Urgent Care

by C. J. Lyons

  Gina hadn’t worked much with the new trauma surgeon, but she had seen her in action. DeFalco didn’t trust the emergency medicine residents yet. She always took over as command doc when no other attendings were around. Normally Gina would argue the point; after all, how was she supposed to learn how to run a trauma if no one gave her the chance? But not today, not with a cop without a pulse on the table.

  Instead, Gina let the medics give DeFalco the bullet points while she quickly assessed the ABCs: airway secured; breathing—no breath sounds on the right, trachea deviated. Which meant no time for C, circulation, until she got a chest tube in place.

  “Tension pneumo on the right, give me a thirty-six French chest tube,” she ordered as she poured Betadine over the right chest and grabbed a scalpel. The nurses, as always, were a step ahead of her; as soon as she said the magic words tension pneumo they were there with an open instrument tray, one handing her a chest tube as the other grabbed the pleurovac.

  Gina palpated the space over the fifth rib, sliced the skin and muscle, and used the large curved hemostat to push her way into the pleural cavity. Immediately a whoosh of air greeted her. As she threaded the chest tube through the hole she’d created, the paramedic doing CPR stopped.

  “We have a pulse,” DeFalco announced.

  Gina confirmed the rhythm on the monitor. A familiar flush of pride flowed through her—she’d literally just brought Officer Boyle back from the dead. “Let’s get labs, four units of O neg, and place a Foley and NG while I start the FAST exam.”

  She reached for the ultrasound, but DeFalco blocked her way. “No need for that.”

  “What are you talking about? I need to find where he’s bleeding from.”

  “Check out his head. There’s no exit wound. Both pupils are blown.”

  Gina frowned at the attending. No exit wound meant the bullet had remained inside, ricocheting within the skull, tearing through brain tissue.

  “Let me see,” she said, jostling past the respiratory tech bagging air into the cop’s lungs to check the pupils herself. Both were dilated, unresponsive to light. She checked the nostrils. “CSF leaking.”

  “Positive Babinsky, his toes are upgoing,” DeFalco said from the foot of the bed.

  “Let’s see what the CT shows,” Gina pleaded. Damn it, she hadn’t saved the man just to declare him brain dead.

  The monitor alarmed. “Lost his pulse,” a nurse called out as she began CPR.

  The team scrambled to run the code. In between pushing drugs and trying to shock the cop’s heart back to life again, Gina checked for other injuries—anything she could fix.

  It seemed like only a few seconds later that she felt DeFalco’s hand on her arm, gently tugging her away from the frenzy of activity surrounding Officer Boyle. “It’s time to call it.”

  “No, we can’t call it! Not yet.”

  “We’ve done everything possible.”

  “We can’t stop yet. Give him more time.”

  “Gina, no amount of time is bringing him back. Call it.”

  “He’s a cop, we need to try.”

  “You’re taking this personally. I’m sorry, did you know him?”

  Gina stared down at the naked body of Officer Boyle. “No. No, I never met him.”

  “Anyone else with objections? No? Then call it.”

  Gina opened her mouth, tried to form the words, but Jerry—her Jerry Boyle—kept staring back at her from the gurney. It could have been him. What if someday it was him?

  Shaking her head, she tore her mask off and backed away from the lifeless body.

  “Time of death, eight thirty-six.”

  LYDIA RETRIEVED HER NINE-MILLIMETER AND AMMUNITION and waited with Nora in the foyer of the shooting range while Boyle called his partner. Nora was going to show him the building where she’d been abandoned. Even though it had been over two years and there was no hope of any usable evidence, Boyle said he wanted to see it, get a feel for this “actor”—the word he used for the killer.

  Lydia bounced back and forth on her toes, wishing she could stay here and shoot. But she couldn’t—wouldn’t—abandon Nora. She just wished she had the right words of comfort to offer. It seemed to only make things worse when she did say anything.

  So, here she was, Nora gripping her hand like a lifeline, getting ready to drive to an East Liberty crack house and see firsthand the place where her friend had been beaten, raped, and left for dead.

  She’d always admired Nora for the way the charge nurse could handle even the craziest of emergencies, the most chaotic shifts, for the way she fought to protect her patients . . . but now it seemed there was more to Nora’s strength than Lydia had ever imagined.

