Her scrubs stuck to her skin, her blonde hair was pulled back into a crude bun. Patients were everywhere and on every possible surface. The hospital, which wouldn’t pass as a clinic back home, was only two stories. It withstood the earthquake, which apparently was offshore. The tsunami hit the island quickly. The locals told her the quake had been impossible to sleep through and when the wave came they ran.
Monica’s station was a second level of triage. The first wasn’t even manned by someone with a medical degree. A receptionist of the hospital had been elevated to triage nurse in one day. She separated those with lacerations that could wait outside. Broken bones, so long as they weren’t open fractures or cutting off circulation, were sent to the same holding area. There were thousands of them.
“Help… please. Someone?” The voice rose above the chaos of the room; moans and desperation filtered thick in the air.
Monica twisted toward the voice.
Two Jamaican men rushed in a twentysomething man on the back of what looked like a plank door. A woman stood over the man screaming for help.
Their desperation alone made Monica’s legs move. Behind the band of newcomers was the poor receptionist-made-nurse. “You said to let through cold feet.”
Monica shook her head. “Cold feet?” Her eyes moved over the man on his back. His head shook from side to side. His ebony skin was ashen.
“His leg. It’s cold.”
Monica moved closer.
“You a doctor?” the woman by the patient’s side asked.
“A nurse.” Monica was reaching for her trauma shears. “Do you speak English?” she asked the man on the door.
He nodded, but didn’t say anything.
“He needs a doctor!” the woman screamed.
Monica felt herself folding into the woman’s drama.
“The doctors are busy. Tell me what’s wrong.” Monica started at the feet since that was where the receptionist said the problem was. The man’s right leg, above the knee, was bent in an awkward position. It didn’t take an X-ray to tell it was broken.
Monica cut from the bottom until she exposed the entirety of the problem.
“He was under the rubble. Two days my boy.” The woman hovered over the patient.
“He’s your son?” Monica asked in attempt to get information and calm the woman.
“Yes, just seventeen. Help him.”
He looked much older. “What’s your name?”
“D-Deon,” he said through chattering teeth.
Airway… Breathing… Circulation… Monica placed her fingers on a pulse point below his injury.
Weak. And cool.
She looked around and hoped her poker face was intact.
The kid was pale, his pulse rate at his wrist too fast.
Femur fractures could bleed. Excessively. And what other damage could the rubble have caused? If she didn’t try to correct the fracture and restore this kid’s circulation soon he could lose his leg.
Monica had never had to do this on her own. In fact, she’d only assisted doctors and only in extreme circumstances. Yet paramedics were often put to the task in the field. Life or limb and all that.
“Help him!” the mother cried.
Walt was in surgery and Tina was two rooms away with just as many severe cases as Monica.
“Deon? Does anything else hurt other than your leg?”
He shook his head.
Monica ushered the men holding Deon to a nearby desk and pushed everything on top of it to the floor.
The men holding the door Deon lay on were older, too old to help Monica with what she needed. The mom was hysterical and virtually useless.
Ignoring the mother, Monica positioned herself over Deon’s face. “Deon, listen. I need to straighten your leg.”
His eyes grew wide, his nostrils flared. “It’s going to hurt. You’re going to want to fight me.” He would fight her… he wouldn’t be able to stop himself. Although he may only be a teenager he outweighed Monica by a good forty pounds.
How the hell am I going to do this?
She looked up and frantically swept the room with her eyes.
Dark hair, Ray-Bans… “Barefoot?” she yelled at the pilot who’d delivered her to hell.
He shifted his gaze toward hers.
“You. Come here!”
Barefoot glanced behind him then back.
“Yes, you. I need your help.” His strong shoulders and lack of relationship with the patient were exactly what Monica needed.
Monica found a towel and wrapped it around Deon’s leg while Barefoot moved to her side.
“I need to straighten his leg.” She gathered the edges of the towel and handed the ends to him. “You,” she looked at the men who had carried Deon in. “Hold his shoulders down. Mom… talk to him.”
The mother nodded. “You know what you’re doing?”
“Yes.” No. Monica hated the self-doubt. But she knew this boy could lose his leg if she did nothing.
Monica lifted her gaze to Barefoot. He’d taken off his sunglasses and she met his dark, piercing gaze. He saw her doubt. She knew it.
“What can I do?” Barefoot asked. His voice was a rough timbre and the opposite of all the panicked calls inside the room. It grounded her.
“Hold this. I need traction so he doesn’t slip.”
Monica crawled up on the table with Deon and wiped the moisture from her palms before grasping his leg.
Just touching him caused pain. Normally, in an ER, this wouldn’t be done without heavy sedation, but that wasn’t going to happen here. Not only did they lack cardiac monitoring, they didn’t have the drugs to accomplish the job. Besides, they didn’t have time for that. As it was, there was no guarantee what Monica was about to do would save his leg.
Because it wasn’t completely cold or mottled she knew he had a chance of saving it.
“Ready?” Barefoot asked, bringing her attention back around.
Monica nodded. “Hold him,” she told the others.
Deon tensed, waiting.
