Night Call
Page 8
“Come on in.” When Linda entered, Jett asked, “Another flight request?”
Linda shook her head. “We just got a call from risk management. They want flight records from one of our runs.”
“The boy with the burns?” Risk management pulled records when a case was under review or someone lodged a complaint. Jett searched her memory for anything unusual about the recovery or transport. True, she’d flown during the electrical storm, but she couldn’t imagine who would have complained about that. And certainly not so soon.
“No, sorry,” Linda said, sounding rattled. Jett could never remember her being the slightest bit off balance. “Not this shift, but one from last week.”
“Which one?”
“The multivehicle accident—the one with the governor’s daughter-in-law.”
The flight where she’d first met Tristan. Jett hadn’t seen her recently, but then she wouldn’t. They worked in different parts of the hospital. She might never see her again. When her stomach tightened, she ignored it and asked sharply, “Why? What’s going on?”
Linda’s expression was grim. “I made a few calls to the nurses in the TICU right after I got off the phone with the admin from risk management. The patient arrested last night.”
“She died?” Jett wasn’t surprised, but she hated to hear it. A trauma victim who made it to the hospital alive, especially a young patient, had a very good chance of survival. Sometimes, though, even the best chance wasn’t enough.
“No, they got her back, but she’s in a coma and they’re not sure about brain function.”
“I don’t get it,” Jett said. “What does it have to do with us?”
“I’m not sure, but they want flight logs and our scene reports.”
“Okay. I’ll get my records together. You and Juan do the same. Just make sure everything you documented is accurate and complete. It was a clean run.”
“I wonder if Tristan knows.” Linda bit her lip absently. “I’m not sure if she’s working today. Maybe I should call her.”
“Risk management must have contacted her too.”
“You’re probably right.” Linda sighed. “I’ll go get started on the paperwork.”
Alone again, Jett thought back to the morning she’d spent stretched out beside Tristan in the sun. She’d never done anything like that with anyone. Just talked. There had never been anyone to talk to when she was growing up, and she’d gone right into the service after high school. It was the quickest way she knew to get to fly. She’d made friends, of a sort. Mostly men and some women who shared the Army experience and the love of flying. No one asked about her. Where she came from or what mattered to her. Or maybe they had, and she’d shut them out. She was good at that and it always worked. Except it hadn’t worked with Tristan.
For a second, she wished she had another hour in the shade of that oak tree to look forward to. Then she shook her head, having learned once already not to give in to wishes. She grabbed her overnight bag and headed toward the small office on the other side of the lounge where they kept their paperwork. She had a report to review, and then another twelve hours until she could return.
Chapter Eight
“I’m going to take an early dinner break,” Tristan told the nurse anesthetist on call with her, a burly guy who had been a medic in the Navy before going to nursing school.
“Sure.” He grabbed the sports section from a pile of eviscerated newspapers on the table in the OR lounge and headed toward the men’s locker room. “It’ll be an hour before they get that femur washout over here anyhow.”
“Page me when the family shows up so I can get the consent.”
“No problem.”
Alone, Tristan surveyed the stark lounge and the detritus of the day’s activities. Crumpled newspapers, empty fast-food bags, coffee cups upside down by the sink. A scrub shirt rolled into a ball and tossed into a corner of the couch. A haphazardly folded blanket that before morning would cover someone—surgeon, nurse, OR tech—as they slept on the sofa waiting for the next patient to arrive. When the routine cases of the day were finished and the day shift went home, Tristan always felt a little bit marooned, as if she were completely cut off from the rest of the world, disconnected even from her own life. The handful of staff left behind to cover emergencies during the night assumed the attitude of front-line soldiers, resigned to hold on until reinforcements returned in the morning. Until the sun came up, no matter what came through the door—multiple traumas, gunshot wounds, burns, exsanguinating postoperative patients, obstetrical catastrophes—the team taking night call had to be up to the task. Because no one stood behind them.
