Here And Now (American Valor 2)

by Cheryl Etchison

  Giving in to the exhaustion for a moment, she leaned into him and rested her cheek on his shoulder. “It’ll probably be later, if that’s okay.”

  “Whatever you want.”

  He loaded her into her truck and sent her home while he ran to the store. She’d showered, changed, and thrown a load of laundry in the wash just as he pulled up in front of her trailer. When she opened the front door, he was climbing the front steps of her deck, grocery bags in one hand and a large bouquet of flowers in the other.

  “These are for you,” he said with a big grin on his face.

  The bouquet was a mixture of roses and lilies and some purple stuff, and large enough she had to use both hands to hold it. She was smelling the different flowers when it hit her. “What did you do?”

  “Not a thing. I promise,” he said with a laugh. “I saw them, thought of you, so I bought them.”

  He wrapped an arm around her and led her back inside, whispering something along the lines of “so suspicious” under his breath. Which was probably right. Before Lucky, the only time men had brought her flowers was when they’d spent the night drinking with their buddies when they were supposed to be taking her out on a date. Or when they were trying to convince her to take them back after she’d dumped their butts. Of course, none of them had ever given her a bouquet like this or she might have considered it longer.

  “The other guys I dated usually brought me one of those half-dead, cellophane-wrapped, single-stemmed roses from the gas station,” she said while adding water to the vase.

  Lucky snapped his fingers. “I could’ve saved, like, forty bucks if I’d bought one of those when I stopped for gas.”

  Rachel shook her head and left him putting the groceries away as she carried the flowers into her bedroom and placed them on the dresser. Lucky followed along behind, and as he undressed, she pulled the blackout curtains closed and shut off the bathroom light, plummeting the room into darkness despite the bright sun shining outside.

  Having already climbed into bed, he held back the covers for her and she placed a soft kiss to his lips. “Thank you for the flowers. They’re really beautiful.”

  “Just so you know, you deserve stuff like this.” Lucky cupped her face as he stared at her with those deep, dark eyes. His fingertips tangled in her hair as he brushed his thumb across her cheekbone. “The flowers, the nice dinner. You deserve all of this. Don’t ever let anyone convince you any differently. Not even me.”

  It was probably the single nicest thing anyone had ever said to her. And when she kissed him a second time and then a third, he pulled away and shook his head. “Now, now, Shortcake. I was promised no funny business.”

  She laughed as he wrapped her in his arms and pulled her close. And as she drifted off to sleep she realized then, despite all of her rules, despite all of her protests, she’d already fallen hard for Lucky James.

  Chapter Eighteen

  THEY WERE ENJOYING their night off, celebrating the end of college finals with Lucky slowly kissing his way up her inner thigh, when her phone rang. Of course they ignored it, until his phone rang a few seconds later and then both of their phones vibrated with text messages.

  The messages were short and to the point.

  Mass casualty event.

  All available hospital personnel to report immediately.

  Within five minutes they were dressed and heading across town.

  Although the staff routinely trained for large-scale mass casualty events, they wouldn’t know what they were in for until they arrived at the hospital; meanwhile the town had become a sea of flashing lights and sirens. Lucky was flipping through the local radio stations to see if there were any news reports, but all that was on was the same prerecorded stuff the stations played night after night.

  By the time he pulled into the parking lot, she was a bundle of nerves. In the nine years she’d worked at the hospital, they’d never had anything more than a drill with fake patients and no real lives on the line. He must have sensed her nervousness, because he took her hand as the automatic sliding doors opened in front of them.

  “Don’t panic,” he said, giving her hand a reassuring squeeze as they headed down the hallway.

  The ER was already filled with medical personnel dressed in trauma gowns and gloves as they waited for the patients to arrive. A nursing supervisor armed with the trauma protocol manual called out, asking everyone to gather around for a briefing.

