Night Call
Page 13
“Sorry. You don’t deserve to be in the middle of that.”
“Ah, hell,” Tristan sighed. “It comes with the territory.”
“It shouldn’t,” Jett said vehemently. “You do a job that not many can, and you deserve to be supported for doing it.”
“Sounds like you have some experience with that.”
“No system is perfect,” Jett said evasively. “I should check out the aircraft.”
“You never answered my question,” Tristan called as Jett started away.
Jett looked back. “What question?”
“About women. Do you date women?”
“No. Not really.” Jett grinned ruefully. “The military wasn’t exactly a great place for it.”
“I’ll bet.” Tristan stayed where she was because Jett looked like she was about to flee. Just like she always did when the conversation veered into the personal. Trying to get close to her was like trying to sneak up on a wild animal. Jett’s senses were sharp and completely honed to guard against being taken by surprise. She expected Tristan to put some kind of move on her. To kiss her maybe, the way Tristan almost had at the party when she’d stopped thinking and given in to the crushing urge to touch her. But Tristan was thinking now, and she had a good hard hold on the desire that had her aching inside. She wasn’t making any kind of move, sudden or otherwise, because she’d decided the only way she was ever going to get close to Jett was to keep surprising her. “You’re not in the military now. So what do you say we get out of the city on Saturday. Take a ride up into the mountains. Hike a little bit.”
“And that would be a date?” Jett bounced the clipboard against her thigh.
“Well, I figured we’ve already done the dinner date routine. Twice.” When Jett frowned, Tristan added, “Hospital cafeteria.”
Jett laughed. “Sorry. And they were memorable moments too.” She was suddenly serious. “What about the redhead?”
Tristan tried not to let her discomfort show. She hadn’t been certain if Jett had seen Darla move in on her, but now she knew. She wasn’t about to apologize for something there was no need to apologize for, but she also wanted Jett to know…what? That her interest in Jett wasn’t the same as it was with Darla? Was that really the truth? She’d been fascinated by Jett from the moment she’d seen her, even though Jett was nothing like the women she usually went out with. She thought about her. Dreamed about her. Christ, she fantasized about her. Fantasized about her taking her the way women never did, hard and fast and in charge. Okay, so that was different. But it wasn’t like she was looking for a relationship with anyone. Still, it felt important to clear the record. “Darla is a friend.”
“No promises there?”
Tristan shook her head.
“All right. Saturday.” Jett nodded, turning the idea around in her mind. “Let’s do that.”
“Yeah,” Tristan said, letting out a sigh and trying to ignore the way her heart jumped around in her chest. “Let’s.”
*
When they arrived at Atlantic City Medical Center to pick up the baby, the neonatal intensivists informed them that the surgeons had gone back in to stop some unexpected bleeding. The last update from the OR nurses was that the surgeons were closing. Linda checked with PMC for clearance to wait. With luck, they’d be airborne within the hour.
In the meantime, the flight team hung out in the lounge, picking at food left on a tray from someone’s abandoned dinner, watching an old Vincent Price movie on the TV affixed high in one corner, and leafing through three-month-old magazines. It was Tristan, Linda, and Jett, and the conversation ranged from hospital gossip to politics and back to the casually personal.
“So, Jett,” Linda said, “what made you decide to leave the military?”
Tristan stiffened and glanced quickly at Jett, who slouched on a sofa. Tristan didn’t think this was a casual question for Jett. Seeing Jett’s expression shutter closed, Tristan had a completely foreign urge to protect her, to prevent whatever bad memories the question stirred from hurting her.
“Probably the same reason you left the ER,” Jett said smoothly. “It was time. I liked the Army. I always liked it. But…” She shrugged. “I wanted something else. Different experiences, I guess.”
“Makes sense,” Linda said, appearing not to have noticed the cool, detached tone of Jett’s voice.
But Tristan noticed. Before she could change the subject, Linda continued on in her usual indomitable fashion.