Monica grasped him above his leg, supported his calf on her thigh. She waited until Deon took a few deep breaths. She glanced at Barefoot and mouthed the words, three, two… one.
It wasn’t a jolt, but more of a pull. Even though Deon screamed out Monica kept pulling his leg, feeling as best she could through his skin as the bone attempted to move back into place.
Her arms shook as she fought the patient and the displaced fracture.
Barefoot held traction and watched her as she struggled to keep her grip on Deon’s leg. Monica shifted her position, attempting to pull the bone through muscles and tendons.
This is just as hard as it looks when the doctors do it.
Deon screamed when the bone moved, but it still wasn’t in place.
“Hold up.” Monica instructed Barefoot as she lost her grip. The femur was closer to being in place, but not right.
Deon was moving on the makeshift gurney, making it even harder to set his leg.
Monica rubbed her hands on the towel and leaned into Barefoot so only he could hear her. “Pull harder.”
He nodded once.
She leveraged one leg on the table and sat taller.
Monica counted down again. Three… two… one.
Deon filled the room with his cry.
Monica pulled with every muscle she owned. Her hands started to slide, she repositioned again and felt his leg move.
Monica ground her back teeth together. Her arms started to shudder under the strain. Finally, Deon’s leg shifted and she manipulated it into line.
“Thank God,” she said.
Barefoot eased his pressure off and she set Deon’s leg on the table. She located a pulse behind his knee, felt a beat. Lower, his pulses in his foot were still faint, but better. Much better.
“We need to splint this to keep it in place.”
The receptionist who’d watched the entire procedure left the room.
Deon was already more comfor
table.
“I’m sorry I had to do that,” Monica told him once she jumped off the table. The swelling and bruising were evident. She couldn’t rule out a critical bleed. She removed a permanent marker from her pocket and flexible ruler. She marked Deon’s leg in two places and measured the circumference. There wasn’t a chart to write on so she did the next best thing… she wrote the numbers right on the boy’s leg. Then at least she would have a starting point when she checked on him again.
He attempted a smile.
“Wait with him,” she told the mother. “We’ll splint his leg and have a doctor look at him as soon as we can.”
Soon could be the next day if his pulses held and the leg didn’t swell, but Monica didn’t want to tell the mother that.
“I’ll try and get him something for pain. Is he allergic to anything?”
“No.”
Monica added the letters NKA to Deon’s leg in pen. No known allergies… such a simple fact written on a chart. Here it could be life or death.
Monica turned away from the patient, her shoulders slumped slightly. The room was packed. If she could split into five people, she still wouldn’t be able to manage what all of them needed.
A strong hand rested on her shoulder. “Good job back there.”
She glanced over her shoulder and up. Barefoot was tall and surprisingly broad. Unlike anyone else, he smelled good. Sandalwood and man. Such a relief from blood, sweat, and dirt. “Thank you for helping.”
“You did all the work. Have you done that before?”
“No.”
“You made it look easy.” He smiled and for a brief moment, the room slid away. Something curled in the pit of her stomach and heated. Was it desire or was it hunger?
The weight of his hand never left her shoulder. It would have been too easy to lean on him.
She shook off the yearning and moved out of Barefoot’s reach. Unable to stop herself, she glanced at his feet. He wore a pair of running shoes.
“I’ve got to keep moving. Thanks for your help.”
Monica took a few steps away only to hear her name. “Monica?”
He remembered?
“The name’s Trent. Not Barefoot.” He lifted a leg and wiggled his foot.
Monica felt her face heat. “Good to know,” she said with a rare smile before turning away.
Chapter Four
“I need a volunteer.” Donald pulled Monica aside twelve hours after she’d set foot in the blazing inferno.
She rubbed a clean hand over her face and blinked a few times. “Volunteer? Isn’t that what I’m doing here?”
Donald offered a half smile. “I need a nurse to go over one county to the east, it’s a fishing village, Port Lucia. The clinic there is bursting. The local doctor hasn’t been seen since the quake.”
Monica shook her head. “There isn’t a doctor?”
“No. There’s a couple of nurses… aides.” He glanced around them. As organized as chaos could go, the room had some order. “Your triage skills kick ass.”
As much as she’d like to bask in the compliment, she couldn’t get over what he was asking. “You want me to go to a clinic where there isn’t a doctor? How does that work? My license…”
“Your license is safe here. There are people suffering and I need to send someone to triage the worst back here. We have standing orders you’ll take with you, and a two-way radio to ask questions if needed. The last thing we need is more walking wounded filling these rooms.”
Monica couldn’t argue with that. “You’re asking for a volunteer?” The way his eyes looked through her said he was more than asking.
“Tina’s good… but you’re better. If I put the best nurse there, I won’t worry that careless mistakes are happening. Either Walt or I will come up every twenty-four hours to lend a hand.”
“A lot can go wrong in twenty-four hours. I’ll need to sleep.”
“Like I said. There are aides. They’ve been sending most of the wounded here. Half of them didn’t need to come.”
Like a bad flu season in California, when the ER would fill with patients, bottlenecking the entire department and eventually the hospital, which made it next to impossible to treat anyone in a timely manner. Here the numbers of critical patients were too great to let sit.