  Nora needed her help, and Lydia felt shamed by her own inadequacy. She didn’t know how to do this. Should she act strong, say nothing, wait for Nora to say something? Or ask questions, help Nora let it all out and talk about the nightmare she’d kept bottled up for two long years?

  She liked it better when she had no friends. No, that wasn’t true, but mierda, did it have to be so hard?

  “We’re set,” Boyle said, stepping out of Sandy’s office as he snapped his phone shut. “Janet is going to run down Matt Zersky and cover the PM.”

  He was in high-energy mode, but after glancing at Nora, he toned it down. Even Lydia flinched a bit at the thought that Janet Kwon was on her way to watch poor Karen’s already mutilated body be cut apart even more during the post mortem.

  The air outside felt dark and heavy with the added weight of moisture. Cold, sticky, slushy. Although she’d lived her whole life until now in L.A., Lydia had visited winter climates—hiking in the Grand Tetons, skiing at Tahoe. That air had been brisk and clean, a pleasure to inhale. Full of light and energy.

  Pittsburgh winter seemed a far cry from that. Pittsburgh winter was coal-dust skies and Scrooge-like shivering that wore her out no matter how many layers she put on.

  “You okay following me?” Boyle asked Lydia as he helped Nora into the passenger seat of his Subaru Impreza.

  Lydia shot him a glare. She wasn’t the one he needed to worry about.

  She walked past him to her Escape.

  The morning traffic had died down, and it seemed no one was in a rush to be out and about on a gray day hazy with thunderstorms alternating between rain and sleet. Lydia had no trouble following Boyle’s silver Impreza as he led her through Highland Park and into East Liberty.

  When they finally turned onto Alhambra Way, she realized that the medical center was only a few blocks away. They were near the church where the riots had started last summer. Alhambra hadn’t been spared.

  The buildings surrounding the yellow-brick three-story tenement Boyle parked in front of were partially burned. Up and down the block it seemed there wasn’t a window intact, many boarded up with plywood serving as blank canvas for graffiti artists, the rest left with jagged glass knifing through empty air.

  Boyle got out of the Subaru, talking on his cell phone as he walked around to open Nora’s door. By the time Nora had stepped out of the car, Lydia had joined them on the soot-stained sidewalk, carrying a flashlight, her nine-millimeter close at hand in her parka pocket.

  Boyle’s jacket was unbuttoned, pushed back to reveal his gun and badge to any prying eyes. He need not have bothered. The block felt deserted. It was the house itself that radiated malevolence.

  Below the slant of a narrow porch roof missing a support beam, the front door gaped open like a lopsided leer. Darkness inside beckoned; there were no signs of life.

  Thunder pealed. The rusted tin roof shook as if laughing. Rain began to pelt them. Nora’s teeth were chattering.

  “You sure about this?” Lydia asked Nora.

  “Yes.”

  Impervious to the rain, Boyle hung up his cell phone and led the way, his hand on his gun. Nora hugged her chest as she climbed the porch steps. She almost lost her balance, but Lydia steadied her.

  Boyle stepped through the door’s opening. A loud p
op sounded. Nora jumped, hugged herself tighter.

  “Stepped on a crack pipe,” he called back. The only sign of life was his flashlight beam. Then that vanished into the darkness.

  “Place is empty; there’s no one here,” he called out a few minutes later.

  Once Boyle sounded the all clear, Nora stepped over the threshold and Lydia followed, one hand holding her Mag-Lite. She didn’t even realize she had drawn her gun until she felt its grip sliding against her sweat-slicked palm. Right now she wasn’t sure whether the adrenaline jazzing her nerves was from fear or the thrill of danger. Nora clutched at her wrist and Lydia reluctantly put her gun away, allowing Nora to hold her free hand instead.

  The smell became overwhelming after a mere two steps away from the open door. The rancid stench of decay, human waste, alcohol, stale sex, marijuana, and mold was enough to make Lydia gag. She wrinkled her nose, wishing she had a hand free to cover it, and breathed shallowly through her mouth.