Tristan pulled on one of the shapeless green OR cover gowns and took the stairs down to the cafeteria on the second floor. She ordered the special and carried her tray into the dining area, checking out the occupants. When she saw Jett at the table where she’d been sitting the week before, she sighed inwardly, admitting she’d been hoping to see her. She’d had a lousy day and the worst was yet to come. The prospect of a few minutes talking to Jett inexplicably cut through the gloom. When she raised her tray in a questioning gesture to Jett, she held her breath. She’d looked for Jett every night since that night in the helicopter on the roof, but she hadn’t seen her. Maybe Jett had been avoiding her. A long minute passed, and Tristan forced a smile before starting to turn away. Then Jett beckoned her over, and a bit of the unfamiliar abandoned feeling disappeared.
“How’s the chicken à la king?” Tristan asked, setting down her tray.
“Is that what this is?” Jett’s voice rose in surprise.
“That good, huh?” Tristan laughed. “I am capable of talking about more than hospital food, but I figured since you already taste-tested it…”
“It’s hot. I recognize pretty much everything that’s in it.” Jett grinned. “That makes it close to gourmet food.”
“Is military food really that bad?”
“Not stateside. But you can’t expect much when you’re deployed.”
Busy sprinkling pepper over her meal, Tristan asked offhandedly, “You miss it at all?” When Jett didn’t answer, she looked up. Jett’s face had gone completely blank. “Sorry. Someday if you ever want to talk about it…” She let the words trail off because she realized she was being presumptuous. Whatever secrets Jett harbored were clearly not happy ones. “You know what. I’m a jerk. Just forget I said that.”
“Why did you?” Jett pushed her tray aside and focused on Tristan. Maybe Tristan was just one of those curious people who befriended everyone casually. She’d known plenty of people like that in the Army, men and women alike. People who would talk to anyone about anything because they enjoyed social interaction, or they just liked the sound of their own voices. Jett had never been like that. She didn’t share what was important to her with anyone, because she didn’t trust anyone that much. She’d learned that lesson at a young age after her brothers scoffed at her dreams and her father tried to beat her into the shape he thought a woman should assume.
“I don’t know,” Tristan replied. “I mean, I want to know. I’m interested in you.”
Jett pushed her chair away from the table, gripped her tray, and stood up to leave. “I’m not that interesting.”
“You’re wrong about that, but I won’t argue,” Tristan said calmly. “I’m glad you know what’s in this stuff, because I’m not sure.”
Jett stopped and looked back. Tristan was pushing the food around on her plate with her fork. Her hand was shaking. Jett slid her tray onto an empty table nearby and sat back down across from Tristan. “I liked the Army because it gave me the one thing I wanted, and all I had to do in return was the job I signed up to do.”
“Just one thing?” Tristan regarded Jett intently. “All you wanted was one thing?”
Jett nodded.
“You love it, don’t you. Flying.”
Jett was so used to keeping what mattered to her to herself, she almost didn’t answer. But Tristan’s words echoe
d in her mind. I want to know you. She wasn’t certain that anyone had ever really wanted to know her before. “If I couldn’t fly I don’t think I’d want to do anything at all.”
“Yeah. I get that.” Tristan wondered if Jett had a woman in her life who she wanted with that much fervor. She tried to imagine what it would be like to be the focus of that kind of passion, to have all of someone’s energy poured into her. She’d had women want her because she was fun or sexy or wealthy. She’d had women beg her or tease her to touch them, to take them, to push them beyond their limits. But she couldn’t remember a single one who had begged to touch her. Hunger like she’d never known rose up inside her.
“You make me wish I were a helicopter.”
Jett laughed and after a few seconds Tristan joined her.
“Why?” Jett asked.
“You make flying sound like a love affair.”
“It’s nothing like that,” Jett said.
Tristan couldn’t miss the bitterness in Jett’s voice. Someone had hurt her, and the realization made her angry. In fact, so angry she was frightened by her own response. In defense, she intentionally changed the subject. “I guess you heard about the patient from last week. The governor’s daughter-in-law.”
