Washed Away

by Carol Marinelli

  “Which I don’t have,” Noah said again, frustration evident in his voice.

  “I’m O negative,” Cheryl responded. “My blood can be given to all groups.” She carried on as Noah shook his head. “It’s no big deal. I’m a regular donor—”

  “No,” Noah broke in. “No way, Cheryl. You’re still weak from yesterday, and anyway, I need you here, helping me.”

  Finally he admitted that he needed her, but even though it was what she wanted to hear, his argument did nothing to sway Cheryl. “One liter of blood won’t debilitate me, Noah. You know that as well as I do, and it will improve Beth’s chances tenfold.”

  “No, we’ll just have to get her pressure up with the saline.”

  “So she can die with diluted blood and a decent blood pressure.” Cheryl’s sarcasm was unmistakable. “For God’s sake, Noah, she’s got cerebral and myocardial hypoxia with tachycardia. She’s prearrest—a transfusion will buy us time.”

  He didn’t answer, just glanced up at the clock. “It’s been ten minutes since I reinforced it, and given we don’t know when she first applied a tourniquet, it needs to be loosened now. I can have a quick look at the same time. Pull the lights down, Cheryl. There are swabs over there.”

  She didn’t need to be asked twice. Grabbing a stainless steel trolley, she rummaged for sterile packs and swabs as Noah opened a surgical pack and pulled on a gown. He washed his hand as Cheryl set up.

  “A quick look,” Noah reiterated, dragging a stool over with his feet and lowering his large frame onto it. “I just want to see what we’re working with. You be ready with swabs. Check her radial pulse once the tourniquet’s off. There are some protective eye shields in the drawer over there.”

  Grabbing two pairs, she put hers on. Careful not to touch his gown, she slipped the second pair over his face, seeing the lines of tension around his eyes.

  “Let’s have a look, then.”

  “I need to change my gloves first.”

  He waited patiently while she did so, both taking a steadying breath as Noah released the green cotton drapes he had used to reinforce the crude tourniquet poor Beth had made from a tea towel. “Shit.” He cursed as he drew back from the injured arm, blood spurting high in the air, confirming what they already knew—the bleed was arterial.

  “She’s severed her brachial artery.” Noah studied the wound as Cheryl skillfully used the gauze. The seconds between her removing the pressure and the wound refilling were the only chance Noah had to get a decent view, and he used it wisely, calling out his findings as Cheryl looked on. “Has she got a pulse with the tourniquet off?”

  “No.” Cheryl eyed the pale, lifeless fingers, her body absolutely still as she strained to catch a pulse.

  “Okay, I’ll try to clip off the severed artery and then we’ll work out what we’re going to do.” He took the artery forceps Cheryl handed to him, and they both winced as Beth let out a guttural moan when Noah managed to clip the severed artery.

  “She’s coming to a bit—this must be agony.” Cheryl moved to the head of the bed as Noah applied a sterile wad of soaked gauze to the exposed wound. “It’s okay, Beth. We’ll get you something for pain very soon.”

  Beth’s eyes flicked briefly open, her face contorted in agony. Her lips moved as if she wanted to speak, then she dipped back into unconsciousness.

  “I’ll wrap up the arm if you can get her some morphine. It’s over there.” Noah pointed to the drug cupboard. “The combination’s eight, four, six, two.”

  Cheryl nodded, but paused halfway there. “Don’t wrap it, Noah. The arm should be cooled for better limb viability. That’s what we usually do.”

  He gave a grateful nod. “There’s an ice machine in the clinic. If you can grab some and deal with her arm, I’ll get the morphine. At least we’ve stopped the bleeding.”

  She set to work as Noah delivered the analgesia, wrapping the arm first before she stacked ice bags around it. Not for the first time she marveled at the equipment Noah had available. His clinic was almost as well equipped as some of the trauma rooms she’d worked in.

  Except for the lack of blood—

  “We’ve got a six-hour window to repair her arm before she loses use of it.” Noah’s voice broke into her thoughts. “That’s six hours from when she injured it, so let’s assume the accident happened an hour ago.”

  Cheryl nodded at his estimate and checked Beth’s blood pressure again.

