Code Triage

by Candace Calvert

  +++

  “Don’t, Kurt. Stop! Oh, please . . . no. ” Sam stumbled backward, hands raised and trembling, barely hearing the screams of the staff over the thud of her own heart in her ears, still ringing from the bullet blast. Was that real? Did he really shoot? She stared, horrified, down at the floor—at the guard’s crumpled body near her feet, the widening expanse of pooling blood. Run, run!

  “No one move!” Kurt shouted, tightening his arm around Kristi’s throat until she gagged, eyes rolling back. “And you—” he took a step toward Sam, eyes wild—“you even breathe and I blast you clear to the gates of hell. You hear me, witch?”

  Sam tried to nod, then startled as the wounded guard grabbed desperately for the hem of her skirt but sank back down, his hand sliding down her leg.

  “Help,” he groaned, gargling a mouthful of blood.

  “Please.” A nurse, crouched beside the desk, rose to her feet. “Please,” she begged again between sobs, “let me help Cappy. Let me just go to him.”

  “Yes, Kurt,” Sam whispered, hearing her voice quaver. “Let us call for help. You don’t want him to die. You—”

  “Don’t tell me what I want!” Kurt bellowed, throwing Kristi to the floor. He clawed at the zipper of his jacket, pulled out a second gun, and bit his lip so hard that blood welled. He sputtered, spit, and glared at Sam. “I’ll tell you what I want.” He whirled around, the muzzles of the guns sweeping over the terrified staff. “I want all of you to stop trying to keep me away from my kids. Stop calling the cops, writing reports. Stop saying I’m not man enough to—” He halted, eyes jerking toward the overhead speakers as they crackled to life again.

  “Code Triage, Internal. All departments prepare for general lockdown. Code Triage, Internal. Prepare for hospital-wide lockdown.”

  The fire doors slammed shut at the end of the corridor, and Kurt jumped, aimed both guns in that direction. His gaze darted around the area as he stepped up to where Kristi crouched. He kicked her hip. She whimpered, and he kicked her again. “You had a chance—but that’s over. I don’t care what you do anymore. I’m taking my kids. You’ll never see them again.”

  “No. Please . . .”

  He glared at her and whirled away, jogging toward the baby’s room.

  “No!” Sam yelled after him, fear for the children overriding all else. “You can’t—”

  There was a sharp explosion and her body jerked backward. She shook her head, confused.

  What’s happening? She heard a barrage of sounds: crack, crack, endless, like a long string of firecrackers. Then screams, keening wails followed by frantic footfalls and shouts. She staggered forward and gasped for breath, fighting a sudden, incapacitating wave of weakness, but lost the struggle and fell to her knees. She tried to stand again and finally felt the pain. Searing, bursting like a grenade, exploding across her belly.

  She sat back and stared down in a daze, seeing the blood, a river of red soaking through her blouse, her skirt, and pooling in her lap, warm and sticky. She clutched her stomach, grabbed a fistful of the flimsy flowered fabric, tried to stanch the flow even as she realized everything around her was going gray and fading away.

  She stretched out on the floor, curled up on her side, and found herself looking into Cappy’s face—eyes open, glazed, lifeless. She thought of Elisa, of Toby, and of Nick. Then wondered if it was too late to pray.

  +++

  Kurt shoved his shoulder against the door leading to the loading dock, dropped the Glock, grabbed it up, and rammed the door again. Lockdown. Did that mean every stupid door was— He shoved again, cursing, and almost fell through as it opened into the morning light. Sirens. They were coming. He had to make it to the car.

  He hefted the guns, one in each fist, and ran toward the parking lot, heart pounding, muscles twitching, his mind beginning to stagger into prickly confusion. The thrill ride that had swept him into the hospital was gone. In its wake was something hollow and brittle, lonely. He pushed his legs faster, sucked in a breath, and smelled blood: acrid, coppery—condemning. He’d shot people. Watched them fall. Heard his children crying, screaming. Abby begging him. My little girl. Looking at him like she didn’t know him. Like he was monster, not a hero. How did that happen? That’s not what he’d wanted.

  He heard a shout, then saw people standing around the MINI Cooper. Security guards. They pointed his way and crouched for cover. He stopped, guns dangling in his hands, mind staggering again. The steady drone of helicopter blades made him blink skyward. Cops. The sirens growing closer. If he shot the guards, got his car . . . Abby’s face filled his mind. Would she understand?

