Luther listened at the chest and gave a thumbs-up. “Breath sounds clear and equal.”
“Good color change for carbon dioxide,” the RT noted.
Tension eased from Lilly’s shoulders. One problem fixed. “Let’s secure this. We need a tube into her stomach to decompress before we get the post-intubation film.” She grabbed the ultrasound machine. A quick check showed the baby’s heartbeat steady but slightly lower than reported by the EMS team. No obvious internal bleeding. Vessels and organs looked good.
“Sonya, page OB again. Get them down here. If you have to drop tackle an obstetrician, I want you to do it.”
“Come on now, Dr. Reeves. You make it sound like OB never wants to come and play with us.” Sonya reached for the phone near her charting station.
“Heart rate is dropping,” Luther noted.
Lilly glanced up at the monitor. She watched as the complexes began to widen apart.
Slowing down.
“Is the blood going?” Lilly asked.
“Two pints in.” Regan knocked at the small plastic door on the rapid infuser.
A low heartbeat was a poor prognostic sign for the pregnant woman. The problem may not be blood loss from her leg fractures but brain swelling that was causing the low heart rate. Their patient was sliding from shock to death.
“I’ve got the X-rays here for you.” Sonya turned the monitor. Lilly walked up to her computer. She scanned through each of the films.
Cervical spine, okay.
Lungs expanded. Heart normal size and position. Thoracic spine, okay.
She opened the pelvic films. No fractures.
Several fractures to each femur.
“Let’s secure an OR. It’s between ortho, neurosurgery, and OB. They’re going to have to figure out who gets first dibs.”
“On it.”
She looked at Torrence’s skin tone and thought back to all those times she had referred to a patient’s color as “ashen.” Now she saw the definition clinging to life in front of her.
Another blood pressure popped up. At least it was improved from before. “Luther, let’s get some Mannitol in here. I think her low heart rate is her brain swelling.”
Lilly rechecked the baby’s heartbeat. Now, it hovered at 100.
“Let’s get her back on her left side and see if the baby’s heart rate picks up.”
“She’s going to code, Lilly,” Luther said.
“Give me a suggestion.”
The mother’s pulse had dropped into the 50s.
“Luther, go ahead and give the Mannitol.”
A cool rush of air from behind caused Lilly to turn around. Her breath paused in her chest as the OB attending strode past her to the patient.
Lilly followed him to the bedside. “Kadin, I didn’t think you were on today.”
“Lilly.” Surprise erased the tension in his face. “Didn’t Drake come down? I’m really sorry. We’re falling apart upstairs. Nurses are spread thin. What do you have?”
Two nurses and a neonatologist followed with an infant warmer.
“Pregnant trauma patient. She stated at the scene she was 28 weeks. Probable head injury and cerebral edema. We’re giving Mannitol for that. Two femur fractures. She’s had two liters of LR and two pints of blood. Thus far, her heart rate is not responding to treatment. I suspect the big problem is her head. The baby’s heart rate is running 100s.”
Kadin glanced at the vital signs on the monitor. “Let me take a quick look at the baby with the ultrasound.”
The trauma door slammed into the wall.
Dr. Davis, the neurosurgeon, rushed in.
“What’s the story?”
Before Lilly could start, Dr. Strevant, the orthopedic surgeon, walked in as well.
“OB and neurosurgery. This is not a good combination.” He stopped next to Dr. Davis. “I got the report from the EMS guys out front. Femur fractures?”
“And head injury. Pupils unequal and she’s unresponsive,” Lilly said.
“We’ll need to get her in the CT scanner,” Davis replied.
Kadin motioned to Regan and Luther to help him slightly ease apart Torrence’s legs, which were constrained by the ankle-to-thigh splints the paramedics had applied. Lilly worried at the patient’s lack of response to the surely painful movement. She was surprised he’d be checking the patient’s cervix.
Unless he thought she was going to deliver.
Luther’s eyes widened at something Kadin said and he began to wave at the neonatologist.
“What’s been the treatment thus far?”
Lilly turned back to Dr. Strevant. “We’ve given her fluid and blood which helped her low blood pressure but not her heart rate. I think her brain is swelling to the point where she’s going to herniate. I’ve given her a dose of Mannitol.”
“She needs to get in the scanner now. What quality of life will she have if we don’t fix her head?”
“She could hemorrhage and die if we don’t fix those leg fractures,” Strevant countered.
“Clearly, she’s stable from that point.”
The belligerent voices of the two surgeons intensified in stereo.
“Five minutes in the scanner is not going to make a difference!”
“It will when she codes!”
The weak cries of a newborn stilled the room. Kadin cut the umbilical cord and settled the baby into a nest of warm towels. The neonatologist hurried the bundle to the infant warmer.
“Wow …” Dr. Davis whistled.
“Well, at least we don’t have to worry about the baby anymore.” Strevant unlocked the bed’s brakes. “I’ll make you a deal.” He turned back to Davis. “Five minutes in CT and directly to the OR. Let’s make sure that baby has a mother to come home to.”
