Silent Scream

by Maria Rachel Hooley

  Besides, just because she was drawn to him did not mean the reverse was necessarily true. Perhaps he, too, saw only the victim she had been, and if Maddie never asked him what he saw, she'd never have to feel that humiliated again. There were some things that cost too much.

  Another gurney bumped hers, prompting her back to the ER. Although it had been relatively calm before, now it bustled with EMTs nurses, and loaded gurneys, overflowing into the halls, and collecting in front of the triage area. There were more than twenty firemen among the patients. At least fifteen civilians were also among the wounded. Each time she faced a new patient, she tried not to see the uniforms of the firemen and quickly asked for their vitals and assessed them before she peered at their faces, lest she find Gabriel staring back at her.

  The current patient, a tall black fireman, suffered not only from burns all over his legs but also shrapnel embedded in his chest from when the building had exploded. "It hurts," he whispered, grabbing Maddie's arm and drawing her close so he could whisper to her. "I can't take this pain anymore." Tears pooled in his eyes and overflowed down his face, washing the dirt from his skin where the tears trailed downward. "Please," he implored her, "I can't take this!"

  "I'll take care of you." She looked over at Yolanda, who had just finished noting vitals on another patient, and waved her over. "I need a morphine drip started on this one."

  "Will do," Yolanda replied, threading her way through the ocean of gurnies toward the supply area to get an IV post and the paraphernalia needed to start the intravenous fluids.

  Maddie turned back to the man and squeezed his hand reassuringly. "You're going to be just fine. The nurses will start an IV with pain meds to take the edge away." She scrutinized his uniform, trying to discern which station he'd come from, but she couldn't tell. "What station are you with?"

  "Seventeen," he grunted, keeping his eyes clenched shut. Sweat beaded on his forehead and ran down his face in two thick streams.

  Maddie inhaled sharply and grabbed the gurney to steady herself. "Was Gabriel Martin on duty with you?"

  "He was called in," the man rasped, struggling to breathe.

  "Did you see him?" She kept a tight hold on the gurney.

  "He..was on the….stairs when it blew."

  "Oh, God," Maddie whispered, and her hand flew to cover her mouth. "Oh, God," she repeated and started looking around the room as if she knew he were there.

  "Are you all right?" Yolanda caught her arm as she placed the IV pole by the man's head. "You look like you're going to pass out."

  "I'm fine…It's Gabriel. He was on the stairs when the building blew up." She began scanning the victims of the explosion, looking for him. "I have to find him."

  Yolanda gripped Maddie’s arm, keeping her from leaving. "Maddie, there are a lot of people here who need your help. You don't even know if he will be brought to this hospital, do you? They could have taken him to Southwestern."

  For a fleeting second, Maggie thought of jerking away and searching through the patients, but as she kept staring at Yolanda's determined frown, she abandoned that thought. She had a responsibility to the people who had been brought here for treatment, not to Gabriel. Still, that didn't stop the rush of her heart or the burning fear of not knowing whether Gabriel were alive.

  With each patient, she went through the motions of healing, but all the faces blurred in a dark mass; none of them were the one she sought. Although most of the patients arrived at the hospital alive, a handful had died enroute, and a few passed away just inside the hospital. Those victims were quickly shuttled to the morgue, but even the out-of-sight, out-of-mind game did not allow any of them to forget. As the sea of faces swam in front of Maddie, she began to feel a surge of hope as she examined a twelve-year-old girl who had sustained a broken ankle from evacuation efforts during the fire. Maybe Gabriel hadn't been hurt. Maybe he'd been far enough down the stairs so that when the building had blown up, he'd managed to get clear unharmed. Maybe the Pope could fly, too.

  That was an awful lot of maybes.

  "I'm Dr. Gilcrest," Maddie said, "and I'm going to help take care of you." She peered at the girl's leg, noting where the bone gouged the flesh. Maddie winced inside at the jagged edges of the bone.

  Tears clouded the girl's face, and she inhaled and exhaled sharply. "It really hurts."

