by Cindy Dees
She positioned herself next to the wall and planted her shoulder against the torpedo’s curving hull. The other divers caught on immediately and moved to help her. She and the two SEALs shoved as one, and the weapon rolled across the downed man and onto his right arm and leg. One more push and it rolled completely off the ledge, disappearing quickly into the darkness below.
One of the other men reached for the injured diver, and she lifted his well-meaning hands out of the way. Fortunately, these guys had recognized her by now and knew she was a Harvard-educated trauma surgeon. The first order of business was to reestablish breathing, not to surface. She inhaled a mouthful of oxygen from her own regulator, holding it in her cheeks. She put her mouth on the injured man’s and blew into it forcefully to clear the water. Quickly, she placed the victim’s oxygen regulator back in his mouth. She grabbed one of the other SEALs’ hands and put it over the regulator to hold it in place. He nodded his understanding. Thankfully, all SEALs had extensive first-aid training and were the equivalent of EMTs.
Next, she slid around to the top of the hurt diver’s head. They had to immobilize his chest cavity as best they could while they surfaced. She slid her hands behind him, grabbing his armpits from underneath. Bracing her elbows on either side of his head, she used her forearms as a makeshift backboard and then nodded to the other men. Now it was time to go.
They were deep enough that a rapid ascent put them all at risk of getting the bends, that bane of divers where nitrogen bubbles formed in the blood causing great pain and possible death. She controlled her breathing carefully so as not to rupture a lung of her own as they swam toward the light above.
She watched the victim’s chest. No movement. The guy wasn’t breathing. Apparently, the SEAL with his hand on his buddy’s oxygen regulator figured that out, too, because partway up, he pressed the button on the regulator that released a stream of air into the victim’s mouth. If they were lucky, the air was under enough pressure to drive at least some of it into the guy’s lungs.
She spared a glance downward and saw an ominous smudge of brown trailing in the water behind them. Dammit. Sharks could smell a few drops of blood at distances of a mile or more. That long, swirling trail was more than enough to attract any sharks in the vicinity.
She fished around with her fingers, looking for a pulse in the guy’s armpit. It was faint and thready, but she felt a throb of circulation beneath her finger. Thank God. Maybe this guy stood a chance of pulling through, even though every second without air was costly.
It seemed to take forever, but in less than a minute they burst onto the surface of the ocean. Aleesha tore off her mask and immediately put her mouth on the injured man’s. In-the-water resuscitation was Diving 101. She felt a distinctive gurgle in the exhaled air against her lips. Bloody hell. Collapsed lung. Nothing she could do about that at the moment.
“Take over this mouth-to-mouth,” she ordered one of the other divers. He nodded and glided into her place, treading water and breathing into his comrade’s mouth.
The second diver commented dryly, “Glad you could join us, Doc.”
She glanced up as she traced the victim’s rib cage with her fingers and slipped into a heavy Jamaican accent. “Din’wan’no jammin’ fun slidin’ me by, mon.”
“Save him, eh?”
She dropped the Rasta rap and replied in all seriousness, “I’ll do my best. Wrap a couple buoyancy belts around his hips, will you? It’s damn hard to stabilize a patient who keeps trying to sink.” Not only did the injured SEAL have practically no body fat to help him float, but that collapsed lung had cost him a lot of flotation capacity.
The second SEAL complied rapidly. Meanwhile, the first SEAL lifted his head and announced, “He’s breathing again.”
“Glory, mon,” she muttered. She glanced at her watch. One minute and forty seconds after the torpedo landed on his chest. Not bad. In fact, it was amazing given the situation. If he lived, the guy probably wouldn’t suffer any brain damage. Big if, though.
She glanced around to see if that fishing boat was still close. Nada. The horizon was an uninterrupted line of blue on blue. “I’m going underneath him to see where he’s bleeding. Either of you got a med kit on you?”
The resuscitator shook his head in the negative. “Got a crash kit on the Zodiac, but that’s it.”
“Speaking of which, get one of those out here stat.” Zodiac was the kind of rubber dinghy the SEALs tooled around in much of the time.
