by Olivia Gates
The woman, Samira, clutched her three children to her as she sobbed into her husband’s chest. He clutched her in turn while Jay tended the severe gash he’d sustained down his back as he’d struggled to save his family.
“We worked for ten years for our house and shop and they were gone in ten minutes,” Jaaber lamented. “We lost the car, the clothes, the children’s paintings—our pictures—our memories. We lost everything. This has to be a punishment from Ullah.”
Jay insisted it wasn’t, that tragedies just happened, that you bounced back as long as you had breath left in you.
When she had used up all her arguments, she said, “Well, Jaaber, you have your family. Look around and see how many people don’t have theirs and count your blessings.”
This seemed to calm him down. From then on he and his wife were of great help, tending other victims’ needs.
GAO had arrived on their heels in more helicopters provided by Malek, and he co-ordinated with them about the transfer of fresh water and more food and medicine for the survivors. And more body bags for the dead.
It was dawn now. At least, her watch said so. The sky was weeping solid sheets of water from an impenetrable barrier of clouds. They were now returning to the affected areas after depositing their last helicopter load of refugees at the camp. It was by now doubtful they’d find more. Alive, that was.
“Pilot—three o’clock, from my position,” she heard Malek barking into his walkie-talkie over the clamor of the chopper and the downpour. “A half-submerged red car beneath a palm.” He turned to Saeed. “We’ll lift the car, see if there are any survivors once it’s back on dry land.”
Saeed nodded and ran to fulfill his boss’s directives.
Moving the huge palm off the car took over thirty minutes, and it took as long to secure the car for the aerial ride.
Once they’d landed the car, Malek, Saeed, Dr Rafeeq, the navigator and the flight engineer jumped out to unhook the cables so the chopper could land.
She jumped down and raced to Malek’s side. He scowled down at her, his face frightening in the harsh floodlights from the helicopter. “Get back in there, Janaan.”
“I’m here to do my job.”
“Do it inside.”
“I have nothing to do inside—no patients, remember?”
He clamped his teeth on an expletive then turned and ordered his men away from the car. It looked like crumpled foil around the victims. He reached for the driver through the compressed space of the pulverized window and Jay ran to the passenger seat to examine the woman. A palpation of her carotid artery gave her an instant verdict. The woman was dead. Long dead.
Hope bled out of her in booming heartbeats as she raised stinging eyes to Malek. He raised his eyes at the same moment, the same bleak diagnosis in his. Dead.
Then she noticed something in the backseat. Was this …?
“Malek,” she cried out. “There’s someone in the back seat.”
Malek raced around to her side, bent to peer into the crack where the tree had flattened the top of the car into the back seat. “You’re right. Let’s hope it’s a child.” Her eyes swung up in shock. He elaborated. “An adult would have been crushed. Being smaller might prove the casualty’s only chance.”
“But the car had been submerged!”
“Half-submerged. The man and woman didn’t drown. The impact of the tree killed them.” Then he bellowed for a crowbar.
It was in his hands in seconds and he pried the compressed space widely enough for Jay’s smaller arm to reach inside and feel for the passenger.
After a minute she pulled back, gasping, her eyes filling. “It is a child. A boy. He’s alive. Barely. God, Malek, please, get him out of there. We have to save him.”
Malek squeezed her arm, his orders bringing his men with chainsaws. Then the nightmare of extracting the boy from the car began. An hour-long nightmare.
As minutes ticked by Jay felt like she would burst with frustration, feeling the boy’s life ebbing with every passing second and unable to do anything about it. If not for Malek’s steadying grip and presence, she would have screamed.
Then the top of the car was torn off and she and Malek pounced on the boy, a little angel of around seven, with silky black hair and fine features, the olive of his skin fading along with his life force.
Trembling, she fitted him with a cervical collar and Malek an oxygen mask. With a shared nod they carried him to the gurney. In the periphery of her vision she saw Malek’s men extracting the dead man and woman from their death trap. Her insides twisted.
