Icebound

by Julie Rowe

  How much had it cost him to ask? As the man in command, he could’ve continued to issue orders, but he chose to ask, to trust she’d make the right decision.

  She needed to trust him to do the same.

  She took a deep breath, ignored the cold rock her stomach had become and said, “I’ll need some help, any suggestions?”

  He squeezed her shoulders and gifted her with a tiny smile, a bare upturn at the corners of his mouth accompanied by wrinkles bracketing his eyes, yet it warmed her.

  Tom lifted his head and glanced at the remaining crew. “Tyler, Bob,” he called, waving the two men over. Tyler was still dressed for outside and Bob looked like he’d just come in, his parka and hood coated with frost and snow. “Give Emilie a hand in Club Med.”

  “Sure thing,” Tyler said with more energy than she could ever remember having.

  Bob nodded.

  Emilie turned to Tom. “We’ll be ready.”

  Emilie relieved Carol and told her to get some sleep. Then she had Tyler wrap electric heating pads around two IV bags of saline while Bob readied the resuscitation equipment near the center of the overcrowded room. They’d need all the space they could get.

  She got the oxygen warmer up and running. The small machine heated oxygen from a tank and misted it with warm water into a mask so a hypothermic person breathed in warm, humid air.

  Tyler stuck his hand under the warm spray. “This feels almost as good as a hot shower.”

  Sharon had told her Tyler could fabricate parts out of little more than a tin pie plate, a button and two inches of rope, but Emilie wondered how reliable he really was.

  “This is no Hollywood shower,” she told him. “It’s a baptism. Pray the warm air and fluids will be enough to save him.”

  “Baptism.” Tyler chuckled. “That’s a good one.”

  Did he think this was some kind of joke? “I’m glad you like it.”

  Bob snorted.

  She looked at him. The short, wide and grizzled fifty-year-old radiated competence.

  He met her gaze then gave Tyler a hard glare. “You ever see a guy with hypothermia?”

  “Ah, no.”

  “They’re not messy like a car accident victim, with blood everywhere. They’re pale, sometimes a bluish-white. I saw a guy up on Mount Everest a few years back. He’d been climbing alone and had run out of oxygen. I don’t know how long he’d been lying there not two feet from the trail, but when I looked at him he was frozen stiff. I couldn’t move his arms or hands or legs. I thought he was dead, until his eyes tracked my hands. His eyes were the only parts of his body he could move.” Bob continued to prepare the equipment. “Scared the crap out of me.”

  Tyler swallowed hard. “What did you do?”

  “A couple other climbers tried to help me move him.” Bob’s hands stopped moving. “We worked for an hour and barely managed to shift him a couple of feet.”

  The silence after that statement weighed heavy.

  “You left him, didn’t you?” Emilie asked.

  “Yeah.” For a moment Bob’s face reflected the agony of that decision. “We had to. If we’d kept trying we’d have all died. That high up, there’s not enough oxygen in the air to keep you alive for long, and certainly not enough to allow you do more than move yourself. Supplemental oxygen only staves off death. It’s why climbers who attempt the summit can only stay for a short period of time. You’re literally suffocating. Slowly, but suffocating just the same.” He fixed Tyler in place with a hard look. “Got it?”

  “Yeah,” the younger man said quietly. “Got it.”

  She caught Bob’s gaze and offered a sad smile. “It’s never easy, witnessing death. It marks us. Changes us. Forces us to—”

  Tom’s voice on the radio, distorted by wind and static, startled them all. “Emilie, we think Stan headed away from the station.”

  She rushed to pick up the receiver. “Do you think he got lost?”

  “I don’t know, but we found one of his gloves in a restricted area.”

  “A glove? Why would he take that off?”

  “He wouldn’t unless there was something wrong,” Tom said. “Either he needed to do something that required a lot of manual dexterity or he was suffering from cerebral edema. Our effective altitude is twelve thousand five hundred feet. If he was working hard and not getting enough oxygen, his brain might have begun to swell. He wouldn’t be too rational.”