“I already hit the panic button. Boat should be here in ten to fifteen minutes.”
Ten to fifteen? Hellfire and damnation, that was a long time to keep this guy alive until she could render proper medical treatment. She nodded grimly and pulled her mask over her face. Quickly she submerged beneath her patient. A long, ragged tear in the back of his wet suit marked the source of the blood. She reached for her thigh and pulled out her field knife, slashing the rubber away from the wound. It was a deep flesh tear, and, as she feared, a pulsing flow of red came from the wound. Arterial bleeding. Not good. Swishing bloody water away from the wound, she slapped her finger on top of the lacerated artery and pressed as hard as she could. Using her fin, she kicked one of the guys above in the leg to get his attention. Quickly he submerged beside her. She gestured for him to take over the pressure. His finger pressed hard against hers for a moment as she slipped out of the way.
She did a quick inspection of the rest of the victim’s underside. Some scrapes and cuts, but nothing else life threatening. Something hard smacked her in the side of the head. She lurched and saw a swim fin headed directly at her face. She dodged out of the way, popping back up to the surface.
The guy didn’t need to explain why he’d kicked her. The rattling, rasping gasps from her patient were self-explanatory. He was in huge respiratory distress, and as she repositioned herself to have another look at his chest, he went into a seizure. His back arched and his face dipped below the water. Any buoyancy he’d had was completely lost and he began to go under. She and the other topside diver grabbed him and muscled his rigid body higher. She kicked for all she was worth, her legs burning like fire. C’mon, c’mon. Relax, already, she begged him.
And then a movement at the corner of her peripheral vision caught her attention. Dorsal fin. Big one.
“Shark,” she grunted, nodding in that fin’s direction.
“Shit. Back in a sec.” The guy let go and submerged, no doubt to warn the diver below. Redoubling her kicks, she managed to keep her patient afloat. Barely. That SEAL had a lot of confidence in her strength to dump his buddy on her like this. To distract herself from the agony building in her cramping calf muscles, she peered through the murky water below. She made out a harpoon in the submerged diver’s hand. He had the sharks handled, then. She hoped.
The diver returned and grabbed the patient again, just as the seizure began to ease, leaving behind an ominous stillness.
“His heart’s failing on me.” She reached for the carotid artery. Yup. Pulse uneven and fading fast. “Here’s the thing. His sternum may be fractured. If we do CPR, we run a real risk of puncturing his heart. If we don’t do CPR, we risk brain damage and possibly not getting his heart going again once I get access to a defibrillator.”
“You’re the doc. You make the call,” the SEAL replied.
She wasn’t a top-notch emergency physician for nothing. She faced these life-and-death decisions all the time. And she had complete faith in her skills. “I’ll do the CPR myself. My malpractice insurance is paid up.”
The guy grinned briefly.
Using her left hand to support the patient, she kept her right hand plastered on his pulse. She’d seen dozens of cases like this—car accidents in vehicles without air bags where the driver wasn’t wearing a seat belt and slammed into the steering column with his chest. She could only pray her current patient didn’t have a lacerated aorta or something equally untreatable in the field.
“Incoming,” the other diver murmured.
She glanced over her shoulder. And gulped. The dorsal fin was maybe fifty yards away, headed straight at them and, indeed, coming in fast. It dipped below the surface about thirty yards out. The shark would come up from below, striking his victim in the soft underbelly.
“You got Smitty.” The SEAL ducked below.
Smitty. Her patient must be Chief Petty Officer Patrick Smith. She’d heard of him. He’d been a SEAL for nearly ten years and was a total pro. And still an accident like this could happen. Something in her rebelled at the thought of wasting a human life in a lousy exercise. It wasn’t worth it. No matter that the SEALs—the entire Special Forces community, actually—insisted that realistic training was the key to their success.
