Silent Scream

by Maria Rachel Hooley

  Nodding, Yolanda replied, “Yeah, and I won’t mention the string of words he uttered.”

  “Don’t worry. I studied Gestalt’s theory. I can fill in any blanks he has with one sentence.” She took a deep breath and mimicked one of the male doctors who was an authority on male chauvinism. “Can’t Dr. Gilcrest handle it? Or do you need a real doctor?”

  The nurses, many of whom had had more than a single run-in with the ER Casanova, tittered and smiled. Maddie herself tried to conceal her laughter, but she couldn’t. Besides, she couldn’t think of a nicer guy to call in on his time off—the same jerk who’d wanted to know if her little ‘episode’ had prejudiced her against going out with him. As if.

  The wail of the approaching ambulance stifled all the laughter as they watched the EMT driving park the ambulance jump out, open the back doors, and tug out the loaded gurney. An oxygen tank was secured onto it, and the woman wore a mask over her face. One of the EMTs, a man in his mid-thirties, rolled the stretcher toward the entrance.

  “Let’s get to it,” Maddie said, and a nurse rushed toward door as the other EMT headed back to the ambulance to pull away from the hospital, allowing another ambulance entry.

  Another stretcher, another patient. Yolanda ran forward to meet the EMT and jotted the pertinent information about the patient, an elderly man, his skin darkened with soot, and his hair singed in places. As the second ambulance pulled away, a third appeared. Amid its delivery—a pregnant woman and her four-year-old son—Dr. Ashford deigned to grace the hospital with his presence. He held up his hands and glowered at Maddie. “This is an emergency? Three people?”

  Maddie immediately went to the pregnant woman ,who was also wearing an oxygen mask. “Seven more are on the way. Probably more.” She looked at the woman, whose face, also covered with soot, was streaked with tears. “It’s going to be all right.” She patted her hand. “How far along are you?”

  “Thirty-six weeks,” she rasped from beneath the mask.

  Maddie felt her shoulders relax slightly as she realized that, although the baby would be premature, it wouldn’t be by much, and that the risks were relatively low. “Are you having contractions?”

  She nodded and looked around the room. “Where’s my husband?”

  “I’ll check on that.” She gazed at the EMT, and he shook his head to show he didn’t know. “How far apart are the contractions?”

  “Two minutes,” the EMT said.

  Maddie peered at the chart lying on the woman’s gurney. As she scanned the info, she knew the woman needed to be in L&D. “It looks like you might get to meet your baby tonight or tomorrow.” She peered at Stephanie, the nurse who had just joined them. “Get her to L&D. Have the desk call and prep them.”

  The nurse wheeled the patient down the hall, pausing at the triage desk only long enough to speak with another nurse before heading toward the staff elevator bound for the second floor. Even as that patient disappeared, two other EMTs rolled their stretchers into the triage area. Ashford met one of the EMTs head-on and held out his hand for the clipboard, barely looking at the sixteen- or seventeen-year-old boy who lay unconscious, his blond hair streaked with soot and matted into clumps against his forehead.

  “What have we got?” Ashford asked, scanning the chart and turning his attention to the boy’s face. An oxygen mask covered both his nostrils and his mouth.

  “The firemen pulled him out of one of the apartments which suffered more of the fire damage. He’s coughing heavily and has swelled nostrils.” He gestured to the boy’s legs. “There are second- or third-degree burns as well.”

  Ashford pulled the covers back, looked at the blackened fabric, and gingerly cut through the scorched denim. As he separated the jeans leg, he peered at the charred flesh below. “Jesus. How far up?”

  “His waist,” the EMT replied.

  Ashford scribbled a notation on the clipboard and waved for a nurse to join them. “We need to medivac him to Oklahoma City. We aren’t set up to handle this.”

  As Maddie watched Ashford from the corner of her eye, she met the other EMT. “Background?” She picked up the clipboard from the edge of the bed.

  “Female, age 42. Chronic hypertensive heart attack. She was inside the building when the fire caught, and it literally scared the shit out of her. We had to defib twice on the way over.”

