Jarvis stopped and stared at her, not wanting to comprehend what she was saying. Another serious patient? “Why didn’t they fly him?” he snapped.
She stared at him helplessly. “I guess they didn’t think he was hurt badly enough. Should I page Claudia?”
He shook his head in annoyance. “If you’re not qualified to take care of this, you shouldn’t be here in the first place.”
They both looked up when the entrance doors slid open and the attendants came through with a gurney.
“Hello, Dr. George,” Connie said as she led the way toward him. “This one flew his Porsche off the side of an embankment, no seat belt. He was thrown clear and landed on the ground. He has a large contusion to the forehead with an overlying stellate laceration. We have him on 100 percent nonrebreather and have run two large bore IVs. While we were at it, we drew lab for a trauma work-up. He has limited response to pain.”
Jarvis bent to look at the pressure dressing on the patient’s forehead, then stopped suddenly. He recognized those polo shorts. He took a closer look at the patient and nearly lost his balance. His whole body went numb.
It was Dwayne.
“Dr. George?” Connie stepped toward him.
He straightened, still staring at the young man. Had to stiffen up. Had to do this right. Dwayne was…his life might…This was horrible!
He reached into his pocket for his penlight, then pulled the young man’s lids back one at a time to check for signs of a blown pupil. None. That was good, although the morphine Dwayne had on board from his injection could have something to do with that, couldn’t it?
For a moment Jarvis couldn’t think, couldn’t concentrate.
No, the eyes were good. Time to check the rest of him out.
The attendants had adequately placed him in full c-spine immobilization on the long spine board. At least they knew what they were doing. He wouldn’t worry about the neck right now. Maybe he could get Dwayne shipped out before he had to think about that.
“Carol?” Jarvis called over his shoulder as he directed the attendants to take Dwayne to the trauma room. “Get ahold of the surgeon on call. We need a consult as soon as possible.”
He pulled out his stethoscope and listened to Dwayne’s chest for breath sounds. His eyes teared up as he stared at the boy’s bruised and cut face. Breathing sounded good.
“Dr. George,” came Carol’s voice from the doorway, “the surgeon can’t be here for thirty or forty minutes. He’s at his office in Willow Springs.”
“What!” Jarvis straightened and was immediately sorry. The room spun around him. He grabbed the cot and steadied himself. “Of all the irresponsible—” He broke off, glaring at Connie. “You should’ve airlifted him.” He turned to Carol. “Call a chopper. We’ve got to get him out of here.”
He bent back down over Dwayne’s body, noting the Harris traction splint on his right leg and abrasions on the left knee. He stared at the splint, confused. Normally it was the driver who suffered a tib-fib fracture from standing on the brake during impact. But Dwayne’s friend had picked him up.
Jarvis turned to Connie. “What happened to the driver?”
The paramedic stared at him blankly for a few seconds, then shook her head. “Dr. George, he was driving. He was the only one in the wreck.”
For a moment her words did not register. When they did he first felt a deep sense of disappointment that Dwayne had not listened to him. Then more fear hit him. He’d been the one to prescribe the morphine after Claudia had warned him not to.
What was he supposed to do next? He couldn’t think. What had he already done? Should he have Tish page Claudia to come back to the E.R.?
The only other thing he could think to do was check for a pulse distal to the fracture site. With hands that had begun to shake, he held his fingers to the top of Dwayne’s right foot. There was a pulse. At least he thought he could feel a pulse, but could he be sure? Maybe he was imagining something that wasn’t there. Maybe he was hoping for it.
He would have to trust his instincts.
“Okay, Tish,” he called. “Let’s get a head CT on this patient before the chopper arrives.”
Was he forgetting something?
He’d been treating patients for over thirty years, and he’d seen his share of traumas in this E.R. Surely he could trust himself by now. A CT was the way to go. It would save a lot of time when Dwayne reached Springfield for neurosurgery.