“It must have been hard having a personal life. Did you worry much about it—you know, the ‘don’t ask, don’t tell’ thing?”
Tristan’s insides quivered, and she wanted to jump up and wave her arms, as if warding off a freight train barreling down on a car stuck on the tracks at a railroad crossing. She felt about as helpless to stop the conversation as she would have been to divert the locomotive.
Jett rose suddenly and walked to the soda machine. As she dropped change into the slot, she said with her back to the room, “I didn’t have much reason to worry about it. A lot of other people did.” She popped the top on the soda as she turned, the fine lines around her eyes deeper than they had been. “They had reason to worry. Even over there, where everybody was needed and people tended to look the other way when rules got broken, that one could still take you down.” She lifted the can and sipped, then headed toward the door. “It’s hot in here. I think I’ll be hot outside where there might be a breeze. Page me when I need to warm up the bird.”
In the next instant she was gone. Linda stared after her. “Uh-oh. I stepped in something, didn’t I?”
“I don’t know. She doesn’t say much about over there.”
Linda rested her head on her hand and regarded Tristan contemplatively. “She is interesting. I like women with a lot of passion.”
“Is that what you think it is?” Tristan asked, drumming her fingers on the tabletop.
“What do you think it is?”
“Pain. I think it’s pain.” Tristan stood abruptly and went after her.
*
The landing pad at ACMC was not on the roof, like at PMC, but adjacent to the emergency room. Several emergency vehicles, angled to disgorge passengers, crowded around the emergency bay on the far side of Jett’s chopper. Otherwise, the area was deserted. At three in the morning, only the dead and the dying and those who stood as the last barrier to inevitable fate moved through the silent hallways inside. Jett leaned against a pole beneath the short overhang in front of the ER entrance and smoked a cigarette she’d scored from a police officer as he’d been climbing into his patrol car.
“Got another one of those?” Tristan asked as she crossed the silent lot toward her.
“No, sorry,” Jett said, holding it out to her. “Be my guest.”
Tristan carefully took the half-smoked cigarette and drew deeply before handing it back. She coughed and shook her head. “I smoked for a year in college and then quit. Every time I bum a smoke, I remember why.”
Jett smiled, took one last drag, and stubbed the butt out against the concrete pillar. Then she slid it into the outside pocket of her cargo pants. “I won’t contribute to your delinquency.”
“I didn’t see you smoke at the party,” Tristan said. “Most smokers do when they’re drinking.”
“I’m lucky. I can smoke or not smoke. I don’t crave it.”
Tristan thought about cravings. She liked women and she liked sex, but she rarely craved either. She wanted the pleasure sometimes, replayed moments with a woman she’d enjoyed on occasion, but only recently had being with a woman begun to feel like an obsession. Since Jett. “So you’re basically a nonsmoker who indulges occasionally.”
“Pretty much.” Jett bent one leg and braced her foot against the pillar. “There’s not much to do in the desert except smoke, toss a football if it’s not too hot, and write letters home or wait for letters to come.”
“I’d be thinking about sex a lot,” Tristan said lightly.
Jett smiled a
crooked smile. “Yeah, that too, I guess.”
“Maybe it’s that old adage about needing to feel alive when you’re surrounded by death.” Tristan spoke quietly, carefully, uncertain of her ground. But Jett had opened the door ever so slightly by mentioning her service, and Tristan desperately wanted to walk through. She wanted to be on the other side of the wall Jett erected between herself and everyone else.
“You must feel the same way,” Jett said, neatly turning the tables. “You’ve probably seen more deaths than me.”
“I don’t think it’s the same. I see violent death. I see senseless death.” Tristan watched Jett’s face in the slanting red light cast by the emergency sign over the double doors behind them, searching for guideposts. She couldn’t find any so she followed her instincts. “I haven’t watched my friends die—maybe for no reason that made sense to me. I don’t think I could take that for very long.”