  He gagged, remembering Kristi on the floor. He’d kicked her. Had Abby seen that, too? And Finn—was he too young to remember? Kurt froze at the sound of a car squealing to a stop. A patrol car, with officers exiting to hunch low behind the opened doors—guns pointed. How did things get this far?

  “Drop your weapons.”

  He hesitated, watching the nearest officer’s dark eyes and knowing in a glance that the man was deadly serious. Would kill him without blinking.

  “Drop them, now,” the cop repeated, raising his voice as more patrol cars surged in. “Don’t make us shoot. Let’s settle this peacefully.”

  Peacefully. Kurt thought of Finn’s face. Smiling in Kristi’s arms until his father stormed in and . . . What have I done?

  Kurt held the officers’ gaze as he took a step forward. He hesitated, held his breath . . . and pointed the guns. In eerie slow motion he saw the officers thrust theirs forward, heard a spray of gunfire—then felt a bullet hit hard against the top of his chest, jerking him sideways. Another grazed his side as his knees began to buckle. A third bullet blasted through his skull.

  +++

  “Suction!” Leigh ordered, straining to see through a frothy red tide of blood at the back of Cappy’s throat. “I can’t see the cords without . . .” She grabbed for the offered Yankauer tube and buried it deep in the pooling fluid, hearing it suck as it tried to clear the guard’s airway. She needed to see well enough to find the vocal cords, slide the endotracheal tube in place.

  “Bag him,” she told the respiratory therapist holding an Ambu bag. “Continue cardiac compressions, give another round of epi, and then I’ll try again.” Try to get him to the OR . . . not let him die here. Don’t die on me, Cappy. The surreal sense of horror struck her as she glanced at the unconscious man on her gurney. Gunshot wound to left chest, massive blood loss, no heart activity. She fought against a sinking wave of dizziness, taking a deep breath. Stay focused.

  “Keep pumping the Ringer’s lactate—someone make sure the lab’s getting those blood products to the OR stat. The OR, not here.” She signaled the charge nurse. “When can surgery take him?”

  “Any minute,” the nurse answered, expression stoic despite soot-dark tear smudges. “They’re taking Cappy first while the other team sets up for Samantha Gordon.”

  Leigh’s throat constricted, the disbelief swirling again. She glanced toward the other trauma cubicle. “How’s she doing?”

  “Conscious, but still really shocky. Dr. Bartle wants to explore her belly as soon as they can get her into the OR.” The charge nurse’s brows scrunched. “She’s worried about her little girl. Sounds like she has no one else.”

  No one. Leigh glanced toward the group of officers standing near the nurses’ desk, then shook the thought away. She turned to watch as the ER tech performed cardiac compressions. Cappy’s wife was at the beauty shop when they’d reached her; their pastor would drive her to the hospital. Leigh would talk with her, tell her that they’d done all they could to get him to the operating room as fast as they could. But . . .

  “Halt compressions,” she ordered, watching the monitor as the tech stepped back.

  “Looks the same, Dr. Stathos,” the nurse told her. “Wide complexes, slow rate.”

  Leigh pressed her fingers deep into the flesh beneath Cappy’s pale jaw. But no pulse.

  “I’m read
y,” she said, returning to the head of the gurney. “Let’s do this.”

  She tilted Cappy’s head, positioned the laryngoscope and tube, and asked the therapist to apply gentle pressure on the Adam’s apple. Leigh peered down the lighted blade and got an adequate view of the cords. She slid the endotracheal tube in place, inflated its balloon, and checked the placement.

  “Okay,” she instructed. “Continue compressions, one more round of epi, and get ready to roll him down to the OR.” She swallowed around the growing ache in her throat. “Let’s give this good man the only chance he has.”

  Even before the next dose of epinephrine was due, the surgical crew, including anesthesiologist, arrived to wheel Cappy down the hallway to surgery. Leigh didn’t realize she was holding her breath until Riley appeared beside her. She exhaled, grateful for company that didn’t require her to give orders. Or bad news.

  “How are you holding up, Leigh?”

  “I’m not sure I’m holding up as much as holding on. Or trying to. I hear you were our Paul Revere. Got the word to the operator?”