Ozark green had deepened with the maturing of spring into summer, and the vibrant colors of purple, yellow, pink and blue wildflowers dotted the shore of Piney River in a scene that could have been a Thomas Kinkade painting. Regrettably, the incredible beauty sure hadn’t improved Lukas’s fishing any. Nor his coordination. He’d already managed to tangle his fishing hook—complete with worm—in Lauren’s ponytail. And they’d only arrived an hour ago. He’d also stepped into a muddy river sinkhole up to his right knee and had apparently frightened off all but one striper, which Lauren had caught and put on her stringer.
True to her word, Lauren did not put any moves on him, and she had obviously not dressed to tempt him. She had no makeup, her hair had not been washed, and she wore baggy overalls with an old blue chambray shirt underneath. She laughed at him a lot, chattered as incessantly as he had feared and managed with all those words not once to bring up the subject of Knolls Community Hospital.
Okay, Lord, he prayed in his head during one of her rare silent moments, You were right, as always. I needed a friend. She was definitely turning out to be a good, Christian friend—still a little deeper than he intended to take it, but the companionship was nice. He didn’t feel quite so lonely.
Thursday afternoon Tedi walked all the way home from summer school by way of alleys. She never saw Dad’s car, but she didn’t want to take any chances. It was kind of fun finding her way through new territory, trying to recognize where she was from the backside of the houses she knew so well. Everything looked so different this way. It almost felt as if she were in a new place, a new town. It would be easy to imagine she was headed toward a new home.
When she came out to Tenth Street, she paused and glanced down toward the circle drive where Grandma lived. Wouldn’t it be great…? But she couldn’t. Dad would come looking for her there, and he would blame Grandma and Mom.
Time to go home and be good and shut up and let Dad do the talking. Maybe he would get tired of the silent treatment he’d gotten the past few days and ship her to Mom’s.
When Tedi arrived home she felt a great surge of relief to see that Dad’s car wasn’t parked in the drive. The past few days, he hadn’t driven out to find her when she’d walked home. Maybe he’d finally given up on his efforts to be pals. That would be good; it wouldn’t be so hard for her to keep her mouth shut.
She pulled the house key out of her pocket and stuck it into the front door lock. It wasn’t necessary. The door was already unlocked. Tedi shrugged and went on in. Dad was probably so out of it this morning that he hadn’t remembered to lock the door. He always nagged her about security, but then he didn’t listen to his own warnings.
She swung the book pack off her shoulders and turned the corner to go upstairs, but the sound of a footfall reached her from the shadows at the side of the staircase. With all of the drapes closed, little light ever seeped into the hallway even when it was bright daylight outside. Tedi stared hard into the dimness.
The darkness moved toward her, just like the monster in her nightmare. She stepped backward. He came faster, with a heavier step. Tedi jumped back and screamed, shoving the book bag toward the shadow. He knocked it aside and kept coming. She pivoted toward the door and tried to open it.
A big hand grasped her arm and jerked her back around. She caught her breath to scream again, but she stopped. It was Dad.
“Why are you running from me?”
His voice sounded slurred, and his hand continued to grip her arm too tightly.
“I d-didn’t know it was you, Dad. It was da
rk.”
He squeezed her arm tighter. “Come with me.”
“Why? What’s wrong? What are you—”
“Shut up.”
He jerked her forward and dragged her through the house toward the office in the back. She could smell the booze more strongly than ever, and she suddenly wished it had been a stranger who had broken in.
He shoved her through the office door and forced her into a chair.
“Dad, what’s—”
“I think we need to spend some quality time together, don’t you?”
She was too scared to answer.
He sat down in front of the desk and picked up a small oblong recorder from the floor. He punched a button, set the recorder on the desk and waited, watching Tedi. “I think we’ve had some trouble with communication lately, just like your teacher says. I want to take care of that problem right now.”
The fumes from his breath washed across her in a wave.
She recognized her own voice—she’d heard recordings of it at school when Mrs. Watkins let them listen.
“I hate him! I wish he were dead!”
Tedi gripped tightly to the arms of the chair on which she sat. She forgot to breathe as she listened to a playback of her phone conversation with Mom from the other night.
