, neither of them were strangers to the staff at St. Mary’s. Their long-standing habitual drinking had instigated several drunken brawls between the two of them and lead to all kinds of injuries over the years. Consequently, Tiffany had been subjected to several stories about the couple by some of the more cynical staff. Try as she might, Tiffany simply wasn’t able to find the humor in their situation. Witnessing it in action now, it was as sad a situation as she’d imagined it to be.
The thoroughly intoxicated gentleman persisted in his drunken effort to get his woman to forgive him. He was persistent. Tiffany would have to give him credit for that much.
Causing a scene, he spoke loudly as he yanked on his cuffs, a horrible metal on metal scraping sound. “Where are you? I can’t see you no more, sweetness.”
When the woman didn’t answer, his voice became deeper and more desperate. “Talk to me, baby. I need to hear your sweet voice.”
Undoubtedly caving in to his drunken charm, her voice softened. “I’m over here, honey bear. They won’t let me come and see you.”
Immediately, he responded with an overt and obvious attempt to gain the poor woman’s full sympathy again. “Eloise, I love you. Baby, they got me cuffed to the fuckin’ bed like I’m some kind of a criminal.”
There was some muffled laughter from the employees and other patients at the man’s childish attempts to curry favor through a bizarre mixture of inducing pity right alongside an open declaration of love.
However oblivious his awkward attempts were to the staff, his wife fell for it rather quickly. “Oh, honey bear, you ain’t no criminal.”
“They’re fuckin’ laughing at me, baby. You know how I hate that shit.”
“Elmer, don’t pay them no mind. Just keep talkin’ to me. You know, you’re my very own honey bear.”
“Oh hell, baby.” There was short, pregnant pause, leading Tiffany to think something truly profound was about to come out of the man’s mouth. “I know I stabbed you and you shot me, but can’t we just call it even?”
Wow, she had not been expecting that one. Tiffany cringed as the sound of more muffled laughter rang out. Chewing her lip, she worried that it would escalate the man who was already displaying a tenuous grasp on his emotions. This whole situation was just hitting a little too close to home for her comfort, making it hard to process all the complexities of the seemingly straightforward interaction.
As a result of their intimate conversation, one of the law enforcement officers stuck his head into the bay. “You two might just call it even, but I call that a confession in front of at least a dozen witnesses. You already had your rights read, so I advise you to button it up for your own good.”
Naturally, the man stared the officer in the face defiantly as he shouted at the top of his lungs. “Sweetness, they tell me I can’t talk to you no more! These sons of bitches are crazier than we are if they think for goddamn minute they can keep us from talkin’ to each other.”
Tiffany sighed, knowing neither of them were probably going to cease trying to communicate with each other until the officers remanded them into custody.
To sum it up, not only was it going to be a long night, but afterward she’d have to listen to the entire episode being retold in lurid detail by a bunch of people who should know better. Unfortunately, Tiffany had discovered early on that her co-workers had become cynical to certain situations, chiefly by virtue of the sheer volume and intensity of the crisis situations they encountered on a daily basis.
Her genuine affinity for her coworkers notwithstanding, insolent and belligerent people with no internal controls being used as sport by people who could do it with impunity rubbed her the wrong way on several different levels. Rare moments like this made her wonder if this environment was the best fit for her after all. Maybe on her next do over, she’d pick another medical setting to ply her wares.
~ Ryder ~
Ryder’s eyes slowly opened and the room drifted into focus. Looking down, he tried to see his injuries. Immediately, it all came flooding back with several stark realizations hitting him all at once.
Thank fuck that he was alive, thinking coherently, and breathing on his own. Grateful to the old man who had intervened when Ace was about to blow his brains out, he realized how close he’d come to dying. Making a mental note of the life debt, Ryder vowed to repay it as soon as he was on his feet again.
There was a sharp, stabbing pain in the back of his head near the base of his neck, and it was severe enough to make his lip quiver. That shit hadn’t happened to him since he was a fuckin’ kid, and it was pissing him the hell off.
Stand up, shake this shit off, and be a man. His father’s words reverberated through his aching head, leaving behind hollowness where warmth and motivation should be. His old man had been one mean son of a bitch and lived his life by an arcane set of beliefs that felt peculiar to Ryder.