They took the boy inside and Malek barked, “Rafeeq, ready OR, Alyaa, prepare CT, Lobna, expose the patient as we work.”
His eyes slammed into Jay, who’d just snapped on gloves, and without words each took a chore.
Just as she finished intubating the boy and started positive pressure ventilation, she heard Saeed’s subdued words in Malek’s ear.
Malek nodded as he finished hooking the boy to the cardiac monitor and oximeter, reported his findings. “Pulse 45, BP 70 over 30, oxygen 80 percent.”
Lobna finished cutting the boy’s clothes off and Jay pounced on him for a quick survey.
“No gross injuries,” she muttered. “God, Malek, his coma and vital signs depression are probably due to brain injury.”
Malek gave a grim nod, then let out a heavy exhalation. “They were his mother and father, Shabaan Abul-Hamd and Kareemah El-Swaifi. He is Adham.”
Adham. Black. Like his silken hair and lashes.
She compressed her lips against pity, calling on the hard-earned distancing techniques she’d developed through years of discipline so she’d be of use to her patients, to her mother, letting herself feel devastation only when they no longer needed her. But they’d never stopped needing her and she’d had her distance program perpetually on.
Then she’d met Malek, then all this had happened and she could now barely locate it, let alone turn it on.
She gritted her teeth, swung her gaze up, groping for Malek’s support.
He gave it, his voice when he spoke, his words, their intensity and import, almost breaking her control. “He won’t share their fate. Not if we have anything to say about it.”
A cold fist in her chest melted, scalded her. Yes. Please.
He turned to Adham and she jumped to join him in a thorough exam. They found no signs of internal injuries. That supported the head-trauma scenario.
Raising his blood pressure to raise his cerebral perfusion took on a new urgency. She announced her intervention method as she implemented it. “I’m giving Adham a 250 c.c. saline bolus. Will continue with a rapid drip for two more liters.”
Malek nodded, making her heart bob in her chest with the approval in his eyes. Then he rose as soon as Rafeeq walked back to them. “Rafeeq, give me vitals every five minutes. I’ll check preparations.”
“I’ll get a GCS,” she called out after him, gliding her hands over the boy, translating his reflexes. Soon she called out her bleak assessment to Malek. “It’s six. One-three-two.”
Malek strode back to them, frowning. “Status?”
“BP 80 over 40, pulse 50, oxygen at 85 percent,” Rafeeq said.
Malek’s huff was eloquent. “Let’s see what’s keeping our measures from working properly.”
He pushed the trolley to the CT machine. In seconds he had Adham inside it, with both Jay and Rafeeq making sure his oxygen and fluid supplies weren’t interrupted.
As Malek put the machine in motion, a terrible realization gripped her.
“Malek—he also has a unilaterally dilated right pupil, with ipsilateral third cranial nerve paralysis. Do you think …?”
Malek grimaced. “His brain is herniating.”
Jay jerked at his corroboration of her new-formed fear.
Her own brain felt about to burst. Adham might have to have a craniotomy to relieve the building pressure inside his skull and if they didn’t have a surgeon qualified for such hazardous
surgery, they would have to reduce Adham’s intracranial pressure long enough to reach someone qualified to operate on him.
With unspoken co-operation they applied the measures to do just that, with Jay administering mannitol and Malek hyperventilating him.
She finished as he did and muttered, “If it doesn’t work …”
He sighed. “We have to give him a chance to stabilize without surgical intervention. He may not need a craniotomy.”
His words failed to bolster her. The doubt tingeing them made her heart itch, constrict. C’mon Adham, please.
Malek turned those potent eyes on her, intent on absorbing her agitation. “If he doesn’t respond, we’ll operate.”
“Wh-who’ll operate?” she croaked.
“I will,” he said simply.
He was a surgeon?
And he claimed she was “of the ceaseless surprises”?