  "We'll see what we can do about your pain." She turned to Yolanda. "Give x-ray a heads-up that she needs that leg done so we can tell the extent of the damage inside." She scribbled a note on the girl's chart and patted the girl’s shoulders, where long, chestnut locks lay. "Emily, we're going to take some x-rays of your leg to see how much is hurt on the inside."

  "Maddie," Yolanda said, carrying a clipboard, "come with me." She tugged at Maddie's arm, half-dragging her away.

  Maddie felt the pit of her stomach fall as she stared at the nurse's pale features. She knew something Maddie didn't. "Did you find him?" she whispered as the two of them walked away, Yolanda leading her toward the triage area where the newer patients awaited treatment. Maddie groaned when she saw all the stretchers filled with people.

  "No… not Gabriel. I found someone else." She stopped in front of one of the gurneys lining the hallway just after the triage nurses’ station. "She doesn't look so good, Maddie." Yolanda peered at the woman on the stretcher and then offered Maddie the chart she held.

  Maddie peered at the patient--a petite blond woman, her face darkened with soot and stained with blood from small lacerations caused by broken glass, some of which was still embedded. An oxygen mask covered her face, and each faint breath fogged the mask. Black mucous clustered beneath her swollen nostrils. Despite all the blood and soot, despite the mask, despite the woman's unconsciousness, Maddie recognized a familiarity to the woman, but she had no clue who she was. She kept staring at the blonde hair tinged with black and tried to imagine her eyes open and the blonde hair clean of soot. Then it finally came to Maddie: Tammy. It was Tammy. The world seemed to narrow to a small hole of light, and darkness closed in around her. She felt the blood pumping through her body at a frantic pace, and she forced herself not to think, not to feel. Think of her as a patient, just like any other, someone who needs your help.

  "She needs a bronchoscopy," Maddie heard herself say in a neutral tone. "Where was she found?" Despite the conversation, Maddie's thoughts raced. She needed to call Sam and let him know Tammy was here.

  "In her apartment, probably sleeping."

  Maddie picked up her hand and peered at the top, where more tiny lacerations decorated the skin with dried blood. "How long was she inside?"

  "We don't know. The EMT who brought her in said the fireman who rescued her was in bad shape and couldn't give any additional information, which is one reason we don't know as much about her condition as we would like."

  As Maddie watched Tammy's face, she thought, I need to call Sam. He would want to know she's here. She started to head for the closest phone but then saw all the gurneys filling the room with patients who needed care. Some of them were critical and couldn’t wait. Realizing there was no time to contact Sam personally, she turned to Yolanda and handed her the clipboard. "I need to ask a favor."

  "Okay." Frowning, Yolanda accepted the clipboard.

  "Call Sam Martin at the Owens Police Department. Let him know Tammy is here."

  "I'll take care of it."

  Maddie walked toward another patient, a fireman who lay so still on the gurney she wondered if he were alive. Even as she began assessing him, all she could think about was Gabriel.

  * * *

  Hours later, Maddie had finally finished the last assessment and paperwork. As she sat on a stool and scribbled notations on a clipboard, she felt tension knotting her shoulders, and she stretched, trying to ease the dull ache. Glancing at the clock, she realized it was 2 a.m., which probably explained why her body only sluggishly obeyed her commands as she set the chart back on the counter. Lifting her hand, she rubbed the back of her neck.

&nb
sp; Both she and Yolanda had checked the roster of names available for all the patients who had been admitted to Memorial in regards to the fire, and they both had come up empty in discovering any information about Gabriel. Maddie brushed the bangs from her face and tried to remain positive. Couldn't that mean he had been one of the lucky few who had not been injured? Perhaps the fireman she'd treated earlier--Ramsey, wasn't that his name?--had been mistaken when he’d thought he seen Gabriel. Hadn't it happened fast enough so that mistakes were more than probable?

  Raising her arms over her head, she stretched and tried to blink away the bleariness. Just as she was heading toward the triage desk to tell them she was going to hide in a back exam room and catch a catnap, she saw a tall man wearing a brown uniform standing in her way. She peered at him and realized it was Sam, the likeness between he and Gabriel unbelievable, and that likeness created an ache within her, renewing her worries. She nervously chewed her bottom lip, wishing she had all the answers Sam wanted to hear.