“We got a call asking for records first thing this morning. I know she had some kind of problem.” Jett was relieved to get away from personal topics. Some things about civilian life were going to take some getting used to, and hearing lesbians talk openly about their love lives was one of them. Talking about romance with Tristan was way outside her comfort zone.
“I doubt it’s a secret. At least it won’t be for long.” Tristan leaned back in her chair and sighed. “A tooth turned up in her right mainstem bronchus. They saw it on the x-ray after she had a respiratory arrest last night. It didn’t show up on earlier films because that part of the lung was collapsed.”
Jett hadn’t had any formal medical training, but she’d spent enough time with medics in and out of field hospitals to have picked up a lot of the terminology. “She swallowed…no, she aspirated a tooth in the accident?”
“That’s one explanation. The other popular theory is that I pushed it down into her lung when I intubated her in the field.”
“I imagine if you had, you’d have said so at the time.”
The iron band of tension that had been constricting Tristan’s head for the last eight hours dissipated as if someone had unlocked it with a key. She’d been reeling all day long from the thinly veiled accusation that she’d been hasty and reckless when she’d decided to intubate the patient at the scene under less than controlled conditions. Having her professional competence called into question hurt. “Thanks. Unfortunately, not everyone agrees.”
Jett frowned. “Is it going to be a problem for you?”
“I don’t know. Maybe.”
“Is it okay for me to ask you that? I don’t want to compromise you.”
“So far, nothing official has happened,” Tristan said. “I don’t plan to discuss it with the other members of the medical team, because they’ll have to testify if it comes to legal action. You might be questioned too, but not about the medical circumstances.”
“She looked like she was in pretty bad shape when you brought her on board.”
“Major facial fractures and a lot of bleeding. Anyone familiar with that type of trauma knows you’ve got loose teeth all over the place. There was just so damn much blood.” Tristan grimaced. “I was worried she was going to choke to death on all that blood. Hell, sometimes it’s just a judgment call.”
“That’s why no one should question your actions without a damn good reason,” Jett said vehemently. “You’re the one on the line. You’re the one making the hard call. It has to be that way, and you should have the support of the hospital behind you.”
“You want to stand up in court and say that?” Tristan joked.
“I would if it would make any difference,” Jett said seriously.
“How do you know I’m worth taking a chance on?”
“You wouldn’t be here if you didn’t know what you were doing. And I think if you had a problem out there, you’d say so.” Jett shrugged.
“Is it me,” Tristan dared to ask, “or do you just believe in the system that much?” She wanted to believe it was her Jett believed in, wanted it so much it scared her. Her parents hadn’t believed her, or believed in her. And her sisters said they loved her but they didn’t want to love her the way she was—they wanted to change her into a person they understood. She’d stood up to them, but it had cost her. She hadn’t wished for anyone to really see her, to believe in her, in a very long time.
Jett collected her tray and stood up. Not that long ago she had believed that the chain of command was sacrosanct. Without order there was anarchy. And in the heat of battle, chaos meant death. She didn’t believe that any longer. She looked down into Tristan’s questioning eyes and saw vulnerability as well as pain. She didn’t even hesitate. “It’s you.”
“Thanks,” Tristan whispered.
“Don’t mention it.” Jett started away, then turned back. Tristan was hurting, and she wanted to give her just a little of the comfort Tristan had unwittingly given her. “I never said thanks for coffee the other day. I—”
Jett’s beeper went off and a second later, so did Tristan’s.
“Shit,” they both said simultaneously.
“Take it easy tonight,” Tristan called after Jett, who had left her tray on the table and sprinted away. She caught Jett’s brief wave before she took off in the same direction, wondering what Jett might have said.
*
When Tristan arrived in the emergency room she discovered Quinn and the other trauma personnel resuscitating two young men, both of whom appeared to have multiple gunshot wounds. Penetrating chest and abdominal injuries. Even as she called, “What do we have,” she saw the long night ahead of her in the operating room.