  Discomfort flickered across Riley’s face. “I was close to the stairs. Thank God.” She glanced toward the door of an exam area across the room. “Is Mr. Denton . . . ?”

  “Alive. In a coma. The chest wound was high—no lung or vascular injury, looks like. The wound in the torso was superficial. But the head wound . . .” She shook her head. “He’s gone down for a brain CT with a fleet of officers in tow. And the neurosurgeon’s on his way in. But I’m fairly certain the injury is devastating.” She frowned, uncomfortable with the mix of feelings his prognosis stirred. He’s killed Cappy.

  “It was your husband who made that shot.”

  “Or maybe his partner,” Leigh answered, then realized it had been a statement, not a question. “You’ve seen Nick since the shooting?”

  “Yes . . .” Riley paused, as if considering her words. “He was in with Sam Gordon.”

  Leigh began stripping off her gloves, wishing her emotions were as easy to shed. If I ever doubted that you’ve given up on me, God . . .

  “I’m going to meet with social services this afternoon,” Riley said, glancing around the littered ER and toward the nurses gathered at the desk. “We’ll need to start doing some individual peer counseling and set up a full hospital debriefing for the affected staff, probably a few days from now.”

  Leigh thought of last spring’s pesticide disaster in Pacific Point. Her friend, nurse Erin Quinn, had done the peer counseling then.

  “Unfortunately,” Riley continued, “this incident today made Golden Gate Mercy the poster child for Critical Incident Stress. And it’s not over. We’ve got Cappy in surgery with an uncertain outcome.” She winced at the prognosis on Leigh’s face. “There’s a Child Crisis investigator going to surgery as well, a pregnant pediatrics nurse with a bullet in her calf, Kristi upstairs in a state of emotional shock, staff trying to keep it all together in the face of their own trauma. And then we have the man responsible for it all. Somehow we’re going to have to find a way to care for him. To the best of our ability.”

  Leigh brushed her hair back, sighing. “I’ve never had this happen. In all my experience in the ER, I’ve never been required to treat an assailant whose victims I know. And—” the shock of it struck her again—“who was shot by my husband. How can this be happening?”

  She scanned the emergency department, strangely vacant in the wake of Cappy’s departure because the patients being treated prior to the incident had been moved to the adjacent clinic. “I’m just grateful I had a surgeon here, a cardiothoracic surgeon on call, and that two of our other docs were close by.” She nodded at Riley. “We’re handling it. We’ll get through it.” She heard a deep groan in the distance and knew it was Sam. I’ll get through all of this, somehow.

  “Yes,” Riley agreed. “We’ll survive. Although—” she glanced toward the ambulance bay doors—“things will get pretty crazy when we’re officially off lockdown. It seems calm right now, but that’s because we’re in the eye of the storm. The operators are fielding hundreds of calls; the media is chomping at the bit to converge on us. And the officers are already scrambling to identify visitors trying to get in to check on family members.”

  “One of those will be my sister.” Leigh fought a shiver. “Caro will be frantic to get in. I’m going to try to get a message to her, but I’ve got to use this temporary lull now to reassess where we stand with the patients I have here.”

  “Meaning Sam Gordon?”

  “Yes. Although Dr. Bartle’s directing her treatment.” Leigh glanced toward the other trauma cubicle. “I was busy with Cappy, and her wounds required a surgeon.”

  “Would you like me to go with you? to see Sam?”

  “No,” Leigh said quickly, telling herself Riley’s offer was part of the job, proof of her kindness. Not because she can read my mind. How do I do this? How do I shut off all these awful feelings?

  “Page me if you need me,” Riley said gently. “For anything. I’m going back upstairs to check on Kristi Johnson and the staff. Then I’m going to set up the chapel as a respite area, have the cafeteria prepare a small table with some snacks, make it comfortable and welcoming for anyone who needs support. Or prayer.” She smiled. “Doctors too.”

  “I’ll let people know.”

  “I meant you. You’re welcome there, Leigh.”

  She bit back a response. How could she explain to this chaplain that she was the last person on God’s comfort list?

  “I’m good—no problem.” Leigh glanced up as the PA speaker crackled.

  “Chaplain Hale, call social services, please. Public Information officer, report to main lobby. Nursing supervisor, report to main lobby. . . .”