  He stepped toward her. "Maddie?"

  "Hi, Sam," she said and nodded toward him.

  "Yolanda called me." He pulled off his hat and cradled it in his arm. "She said Tammy had been brought here."

  "Yeah." Maddie gestured to the triage desk. "I can find out what room she's in for you."

  He lightly grabbed her arm and stopped them both. "How is she?"

  "I'm the wrong person to ask, Sam." She gazed at his dark eyes, the same shade of brown as Gabriel's. "I didn't even do the ER assessment. I just saw her and knew you'd want to be called."

  His fingers slowly uncurled from around her arm. "Okay, maybe you didn't do the actual assessment, but Maddie, you've seen her. Tell me what you know?" His dark eyes implored her and he frowned painfully. "Please?"

  Maddie swallowed hard and tried not to tremble. She tried not to make this personal, but it really didn't matter that she was a doctor. Before she'd ever received that degree, she’d been a human being, and humans felt things. They cried when they hurt, they laughed when they could, and sometimes, when there were no other options, they grieved. "She didn't look good, Sam. There were lots of signs of smoke inhalation and—”

  Yolanda appeared beside her and said, "I need to speak with you." She leveled a meaningful gaze at Maddie.

  "Can't it wait?" she asked, meeting Yolanda's gaze.

  "No." She pointed toward the triage desk. "There's an urgent call for you."

  "Excuse me for a moment," she said, touching Sam's shoulder. "I'll be right back." Yolanda tugged her arm, and the two headed to the desk.

  "What is going on?" Maddie asked. "I was just telling Sam about Tammy."

  "Gabriel's at Southwestern."

  "What?" Maddie grabbed the counter and tried to steady herself. "Why wasn't he brought here?" It was a useless question. She knew that. But it gave her time to prepare for the questions she didn't want to ask but knew she would.

  "At a massive incident site, they always divide up the patients. It was just the luck of the draw." Yolanda peered at her intently, but Maddie looked away, knowing fear had inscribed itself deep into her features. It had become a part of her that she could not hide, no matter how desperately she wished to.

  "How is he?" she whispered, grasping the counter so tightly her knuckles had turned white. She held fast to it, as though it were the only thing keeping her upright. Hell, maybe it was.

  "He was taken to Southwestern but coded out before he arrived."

  "Oh, God." Her voice cracked under the pain, and she felt her knees wobble, threatening to dump her onto the linoleum floor, but the counter supported her. "Oh, God." Tears burned her throat and eyes, and she swallowed hard and fast, over and over, trying to blink them away. I should have called him, she thought. I should have at least said thank you again, or even asked him how he was doing. She felt the weight of Yolanda's hand press down upon her shoulder, and, more than anything, she just wanted to run away. Shaking her head, she thought of all the times she'd been the one to tell someone that kind of news, and no matter what, the pain of it had never really touched her. But now, this had come too close. Her body trembled violently, as though it were like a soda which had been shaken and now waited for someone to open it. "What happened? Do they know?"

  Yolanda kept rubbing her shoulder. "He was the one who went in after Tammy. He knew she was in there, and he knew he couldn't let her die. So he went."

  Cringing, Maddie knew that explanation fit. He would have done that. She peered at Sam. His head was tilted to the floor and he stared off into space as though oblivious of everything around him. He thrust his hat back on his head and leaned back against the counter. Although his skin normally appeared darker, today the pallor of his cheeks contrasted sharply with the brown uniform he wore.

  "Maddie?" Yolanda said. "Are you all right?"

  Maddie turned back toward the nurse and nodded, hoping like hell the tears were gone from her eyes. "Yeah, I’m fine." Lifting one hand, she rubbed the back of her neck, trying to massage away the panic her fingers couldn't touch. It didn't matter that she couldn't grab it and throw it away.

  "They haven't been able to get hold of Sam and tell him. I know he’s here, but you don’t have to be the one to tell him." Yolanda looked toward Sam. “Do you want me to tell them to call the police department and have them get through to him?"