She listened to her own sobs, to Mom’s reassuring voice, and now she concentrated on that voice.
What was Dad going to do? He’d already been listening to this, she could tell by a quick glance at his face. What would he do this time?
Mom’s recorded voice returned. “Where is your father?”
“He’s not a father. He’s a horrible…”
The next few phrases washed over Tedi, but she couldn’t hear them—her heart was beating too hard and fear gripped her too tightly. She couldn’t look up at Dad. She heard her recorded voice telling Mom again that she hated Dad. She heard Mom telling her to go to bed. And then she heard Mom telling her to pray.
She started praying now, silently and quickly. God, help me! Please, help me! Please save me!
Dad took a deep, long breath and rested his elbows on the desk for a moment. He buried his face in his hands, rubbed his eyes, exhaled. He shook his head and turned to Tedi on the swivel chair.
“You just can’t leave it alone, can you?” he snapped, his eyes blazing blue fire.
She didn’t answer. She didn’t know what he was talking about.
“You’ve got to keep running to your mommy with everything, as if she’s the only one who can make things better. You didn’t ever consider the fact that she’s the one who started all the problems in the first place.”
Tedi stared at Dad. With the fear, a little anger now mingled.
“It’s her fault we’re divorced.”
That wasn’t true, but Tedi stayed quiet. She hoped her growing temper didn’t show in her face.
“You’ve let her twist your mind against me until I’m some kind of monster in your eyes.” He paused and his eyes narrowed. “Apparently, a stupid monster! I don’t even have the brains to help you with your homework. But you didn’t tell your mother that you wouldn’t even let me try!” His voice grew louder, filled with more anger. He wheeled closer to her, bending forward until his breath burned her eyes. “You didn’t tell her that, did you? Why not?”
She couldn’t keep sitting there. She felt as if she were being swallowed by the anger in his eyes. Slowly she stood, but he stood, too, blocking the door.
She tried to speak, but her voice caught. She swallowed and tried again. “I didn’t want you to help me,” she answered honestly. She couldn’t think of any quick lies, and he wanted an answer.
“Why not? Aren’t I good enough? Are your mom and your grandma the only ones who know enough to help you?”
She swallowed again and started to nod, but stopped at the flare of fury that crossed his face. He took a step toward her. She couldn’t step back. She knew she couldn’t get away, but she had to try. She jumped to the side and tried to duck past him, but he grabbed her.
She screamed and tried to wrench from his grasp. She couldn’t. His hand came up.
“Daddy, stop!”
He smacked her sideways, snapping her head back. She felt herself falling, felt her head hit something hard. Everything disappeared….
Chapter Thirty-Two
“Code orange, CT. Code orange, CT.” The announcement came through the overhead speakers, blasting Jarvis where he sat at the desk with his head in his hands. He looked up with a frown as Tish dropped what she was doing and rushed out the door toward radiology. Why were they calling a code?
Radiology. Dwayne. He was crashing.
Jarvis forced himself to his feet, stumbled against the chair, righted himself and rushed after the nurse. This could not be happening. The chopper would be here any time. Dwayne couldn’t die. He’d been stable when they wheeled him out.
Nurses, techs and aides rushed toward the CT room from every direction, but they gave Jarvis right of way. He was the E.R. physician. He was the one in control.
He reached radiology to find others converging on the room that held the patient. Though the red warning light was still on above the door, no one paid attention as they rushed past the CT computer and circled the gantry on which Dwayne lay. Claudia already stood beside him, releasing the clamps from the IV tubing and calling for help to lift him off the gantry and onto the wheeled cot. He was still strapped onto the backboard with the c-collar around his neck. He looked so young and helpless.
Jarvis groaned. This was a horrible place to try to do a code, and as more people rushed into the already-crowded room, shouting questions and getting in each other’s way, the level of confusion grew.
“Let’s get him back to E.R.,” Jarvis said.
