Breath of Life

by Sara Marion

  She arrived at the emergency room and saw Susie, one of her favorite nurses and friends at the hospital.

  “Big pile up on 1-70. Overturned semi and cars that couldn’t stop in time. Half the victims are coming here. The other half are going to Geary County hospital.”

  “I should probably just tell Jack I will meet them in KC. I don’t think I will ever get out of here. Why couldn’t this happen next weekend. The one weekend I make plans,” Paxton groaned.

  They waited for the ambulances. It was chilly out there but they were ready. Steve joined them as the first ambulance arrived. EMTs jumped out of the back.

  “What do we have here?” Steve jumped first.

  “Unidentified male. Thrown from a car, unconscious, scrapes maybe some internal bleeding.”

  “Okay let’s roll. Get him into O.R. 3,” Steve commanded as they wheeled him back. Paxton heard him shouting more instructions to his nurses. Paxton hoped she was as lucky as Steve was with her patient. By then the other surgeon on duty came out.

  Two more ambulances came in at the same time. Paxton jumped to one as the doors swung open.

  “What do we have boys?” She helped unload the patient.

  “Unidentified female, car caught on fire. 3 degree burns, multiple lacerations to the face, neck and arms. She was hit by two other cars who couldn’t stop. Possible broken back, knee looks shattered, distended abdomen, we think it’s bleeding.”

  “Okay, let’s go.” Paxton knew she got the shit-storm for patients. She wasn’t getting out of here anytime soon.

  She shouted orders to Susie and other interns. Ordering tests, blood work, and x-rays scans. She knew she didn’t have much time. Someone brought in a portable ultrasound machine. She started with the abdomen. The EMTs were right, severe internal bleeding. Paxton felt over the ribs, several broken ribs. Nasty bruising from the steering wheel. Paxton felt sorry for her. She wasn’t sure where to start with treatment but she needed to get to the O.R. stat to stop this bleeding. After a few more seconds, she knew she would have to do exploratory surgery to find out what was causing the bleeding.

  “Find an open O.R. and let’s get there now,” Paxton shouted out.

  “O.R. 5 is open and ready.”

  “Let’s move people.” Paxton was ready to try to save this girls life. “Susie, call Jack and tell him I may not be up until tomorrow.” She saw Susie scamper off.

  Paxton was scrubbing her hands and arms when Susie appeared. Her focus was broken. “Jack said...”

  “Susie, please. I know what Jack probably said, I need to focus now. Can you please do my rounds and check on patients for me? I will owe you big time right now,” Paxton pleaded. She saw Susie open her mouth but closed it. “I’m sorry Suz... what did Jack say.”

  “He said Duke and Ella haven’t made it yet. So he is going to ask them to put off driving until tomorrow.”

  “Probably stuck behind the people trying to clean up the accident. Thanks. Keep me posted if Jack calls unless I am in there.”

  “Ok,” Susie smiled.

  Paxton hated hurting Susie’s feelings. She was so focused on how to save this person’s life that she didn’t want to hear about Jack having to wait or say that it’s okay she’s running late. She just wanted to be there with them. She finished scrubbing and headed into save this girl’s life.

  A few hours later, Paxton walked out of the O.R. She was exhausted. The weight on her shoulders were heavy. She couldn’t save the girl’s life. She closed and had the nurses look for identifying scars, tattoos, marks that will help find the family. She hated delivering this news. She slid down the wall just outside the O.R. She just needed a few moments.

  “You’re out!”

  Paxton looked up and Susie was striding towards her. “Jack called, Ella and Duke didn’t make it. He can’t get a hold of them. I was coming to tell you this when I was pulled into Steve’s patient’s room. It was Duke. He’s asking for you.”

  Paxton’s head jerked up. She scrambled to her feet. If Duke was in the accident and the unidentified male, “Who was in the other ambulance that pulled up?” Paxton asked.

  “Male, 55. He hit the semi first from what I was told.”

  “Any other patients brought here?”