  “So we’ve got five hours. But even if the phone lines come back on in the next few minutes, from what I’ve heard on the radio, the rescue teams have already got their work cut out. There isn’t going to be a helicopter standing by, just waiting for me to call them. Add on flying time…”

  “Flynn brought a cell phone.” Hope flared in his eyes, but the grim shake of her head doused it immediately. “There’s no signal, but he’s got the phone, Noah. The second he gets a signal, he’s going to let us know.”

  “He’s seven years old. He shouldn’t have to be going through this again.”

  Again.

  Cheryl acknowledged the pain behind the word, but this was no time to dwell on the past.

  “Push the fluid through,” Noah said. “I’ll go and grab the radio, then check the boys and see if I can find out anything.”

  He didn’t await her response, just headed out the door as Cheryl checked her patient. Although Beth desperately needed blood, the elevated legs, IV fluids and oxygen were temporarily having an effect, rallying her slightly. Her pulse was stronger, and her eyelashes flickered as Cheryl gently called her name, urging her back to a world that to Beth must seem so cruel.

  “Flynn…Paul?”

  “They’re okay,” Cheryl quickly reassured her. “They’re in the lounge. Noah’s gone to get the radio so we can see how the roads are doing.”

  “I didn’t know what to do….”

  Her head was lolling around on the hard table and Cheryl scanned the room. Pillows were clearly not needed for pets. She settled for a foam wedge and, covering it with a drape, she placed it under the woman’s head.

  “You did everything right,” Cheryl soothed. “You did an amazing job to get here.”

  “I knew I had to.” Beth’s eyes closed with the horror of it all, her words coming out in short phrases as her weakened body struggled to draw breath. “A branch came through the window. I was trying to put up some plastic sheeting. I couldn’t just leave it.”

  “It’s okay, Beth.”

  “The rain was coming in, the noise was awful. I just slipped.”

  “Don’t think about it now.”

  “I can’t not think about it. There was so much blood, Flynn was screaming—we both were. But you know what that little guy did?” A look of wonder spread over her face, and her voice was a shallow whisper as she tried to speak. “He ran and grabbed a tea towel, told me I should keep the arm up. He’d been along to the fire lectures with Hal. Seven years old and he was telling me what to do!”

  “That’s quite a guy you’re raising.” Cheryl smiled. “He takes after his mom.” She watched as Beth frowned. “You drove here, Beth.” Cheryl’s voice wavered with emotion. “I don’t know how, but somehow you had the presence of mind to get in the car and drive.”

  “We nearly didn’t make it.”

  “You did make it, though,” Cheryl said more firmly now. “You got your babies and yourself to safety. You did an amazing job.”

  “If Hal goes home, sees the blood…” She was starting to cry now, and Cheryl hushed her.

  “Stop worrying about Hal,” Cheryl said firmly. “Right now we need to concentrate on you for a while. I need to ask some important questions. Do you know your blood type?”

  Beth nodded, but her eyes were closing now as she drifted back into unconsciousness. Cheryl was having none of it. Pulling Beth’s earlobe, she called her name to rouse her.

  “What’s your blood group, Beth?”

  “O positive.”

  “Are you allergic to anything
?”

  Again she shook her head, but Cheryl wanted firm answers. “Beth, are you allergic to any medications. Are there any antibiotics you can’t take?”

  “No.” Beth’s eyes closed again, and this time Cheryl rubbed Beth’s sternum, forcing her back to consciousness.

  “Any medical problems, Beth—diabetes, epilepsy, anything we need to know?”

  “No,” Beth moaned. “I just want to sleep.”

  “What did she say?” Noah was back now, but waited until Cheryl finished attempting to get a blood pressure reading.

  “That she was trying to push a branch back through a window and slipped.”

  “I wonder if she has any allergies.”

  Cheryl shook her head.

  “You asked?” Noah instantly regretted the question when she flashed him a dark look.

  “Of course I asked. She’s O positive and she said she’s had no serious illnesses in the past.”

  He took a deep breath, stared at the clock as if wishing it would stop ticking for just a while. “I’m going to have to attempt a repair.”