  “What we have is an eighteen-wheeler versus charter bus. Life Flight helicopters are en route to the scene. Police and fire estimate fifty to sixty passengers with a variety of injuries. Most patients are assumed to be fifty years and older. We’re getting conflicting reports that there may or may not be other vehicles involved.”

  Rachel’s panic level began to rise. There was no way their small regional hospital would be able to handle all the casualties. As a level three trauma center, the ER’s main objective was to stabilize critical patients and transport them via helicopter to either Oklahoma City or Dallas. If there were more critical patients than helicopters available, the outcome could be horrific.

  “Be prepared for a high number of walking wounded being transported via private vehicle. The senior nurses will be stationed in the ambulance bay and tagging patients as they come in. Floor nurses will assist with transferring patients into available rooms upstairs. Those patients are ones who do not require surgery but might need further testing or observation.”

  As they waited on the first casualties to arrive, Lucky and Rachel stocked the trauma rooms and crash carts. “How are we going to handle all of these patients?”

  “We won’t,” he said matter-of-factly. “They won’t all survive, Rach. So all you can do is take them one at a time. If you try to save them all at once, you’ll end up saving none.”

  Within a matter of minutes, ambulances, police cars, and small shuttle buses were lined up outside the emergency entrance.

  Nothing in her nursing school training could have prepared her for what she saw. An endless sea of patients, battered and bloodied, taking up every available space in the ER. The less emergent cases lay on gurneys in the hall while the walking wounded sat in waiting room chairs. It was a scene she’d only ever seen in the movies.

  Tasked with starting IVs and taking vitals of several patients in the hall, Rachel was just about to insert a needle into the vein of an older gentleman when someone grabbed her arm.

  “Hey.” Rachel yanked her arm free of the person’s grip and spun around to see a dark-haired man, his face and shirt covered in blood.

  “My wife,” he cried, pointing to an area where the less critical patients were seated. “She’s stopped breathing. She’s not breathing.”

  She followed him into the waiting room where the woman slumped over in her chair. Rachel sat her up straight, shook her shoulder, and quickly checked for a pulse and a tag, but found neither.

  “Where’s her tag?” she asked the husband as she moved the woman to the floor. He shook his head. “Her triage tag?”

  “She doesn’t have one,” he answered.

  Rachel yelled for a Code Blue as she tipped the patient’s head back, opening her airway. She ground her knuckles into her sternum in hopes of waking her. Still no response. “Code Blue,” she yelled a second time, hoping someone else would arrive to help her. In the middle of the waiting room, with dozens of eyes focused on her, she began chest compressions. Rachel winced as she heard the crack of her ribs, but knew nothing could be done about it.

  Rachel stopped compressions when an orderly appeared and they rolled the woman onto a backboard and lifted her onto a gurney. She then stepped up on the bottom frame of the gurney, giving her enough height and leverage to continue. The orderly, along with the woman’s husband, negotiated through the crowd of waiting patients. As Rachel continued chest compressions, she directed them into a smaller exam room
that had just opened up.

  “Get me some help!”

  The orderly darted out of the room, leaving her with the dark-haired man as he held his wife’s hand and begged her to not leave him.

  It felt like minutes, although it was likely a matter of seconds, before a nurse she recognized from floor appeared. “Sir, you need to wait outside. There’s not enough room in here,” she said. When he didn’t budge, she took him by the arm and forcibly moved him out the door.

  With the patient’s husband out of the way, the other nurse pushed in a crash cart.

  Rachel’s arms and shoulders were burning, but she continued with compressions as the other nurse intubated the patient and began ventilating. They desperately needed more help.

  Then from out of nowhere, Lucky appeared in the doorway.

  LUCKY WASN’T SURE how long she’d been doing compressions, but judging by the look of strain on her face, he guessed she’d been at it awhile. “Do you need to trade off?” he asked.

  “Yes, please.”