  “No they were DOA or air lifted to St. Francis. I checked and Ella was not transported anywhere else. She would have been brought here. There are a couple more unidentified people that are getting treated that have just scrapes and bumps. I didn’t see Ella.”

  Paxton broke through the O.R. doors she just came through a few minutes ago. “Ally, check her hip,” Paxton ordered.

  “Which one and what am I looking for?”

  “Does she have a tattoo on her left hip?” Paxton saw Ally remove the surgical covers.

  “A crescent moon with a string tied likes its hanging,” Ally looked up.

  Paxton covered her mouth. She ran over and saw for herself. Paxton’s right hand went to her hip where the other half of the tattoo was. Paxton had the hanging stars. If they stood next to each other they had hanging moon and stars. Their best friend tattoos.

  “No, no.” She looked at the face. It was swollen and cut up but if she looked hard enough, she could see Ella’s face.

  “NO!”

  “Dr. Mercier?” Ally’s voice rang out trying to understand what was going on.

  “No, no, no.” She sank to the floor. Ally looked out the window and saw Susie.

  “I need help in here!” Ally shouted.

  Susie came rushing in. She tried reaching for Paxton. Paxton shoved her away. She didn’t want anyone touching her. Susie attempted again.

  “Everyone out!” Paxton ordered. Ally and Susie stared at her and hesitated.

  “Out! Get out!” Paxton threw a discarded cover at them.

  Susie went to the phone and called someone. Paxton figured it was security or Steve to come in and help. Paxton couldn’t believe her best friend ended up on her table. She should have recognized her. She should have been able to save her. She had everything under control until her body just gave up and she coded. She heard the flat line of the heart monitor. They tried resuscitating her for five minutes. Her heart just wouldn’t start. Paxton called time of death instead of trying harder.

  She went over every cut, stitch, every movement she made. Did she check every part she could? Paxton rocked herself. She reached up to her best friend. She needed to try again. She flipped the heart monitor on. They hadn’t taken her off yet. The flat line alarm went off. She grabbed the defibrillation paddles.

  “Don’t you die on me!” She pressed the paddles into her best friend. Ella’s body reacted to the shock and fell flat on the table again. “No, you don’t get to leave me. I won’t let you.”

  She charged and pressed again. Flat line. “You come back to me now.” She charged again. She pressed them again. Tears falling down. Ella’s body lurched. The flat line continued.

  “You can’t leave Duke. I can’t tell him. You come back right now!” She pressed again. Another lurch, the sound of the flat line.

  She set the paddles down. She started CPR. She needed to get the blood flowing, get the oxygen to her brain.

  “Paxton, stop!” a voice cried out. It was Jonathan.

  Paxton struggled as he grabbed her arms trying to pull her away from Ella. She couldn’t stop working on her best friend. She was losing precious time.

  “Let me go!” She screamed. She slammed her foot on his instep. He let go instinctively. She went back to Ella.

  “Paxton, enough! She’s gone,” Jonathan ordered. His expression was filled with concern for his friend.

  “No, I can save her. I missed something. I just need to go back in.” Paxton was frantic.

  “Go call Jack, get him here now,” he whispered to Susie. “Does Duke know yet?”

  “No. I’ll go call.” Her heart was heavy too.

  “Ally, take the paddle out. I don’t want her burning Ella’s body,” Jonathan ordered quietly but
Paxton still heard him. She knew that he was trying to protect the hospital. She continued working on her friend.

  A few more minutes went by. Paxton still heard the flat-line of the heart monitor. She knew Ella was gone. She laid her head on Ella’s chest. Tears were streaming down her face. Jonathan pulled her into him.

  “I’m so sorry Paxton.”

  She collapsed in his arms and Jonathan just held her. She cried and he slowly rocked her side to side. The tears continued for a few more moments. She stood up straight and wiped her eyes.

  “I have to go tell him,” Paxton voice was strained.

  “I can do that.”

  “No, she was my patient.” Her eyes darted to him, she slipped on her professional mask. “I need to inform the family.”