The nurses prepared to move Torrence. When they’d left, Kadin let out a long breath and turned to face Lilly.
“Why don’t we step into the workroom for a few minutes before I have to go to the OR. There’s a woman getting prepped for her C-section.”
“What happened?” Lilly tore her gown off. “We don’t like to deliver babies in the ER.”
“When I went to check, the baby was sitting right there.”
“I thought she might be contracting.”
“Trauma can make the body do strange things.”
Kadin discarded his bloodied gown and gloves in the biohazard bin and turned to Lilly, his mask still in place. She reached up and threaded her finger through the elastic and slipped it from behind his ear, the stubble scratching her thumb as she eased it from his face. She wanted to linger with her hand against his cheek. There was something about Kadin, something that came from within, that tapped against the shell she’d built to keep people at bay.
The more they were together, the more she felt her will to keep him at arm’s length slipping.
After tossing the mask into the trash, Lilly placed her hands on her hips. “I wish you would have told me what was happening.”
“I thought I said something along those lines.”
“All I saw was Luther’s panicked face.” She signed the trauma chart for Sonya.
“While everyone else was arguing, I did what needed to be done.” Kadin led her down the hall.
“How do you think the baby is?” Lilly asked.
“It’s a girl, and she’s gorgeous by the way. She’s going to have a rough start, but the neonatal team will take great care of her.”
They entered the central work space. Lilly stopped at the sight of a four-foot rose tree, its trunk slender with a rounded crown of dark green foliage set off by full white blooms, standing near her things. Kadin cupped her elbow with his fingers and eased her forward.
“It’s for you, kind of.”
“What did you do?” She reached up and fingered the leaves with the tips of her thumb and forefingers. Bending down, she inhaled the distinctive scent.
“It’s for your mom, Lilly.”
Kadin stepped to the other side of the plant and st
uffed his hands into the pockets of his scrub top. “I was hoping to do this differently. Be all dressed up. Not be on call …” He pushed his fingers through the sun streaks in his light brown hair. “Dana told me about today.”
“I see.”
“She said white roses were your mother’s favorite flower. I thought we could plant it, and then it would be there for her all the time.”
“Kadin …”
“I asked the groundskeeper if it would be all right.”
“I …”
“Is it okay?”
“How did you even find one so late in the summer?”
“I bought it in May. I’ve been trying to keep it alive ever since.”
Lilly was mute, trying to search for the right words to express her shock at his generosity, her utter thankfulness at his tenderness, her confusion about the wisdom of entering a deeper relationship with him. Was friendship enough or was she looking for something more? Before she could speak, she was elbowed in the back and nearly fell into the tree.
“There’s a detective looking for you.” Dr. Anderson nudged her as he breezed by on the way to his computer.
“What’s up with that?” Kadin asked.
Lilly shook her head, unsure whether Kadin meant Anderson or the detective. “Long story.”
“Are you upset?”
“Not about this.” She cradled a bloom. “I can’t go to the cemetery tonight.”
“I know it’ll be hard. We can go together soon as Drake turns up. I’ll help you plant it.”
“That’s not it. The cemetery is closed and my keys are missing.”
“Aren’t they right here?”
Lilly looked down.
They were posed on top of her bag.
Chapter 2
DETECTIVE NATHAN LONG perused the series of manila folders open on his desk. He knew in his heart his city was in trouble. There was a monster in their midst. Frustrating though it was to admit it, he needed help on this one.
That meant asking the FBI to consult.
Before his demise from the Bureau five years ago, he’d been a lead hostage negotiator assigned to the Denver, Colorado, office. He was well known and respected by local law enforcement for his calmness under pressure, which he considered an honor as his age at the time was just shy of thirty. Nathan’s attention to detail and his quirky ability to surmise a situation quickly, determine a course of action, and have the issue resolved in under an hour solidified his reputation.
Most of the time.
That was before he met John Samuals. Initially, it had seemed like any other ordinary day—at least for a hostage negotiator. According to reports, Samuals had been holed up in his rural home in south central Colorado for several hours, threatening his wife and six children. He was well known to Teller County Sheriff’s office because of the anti-government literature posted on his property. This included several large plywood, spray-painted signs asserting his right to privacy and weapons. Due to concern that he may be stockpiling guns, he was flagged as a potential terrorist bringing him onto the radar of the FBI and Homeland Security.
Nathan and a few other agents neared the property after a two-hour drive from Denver. Upon arrival, on-scene law enforcement had been unable to make contact by phone. All utilities had been disconnected the previous week. No phone. No gas. No electricity. The temperature was nearing 105 degrees in the mid-afternoon July sun. Combine the record-breaking heat and humidity, and the temperature felt closer to 120. A hot temper fueled by oppressive heat was like a fuse lit on a barrel of TNT.
Nathan wore the famous bureau–blue, button-down-collared polo adorned with the FBI seal on the left breast, which was always his choice for fieldwork. His pants were heavily stitched khakis with large cargo pockets cinched with a department store brown leather belt. The only trick was finding one wide enough with a sturdy buckle to properly support his holster, one spare magazine, handcuffs, badge, and cell phone. Nathan learned a long time ago to spend the money for comfortable, protective footwear. Tired, sore feet could be a mental distraction during a marathon standoff. Baseball cap was snug on his skull to shield from the heat.