  Maddie also looked at Gabriel's brother and the haggard expression on his face as his eyes met hers—wounded eyes, not ready to accept this. He'd buried a sister already. He couldn't take this alone.

  "No, I'll tell him. Do you know what room Tammy is in?"

  “204.”

  Maddie started to walk away, but Yolanda grabbed her arm.

  "You sure you feel up to this?"

  "What does that have to do with it?" she replied softly. "Gabriel saved my life, Yolanda. He did so many things for me he didn't have to do, things I didn't understand until now. I'm going to go see Sam and try to help him through this. Since I’m due for a break, first I’ll take him up to Tammy’s room "

  "Maybe you should tell him you loved his brother."

  "I don't…." The words died as she thought of Gabriel. She could still hear his voice in her head—patient, calm, sweet. And that was when she knew what regrets were made of.

  “Maddie, you should just take the rest of the day off.”

  “No.” She edged over to Sam, staring at the tiles of the floor instead of his worried face.

  "Do you know what room she’s in?” he asked, and without waiting for her answer continued with another question. “Can I see her?" he asked softly, staring at the white-tiled floor.

  "Tammy’s in room 204, and you can see her in a minute. I need to talk to you first.” Maddie folded her arms across her chest and braced her back as she reached for some kind of professional aura she didn’t feel. She wasn’t just the doctor in this case. It was personal, and she felt it. “It wasn’t just Tammy who was involved in the fire, Sam. Gabriel was hurt, too.”

  “What?”

  “He found out Tammy was in the building, and he went in after her. As he was leaving the apartment, it exploded.”

  Sam’s shoulders sagged, and the color drained from his face. “Not Gabriel, too.”

  She reached out and touched his shoulder. “He was brought in as a DOA at Southwestern.”

  As she touched his shoulder, Sam sagged as though the weight of the world had pressed him down. “If Tammy was brought here, why wasn’t he?”

  Maddie shivered from an unexpected chill. She looked toward the door and finally understood why. One of the janitors was cleaning the glass doors and constantly setting off the automatic doors, allowing the winter wind and snow inside the ER. As she turned back to face Gabriel’s brother, she knew by the stony expression on his face he had asked the question of her for the same reason Maddie had asked Yolanda: it bought time to get emotions in check. Still, even if it were a diversionary tactic, it still deserved an answer. “It’s policy at an extensive emergency
scene to divide the patients among outlying hospitals to minimize overwhelming the staff and maximizing treatment.” She pushed a stray hair from her face. “The nurses at Southwestern have been trying to reach you but haven’t been able to, so I told them I would relay the message.”

  “Do you know what happened?” Sam spoke in a quietly neutral tone as he peered at the ground. His fingers curled inward, forming fists that trembled with raging emotions forced in check.

  “He was on the stairs when part of the building exploded. I’m sorry, Sam. You will never know just how sorry I am.” Her voice cracked, and she tried to keep the tears invisible, but her eyes flooded with them, and she suddenly felt his arms around her, drawing her so tightly to him she almost couldn’t breathe. He held her close, his body trembling as they both cried. She closed her eyes and gave in to the weariness and pain she could no longer contain. Maddie didn’t know how long she stood there, but when they’d finally parted, she could see a large wet spot where her tears had soaked into his uniform. She brushed at the spot, trying to minimize it. “Sorry about that.” Then she dabbed at her own eyes.

  “Don’t worry.” He shoved the hat back on his head. “It’ll just look like melted snow.”

  She looked at her watch. “I’ll take you to Tammy. I heard it was Gabriel who saved her.”

  He winced as the words struck him. “He talked about you a lot, even after things had settled down and your life had gone on. He really had no reason to think about you, but he did.”

  “Why?” Maddie led them both toward the public elevator and pushed the up button.

  Sam shoved his hands deep into his pants pockets. “Lots of reasons, I expect.” The elevator doors slid open, and the two of them stepped into an empty car.

  “Such as?” Maddie watched him take off his hat and lean against the wall. He closed his eyes and rested his head as his hands settled on the silver bar that ran waist-high around the elevator. Even though his body was still, as if gearing up for what he was about to see, his fingers frantically thrummed the metal in a wild, patternless motion.