  “There’s no point.” Cheryl’s matter-of-fact voice forced his attention. “Not if she doesn’t get blood first. You know that as well as I do, Noah. Her blood pressure’s sixty over zip, she’s tachycardic. She simply won’t make it through an operation without blood.”

  A muscle was pounding in his cheek.

  “Like I said, I gave blood a couple of months ago,” Cheryl insisted. “Nothing’s changed since then. I haven’t taken any drugs or had a tattoo, and I haven’t slept with anyone since then except…” She swallowed. “Except you, Noah.”

  “I had an insurance medical last month.” Noah gave a tight shrug. “I had all the bloodwork done, and apart from you…”

  “Then there’s no reason we can’t transfuse Beth with my blood,” Cheryl said deliberately. Sensing his hesitation, she took a deep breath and played her final card. “I know about Cody, Noah. I spoke to Beth about it, and she told me that everything possible had been done for him. That gave her some comfort. Surely that comforts you, too.”

  He gave a slow nod as Cheryl continued.

  “Everything possible,” she said again. “I’m O negative, Noah, and Beth needs blood if she’s to stand a chance—we have to do this. Have you got the equipment?”

  He took time to answer, first staring back at her before nodding resignedly. “I take blood from animals a couple of weeks prior to planned operations if I think they might need a transfusion.” He gestured to a large silver chest of drawers. “You’re sure about this, Cheryl?”

  “More than sure.” She nodded, heading for a chair and sitting down as Noah collected the equipment.

  “We should go through to the bedroom, you can lie down….”

  “That’s not very fair to Flynn,” Cheryl pointed out. “Bring me a stool so I can put my feet up, and after it’s over, I’ll go and have a drink and sit with Flynn while you set up for surgery.”

  It was a simple procedure, no drumroll or fanfare needed or wanted as Noah slipped the needle into her arm. As the bag filled, Noah tended to Beth and set up for the impending operation.

  “It’s full,” Cheryl called. “You can take one more without causing any problems.”

  “You nearly drowned yesterday,” Noah pointed out, but he knew arguing with her was useless. The fragile woman of yesterday had disappeared, replaced instead with an assertive, confident woman. But strangest of all, Noah mused as he switched the bag for an empty one, checking she was okay for the umpteenth time, then connecting the vital fluid to Beth…Strangest of all was that, as chameleon-like and complicated as the two Cheryls he had witnessed were, he loved them both.

  “DRINK ALL OF IT.” Noah’s voice was the firm one now as he placed a massive jug of orange juice on the bed table beside her.

  Despite her insistence that she’d be fine, the second Cheryl had attempted to stand, tiny white dots had danced before her eyes and Noah had had to carry her through to the bedroom.

  “I’m going to make up a bottle for Paul and then we’re going to feed him, and while I do that, I want you to watch Cheryl.” Noah winked at Flynn. “Make sure she drinks every last drop of that juice and eats these biscuits, and don’t take any arguments from her.”

  “Can I go to the bathroom first?”

  “Sure you can, buddy.” Mindful of the boy’s sore arm, Noah helped him off the bed and led him to the washroom. Once he was safely in, Noah came over to Cheryl, talking in a low tone so that Flynn couldn’t hear.

  “All I want to do is repair the artery.” His mouth was set in a hard line, but his voice was firm now that his decision had been made. “No heroics, no fancy work, just repair the artery to restore blood flow. The vascular surgeons can do the rest. I’ve done this type of thing before, lots of times, just not on a human.”

  Cheryl knew he was trying to rationalize things, to talk himself through the barriers he faced. Cheryl knew something else, as well.

  She loved him.

  “I think we should feed the baby and get him settled before we start,” he said. “The last thing we need is to be disturbed, and Flynn will get upset if he’s crying. Anyway, you need to have rest and get some fluid inside you.”

  “Noah…” She tried to meet his eyes, but Noah stared somewhere fixedly over her shoulder. She moved her hand to touch him, then pulled away, knowing words were all she could offer at this point.

  “Like you said, you’ve done similar types of repairs before,” Cheryl reminded him. “You’ve got a well-equipped surgical room, and I might not be Carly, but you’re about to find out I’m one helluva nurse.”