The FBI bare necessities.
Nathan exited his vehicle and surveyed the front of the structure. Dilapidated would be a compliment for this home. The roof had several areas of missing shingles. One side of a porch swing had broken off and the free end scratched against the porch, the pull creating an incessant squeaking on the chain that rattled at Nathan’s nerves. Old wood siding showed from beneath the chipped white paint, making the house look gray and brittle. Three windows faced his direction from the upper level, and two large windows framed either side of the front door. Nathan noticed a flimsy white curtain pull aside from the middle window on the upper level. A young girl with raven hair and curious eyes fluttered a wave. He returned the gesture. Her fingers lingered on the glass before she was pulled away by someone unseen. The curtain closed.
Raven—that’s what he would call her.
Nathan found the on-scene commander, who was the local sheriff. He extended his hand, and they shook hands briefly.
“George Benson. Glad to make your acquaintance.”
Nathan smiled. Southern charm was like ice-cold beer to his nerves, smoothing his frayed edges. The sheriff smiled back, his chocolate brown eyes echoed the rich tone of his skin.
“What do you know?” Nathan readjusted his baseball cap, which was already slick with sweat after a mere two minutes outside.
“Seems Mr. Samuals has run into a bit of financial trouble,” Benson explained. “Lost work at a biomedical firm several years ago. His job was the family’s only income. Been in a downhill slide ever since. He’d been eking out a living by doing odd repair jobs in town but seems his reputation caused his customers to shy away. Last week all their utilities were turned off. So no landline we can use.” He wiped his face with a dark blue bandanna. “His vehicles have been repossessed. Today two of my deputies came to evict them from the property, and all hell broke loose. He grabbed a shotgun, got off several shots before they were able to take cover. They knew there were kids inside so they didn’t return fire. All they could really do was get somewhere safe, begin observations, and call in the cavalry.”
“Was anyone hurt?”
“One deputy took a couple pellets from the shotgun blast to the arm. He’ll be all right. That was a couple hours ago.”
“Where is the injured deputy?”
Benson pointed to a vehicle near the front of the house. “He’s behind there.”
“How far out do you think SWAT is?”
“Seems like the devil came to play today. Our SWAT team is on another incident but El Paso County has offered assistance. Their tactical team should be on scene in another twenty minutes.”
“When was the last time you spoke with him?”
“Can’t say we’ve done much talkin’. We’ve tried to make contact through a megaphone. He doesn’t respond.”
“Has there been any additional gunfire since the initial encounter? You sure he’s still alive in there?”
“Oh yeah, he’s still kickin’. He’s been peekin’ from the windows.”
“Do you know for sure how many people are in the home?”
“At this point it’s an educated guess. We talked to several people he goes to church with and know he’s married with six children ranging in ages from twenty-three on down to three months. Several different children have been spotted looking out as well, so we think they’re all in there.”
“Do you believe they’re centralized in any one area?”
“Not sure, but I doubt it.”
“You have any floor plans for the house?”
“My deputies are workin’ on that as we speak. This house is older than Abraham, and there may not be any plans on file. We’re talkin’ to some neighbors to see if they’ve been inside. Bad part is he’s an isolationist so even that is doubtful.”
“What kind of weapons?”
“When you’re interviewing the neighbors and friends from church, make sure they’re asked what kind of weapons he has in the home.”
“Not a problem.” He ordered the command through the radio.
“What does he look like?”
“Grizzly Adams on crack would give you a good mental picture.”
“He’s using drugs?”
“Not illegally, but when he lost his job, he came undone. I heard he caused some strange accident. People died.” Benson wiped his brow. “We’ve been in contact with the family before. A couple of times related to domestic violence issues. Wife called once because he tried to commit suicide. That was about a year ago.”
“Maybe she should have let him,” Nathan said. “Did you make an arrest on any of the domestic complaints?”
“Nope. From what we could gather talkin’ to the oldest child, the incidents were all verbal. He apparently threatened to off the whole family and himself, but the wife wouldn’t cooperate with the responding deputies. She never acknowledged that he made the threats, and she would just say he was all talk, anyways. I guess she needs him around more than she needs him in jail.”
“So your deputies have been inside?”
“Actually, no. He always came out to meet ’em. When our guys would insist on checking the welfare of the rest of the family, John would just yell for them to pile out, and they all came runnin’. He’s pretty territorial, and he’s got this family under his thumb.”
Nathan slid his pen from behind his ear and flipped his notepad onto the burning hood of the command vehicle. The heated metal would have seared his palm in a heartbeat, but the paper provided a barrier and would take a while to burst into flames.
Maybe.
A glint from the front of the house caught the corner of his eye, and he turned to look. Raven was in the upper left window, flashing him with a mirror. Once their eyes met, she placed her palm on the window before easing back.
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