  Other than a pile of half-burned, broken furniture, the front room was empty. The whole house felt empty, the only signs of life the brightly colored graffiti that glared in the beam of her and Boyle’s flashlights.

  She remembered the words painted onto Karen’s skin and wondered if it was the same artist. Then shuddered as she tried not to imagine Nora going through that same hell on earth.

  Boyle quickly glanced through the rear rooms on the first floor, his flashlight dancing its way over the moldering piles of debris. “Nothing down here.” He turned to Nora, catching her face in his light like a deer on a dark highway. “You said he took you upstairs?”

  Nora nodded. They rounded the corner and shone their lights on the staircase leading up to where Nora had said she’d been abandoned. The banister was missing, but the steps appeared intact. Graffiti overlapped graffiti, covering the steps, the wall, and the ceiling overhead, an effect that made the darkness more disorienting than ever. No sound except the occasional scurry of rodents and the hollow echo of the storm raging.

  Boyle motioned for them to wait where they were as he climbed the steps and vanished into the black shadows beyond. Lightning arced outside the front window, blinding Lydia with its brilliance. Thunder followed, rattling the little glass remaining in the window.

  When her eyes adjusted again, Lydia could see Nora standing at the foot of the stairs, her gaze focused on the darkness at the top. Anguish twisted her face, made even more ghostly in the flashlight’s sharp scrutiny. Lydia laid a hand on Nora’s arm. Goosebumps rippled across Nora’s flesh.

  “Let’s get out of here,” Lydia said. “We can wait for Boyle outside, in the car.”

  Nora took a step forward, shaking her head, her lips trembling.

  “No. I need to see . . .” Her voice trailed away.

  Boyle’s light returned to the top of the steps. “Which room, Nora? It’s like a maze up here.”

  “Hold on,” Lydia hollered, covering for Nora as the other woman pressed her body against the wall and took several deep breaths. “We’re coming.”

  The sound of Boyle’s cell phone made her jump. Someone—Gina, no doubt—had programmed it to play the “Bad Boys” theme from COPS. Even Nora managed a faint smile as she continued climbing up the steps.

  Jerry called down from the landing. “Nora, have you seen your New Year’s date, Matt Zersky, since the night you were abducted?”

  Nora shook her head, eyes creased in puzzlement. “No. But it was only our second date, we weren’t serious. And after what happened, I didn’t exactly seek him out. Why?”

  “His parents reported him missing a week after you were abducted. No one has seen him since.”

  SEVENTEEN

  Friday, 9:03 A.M.

  GINA TRAILED AFTER DIANA DEFALCO AS SHE WENT to talk to Officer Jeremiah Boyle’s family; an ex-wife and a college-aged son surrounded by a crowd of black uniforms that filled the hallway.

  “What happened, doc?” One of the police officers rushed forward when he saw them approaching. An advance guard.

  Dr. DeFalco met his gaze and merely shook her head. The officer’s face blanked for a moment, and then he turned to face the others. Before Gina and DeFalco could say a word, the wife was crying, clinging to her son. The son was trying hard not to cry, to stand up straight and bear his mother’s weight.

  “I’m sorry,” DeFalco began.

  “The son of a bitch,” a cop muttered behind her, his words undercut by the sound of armed men adjusting their gun belts, preparing for war.

  “We did everything we could,” DeFalco continued.

  The wife nodded her head without ever looking up, her shoulders sagging. “I know,” she whispered. “I always knew it would be like this. Every night I went to bed dreading this moment.”

  “Mom—” The son couldn’t say anything more, his face twisting in pain.

  “We have a counselor—”

  “No.” One of the officers stepped forward. “We can take it from here. Thanks, doc.”

  “If you have any questions, please feel free to ask. Anytime.” DeFalco backed off, but the ex grabbed at her sleeve. She missed, and caught Gina instead. Gina flinched, looking down at the woman with panic.

  “Tell me,” Mrs. Boyle choked out the words. “Did he suffer?”

  Gina opened her mouth, but a dry sputter was all that emerged. She couldn’t lie—she should, by all mercy, she should—but she couldn’t. But the son had already grasped his mother’s hand, releasing Gina.

  “Not as much as we’re gonna make the bastard who did this suffer,” one of the men muttered as Gina backed away.