  Immediately she stepped down and back, giving him room to take her place. He looked at the older nurse ventilating the patient, then back to Rachel. “Who’s running the code?” he asked while resuming compressions.

  Rachel looked to the other woman, then back to him. “You? Me? No one,” she said, tossing up her hands.

  She was starting to panic, and if this patient was going to survive, he needed her to stay calm.

  “Rach, I need you need to start an IV and run it wide open. Then hook her up to the defibrillator so we can shock her.” Rachel nodded and immediately went to work removing the patient’s clothes and attaching the defibrillator pads. Lucky turned to look at the older woman who was bagging the patient. “How are her breath sounds?”

  “You don’t really think you’re running this, do you?”

  Lucky continued the chest compressions. “What? Do you want to run it?”

  He knew exactly what was coming next.

  The nurse’s face pinched, a sure sign she was on the verge of yelling at him. “You’re not qualified to run a Code Blue. Someone needs to go get a doctor.”

  Lucky nodded toward the door. “Have you seen it out there? The docs are dealing with stuff far more difficult than a Code Blue.”

  The alarms and the crash cart kept beeping as Rachel charged the defibrillator. “It’s ready to go.”

  Lucky, along with the other nurse, stepped back as Rachel pressed the button that delivered two hundred joules. With the patient still in full arrest, Lucky resumed compressions.

  The next five minutes were more of the same. Compressions. Vent. Shock. Repeat. The older nurse began yelling at every orderly, tech, and random person who wandered by the exam room door, asking them to get a doctor. And still, none showed.

  When Rachel took over the chest compressions, the older woman handed over the vent bag to Lucky, saying she’d go find a doctor herself.

  “How long have you been doing compressions?” Lucky asked as he placed his stethoscope in his ears.

  Rachel looked at the clock on the wall. “About fifteen minutes or so? She’s been in here ten. I’m not sure how long it took to get from the waiting room to here.”

  He nodded, signaling he heard her answer, then went about listening to the patient’s breath sounds as he continued to bag her. Earlier his gut instincts told him something was seriously wrong, but the other nurse wouldn’t ever say how the breath sounds were. The patient’s trachea hadn’t shifted, so either both her lungs were fine, or they both were bad. Lucky listened to the right side, then the left. There were breath sounds on both, but were distant.

  Lucky looked up just in time to see a familiar face in the hall. “Howard!” Lucky waited a moment and yelled again. “Howard! Get in here!”

  The ER tech rushed in the room and grabbed two gloves from the box on the wall and pulled them on. “What do you need?”

  “Can you take over chest compressions for her? Rachel, I need you to bag her.”

  After they all rotated positions, Lucky pulled a chest tube tray from the crash cart.

  “Tension pneumo?” Rachel asked.

  “Bilaterally.”

  He could try a needle aspiration, but really there wouldn’t be any point. The patient needed a chest tube and it was a procedure he’d performed dozens of times.

  “I know you have a lot of experience, but you can’t do this, man.”

  Lucky glanced up at Howard as he swabbed antiseptic over her skin. “You just keep doing compressions. I can handle this. I’ve done these for twelve years.” He made his incision along the rib, then traded the scalpel for the angled hemostat. “I’m sure as hell not going to stand by and let this woman die because we can’t seem to find someone to come do it.” Lucky worked the hemostat over the rib and into the chest cavity, then pried it open so he could insert the chest tube. “How does she sound?”

  Rachel pressed her stethoscope to the patient’s chest. “Better. She’s easier to bag, too.”

  “That’s exactly what we wanted to hear.” He stitched the tube in place, then grabbed a second tray from the cart and traded places with Howard. Within minutes he had the second chest tube in and was stitching it in place.

  “Should we shock her again?” Rachel asked.

  “Yeah.”

  Howard charged the defibrillator and once again they all stepped back as he shocked her. A couple of seconds later, a normal rhythm beeped on the monitor.

  “You did it,” Rachel said with a smile as she continued to ventilate the patient.