“This one,” Quinn said, indicating a patient in whom she had just finished inserting a chest tube, “needs to go upstairs right away. Probable punctured lung. Maybe great vessel injury.”
Tristan hurriedly assessed the breath sounds. “Portable chest x-ray?”
“It’s hanging.”
Quickly surveying the radiograph, she saw that the right lung was nearly white. Most likely filled with blood. “O2 SATs?”
“Just getting them,” one of the nurses called. “Seventy on sixty percent O2 and a rebreathing mask.”
“Hell,” Tristan muttered. “Let’s get a tube in him.”
Another one of the nurses grabbed a suction catheter and cleared blood and fluid from the patient’s mouth. For just a second, Tristan hesitated, thinking of the governor’s daughter-in-law. So much blood. Maybe she should have waited. Maybe she had been hasty.
“His pressure’s dropping,” a nurse reported.
Tristan glanced at the oxygen readout. Sixty-five. She pushed her way around to the head of the table and grabbed a laryngoscope. “Give me a number eight tube.”
In less than a minute she had inserted the tube into the trachea and was pumping in a hundred percent oxygen. The patient’s blood pressure stabilized immediately.
“His SATs are coming up,” the nurse said.
“Nice, Tris,” Quinn said.
Tristan lifted her shoulder. She had only done her job, just like everyone else in the room. With the patient secured, the tension level in the room plummeted. “So, Quinn, they finally made you come back to work, huh?”
“Honor went home today. I don’t have any more excuses.”
“How’s she doing?” Tristan taped the endotracheal tube to the patient’s face to prevent it from being dislodged during transport.
Quinn nodded, a fleeting expression of discomfort crossing her face. “Honor insisted she was ready days ago, but with the blood loss…she’s still pretty weak.”
“Jack go home too?”
“Everybody.”
“No wonder you wanted t
o work.”
One of the nurses poked Tristan in the arm. “Some people actually like family life.”
Tristan rolled her eyes. “Sorry.”
Quinn slid her a grin as she secured the dressing around the chest tube. “Don’t forget practice this weekend.”
“I’ll be there.”
“Coming to the party at Linda’s?” another nurse asked. “Linda invited all of us.”
“Planning on it,” Tristan muttered. She hadn’t called anyone for a date yet, although she’d thought of it several times. She wasn’t sure why she was waiting.
“Okay, that’s it,” Quinn said, stepping away from the table, all business again. “Let’s get him upstairs. The other one is waiting on vascular unless something changes. Any problems, call me.”
Tristan secured her tubes and the oxygen tank, one hand stabilizing the patient’s head as she pushed the stretcher toward the elevator. Just as she, Quinn, and a nurse crowded on, the trauma beeper went off again.
The second-call anesthesiologist was waiting in front of the elevators opposite the OR when the doors opened. “Healthstar’s on its way in with a level one,” he said to Tristan. “You want me to take it?”
“No. You take this one. I’ll get the incoming.” Tristan handed off the patient and caught the elevator doors just as they were closing. She jumped in.
When she reached the roof, the helicopter hadn’t yet landed, but several nurses and the trauma fellow were already there. Tristan stepped a little bit away from them as they chatted while waiting and watching the sky. As the helicopter settled onto the landing pad, the turbulence from the rotors and the glare of the bright landing lights brought tears to her eyes, but she stared through the sheen of moisture, hoping for a glimpse of Jett at the controls. As soon as the skids touched down, the trauma team rushed forward and she went with them.
Tristan was almost to the aircraft when the cockpit door swung open and Jett jumped out. She had a brief glimpse of Jett pulling off her helmet and rifling a hand through her hair. Their eyes met and Jett smiled. Tristan had only a second before the medevac crew delivered the patient. Even though her attention was elsewhere, she held on to the smile as if it were a gift. Just before she stepped into the elevator, she looked back. Jett still stood on the rooftop, a solitary figure backlit against the night sky, watching her.