She couldn’t believe she hadn’t realized he had to be a surgeon when he’d asked Rafeeq to prepare OR! Soggy cotton had replaced her brain. And if he talked about performing a craniotomy in their circumstances with such assurance, he wasn’t just any surgeon but a superior one.
And she believed he was. Believed he could do anything, was delirious with gratitude he was there to do it.
She only hoped he’d let her assist him. She’d trained for six months in trauma surgery before changing her direction for a predictable specialty, shift-wise, for her mother’s needs.
The need to lean on him was overwhelming. As if he felt her need, he drew her back against him as they watched CT images forming on the monitor. She breathed in his scent, absorbed his steadying power, her mind racing to process the opacities pinpointing hemorrhage and diffuse tissue swelling.
Then his voice broke over her, filled with compassion and somberness as he discussed diagnosis and possibilities.
The CT machine whirred to a stop and Malek reversed the gliding table. As he saved and printed out the results, Jay examined Adham, reassessing.
A minute later she raised her eyes to Malek’s and choked, “The deficit’s increased. Malek, you have to operate.”
Malek held her gaze, her hand. “We will.” He searched her eyes. “You do want to assist me, don’t you?”
Malek moved the suction probe to and fro over the subdural hematoma. “A bit more irrigation here, Janaan.”
But she was already gently irrigating in conjunction with his suction to loosen the clot.
By now he knew he didn’t need to give her directions. She was a flawless, intuitive assistant. The best he’d ever had.
They now worked together as if they’d worked together every day of their lives, handling the most delicate part, removing clots that had collected between the inner and outer coverings of Adham’s brain, then delving deeper into the brain to remove clots formed there and closing bleeding arteries.
“Craniotomy is the worst emergency surgery there is, right?” Jay whispered.
So she wasn’t as firm as she appeared to be. He snapped a look at her and her reddened eyes discharged another chain reaction in his chest. No, not firm, disintegrating with worry and pity but holding up nevertheless, functioning at optimum, to be his support, and Adham’s. It was a marvel that she could.
She might be used to trauma, but trauma surgery was something else altogether. And then she was right. Among all the gory, horrific procedures, opening the skull, exposing the brain, took the cake. And when it was a child, his own personal worst-case scenario, and not any child but one who didn’t have a family to wake up to, a home to go back to.
He gritted his teeth, gave her the support she needed, channeled all the sympathy into his healing abilities.
He could still do nothing about the brain tissue lacerations. It was time to close up.
As he started closure, Jay suddenly talked again, her voice an impeded rasp. “He’s going to be OK now, isn’t he?”
He raised his eyes to hers, felt confident enough to say, “He’s so young, his brain will get over the insult.”
“And what about—about.?”
He had to spare her articulating her anxiety. “I’ll take care of him. I’ll take care of them all. I promise you.”
He could only see her heavenly eyes, kindling with a warmth that spread right to his bones, glittering with unshed tears. One escaped to darken her mask when she gave a vigorous nod.
They fell silent again as they concluded Adham’s procedure. Jay drew the skin over the craniotomy, stapling it and applying dressings while Rafeeq terminated anesthesia.
As their assistants took Adham to IC, Malek took Janaan’s arm, escorted her to the soiled compartment. She swayed against him. He helped her take off her surgical garments. She was pale, her lips blue, her eyes raw, tearing at his insides even harder than the ordeals they’d been through. He took her hands in his, a pressure building inside him. He had to release it.
He cupped her cheek. “Janaan, I can’t express how thankful to God I am that he sent you to my people in their hour of need, and to me to stand beside me in this trial.”
Before he surrendered to the urge to complete the madness he’d started back in Adnan’s restaurant, he closed his eyes then turned on his heel and rushed to plunge himself into the distraction of the ongoing crisis.
Jay stood there, her heart pounding so hard it shook her.