A metallic, hissing noise from below startled her and then a mighty thrashing erupted in the water about twenty yards away. The gray, sinuous body of a shark breached the surface, writhing violently. She caught a flash of steel embedded in his belly. It seemed like only seconds until a second dorsal fin appeared, slamming into the wounded shark. The water around the twisting beasts frothed red and angry. Oh, Lord. She got to do meat-ball medicine on a gravely injured man mere yards from a full-blown shark feeding frenzy? Uncle Sam wasn’t paying her enough for this day’s work.
On cue, the pulse under her finger skipped a beat. And another. Lovely. The other two divers were below fighting off maddened sharks while she performed solo CPR on a guy who, if she made the slightest mistake in her technique, she’d kill. He’d be a tough patient lying in a fully equipped emergency room, let alone floating out here in the ocean.
Well, she’d signed on with the Medusas because she craved adventure. Bully for Uncle Sam for delivering, because this was one hell of a challenge! Practicing trauma medicine in an actual hospital was starting to look downright tame by comparison. And maybe that was the answer to the question that had been bugging her recently, of why she’d stay with a team whose primary mission was to kill: she was an adrenaline junkie. Why this came as a surprise, she had no idea. Lord knew, she’d been taking risks her entire life. She’d jumped off the roof of the house, the first time, before she’d turned six, for goodness’ sake. It was a lousy reason to be out here doing this job, and it was going to bite her in the bonn-bonn someday.
But right now she was going to save this patient no matter what monkey wrenches he threw at her. Summoning all her skill, she commenced ever-so-delicate CPR as his heart stopped beating completely.
How long she carefully compressed Smitty’s chest, stopping every so often to breathe into his mouth, she had no idea. But she was light-headed from the exertion of forcing air into his dying lungs, she was cramping from her hips to her toes from keeping both him and herself afloat, and in another minute or so she was going to puke from all the sea water she’d swallowed.
Finally a new noise intruded upon the thrashing and splashing behind her. An engine. Running at high RPMs and coming fast. As she moved from Smitty’s mouth back to his chest, she spared a glance in the direction of the noise and saw a Zodiac holding six black-clad men flying across the water. Hallelujah.
In a matter of seconds, many strong hands reached down, lifting Smitty gently into the vessel and hoisting her into the boat. Without ado, she leaned over the side of the Zodiac and barfed up the entire seawater contents of her stomach. No time to feel sorry for herself, though. She had a patient to take care of.
The SEAL team already had the med kit open and a mobile defibrillator powered up. She snatched a scalpel from the kit and sliced open Smitty’s wet suit. A dark purple, basketball-size bruise covered the collapsed center of his bare chest, and now that she could look at the damage, an unnatural dent in the long vertical breast bone announced that his sternum was, indeed, broken. She grabbed the paddles of the defibrillator and slapped them into position.
“Clear,” she called tersely. She pressed the buttons on the handles, and Smitty jerked. “Get a breathing bag on him.” She grabbed a stethoscope, yanked it over her ears and placed the listening end on Smitty’s chest. Dat a boy. A nice, steady heartbeat. He was a fighter, all right.
“I need you guys to lift him straight up. Keep him flat so we don’t dislodge that sternum, but I’ve got to get at the lacerated artery.” The SEALs complied carefully. She reached in the med kit for a nifty pressure balloon invented by military medics for just this sort of situation. She lay down on her back and slid beneath her patient. Working at a distance of about three inches, she used a scalpel to widen the wound around Smitty’s torn artery a tiny bit. Blood sprayed in her face—please, God, let this guy not be HIV positive—but there was no helping it. She inserted the balloon next to the torn artery and inflated it quickly, using pressure from the balloon to squeeze the artery shut. She swabbed the area and waited a few seconds for leakage. Nada. Good seal. The internal pressure bandage had worked.