  “If that’s true, you need to find him fast.”

  “Amen to that.”

  “We’ll be ready for him.” Emilie put the radio down, her knuckles white. She sucked in a deep breath then pushed it and her desire to be out there searching out of her chest.

  Trust was tough.

  Time passed slowly as she, Bob and Tyler readied the clinic, moving everything that could be moved out of the way and making sure supplies and equipment were positioned close at hand.

  It seemed like only seconds passed before Tom’s voice boomed out of the radio again. “Emilie, we found him and we’re on our way back to the station.”

  Hope blossomed in her chest. “What’s his condition?”

  “He’s unconscious. No movement.”

  “Is he breathing?”

  “Just a second.”

  Emilie forced herself to remain motionless while she waited.

  “Yes,” Tom replied, and she was able to relax. “His respirations and pulse are slow, but there.” He paused. “His fingers are frozen solid.”

  “Understood.”

  “We’re bringing him inside now. We should have him to you in two minutes.”

  “What do we do first?” Tyler asked Emilie. His smile and loose stance were gone, replaced by stiff lips and a rigid back.

  Good.

  “We get his clothes off and take his temperature to see what we’re dealing with. If he’s not too cold we’ll start him on the warm IV and heated air.”

  “What if he’s really cold?”

  “We put a heated tube down his throat and pump warm water in and out to warm him from the inside out. He’s got a pulse and he’s breathing, so he shouldn’t need that.”

  “How long until he’s better?”

  “It takes as long as it takes,” Bob snapped, telling Emilie that Tyler’s questions were getting on his nerves.

  “Several hours,” she put in. “If he doesn’t die.”

  “Die?” Tyler’s voice tapered off, his eyes growing wide. “He could die?”

  “That’s life at the pole,” Bob told him with a hard look. “Keep focused. Don’t internalize. Think. Decide. Act. There’ll be time for freaking out later.”

  Emilie raised a brow at his tone, but said nothing. It was good advice. “Make sure the crash cart is within reach, Bob. We may need it. It’s not unusual for a hypothermic person to go into cardiac arrest during recovery.”

  The pounding of feet echoed down the hall.

  The doors burst open and a gurney shot through it like a torpedo, powered by Tom and two others so bundled up Emilie couldn’t identify them.

  They brought the gurney to a halt and Emilie reached for Stan’s face mask. She’d been told by the last station doctor during his debrief that skin could freeze so fast in these ultralow temperatures that a person’s clothing could be literally glued to their skin by a layer of ice. Stan’s clothing was stuck tight.

  “Okay, I want his clothes off first. Everyone take an extremity. Cut through his clothes, but don’t rip anything. You might take skin with it.”

  “Yes, ma’am,” Bob said. Tyler gave her a quick nod and went to work, as well.

  “I’m staying here,” Tom told the two who’d helped bring Stan in. “You guys tell everyone to stand down and grab some sack time.” He moved in to assist Tyler, giving Emilie a brief, tense glance.

  She responded with a nod she hoped was reassuring then concentrated on Stan’s face. It was hard to tell where his skin ended and the balaclava began. She rubbed her hand gently over the edge of the cloth wher
e it met with skin then eased her fingers under the mask, teasing it away from his face. After a few seconds the balaclava came free and she pulled it completely off and tossed it on the floor.

  Tom and Tyler worked on Stan’s trunk, cutting through layers of parka, wool coat, waterproof windbreaker, thermal long underwear and cotton shirt, while Bob cut and removed many layers of pants. Soon the unconscious man was naked.

  Tom put his hand on Stan’s chest. “Damn, he feels cold.”

  Emilie stuck a digital thermometer in his right ear. “Eighty-seven point eight degrees.” She examined his hands. They were a waxy white until the last knuckle of each finger. The tips felt like ice cubes. “You’re right, the ends of his fingers are frozen.”

  “Eighty-seven point five,” Tom reported, pulling a second digital thermometer from Stan’s left ear. He grabbed some blankets and covered Stan with them.

  “Is that bad?” Tyler’s tone was so subdued it was almost a whisper.