  Maddie peered at the pale face of the unconscious woman. Sweat beaded on her forehead. “How’s her pulse been?”

  “Not great–her body is giving out on her.”

  Maddie handed the clipboard to a nurse. “Put her in room two.” She waved down the hall toward the examination rooms. Just as she was about to follow the stretcher, she saw three more fire victims rolling in. One of them, a thirtyish woman, screamed and tried to rise despite the deep gash in her forehead.

  “My son!” she screamed, flailing her arms wildly, trying to fly off the gurney.

  Maddie rushed forward. “We need to sedate her before she hurts herself or somebody else. Give her one milligram of Ativan.”

  As Maddie stepped up to the end of the gurney, one of her legs kicked outward, slamming into Maddie’s stomach and knocking the breath out of her. She reeled backward, stumbled, and slammed her head on a nearby metal rolling cart. Her vision dimmed to blackness.

  “Dr. Gilcrest?”

  Maddie heard the voice from a great distance away, as though someone had plugged her ears with cotton. She could feel a piercing pain ripping through her head, but then, as the blackness closed in, the pain and everything else disappeared, swallowed by darkness.

  * * *

  "Maddie? Can you hear me?"

  Maddie groaned as the sound of her name jolted her from unconsciousness. Even before she opened her eyes, she felt pain clawing at her brain. Forcing her eyes open, she cringed at the harsh fluorescence overhead, occasionally blocked by the five nurses gathered round her. "Don't you guys have patients to see?"

  The nurses peered curiously at her before dispersing from the exam room, leaving only Yolanda to tend to her. "Welcome back to the land of the living." Yolanda touched Maddie's forehead, prodding a couple of inches above her left eye.

  "Damn!" Pain exploded in Maddie's head, and she pushed Yolanda's hand away. "That hurts."

  "I imagine it does. It's still bleeding." Yolanda grabbed some gauze and lightly dabbed at it. No matter how gingerly the nurse touched, Maddie winced.

  "How long was I out?" She watched Yolanda dab the gauze against her head and then pull it back soiled with blood that dripped onto the nurse's plastic gloves.

  "A few minutes."

  Taking a deep breath, Maddie folded her arms across her chest. "What happened?"

  Yolanda dropped a soiled gauze strip into the haz mat bin and paused to pick up another. "You don't remember?" She paused as Maddie shook her head. "Maybe that little tap on your noggin did more than I thought. You were about to treat one of the victims from the fire when she went ballistic and kicked the fire out of you. You fell backwards and hit your head on the corner of a metal cart."

  "The fire! God, the ER must be swarming!" She tried to jump off the gurney, but Yolanda held her in place.

  "Hold up, hotshot. You can't treat patients right now." She dabbed a fresh gauze pad at Maddie's head.

  Maddie jerked away. "Why the hell not? And who is going to do it if I don’t?"

  Yolanda held the bloodied gauze in front of Maddie. "You can't go in there and bleed all over them, Maddie. That's the last thing we need." She pushed Maddie's bangs from her face. "It looks like you could use a few stitches."

  "Is Ashford the only doctor in there? He can't handle that! He may think he’s God, but we both know he isn’t!" She tried again to squirm off the table, but Yolanda caught her by the wrist.

  "Damn it, Maddie, just stay put for a few minutes, will you?" She poured an antiseptic cleanser on one of the gauze pads and began cleaning the abrasion. “We called in Jamie Peterson to help pick up the load. He’s on his way and should be
here any minute.”

  Maddie scratched her fingernails on the sheet. “Great. I’m sure this whole damned thing confirmed Ashford’s belief that I was incompetent, didn’t it?” She waited until Yolanda had finished cleaning the scratch and then hopped off the gurney despite Yolanda’s protest. “I’m not going out there. I just want to see what my head looks like, all right?”

  Reluctantly, Yolanda nodded, giving Maddie space to head to the wall mirror. As she stepped up to it and peered at her reflection, a new rivulet of blood pooled at the cut and seeped down her temple. Maddie drew her bangs away and shook her head. “Damn. You’re right. It is going to need stitches. Can you do them?”

  “Can you sit still long enough for me to finish, or are you going to be dancing out the door midway through?”