“You lose your sense of time,” Jett said as if talking to herself. “One day, two days, ten. Three months, six months, it all becomes just one long endless day and night, always the same.” She looked at Tristan, her expression confused. “If you really think about it, really let yourself think about what’s happening, you’d go crazy.”
“I’m sorry.” Tristan didn’t want to say the wrong thing, do the wrong thing, but she ached for her. Gently, she cupped Jett’s jaw, tracing her thumb along the sharp angle.
For a few seconds, Jett leaned into Tristan’s hand, then slowly drew away. “Not your fault. Besides, I signed up for it, right?”
“I don’t think anyone signs up for that kind of madness, do you?”
Jett shoved her balled hands into the pockets of her pants. “Some do, I think. The engagement is what it’s all about for them. Others just love the service, being part of something bigger, grander than themselves. Gail was…”
The sudden silence in the hot still night was nearly suffocating. Tristan took a deep breath and still felt as if she were drowning. “Gail. A…friend?”
“Not exactly.” Jett pulled her beeper off her waistband and peered at the readout. “They should be ready for us pretty soon, don’t you think?”
“Babies are tricky,” Tristan said, taking her cue from Jett and letting the subject drop. Part of her wanted the story on this woman who was obviously more than a friend, but part of her didn’t want to hear there was someone special somewhere. That was different for her too. Very different. “None of their systems are mature, so they don’t quite respond to anything the way you expect.”
“Sounds like a real challenge.” Jett strode toward the emergency room doors, all business again.
Tristan kept pace with her. “I don’t mind. I thrive on challenges.”
Chapter Fourteen
“What’s our ETA?” Linda shouted, leaning around the Plexiglas shield that separated Jett from the treatment bay in the helicopter. She clamped a hand on Jett’s shoulder to get her attention.
Jett pulled her headset away from her ear so she could hear and checked beside her. Linda, Tristan, and the patient were crowded into the space just to her right and behind her. When she was transporting an adult, usually all she could see were their legs. “About fifteen minutes. Problem?”
“The baby’s looking bad. Bleeding again, Tris thinks.”
“Roger. Tell her to hold on. I’ll push it.”
Linda nodded and scrambled back to inform Tristan. “Another fifteen minutes max. How’s it going?”
Tristan knelt on the deck next to the incubator, sweating under the heat lamps that kept the 2800-gram preemie warm. She shook her head grimly. “O2 SATs are falling and her pressure’s bottoming out. God damn it, they never should have transferred her when she was this unstable.”
“Is it her lungs?” Linda squatted next to Tristan and rehooked her safety harness. The ride was smooth—it always was with Jett flying—but she didn’t want to get tossed around if they hit unexpected turbulence.
“I don’t think so. She’s either septic or bleeding again.” Tristan raced through a mental checklist of therapies she needed to institute and the signs and symptoms of further decomposition she couldn’t afford to miss. Linda was experienced and a great medic, but Tristan alone could make the decisions that might mean life or death for the neonate. “I think they’ll need to go back in to be sure.”
“I’ll radio ahead to tell them we have a full alert.”
“Better give the OR a heads-up too.”
“Will do.”
“How much blood did they send with us?” Tristan asked, watching the BP tail downward. Either the baby was bleeding or her heart was quitting on them.
“Just the one unit.”
“Is it all in?”
Linda tilted the small plastic bag and squinted at it. “Just about. Do you want me to start some saline?”
“Yes, but keep it slow. We don’t need to add fluid overload to her problems.” Tristan gently probed the abdomen. “Tight as a drum. There’s so much pressure below the diaphragm, I’m having trouble ventilating. Another couple of minutes and I’m going to have to open that incision. Jesus. Call the surgeons again and see what they say.”
A minute later, Linda pulled off her headset. “I talked to Quinn. She says if we release the sutures, the sudden drop in intra-abdominal pressure will probably make her blood pressure fall too. She might arrest. Last resort only, she said.”