  “I’ve seen worse,” she said.

  “What are his chances?”

  She put a tourniquet around Stan’s right wrist so she could find a good vein for an IV. “I’d rather not guess.” She rubbed the back of his hand, but it remained cold and stiff. “Damn it, his veins aren’t popping up.”

  “I’ve got the same problem over here,” Tom reported.

  “There are two cut-down trays on the counter behind you.”

  “Cut-down?” Tyler asked, his voice cracking at the end of the question. “You’re going to cut him?”

  “I’ll have to, to find a deep vein to thread the IV needle into.”

  Tyler’s face went pale as Tom handed her a tray.

  His jaw was clenched, his eyes narrow, their color faded, making his anxiety palpable, but his hands moved with deliberate precision. Worried, but under control.

  “I’m not surprised we had to do this, Tyler. As the body cools, blood circulation is reduced in the extremities in an effort to keep the core organs at a normal body temperature.”

  “You mean he could die?” He sounded like she’d punched him in the stomach.

  She glanced at Tom, who met her gaze with a flat mouth and solemn nod. Ready to do battle.

  “It’s possible,” she answered, searching for the likeliest spot in Stan’s arm for a vein. She took in Tyler’s fearful expression. “But Stan’s tough, I think he’ll pull through.”

  Aside from the whirr of the air warmer, there was complete silence in the medical center.

  Emilie made her first cut and found the vein immediately. She inserted the needle and started the warm IV drip.

  Across the gurney, Tom had started his IV drip, as well. He gave her a crooked grin. One battle won. “Ready for some warm packs?”

  “Almost, just let me give him some dexamethasone to counter the brain swelling and check him for any injuries we might have missed.” She unlocked her pharmacy cabinet, found the drug and showed it to Tom.

  He nodded and she injected the medication into Stan’s IV. Emilie pulled the blankets back and ran her hands over Stan, feeling for hidden injuries. “Did you know that the last sense a person retains and the first one to come back after unconsciousness is hearing?” When she finished, she gestured at Tom to grab the warm packs and fresh blankets.

  He raised a brow as he pulled the packs and blankets out of the warmer, handing one of each to Emilie. “I’ve heard that.”

  She glanced at Tyler and nudged him with her elbow as she tucked the blanket around Stan’s hips. “Stan’s going to be just fine, right, Tyler?”

  “Um…right, Doc,” he said, after a second, bobbing his head up and down. “Stan’s going to make a complete recovery.”

  “My faith in the company that signs our paychecks has been restored,” she said with a smile.

  “Why do you say that?” Bob asked. He stood out of the way by the crash cart so they could move around the gurney unobstructed.

  “Because despite the annoyance of some of their procedures, Nexadren hires intelligent people.”

  “I don’t know about that,” Bob said. “Seems to me, Stan and the crew he went out with could’ve used a few more smarts.” He turned to Tom. “Isn’t everyone supposed to go out and work with a buddy?”

  “Yeah.” Tom’s reply was stiff. “I’ll find out why he was alone when I do my investigation.”

  “Is this Stan’s first winter here?” Emilie asked, careful to keep her voice soft.

  “No, his third.”

  “So this could happen to any of us?”

  “Unfortunately it looks that way.”

  “Maybe we should have a meeting with the entire crew to review the dangers, symptoms and treatment for altitude sickness? It seems to me that this is a good opportunity to promote general safety at the station.”

  One side of Tom’s mouth tilted upward. “Are you handling me, Em?”

  She met his gaze. “What do you think?”

  “I think you’re a damn good doctor.”

  “Uh-huh, now who’s handling whom?”

  He didn’t answer, but shrugged, still smiling.

  She hadn’t fooled him for a moment.

  Stan’s body temperature rose slowly but steadily over the next hour. She and Tom rotated fresh hot packs and blankets frequently, and they gave him a couple of liters of warmed fluids.

  After another hour she decided the danger of Stan going into cardiac arrest had passed and Bob and Tyler were no longer needed. She sent them to get some sleep.