It took Lobna asking if she was all right to shake her out of her trance. Jay blinked, asked the one thing she could think of, “What kind of surgeon is Ma—is Dr Aal Hamdaan?”
Lobna gaped at her as if she’d asked her what kind of vegetable he was. “He is not.”
It was Jay’s turn to gape. “He’s not a surgeon?”
The woman gave an apologetic smile, her eyes brimming with curiosity. “Sorry, but I don’t use English beyond medical terms much. I mean he’s not just a surgeon. Sheikh Malek is our Health Minister, the best Damhoor has ever had, or will ever have.”
CHAPTER SEVEN
JAY STOOD OUTSIDE her tent, surveying the hundreds of multi-sized, waterproofed ones lined up on the arid hill. Something was different about them today. They were dry.
She looked up and the sun zapped her eyes with its 8 a.m. glare. She snapped them away, looked around the waking camp, “sabaah’l khayr”, an automatic good morning, on her lips as she greeted the people passing by.
Things had slowed down in the past three days, with the rain stopping, the injured either back on their feet or at least getting better, and all the displaced people getting used to their temporary but very adequate accommodation until a permanent replacement for their losses was devised.
It had been a week since it had all started. And during that time, when the constant toil and preoccupation had allowed her moments of coherence, she’d only been able to think of one thing.
Malek. And the fact that he wasn’t only a sheikh, wasn’t only a surgeon, but was the Health Minister.
Why hadn’t he told her?
She’d told him everything about herself—everything—and he hadn’t even introduced himself properly. If he had, she would—would.
What would she have done? Not acted like a fool around him?
She doubted she could have done anything differently. He only had to look at her, breathe near enough to fry her restraint circuits, unleash emotions and responses she hadn’t known she’d come into this life equipped with and.
He should have told her!
But he hadn’t. He’d kept her within those three feet throughout the very long workdays, as thoughtful, witty, infuriating, attentive, dominant, accommodating, provocative, appreciative, and just plain overwhelming as he’d been from that first moment. And to add insult to injury, he’d kept milking her for more intimate details about her life. And no matter how she tried to hold back something of herself, he just drew it out of her as if by magic, giving back nothing, until she felt she was standing naked in front of a two-way mirror where he sat in the dark on the other side, watching her unseen, unfathomable.
And here he was, striding towards her, his sight and presence overriding her logic and control. It made her mad. He made her vulnerable. And she couldn’t let herself be. She had to put up resistance, wait it out. It would end all too soon.
“Janaan—you didn’t get any sleep!”
Something alarming thrummed behind her sternum at the concern that hardened his voice, his gaze, made her step backwards when he would have taken her arm.
She covered her reaction in levity. “Look who’s talking.”
His gaze softened, conquering the scolding. “Let’s not look. Shaving is a distant memory, and I’ve metamorphosed into a thug. No, wait—the thug phase was the first three days. I’m now in the pirate one.”
Yeah. Right. And she wondered which phase was even more arrhythmia-inducing. “And look who’s being ridiculous …”
She choked. She had no brakes where he was concerned.
He only laughed, that heart-breaking laugh of his. “That’s my Janaan, the only one I count on to smack me over the head—even if it’s with a compliment this time.” He scratched his beard in a cross between uncertainty and teasing. “I guess.”
It was no use. Her lips spread on sheer pleasure that he was near, that he existed. “Don’t guess. You accomplish Herculean tasks without blinking, but shaving is a big deal?”
“Aih, ed’hukki—laugh at a poor man’s expense with your time-defying smoothness.” He pantomimed running his fingers down said smoothness. She felt each touch, barely stopped herself from jerking away. “And to think women lament what they do to maintain their beauty. Try shaving twice a day.”
“You mean you don’t have someone or two to do it for you?”
He pouted. “What, alongside those assigned to scratching my itches? Wonder whatever befell them this past week.”
She squeezed her eyes shut. “OK—that was stupid and prejudiced.”