  Something must have reached him—the unwavering support in her voice, the confidence in her own ability—and finally he managed to look at her.

  “I could just leave it. I’ve tied off the artery.” That muscle in his cheek was pounding again.

  “I could have tied off the artery, Noah,” Cheryl said. “But unless the phone lines come on now, unless we get her to a hospital quickly, then she’ll lose her arm.” She paused for effect. “You can do this, Noah. You don’t have a choice.”

  “You do, though.” Finally his eyes found hers, but the earlier tenderness was noticeably absent—no loving look, no warmth in the blue pools. “I understand completely if you want to step aside, Cheryl.”

  “I’m beside you.” She didn’t blink, didn’t hesitate, just stared right back at him. “Whatever the consequences, we’ll face them together.”

  CHAPTER TEN

  “HOW’S HE DOING?”

  There was an expression in Noah’s eyes she couldn’t read as he stood in the doorway, watching as she attempted to feed a fretful baby.

  “Not so good,” Cheryl admitted. “He won’t take the bottle.”

  “Let me try.”

  He took the restless baby from her, and Cheryl watched in admiration as somehow he managed to get the infant to suck on the nipple. She’d been trying for ages, the whole time Noah had been setting up the O.R., Cheryl had been wrestling with a baby who wanted nothing more than his mother.

  “How did you do that?” she asked, watching as Paul hungrily gulped the formula Noah had prepared.

  “Years of practice.” Noah shrugged. “Mind you, this is the first human baby I’ve ever fed.”

  “Flynn’s sound asleep.” Cheryl gestured to the little guy curled up on the bed beside her. “He made sure I drank all my juice before he dozed off. How’s Beth?”

  “Better. The blood did the trick. Her pressure’s up and she’s more rousable now. I’ve set up the O.R. and changed into clean blues, so I’m going to give her the local anesthetic. If you’re ready, we should probably get started. Do you think we should bring Paul in so we can keep an eye on him?” Noah asked, waiting as he gently laid the infant in a makeshift crib he had fashioned from a drawer and some towels. He offered his hand as she stood.

  “He’s a healthy baby, Noah,” Cheryl pointed out. “If we keep the door
open we’ll hear him if he wakes. We’ll hear Flynn, too.”

  Still she sensed his hesitation.

  “Noah, this isn’t ideal, none of this is ideal, but Beth’s surgery is intricate. You need all your attention to be on her. Paul’s been fed and changed, he’s asleep. I can duck out and check on him, but you have to focus on repairing Beth’s arm, not look out for a sleeping baby. He’s warm and safe and he’s got his brother watching over him.”

  She eyed his worried face in concern and ached to put her arms around him, comfort him, somehow convince him of the confidence she had in him. But Cheryl knew it wasn’t her place now, and after one final check on the sleeping brothers, she followed him quietly into the operating room.

  He’d been busy.

  A massive cart was covered in sterile drapes. On another, packs and suture material lay waiting to be opened once the two of them were gloved and gowned. Local anesthetic and the sedative were already neatly drawn up on the crash cart, and Cheryl checked her patient, noting with quiet satisfaction that even though her pulse was still rapid, her blood pressure was no longer dangerously low. If Cheryl had had any doubts as to the necessity of this procedure, they were eliminated when she looked at Beth’s dark blue fingers peeking out from the drapes.

  They had no choice.

  No choice at all.

  As Beth’s eyes opened, Cheryl smiled down at her. “How are you doing there, Beth?”

  “Scared.”

  “I know,” Cheryl said gently.

  “I think I remember Noah saying something about an operation.”

  Cheryl felt him come behind her, could feel the warmth of his body as he stood over her shoulder, his masculine scent mingling with the antiseptic, his voice tender but firm. She was acutely aware of his hand at the small of her back, moving her gently aside as he spoke to Beth.

  “I did say that, Beth,” Noah said clearly. “And now you’re awake, I want to go over everything with you, if that’s okay.”

  He dragged the stool over again, and Cheryl decided if he ever wanted a career change, becoming a medical doctor should be at the top of his list. Cheryl felt a lump in her throat, watching as he explained the procedure to Beth, calming her, yet somehow managing to impart the gravity of the situation.