  Maddie walked back to the gurney and perched on the side of it. “I’ll be a good girl, Mother. Just hurry the hell up, will you?” She watched as Yolanda prepped the local and all the other implements.

  “You need to tuck your bangs from your eyes, Maddie,” Yolanda said as she picked up the syringe.

  Maddie gathered the long bangs and brushed them behind her ears securing them. “That good enough?”

  “Works for me.” Yoland moved the syringe toward Maddie’s head. “Better get ready. I’ve heard locals hurt like an SOB.”

  “Did I mention your bedside manner sucks?” Maddie took a deep breath as Yolanda administered the painkiller. More than once, she stiffened as the jagged rip of pain lanced her forehead. “Damn.”

  “I’m finished.” She threw the syringe into a sharps container and picked up the needle and nylon. “Give it a few minutes to numb the area, and I’ll stitch you up.”

  “How’s the woman who kicked me?”

  “Sedated.” Yolanda threaded the needle. “But not before she kicked at least two other nurses. “She had some strong legs.”

  Maddie looked down at her left hand and arm, the one which had been broken. Twisting her hand back and forth, she felt stiffness and knew it wasn’t as flexible as before. Then again, she had never doubted that flexibility was gone entirely, taken by a man who’d wanted to destroy her.

  “You ready for me to start stitching?” Yolanda asked.

  Shrugging, Maddie replied, “As ready as I’ll ever be, I guess.”

  As Yolanda pierced the skin with a needle, she glanced at Maddie's expression. "Can you feel that?"

  "No."

  The nurse drew the nylon, tugging the jagged skin together as she calmly asked, "Have you heard from Gabriel lately?"

  Maddie felt a flush color her cheeks. "No, did you expect me to?"

  The nurse drew another stitch together and paused to wipe away the fresh blood staining Maddie's forehead. "I just thought he might have called to check on you, that's all."

  Maddie chewed on her lower lip. An image of Gabriel jumped into her mind, him sitting at Yolanda's kitchen table, his chin resting on his hand as he leaned toward her. Even in this memory, he’d exuded such a quiet confidence, a warm strength wrapped deep in a silence. She touched her arm, remembering how his hand had felt as it lingered there. His face, features sharpened and defined with time, had reflected her losses as she’d spoken to him. She could remember the way her emotions had furrowed lines into his forehead and how those creases had eased only after she could laugh again. And he had made her laugh. Why had she been so important to him?

  “Ouch!" she snapped as Yolanda tugged another stitch closed. “I felt that one.”

  Yolanda paused and met Maddie’s gaze. “You need more of the local?”

  “No. I’ll be fine. You’ll just have to put up with my whining.”

  "Lucky me." She kept stitching, cleverly anticipating Maddie's action before she moved, but once Maddie flinched, Yolanda almost jabbed the needle lower, toward Maddie's eyebrow. "Be still!" she chided, "Or else this might just end up in your eye! Have you thought about calling him?" she asked, dabbing the wound again. "I bet he'd like to hear from you and know things are going all right."

  Maddie ducked away from her, shaking her head. “Oh, really? I rather thought he was just a guy doing his job. It’s not his fault he found me.”

  “I’m never going to finish this if you don’t sit still.” She held Maddie’s chin and started to stitch again. “Besides, he went way above and beyond his job. We both know that. He’s a fireman, not a cop, Maddie. His job was over the minute you were loaded onto a gurney and driven to the hospital.”

  Clenching the sides of the gurney with her hands, Maddie asked, “So what’s the point of your questions?”

  “Because there’s something between the two of you, and it’s far from finished.” She managed to get in another stitch despite the sudden arch of Maddie’s eyebrows.

  “What?”

  “You heard me. I’ve got three more stitches, so could you keep your eyebrows from rising when you want to play dumb?”

  “There’s nothing between Gabriel and me,” she snapped, crossing and uncrossing her legs at the ankle. “And you know it.”