  Paxton pulled herself together. She knew she wasn’t being very professional at the moment. She took a couple deep breaths and walked out of the room.

  She saw Steve walking down the hall when she hit the surgical floor. “Where is Duke?”

  “412. I’m so sorry Pax.”

  “Don’t,” she threw up one of her hands to stop him from talking. She looked away from him. “I need to inform the family.”

  Paxton knew she had a job to do. She was responsible and the lead on the case, she had to finish her job. She knew she wasn’t far from the door where she would completely destroy someone’s world. She knew took away his wife and his future. When she got to his door, she hesitated. This was going to be hard and she didn’t know how she was going to make it through this one. She steeled herself and walked in through the sliding door.

  “Hey there Pax.” Duke’s tense arms relaxed when he saw her enter the room.

  “Hey Duke,” Paxton paused. She couldn’t do it. She felt her nerves waiver.

  “Have you heard about Ella? I haven’t heard anything about her yet. Do you know if one of your colleagues has her case?”

  Paxton could hear the hope in his voice. He had no idea how bad of a condition his wife was in. This would make it even harder. “She ended up on my table. She came in as an unidentified person.”

  “So how is she? When can I see her?” He lifted himself up. His face fell when she hesitated trying to control her emotions. The hard part was here. She shook her head.

  “I tried. I did everything I could, but Duke her injuries were serious.” She took a step closer and grabbed his hand. He was silent. “She had swelling and lacerations to her face. Serious internal bleeding, broken ribs. I took her into the O.R. and started working on her. Her body gave out on her a few hours into the surgery. She didn’t make it Duke. I’m so sorry.”

  Paxton felt Duke tighten his grip. She allowed her tears to fall. Her job wasn’t done but she started to fall apart anyway. “I’m so sorry. I tried. I’m sorry I couldn’t save her.”

  “No, she can’t be gone.” Duke shut his eyes. He shifted in the bed as the emotions took over. “Pax, no. No, please say it’s a mistake.” Tears were falling down his face. Paxton knew she just annihilated his world. She couldn’t even say anything. “Pax, oh God! It can’t be her, not my Ellie-bear. Why her?”

  “I’m sorry. I’m sorry.” That was all that Paxton could manage.

  Her own tears were falling. He didn’t want to hear about everything that happened but she waiting for the questions, she was waiting for the anger, the resentment.

  She went over the surgery again in her head. She was sure she missed something. Something that if she were just focused a little bit more she would have seen it. She should be wheeling Ella to recovery instead of the morgue.

  Jack and Jenny came into the room a few minutes later. Jack leaned in to give his best friend a hug and his condolences. Once he cleared, Jenny took his other hand. Their tears were falling. Paxton knew all these tears were because she didn’t save her friend. She sat there watching. She knew Ella should be here with them.

  Jack wrapped his arms around Paxton. She stood limp in his arms. The tears were stopping as she was just numb. Her mind was still racing trying to figure out why Ella left her. Why Ella ended up on her table.

  “I have to go.” Paxton wiped the tears from her face.

  “Where are you going Tiger?”

  “I have patients I need to check on.” She felt everyone’s stare. She didn’t want to admit that she couldn’t look at them and their pain knowing she caused it.

  “You are thinking about patients right now? Ella died on your table and you are thinking about your patients? What is wrong with you? Don’t you even care?” Her mother lashed out at her.

  The words stung Paxton. She knew that her mother held her to a higher standard than most surgeons. Jenny heard the stories of Paxton saving the unsaveable before. The people who everyone else would have given up on but now her mother couldn’t understand why she couldn’t save Ella.

  “I have to go, I’m still on duty,” she quietly said. She turned and walked out the door.

  When she left and started down the hallway, she realized she hadn’t informed Ella’s uncle. She forgot that he didn’t know. She went to her office, grabbed her phone and dialed his number. He picked up on the second ring and Paxton gave him the news. She heard the phone drop to the floor and something break on the other end. She flinched. Ryan came to visit Ella every three months. He was just here a couple weeks ago visiting. Paxton shook her head, the line went dead.