She wiggled out from beneath Smitty. The wind tore at her hair, and she registered vaguely that they were streaking over the water. She did a quick exam. As she’d anticipated, Smitty’s right arm was broken. It would need to be pinned, but the clean break in the middle of a bone was a full recovery sort of injury. He had six ribs broken outright. X rays would probably show several more fractured. Those were gonna hurt like a big dog before they healed. Left lung collapsed. Right lung holding up nicely, however. Would need the chest cavity suctioned for blood and seawater. She’d need a picture of the sternum, to determine whether or not surgery would be required to mend it. MRI would be necessary to see how contused his heart was. Hopefully the sternum had done its job and, by taking the brunt of the impact, protected the heart from serious injury. No sign of shock, yet. This guy had a hell of a constitution to be holding up as well as he was. Even his blood pressure was surprisingly good.
She continued to monitor his vital signs on the ride back to shore. An ambulance met them at the dock, and she rode to the hospital with Smitty. Only when she’d assured herself that the waiting trauma team knew its stuff did she relinquish control of her patient.
And then it was over. Suddenly weary as the adrenaline drained from her system, she walked back into the emergency room to update the anxious SEAL team waiting there. She announced in her thickest brogue, “All fruit ripe, mon. Barring any further complications, Smitty should pull through.”
Everyone sagged in relief. Bud Lipton, the team leader, spoke up. “You did good, Doc.”
Praise? From a SEAL? Wow. Her insides warmed with the compliment. “Thanks.”
“Let me give you a ride back to your quarters. I expect you’re ready to clean up and get out of that suit.”
Getting bloody and filthy was part and parcel of trauma medicine, but the gore probably was a little unnerving to other people. And she’d completely forgotten that she was still wearing her rather revealing wet suit. “Me tink you right, bruddar,” she mumbled. Sometimes it was easier to hide behind her islander persona than to feel naked in front of these too hard, too perceptive men.
Lipton and a couple of the others rode across the Navy base with her. When they pulled up in front of the visiting officer’s quarters, Lipton said casually, “Next training evolution begins at midnight tonight. We’ll be swimming, so bring your dive gear.”
Right. One of their men had just escaped death by a whisker, but training went on. How harsh was that? Special Ops was a callous world that had no time for the weak.
So what was she doing in it, then? She’d asked herself that question many times since she’d joined the Medusas. She was a doctor. A healer. She’d signed up to work in a nice, safe hospital. She’d never seriously expected to get near danger in her career, even though she was technically a military officer. That is, until she’d accepted the irresistible challenge Vanessa Blake had dangled in front of her—to become a Medusa.
Ever since her first mission in the field a few months back where she’d been ordered to shoot people, and had, this dilemma had been building. How in the hell was she supposed to work and live among these operators who held
life so cheaply, to become one of them herself, when she’d dedicated her entire life to saving lives, not taking them?
Houston, we have a problem.
Chapter 2
Aleesha rolled over and groaned as her muscles protested. Wicked pain there, girl. Last night’s midnight swim with the SEALs had turned into four grueling hours of cold-water diving, and she hadn’t found any of the answers she sought. She’d swear the instructors were trying to break the Medusas if she didn’t already know that SEALs actually enjoyed causing themselves pain. She looked at her watch. Noon. She had to get up in a half hour anyway. The Medusas were pulling a harbor security shift this afternoon and had to be in the water by two. A big, fat dose of that seventy-five percent bo-o-oring duty, but someone had to do it. The Miami Port Authority was undermanned today, and the SEALs had jumped all over volunteering the Medusas for the diving assignment. At least it would be good practice for her teammates, none of whom had the diving experience she did.
She rolled out of bed. Might as well spend the extra half hour in a hot shower pounding loose her sore muscles. She turned on the water full blast. While it heated up she made a quick phone call to the hospital. Smitty was in serious but stable condition. Heavily sedated for pain control, but expected to make a full recovery. Hot damn.
She stepped into the shower and let needles of scalding water massage her aching muscles. God, that felt good.
About two hours into last night’s swim, she’d exceeded her anaerobic threshold, and oxygen had become insufficiently available to her muscles, meaning they couldn’t break down excess pyruvate. That state had, in turn, triggered glycogen production, which broke down into lactate acid and hydrogen ions, making the muscle tissue environment so acidic that muscle function began to shut down. Force of will had kicked in at that point. She’d overridden the signals from her body that told her to stop, and she’d finished out the swim.