  “I don’t know anything of the sort!” she retorted, hurriedly finishing another stitch. “What I know is that he made you feel safe and human and some part of you let him inside even though you really didn’t want to.” She finished another stitch. “Like it or not, he’s still there inside you, waiting for you to realize what’s going on and accept what you might feel.” She finished the last stitch and tied it off before covering it with a bandage. “The stitches aren’t the best I’ve done, but they’ll do.” She tossed the remnants in the haz mat bin along with all the soiled gauze pads.

  “Yolanda, I don’t plan on seeing Gabriel again.” She hopped off the gurney and brushed her bangs over the wound, trying to conceal it. “I don’t know where you got this crazy idea from, anyway.”

  “More’s the pity.” Yolanda tossed the plastic gloves into the haz mat bin and turned to Maddie, her dark brown eyes flashing with a passion that Maddie hadn’t seen in her before. The nurse tapped her chest. “From in here, Maddie. I got the idea from in here. Maybe one day you’ll understand what it’s like to feel without thinking. I just hope Gabriel’s around when you do.”

  The examination room door swung open, and a nurse stepped inside, carrying a clipboard in one hand she tapped against the other as she looked at Yolanda. "Is Dr. Gilcrest going to be able to assist in the ER?" She looked down at the clipboard. "The building exploded. More casualties are en route, many of which are firemen who were in the hot zone when it blew."

  "Of course I'll be able to assist," Maddie replied, stepping away from the table. "What kind of numbers are we looking at?" She held out her hand for the clipboard and perused the top sheet. Despite the calm in her voice and manner, inside Maddie felt her heart rate double, making it difficult to breathe. Firefighters wounded? Dead? A cold chill swept down her spine, and even as hard as she tried to hide it, she shivered from the pit of ice forming in her stomach. Please don’t let Gabriel be among them.

  Her gaze happened on the figure she sought: five fatalities so far, at least 25 wounded on their way to the hospital. Another twenty were headed to Southwestern. "Have they mentioned the status of the fire?"

  "Out of control. Pretty much all of the fire stations are involved in this one--it's too big and threatening.

  "In other words, all the firemen have been called in for this one."

  "Yeah."

  "God." Maddie handed the clipboard to the nurse. As she lowered her hand, she saw the trembling of the fingers and felt her chest constricting that much more. Please keep him safe, she thought. He's a good man. "What's the ETA?"

  "Any minute."

  Taking a deep breath, Maddie replied, "I'll be right there."

  The nurse took the clipboard and strode out the door, leaving it open as she disappeared down the hall.

  "We need to call in Richards and Klein to assist. Ashford Peterson, and I can't handle this emergency by ourselves." Maddie tried not to envision Gabriel lying
on the table in front of her, his body broken beyond recognition, but she couldn't help it.

  "Sure you're up to this? You're awfully pale." She peered closely at Maddie's face. "Or maybe that's those damned emotions you work so hard to keep under wraps."

  Maddie took another deep breath. "I'm fine. It's just been one long day."

  "It's about to get worse. I'll go make those calls." Yolanda headed toward the hallway but stopped short in the doorway. "You know, you may not have a choice about whether you see Gabriel again." She drummed her fingers against the doorway molding. "The question may be whether he is alive or not, and can we save him if he is."

  Chapter Twenty-Two

  As the patients arrived, Maddie worked on them side by side with Ashford. Neither of them paid attention to the other, instead focusing on their patients. There were more than enough of those. Although Maddie tried to keep busy, her mind wandered back to the conversation she'd just had with Yolanda. During the weeks since the assault, Maddie had often thought of Gabriel; sometimes, she still saw him in places he wasn't--almost like a ghost haunting her mind. He was in the cars that passed or in a stranger with dark hair she saw the back side of as she walked behind. In short, he was always within sight, but never quite near enough to talk to, not that she would have approached him or known what to say.

  More than once, she'd wondered what it might have been like if they'd met under different circumstances. But that would never be possible, and Maddie didn't want to think about the woman he’d met--the one who’d known fear so intimately. Maddie shuddered. She never wanted to be that person again, and if that meant letting go of Gabriel, she could do it. Besides, that woman had had a self-destructive side, and Maddie didn't want to be her. Some things were just too difficult to do and keep breathing.