“You heard the doctor,” Claudia said. “Rachel, put him on an ambu bag.” She helped them transfer Dwayne, then led the way out of the room and down the hallway. She glanced at the automatic pressure cuff on the patient’s arm. “Doctor, the BP is 45. He’s in shock. He needs blood. How much do you want?”
“Four units.” Jarvis gestured toward the lab tech. “Do you have him typed yet?”
“No, Doctor. We’ll have it soon.”
“No time,” Claudia snapped. “Doctor, what type do you want?”
“O negative.” He had to concentrate, couldn’t stumble now.
They wheeled Dwayne into the trauma room.
“How fast do you want it?” Tish asked.
Jarvis turned and glared at the young woman. “He’s bleeding to death, Nurse. Put it in a pressure bag and get it in him as fast as you can.”
“O2 sat is only 76 percent,” Claudia warned.
Jarvis couldn’t show any weakness in front of this crew. “We’ll have to intubate. Get me a 7 tube and a curved blade.” He’d done this before lots of times, but not working around a c-collar and not when he was in so much pain he could barely concentrate.
While Tish hung the blood, Claudia handed Jarvis a curved plastic tube with a 12-CC Luer Lok syringe attached. “I’ve already checked the bulb and lubricated the tube, Doctor. Everything’s ready.” She snapped open a laryngoscope and instructed a tech to raise the bed.
Taking the scope, Jarvis leaned over Dwayne’s mouth and gently pried between the teeth. He slid the laryngoscope blade down the right side of the tongue and used it to push the tongue up and to the left to get it out of the way. With light from the scope, he tried to get a view of the vocal cords. Nothing. He couldn’t even find the epiglottis. He pulled up as much as he dared, but still got nothing. His hands shook and his head pounded with pain so sharp it blurred his vision. He couldn’t do this.
He had to do it.
He must have overshot. He pulled back up. There! He saw the epiglottis, but still no cords. They should be right beneath. He raised the blade a little more, prying forward.
A tooth snapped.
He muffled a curse. He couldn’t get it. But he had to keep trying.
“Docto
r, O2 sat is 72 percent,” Claudia said.
He pulled back the scope. “Bag him.”
Tedi lay on the living-room sofa where Theo had carried her from the office. Her face glistened with moisture from the wet cloth Theo was using to try to wake her. He bent down and listened for a heartbeat again. It was still there. He couldn’t tell if it was slow or fast. He could barely hear it over the roar in his head. He could hardly think over the voice that kept telling him he’d killed his little girl. He’d hit her. Hard. There was probably a place at the back of her head where she’d smacked against the edge of the bookcase.
But she wasn’t dead. Not yet.
“Tedi!” he shouted, grabbing her hands and squeezing them tightly in his own. “Tedi, please wake up. I’m sorry. I’m so sorry.” His eyes and nose dripped from tears. He couldn’t believe he’d hit her.
She didn’t move. He leaned forward and felt the faint whisper of her warm breath on his face. He should be the one lying there unconscious and broken. What had he done?
He glanced toward the phone. He should call an ambulance. He had to get help for her fast. But he could get her there faster himself.
He ran into the kitchen and grabbed the keys to his car, shoved them into his pocket and ran back into the living room.
Gently he lifted her into his arms and carried her out to the garage. “Tedi, please don’t die on me, baby. Please don’t die.”
Sweat from Jarvis’s hands made the laryngoscope hard to grip. He wiped first one hand, then the other on his shirt. It wouldn’t work. He couldn’t get it.
“Dr. George, the O2 sat is 69 percent,” a respiratory tech announced.
He gave up and straightened. “Bag him again. Claudia, get that c-collar off the patient.”
Her eyes widened in surprise. “That could paralyze him.”
“Don’t you think I know that?” Jarvis snapped. “The collar is blocking the intubation. He’ll die if we don’t—”
“Dr. George,” Carol announced from the door. “The flight crew is here for the patient.”
The two newcomers, a female paramedic and a male nurse, were not shy. They stepped into the room and walked to opposite sides of the bed.
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