  After spending a few minutes collecting herself again, Paxton went to the nurses’ station on the surgical floor and picked up her charts. She looked through them. The words didn’t make sense to her. She kept flipping through them, re-reading them but all she thought about was Ella’s surgery. She was looking for what she missed. No one said a word to her as she stood there with her lab coat on, reading those charts appearing like she didn’t just lose her best friend. Paxton figured the news spread quickly throughout the surgical floor. Everyone was waiting for her to break down. She wouldn’t give them a show.

  “What are you doing?” Steve’s voice broke her concentration.

  “What does it look like?” She retorted.

  “Leave it, we will take care of it. You need to be with family. You just lost Ella. She was your best friend, hell she was your sister.”

  “Adoptive sister. I’ve got work Steve. I need to stay busy.” She sounded cold, she knew it.

  “Don’t do this. Go be with Jack. Be with your mother and Duke. They need you now more than your patients. You are not in the right frame of mind right now to be tending to others.”

  “But good enough for my family?!” She snapped back at him.

  Paxton gave him an icy-cold stare. Steve let out a frustrated sigh. He knew he wasn’t going to win this one. He knew how stubborn Paxton was when it came to her patients.

  “Fine, but once you make your rounds, I’m taking over your cases.”

  “No Pax, you need to take some time. Get your head back.” Jonathan stepped around Steve.

  “I’m fine. I just…I just need to do my job.” The tears pooled but it would only prove their point if she let them fall.

  “You are on administrative leave effective immediately,” Jonathan stared at her.

  “You are on the board, not the chief of surgery.”

  “I manage just as much as the chief does. Don’t play that card with me, Paxton. Just take your leave,” Jonathan hardened his voice but he was also pleading with her.

  Paxton felt like they were backing her into a corner. She looked around and noticed she was already causing a scene with the nurses. They had been staring at her since she picked up her chart and now the president of the hospital and her right-hand man were trying to get her to leave. She reluctantly gave in.

  “I quit.”

  “No you don’t. You are on leave,” Jonathan stared her down. He knew she was a valuable asset and she didn’t know what she was saying. Paxton threw her charts down on the counter and left.

  Jack was walking towards her. “I need to get out of here,” she said storming past
him.

  “Paxton wait!” Jack called after her.

  Paxton didn’t listen. She went to her office and gathered all her things. She went out the back door to the reserved parking for the doctors. She threw it in her SUV and climbed in.

  She sat there and let the tears fall. She rested her head on the steering wheel. Her best friend was gone. The one who always brightened the world around her. The one that believed in her and shared her darkest secrets. The one that pushed her to be better. The one she killed. Her door open and she jumped. It was Jack. He pulled her out and held her. She fell apart again. He picked her up and carried her around to the passenger seat.

  She didn’t remember the drive home but Jack carried her into the house. He bathed her in the shower, he dressed her and got her into bed. The whole time tears were falling down her cheeks. She was numb now. She couldn’t feel anything but the emptiness of knowing she would never see or talk to Ella again, because of her. Because she couldn’t save her best friend, because she wasn’t good enough to save her.

  Paxton floated through the days barely functioning. All she saw was Ella open on her table. She studied the images trying to pin point the one move she made that caused her best friend to lose her life. She avoided the hospital. She couldn’t walk the halls. It was too much. She would have to walk the halls she took trying to save Ella. She would have to see the room where she broke Duke’s heart. She would have to face the people she broke down in front of. She would get looks of pity. She remembered those looks the day of the funeral.

  After much debate Paxton wanted to give a eulogy for her best friend. She stood up there at the podium in her black dress. She didn’t wear any make up that day, she knew it would only be ruined. Jack sat there in the front row with her. She pulled her speech out of her clutch. She collected herself as she unfolded it and set it in front of her. She remembered writing all the good things that Ella had done, all the wonderful memories but the tears kept her from being able to read any of it. She looked out into the crowd that had gathered. The funeral home was full and people were even standing in the background. She saw how many people Ella touched and how many people she brought together in her death.