“She’s going to arrest if I can’t get some oxygen into her.” Tristan checked all the monitors again. “Tell Jett to find someplace closer. We’re not going to make it like this.”
“All right.” Linda scooted forward and got Jett’s attention. “We’re in trouble back here. Is there anyplace else?”
Jett shook her head. “It’s too late to turn back to Atlantic City, we’re more than halfway to PMC. We might try Cooper in Jersey, if they can take us. Hold on, I’ll get them for you.”
When Linda got one of the ER nurses on the Technisonic radio, she quickly relayed the situation. After listening for a few seconds, she disconnected. “They just closed to emergencies. Their OR is backed up with victims from a five-car crash on the New Jersey Turnpike.”
“Then we head for PMC. Tell Tristan I’ll have her down in five minutes.” Jett spared a quick glance behind her and saw Tristan working feverishly over the tiny form that was nearly invisible beneath the array of tubes, wires, monitors, and IV bags. It was always a shock to look back and not see the deck awash in blood or to hear the screams of the wounded.
Jett pushed the throttle to the max and as they streaked above the expressway, the flashing headlights below them came at her in the dark like tracer fire. The first time she’d taken a helicopter up after coming home, she’d seen the lights and thought she was under attack. Even now when caught unawares, she braced for bullets to pierce the cockpit and hit her. Tonight the enemy was time. She tried not to think about Tristan and the war she waged behind her, but she couldn’t help it. She wanted to help her. So often she’d felt helpless to help, to stop the waste. Now as then, her impotence fueled her anger. Quickly, she shook her head to clear her mind of the past and the things she could not change. She pushed her aircraft, because that was all she could do. It didn’t feel like enough, but then it rarely had.
*
“How long?” Tristan shouted. She hand-bagged the baby, hoping to get enough oxygen into her to keep her heart and brain working. Every breath was harder to deliver than the last. The infant’s lungs just didn’t have enough room to inflate with her intestines pushing up against her diaphragm.
“Three, four minutes.” Linda took in the numbers on the portable O2 monitor. “God, Tristan, this is bad…”
“I can’t push in any more air. If I increase the inspiratory pressure much more, I’m going to blow a lung.” Tristan flicked the thin blanket away and exposed the distended abdomen. So much blood had accumulated beneath the surface, the thin skin appeared purple. “Give me a pair of scissors.”
Without hesitat
ion, Linda handed the instruments to Tristan. “I’ll get wet packing ready.”
Tristan clipped the first few sutures holding the abdominal incision together and loops of small intestine and bloody fluid immediately poured out. She caught the thin, delicate ribbons of bowel in her palm and protected them until Linda could wrap them in sterile saline-soaked gauze. Immediately, she was able to ventilate more easily. And just as quickly, the blood pressure fell. Sixty. Forty. Twenty. Nothing.
“She’s arresting!” As Tristan began closed cardiac compression, she realized the engine sounds were fading. They’d landed.
The doors flew open and Quinn jumped in. “What have you got?”
“Twenty-nine-week-old preemie,” Linda announced. “Dead bowel resected at ACMC, prolonged intra-abdominal bleeding. We think she’s still bleeding.”
“I had to open the incision,” Tristan told Quinn as the rest of the OR team sorted the monitors and lines to offload the patient to the waiting gurney. She jumped out and grabbed the stretcher across from Quinn. “I lost her pressure right away.”
“Are we ventilating now?” Quinn asked tersely as they raced across the rooftop toward the elevators.
“Better. O2 SATs are coming up.”
“Good.” Quinn pressed a finger to the baby’s groin. “I’ve got a pulse. Linda, can you run downstairs to the blood bank and get two units. I don’t want to wait for a courier to bring it up. And call and see if the peds surgeon is here yet.”
“You got it.”
Linda disappeared down the stairs while everyone crowded into the elevator. The doors closed, and silence descended on the rooftop, broken only by the faint ping of the cooling helicopter engine and Jett’s quiet footsteps as she secured her aircraft.
*