  She pushed her way through the sea of uniforms, ignoring the sound of her name being called.

  She found herself in the clean holding room. It was empty, and quiet except for the drip of a faucet. Gina sagged against the shelves, her vision blurred. Her legs trembled, then weakened, and she slid to the floor. She hugged her knees to her chest, burying her face.

  The door opened and she glanced up. Ken Rosen stood there. Assessing her with the same unemotional scrutiny he brought to everything. “You look like you could use someone to talk to.”

  “I look like a baby.” She swiped her fist across her eyes. “Go ahead and say it. It’s what Diana DeFalco thinks, it’s what everyone thinks, it’s what Jerry will think.”

  “Jerry? What’s he got to do with this?”

  “The cop who died? His name was Jeremiah Boyle—Jerry Boyle. I freaked. Still am. Can’t stop thinking—what if that had been my Jerry? What if I do marry him and someday he walks out the door and never comes back? What if I let him into my life, into my heart, and then lose him? Forever.”

  Gina shook her head, her fingers massaging her throat, tangling in the chain where Jerry’s ring hung around her neck. “I don’t look good in black.”

  The joke fell flat.

  “You can’t think like that.” Ken finally broke the silence. “Bad things happen to all of us. And, as silly and awful and inconceivable as it sounds, life does go on. You will go on. Time has a way of healing things that even medicine can’t.”

  “You sound like a freaking Hallmark commercial.”

  He didn’t take the bait, but instead sat there beside her on the floor, holding her hand, saying nothing. As if their conversation yesterday—and the slap that accompanied it—had never happened. As if it didn’t matter. She blew out her breath, an unaccustomed feeling settling over her. Not quite serenity, not quite acceptance, not quite clarity . . . but almost.

  “You know what the worst thing is?” Why couldn’t she stop talking? She didn’t want to say any of this, expose secrets she didn’t even allow herself to see. “When I imagine it—Jerry gone—I can’t even think of how it might happen or what he might suffer. All I see is me. Alone. All I can think is: Who would take care of me?”

  She yanked Jerry’s ring free, holding it up to the light. It glistened like a star in the light of the single sixty-watt bulb. “Pretty selfish, huh? Selfish and stupid. But that’
s me. That’s the kind of woman he’s getting.”

  She tucked the ring away, stood, and brushed off the back of her scrubs.

  Ken got to his feet as well. “You’re afraid he’ll regret his choice?”

  “No,” Gina said, rearranging her stethoscope around her neck and adjusting her expression to her usual armor-plated banality. “I’m afraid I will.”

  AMANDA AND LUCAS SCOURED THE CAFETERIA and gift shop looking for Tank and Narolie. “I thought the way he was complaining about the food, he’d come down here looking for something better.”

  “Where else?”

  “The kid in the teen lounge said something about they were watching the storm, but I don’t know where—” She stopped. “The research tower. It’s taller than the patient tower, has more windows, better views.”

  “Okay, we can start at the top, work our way down.” They headed toward the elevators. Usually Lucas avoided elevators—microincubators, he called them—but Amanda had lost her postcall second wind and was starting to drag. No way was she about to climb up to the eighth floor where the pedestrian skyway connected the two buildings. Luckily they caught an empty elevator car.

  “If we don’t find him, Dr. Frantz is going to kill me,” Amanda said as she pushed the button for the eighth floor. Until a few years ago it had housed all the call rooms and the helipad. After the research tower was built, the helipad was moved to a paved area beside the ER and now each floor had its own tiny call rooms.

  “Stop worrying about Frantz,” Lucas said.

  “What if I don’t match here at Angels?”

  “Then we’ll go someplace else.”

  “Are you crazy? How can you think of leaving? Except for medical school you’ve never lived anywhere else. Your dad’s here. Your research. Your career.”

  “You go, I go. Besides, what medical center could resist hiring a double-boarded neurologist and a brilliant up-and-coming pediatrician?”

  Even through her haze of fatigue, she realized what he was offering her. Change didn’t come easily to Lucas; he preferred his life predictable and well ordered. She turned to him, touching his arm. “When we first met, I thought you were the heartless logical one and I was the hopeless dreamer.”