  Riley sighed. “It seems our lull is already ending.”

  Leigh watched Riley walk back through the ER, then glanced around the trauma room at the clutter and debris remaining from the resuscitation. Crash cart drawers open, empty epinephrine syringes lying on top, dangling cardiac electrodes, the laryngoscope, and suction tubing, filled with frothy blood and still making futile, soft sucking noises. She crossed to the machine and turned the knob, silencing it. Her eyes caught on Cappy’s cutaway clothing lying in the corner. Bloodstained shirt, trousers with his belt, a cluster of keys with the worn, plastic charm holding photos of his grandchildren. Her throat squeezed and the thought came again—just as she’d asked Riley. How can this be happening?

  “Dr. Stathos?”

  Leigh glanced at the nurse. “Need me?”

  “Dr. Bartle’s gone ahead to the OR. Can you peek in on Miss Gordon? We’re just about to hang the first unit of blood.”

  “Sure. I’m on my way.” Out of the lull, back into the storm. That God wants me to battle alone.

  +++

  Sam closed her eyes, swallowing around the rigid tube threaded through her nostril and down the back of her throat. She tried not to gag or think about how much of the dark fluid siphoning back was blood. Then she shuddered at something so much worse—the terrifying image of Kurt Denton aiming the gun. How did this happen?

  Through a floating haze of morphine that kept the pain in her belly barely below screaming level, she heard a voice at the doorway. “Nick?”

  “No. It’s Leigh Stathos.”

  Chapter Seventeen

  Leigh scanned the monitor’s display of vital signs: BP 92 over 48, pulse 104, respirations 22, pulse oximetry 98 percent. Then she glanced down at Sam’s face. She was pale, deathly pale, making the incredible lilac eyes shocking in contrast. Her lips were sallow, nasal folds as white as a fish belly, all signs of critical blood loss. She’d suffered a penetrating wound to the lower abdomen—intestinal most likely. Beneath an oxygen cannula, a nasogastric tube emerged from her nostril, dark as an eel with blood and bile. Three IVs and a unit of fresh frozen plasma hung from metal hooks overhead. Sam’s flowered skirt, stained and cut to shreds, was draped over the garbage bin. “How are you feeling?”


  “Like I’ve been shot in the gut.”

  Leigh wrestled a bitter urge to say she knew how that felt. “On a scale of one to ten, how’s the pain? I can order something for you.”

  Sam’s eyes drifted upward, and Leigh glanced quickly at the monitor. No change. “Sam?”

  “Where’s Dr. Bartle?”

  “He’s in the OR; we’ll be moving you there in a few minutes. He’s really the one directing your care.”

  “Because you don’t want to.”

  Leigh made herself take a slow breath. “You needed a surgeon. I had a patient under CPR.”

  “The guard. How is he?”

  “In surgery.”

  “I saw his eyes . . . all that blood.” Sam’s fingers fluttered to her throat, IV tubing dangling from her wrist.

  Leigh thought of Riley’s words, that Golden Gate Mercy was the “poster child for Critical Incident Stress.” Sam Gordon looked stressed as well as gut shot.

  Her bloodless lips pressed together. “Kurt Denton’s still alive?”

  “Yes.” Leigh glanced toward his assigned room. He hadn’t returned from CT. “I can’t really discuss his condition.”

  “I’m not asking you to,” Sam said, gasping against an apparent stab of pain. “Nick will tell me what I want to know.”

  Don’t, Leigh. Let it go.

  “Where is he?” Sam asked, glancing toward the door.

  “I don’t know. And I’m leaving,” Leigh said, catching sight of the nurse outside the door. “I have to see my other patients. If you want anything, have the nurse call me.”

  “The only thing I want is . . .” Sam smiled weakly, her gaze focusing beyond Leigh. “There he is.”

  Leigh turned to see Nick standing against the wall outside the trauma room. He lifted his hand and it took her a few seconds to realize that he was gesturing to her, not Sam. But it took less than an instant to realize the truth. His critically injured lover had nailed it: Leigh hadn’t wanted to treat her. The truth was that she’d asked Bartle to take over because, in the confusing and chaotic moment that Sam was rushed, bleeding and helpless, into the ER, Leigh had remembered: I killed her in my dreams again last night. The memory had horrified her. A doctor dreaming of murder—how could that be?