“So… can I count on you?”
The inside of Monica’s stomach twisted. She liked to think she had some autonomy as a critical care trauma nurse. The bottom line, however, was there was always a doctor around. She followed a doctor’s orders.
A cry from a patient three beds away had Monica glancing around the room. All day she’d treated people, tended their needs… directed them to the next level of care if need be and she could count on one hand how often Donald or Walt had made it past her side.
“How far away is Port Lucia?”
There was an excited hum in his veins Trent had forgotten existed. For the first time in what felt like ever, he woke with sense of real purpose. He tried to convince himself the reason for his overzealous sense of self was due to the state of emergency the island had been under since the quake. That was part of it, but the itchy, hot exhilaration came from something much baser.
Blonde hair and cool blue eyes found him while he slept. Even there, her sassy tongue and knowing eyes found a moment to mock his bare feet.
Before leaving his chopper on the tarmac the night before, he’d been asked to arrive early to pick up one of the American nurses and deliver her to Port Lucia. Because Trent’s home resided between the short runway and Port Lucia, Reynard asked him to deliver the nurse personally. There wasn’t anywhere to land the chopper close to the clinic so a short drive would be in the travel plans.
Trent wanted to ask which nurse was taking the new assignment, but didn’t. He’d find out soon enough. He didn’t hold too much hope that Monica would be that nurse. He knew she didn’t take to flying and probably wouldn’t volunteer.
Either way, he’d have an excuse to see her again briefly, if only to find out who he was escorting around the island.
After a short shower and a cup of god-awful instant coffee, Trent filled Ginger’s dog bowl and pulled his Jeep out of his driveway.
Clouds blocked the morning rays of the sun and threatened more than a few drops of rain. The last thing the island needed was bad weather.
The closer he made his way toward the airstrip, the more concerned with the clouds Trent became. Visibility was everything in a helicopter. If the ceiling of clouds wasn’t high enough, he’d be grounded until the thick layers lifted.
Alex, one of his pilots, met him outside of the air traffic tower. Alex was a good thirty years older than Trent. He and his wife, Betty, both flew for Blue Paradise Helicopter Tours, an offshoot of Fairchild Vacation and Charter Tours, which Trent and his brothers owned. Unlike Jason and Glen, Trent decided to run one exclusive leg of the worldwide company. A decision that still provoked arguments between the three of them.
He and Alex shook hands. “You look like you finally slept,” Alex told him.
“A good six hours. You?”
“More like four. Betty had a hard time falling asleep.”
“It’s hard to close your eyes and see anything other than destruction.” Trent almost felt guilty for dreaming of a blonde nurse.
“She told me to come pick her up if we really needed her. Otherwise she needed a break.”
Trent shook his head. “No worries. Outside of some jockeying, I think the officials will take over most of the runs. I’m doing an early run,” Trent told him. “If you’re not needed go home.”
Alex shook his head. “I need to do something.”
Trent knew how his friend felt. Everywhere they looked there was a need for help. Even if it lay in the packing of water bottles… or body bags.
He squeezed his eyes shut and pushed away the thoughts of lifeless people… of the despair that took him by the throat every time he landed his helicopter.
Above their heads, the clou
ds were breaking up. “I’ll be on the radio when I’m onboard. I have an angel to deliver to Port Lucia. Call me if you need anything.”
Alex nodded and leaned against the building.
Trent walked around his aircraft and performed his visual inspection of the chopper before climbing inside. He signaled air traffic and awaited their approval before taking to the air.
A sputtering of rain graced his short ride and heated the air. This, exactly this, might not be quite what it was he imagined when he decided to live on the island. But life wasn’t always what he thought it should be.
Hell, his own parents had expected so much more and yet their lives had been cut short… so painfully short.
Trent’s jaw ached and he forcefully managed to stop grinding his teeth. Temporary lights blinked where his intended target lay. He flipped the chopper into the onshore wind and set the skids on the ground. Unlike any time in the past, there wasn’t an extra hand standing by when he powered down the chopper and exited his aircraft.
People lined the outside walls of the hospital, some waiting on loved ones… others simply waiting. Trent kept his sunglasses in place… and his mask. The air smelled of humidity, death, and despair. Such a far cry from the happy-go-lucky tourist and sightseer that had been in his life only a few short days earlier.
Even though the island had experienced nothing short of an apocalypse, the world still slept during these early hours. The stairwell was filled with people. Some slumped in sleep beside the walls, others were awake beside them. Trent moved past them in search of the director.
Past the room where he’d witnessed Monica help fix the boy’s fracture the day before, he moved into the next room. There lay two dozen patients. Some with IV bags of fluid hanging over them giving some semblance of normalcy of a hospital. Trent knew better. There was nothing normal about people stacked this high or thick in what used to be a waiting room.
He glanced around and found a nurse he recognized from the flight over slumped against the wall. She’d fallen asleep. He considered waking her, but realized that no one in the room was screaming for assistance, so he moved on. Up the stairs he found a smaller room with an attendant… or maybe it was a nurse… with a half dozen patients.
Not Quite Enough (Not Quite series) Page 4