  She looked at Tom and opened her mouth, but before she could say a word he was already talking. “Forget it. I’m not going anywhere.”

  Emilie tried to hide a smile. “I was going to offer you a chair.”

  “Oh, sorry.” He ran a hand through his short hair. “Sure, a chair might be a good idea. Don’t know how long it might be ’til he wakes up.”

  “It may be a while.” She rolled her desk chair over to him, and he dragged it to Stan’s side and sat.

  She grabbed the only other chair in the room and brought it over to the other side of the gurney.

  “Should we move him to a bed?” Tom asked, his gaze on Stan’s face.

  “Until he comes around, I’d rather he was right here where I…we…can keep an eye on him.”

  Tom nodded.

  “How long have you known him?”

  He sucked in a deep breath. “About ten years. We met on a job in Taiwan. After my first winter-over on the Ice, he decided to give it a try and liked it too.” A chuckle escaped him and he smiled, but the moment didn’t last.

  She watched Tom’s face slide into frigid sadness.

  “Stan reminds me of my favorite uncle,” she said. “The guy is a truck driver and the life of the party. But if you want something done, you call him and he’ll get it done.”

  “Yeah, that’s Stan.” Tom’s lips pressed together. “But, will he still be Stan when he wakes up?” He turned his head to look at Emilie. “Did we get to him in time?”

  “He was suffering from brain swelling, but hypothermia isn’t all bad when it comes to that. The cold can actually help slow down the effects of cerebral edema.” She stood, pulled her penlight and checked Stan’s pupil reactions to the light. “Normal.”

  Judging from the tension in his jaw, her words didn’t make Tom feel any better. “We’ve done all we can,” she said. “It’s up to Stan now.”

  Tom grunted. “The big moron knew better than to go anywhere alone.”

  “Did he get separated from the group he was with?”

  “They stayed within eyesight of each other for the first twenty minutes. It was another ten minutes before anyone realized Stan wasn’t with them anymore.”

  “The conditions outside, were they changing?”

  “Yeah, winds were picking up, barometric pressure was going down, not much, but…” His voice trailed off. “Air pressure was going down.”

  “Coupled with the lack of sleep, stress…that could’ve triggered a physical response.�
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  Tom cradled his head in his hands and swore.

  “It’s not your fault,” she told him.

  He shook his head.

  “No. Stop. Don’t even try to go there,” she said with a growl. “I’ve been living with guilt for more than a year and I can tell you with complete certainty that you could not have foreseen this.”

  He skewered Emilie with eyes that radiated anger. “It’s my job to foresee problems and hazards. The way things have been going this week, I should be fired.” He stood and strode away, but stopped before the doors, his hands fisted at his sides.

  She went to him and put a hand on his shoulder. “I’d hire you back in a second.”

  He turned to face her. “Why?”

  “Because you’re honest and you care. If the problems this week happened because of neglect or stupidity, I’d say, yeah, you’re fired. But they didn’t. Life here is hard.” She attempted to wrap her hands around his biceps, but they were too thick. She hung on to him anyway, and tried hard not to notice his warm strength. “Someone very wise explained it to me this way. Gravity works here, but that’s about it.”

  “Funny.”

  “Come on.” She tugged him toward Stan.

  Tom sat again and stared at his boots. “I hate this.”

  “What?”

  “Waiting.”

  She put her hands on her hips. “You’re a fixer, aren’t you?”

  “A fixer? For what, your car? The plumbing?”

  “No. People.”

  “I wish. I can’t even fix myself.”

  “Can anyone?”

  He looked at her. “I suppose not.”

  “I rely on my family and friends to keep me honest.”

  “Friends, yeah, but family…” He shook his head. “Not mine.”

  “You’ve got lots of brothers and sisters, surely there’s one you—”

  “No.”

  He had no one? “Your parents?”

  What came out of his mouth was a grim parody of a laugh. “My mother never made a move without my father’s permission, and my father never gave it. To any of us.”

  She swallowed a mouthful of regret. No one should have to grow up like that. “I’m sorry.”