He’d raised him and his sister all by himself, engraining more than a bit of his weirdness into them, but Ryder missed him anyhow. Subsequently, the cumulative effects of getting run over by a truck and catching a few bullets virtually guaranteed following his father’s advice would prove an impossible task tonight…assuming it was night.
Steeling himself for the pain he knew was sure to come, Ryder forced his body up to a sitting position. The searing pain in his head literally took his breath away and made the room spin in lackadaisical circles. Closing his eyes to stave off the nausea climbing up this throat, he eased back down on his pillow. He was in serious pain, and the drunk couple yelling totally transparent, lovey-dovey shit back and forth was not helping.
That’s when it finally hit him; he appeared to be in a medical facility of some sort rather than jail, which was always a possibility when you were dealing with cops. He couldn’t be just sitting around on his dick when Ace was still out there somewhere, looking to do harm to his brothers. Regardless of the excruciating pain, getting back on his feet was the only thing that mattered to him at the moment.
Ace’s mocking face rose in his mind, and Ryder knew he would have to be diligent about finishing the job he started by shooting him. Trying to sit up once again, he accidently knocked over a side table. He’d seriously underestimated the effect of whatever drugs they had given him. For the first time in his life, merely moving his arms took all the strength he could muster.
This whole situation was total bullshit, caused by whatever poison they were pumping into his veins. Refusing to allow it to break him, he pulled furiously at the IV hanging from his arm to keep any more of the meds from entering his body and consequently making him weak. Cursing under his breath, he realized that someone was going to hear the ruckus he was making, and he was in no condition to effectively defend himself until the damned drugs wore off.
Just as he’d feared, one of the nursing staff came rushing into the room, appearing astounded at his clumsy attempts to get out of bed. Hastening her way over to him, she tried vainly to push him back down onto the bed. Her small hands on his massive chest were a barely noticeable distraction. In his drug-induced haze, he found the idea of her trying to physically move him totally fuckin’ hilarious. Did the diminutive nurse actually think she could push him even an inch? Smiling up at her, he resisted the initial urge to gather her up in his arms and sit her pretty little ass in his lap.
“You have a concussion, Mr. Staunton, therefore you shouldn’t be trying to get up. Do you mind if ask why you tore out your IV?”
In response to her unwanted interrogation, he gave the inquisitive little bitch an icy glare as he responded brusquely. “Does it ever occur to you folks that maybe we don’t all want that poison dumped into our veins?”
Of course, she was in professional nurse mode at the moment and not in the correct frame of mind to accept him advocating for less medication. “You’re injured and not thinking properly right now, Mr. Staunton. You need
the medications to keep from getting an infection, and the IV provides fluids when you’re unconscious and can’t consume liquids on your own.”
Shaking his head in disagreement, Ryder was certain that in her mind all her trite justifications made perfect sense. In his opinion, doctors didn’t have the right to pump a man full of shit he never agreed to. Rather than mansplaining all about his theory that doctors should render minimal lifesaving care until the person gives consent, he decided to stick to the point.
“That may be, but you need to back the fuck up and talk to me like I’m a fuckin’ human being and not some senseless fuck like the guy down the hall, screaming romantical nonsense to his old lady. I know that I’m supposed to be all grateful and compliant and shit, but that ain’t the way the good Lord made me, doll.”
Unclear what he’d expected her response to be, he was pleasantly shocked when a contrite expression instantly jumped onto her lovely face. “I honestly wasn’t trying to be disrespectful or coerce you into accepting medications you clearly don’t want. Many patients wake a little discombobulated and not thinking clearly. I can now see you do not fall into that category, so you have my sincerest apologies. What would you like to know?”
“What the hell is wrong with me? My head feels funny.”
Tilting her head slightly, she articulated her words carefully for no reason he could discern as she explained the obvious. “You were hit by an oncoming vehicle, causing a severe concussion. Then you were shot twice.”
“Any particular reason you’re takin’ me on this scenic guided tour down memory lane? In case you forgot, I was fuckin’ there, so clearly I know all about that shit. What I need to know is what happened after I came here.”
Rather than showing irritation, she smiled indulgently at him as she responded, seemingly not as offended by his gruff manner as most women he’d met. The ounce of acceptance and understanding when he was having the roughest day of life loosened something slightly in his chest.
“Unfortunately, EMS had to sedate you on the chopper, and that’s contraindicated for individuals who’ve sustained a head injury.”
Marked for Death Page 2