  The woman was already pinking up when Hamilton appeared in the doorway and Lucky swore under his breath. “Who authorized you to insert not one but two chest tubes in this patient?”

  “No one authorized me.”

  Hamilton pointed to the hall. “Outside. Now.”

  Lucky looked at Rachel and Howard, their expressions both one of shock. He then turned and followed Doctor Dick, who was waiting for him with his hands on his hips, out into the hall. Lucky was determined to speak first. “There are still dozens of patients requiring treatment or haven’t you fucking noticed?”

  “Fuck you. You performed a procedure you know you are not legally allowed to do.”

  Lucky crossed his arms over his chest. “The patient had a bilateral tension pneumo and had been down fifteen minutes.”

  “Then you should have called me immediately.”

  He took several steps forward, forcing Hamilton to look up at him. “If I had waited, she’d likely be dead.”

  Hamilton stepped back. “You are hereby dismissed and I will be filing a report with the disciplinary committee.”

  “Are you fucking kidding me?” Lucky shook his head. “You want me to leave now? We’re in the middle of probably the worst casualty event this town has ever seen and you’re throwing me out? What the fuck is wrong with you?”

  Hamilton turned and gestured to a security officer standing in the hall, and the next thing Lucky knew, he was being escorted from the hospital.

  LUCKY WENT BACK to his place, showered, then spent the next several hours staring at the ceiling as he replayed the whole scenario in his head. If he had waited for someone “qualified” to do the procedure, the patient could have died or suffered brain damage at least. And if given the choice to go back in time, he would do the exact same thing. Because saving a life was more important than following hospital policy.

  Breaking rules and regulations was not something he did lightly. He understood why protocols were in place. But damn if he was going to stand by and watch a woman die, not when he had the skills and training and experience to help her.

  How was it that his training and real-world experience were regarded as nothing in the civilian world? Because he didn’t have a piece of paper with the letters MD or PA or RN behind his name? He had more trauma exp
erience than most medical doctors. Had completed trauma rotations in civilian teaching hospitals as part of his program. So why was it the moment he received his discharge papers, all of that training, all those years of experience, didn’t mean shit anymore?

  He just couldn’t wrap his brain around it.

  Of course, it wasn’t as if this came as a surprise. He’d known the deal when he decided not to re-up with the 75th. But he’d convinced himself he’d be able to tolerate it. He’d survived SOCM and RASP and Ranger School when so many others had failed because they didn’t have the iron will and stick-to-it-iveness to graduate. He thought that same mental toughness would help him survive undergrad and then medical school. But being handcuffed by policies and treated as less than qualified was too much for him to bear anymore.

  Several hours later he was still fired up about all that happened with Doctor Dick, so he decided to take out his frustrations on the pavement. He was in the process of tying on his shoes when his phone rang and he answered without looking. Within a matter of minutes his carefully crafted plan had gone to hell in a handbasket and his phone lay on the floor in a dozen pieces.

  Lucky headed out the front door with no real direction, no plan of how far he’d run or any concern about the cold drizzle that fell. Two hours later he found himself on the two-lane road that led past Rachel’s house. He didn’t understand much that was going on in his life at the moment, but when he crested the small hill and her place came into view, he knew one thing was certain— she would make everything better.

  By the time he climbed the front stairs of her deck, the tips of his fingers were good and numb. He rapped his knuckles against the glass storm door and waited. With no sign of movement, he knocked a little harder the second time, since the woman could sleep like the dead. Finally, he opened the storm door and tried the knob of her front door, and in true small-town fashion, the damn thing was unlocked.

  “I swear, woman,” he mumbled under his breath.

  Just inside the door, he slipped his shoes off on the tile and stripped out of his wet clothes. After throwing his clothes in the dryer, he grabbed a clean towel from the perpetual clean laundry pile waiting to be folded, and dried off as he made his way to her bedroom.