CONSULTANT IN CRISIS

by Alison Roberts

  The scream that cut through the closer sounds made Kelly flinch. They all stopped walking.

  ‘What the hell was that?’ Fletch’s face was in shadow behind the beam of his headlamp but Kelly could see the lines of focused concern. A prickle of perspiration broke out down the length of her spine. The sound had been inhuman in its intensity but its echoes carried the undercurrent of suffering.

  The sound came again. Drawn out this time. Long enough for analysis of its origin. Mechanical, thank God, not human.

  ‘It must be the lift shaft,’ Owen decided.

  ‘They were going to try and raise it from the roof,’ Dave nodded. ‘It was stuck between floors.’

  They should be nearing the end of the first wing of the shopping centre soon. Kelly knew it joined a central atrium that led to department stores and the supermarket.

  ‘Don’t forget there’s another level below us,’ Dave warned his team. ‘Be aware of how stable the surface you’re walking on is and watch out for altered elevation.’

  Kelly nodded. She remembered the example of the Oklahoma bombing incident that Tony had used during a lecture on hazards. A firefighter had fallen four floors from basement level 2 to basement level 6 after stepping through a doorway. Then there was the only death amongst rescuers from that disaster, where a nurse was killed after being hit by a computer falling from above. ‘Look Up and Live’ was the catch phrase drilled in by their instructor.

  They had a level above them now. Kelly looked up and stopped walking again. Jagged beams poked into a darkening sky ahead of them. What should have been the ceiling over the atrium had been partially obliterated. The end of the mall had not been apparent because there was no space for it to join. It was a pile of rubble reminiscent of the hardfill tip but far more daunting and dangerous.

  This was real.

  There were no tape recorders hidden amongst this wreckage. No co-operative class members safely tucked into a well-shored void, waiting to be discovered. There were real people trapped in here.

  And some of them could still be alive.

  Kelly took a deep breath through the filter of her dust mask. Her own fear was forgotten. They had a job to do and it could mean the difference between life and death for someone. Maybe for many people. She looked around at her team members to find Fletch was watching her. He smiled gently as though he had read her thoughts and knew she was ready. Then he nodded agreement. Fletch was also ready.

  Where would they start? They couldn’t climb over this wreckage and call to try and locate survivors. This was no neat hill of compacted debris. Walls and ceilings had toppled but Kelly had no idea what pattern of collapse was involved. Was it a curtain-fall collapse? A lean-over or lean-to floor? Or was it a tent or cantilever collapse that would mean accessing voids and confined spaces? It looked like a medley of all the patterns they had studied and it was nothing like the textbook diagrams. Kelly waited, along with the rest of the team, for instructions from their squad leader, but Dave was having a conversation by radio link to the scene commander. He moved about as he spoke, staring back in the direction they had come from, and seemed to be identifying their location.

  ‘We passed the pizza place on the left as we came in. Then there were two or three clothing stores and a shoe shop. We have a jeweller’s on the same side and a children’s clothes shop opposite. We’re blocked at this point by a major structural collapse.’

  Dave moved ahead of the team by a few strides. He tested and then climbed onto a sloping concrete slab, ducking his head to clear a huge steel beam. His headlamp was sweeping in a large arc, the focus of which was concealed from those still at ground level. He was nodding.

  ‘Yes. I think so. I can see a gap and what looks like the back of the bookstore.’

  Kelly didn’t hear the message Dave was receiving as noisy pneumatic equipment was activated nearby. She could, however, sense that action was imminent. Dave was climbing back down towards them.

  ‘Roger, got that.’ Their squad leader sounded decisive. ‘We’ll do our best.’ He lowered his radio. ‘There’s a group of people trapped in the back of a pharmacy,’ he told the team. ‘They’ve managed to make cellphone contact. The shop backs onto the west mall which is at ninety degrees to the section we’re in now. Our team is closest so we’re going to try and locate them. There’s a bookstore beside the pharmacy and it looks as though we can access that from here.’

  ‘How many people are in there?’ Fletch was right behind Dave as he led the way forward.

  ‘Ten. Three are badly injured by the sound of it.’

  It wasn’t as terrifying as Kelly thought it would be. She had to concentrate so hard on where she was placing her hands and feet, trying to assess stability and to listen and watch for hazards, that there was no space left for personal fear. The pile of books she stepped on was slippery, however, and the momentary loss of control gave her a nasty jolt. She was grateful for the hand that caught her arm and steadied her. She gave Fletch a nod of thanks.

  Part of the bookstore was relatively intact but it was impossible to tell if the shelves were against the wall bordering what remained of the pharmacy.

  ‘Space yourselves along this wall,’ Dave instructed. ‘We’ll see if we can hear anything.’

  The long blast on his whistle called for silence. The signal was repeated and followed by shouts that echoed down the lengths of the intact portions of the mall. By the time the team had positioned themselves it was as quiet as it was likely to get. The pneumatic cutting gear being used somewhere overhead was the last to stop. Kelly was first in line. She used the metal stapler she had found to bang on the shelf space she had cleared of paperback books.

  ‘Rescue team here,’ she yelled. ‘Can you hear me?’

  The waiting was nothing like the practice scenarios. Kelly wanted desperately to hear something. The seconds ticked by. They were all waiting and listening.

  ‘Nothing heard,’ Kelly said.

  It was Owen’s turn then. And then another rescuer. Then it was Fletch.

  ‘Rescue team here.’ His voice seemed so loud. Surely it would carry through more than one wall. ‘Can you hear me?’

  Kelly could hear nothing. The tension mounted. They had to be close.

  ‘I can hear tapping,’ someone called.

  Kelly could hear it now, too. She could feel it when she put her hand against the wall.

  ‘I can hear a voice.’ Dave pointed to his right. ‘Let’s shift the line and start again.’

  This time they could all hear the response.

  ‘We’re in here…We need help!’

  ‘We’ll get to you as soon as we can.’ Owen was at the point where the voice was loudest. ‘We’re just organising some equipment to get through the wall here.’

  Dave was on the radio, relaying information and organising back-up. They needed gear to cut through and support the hole they would have to make in the wall. They needed help to move people and first-aid supplies to treat the injured. Progress seemed to be so slow to Kelly. Available space restricted the number of rescuers that could get close. Manoeuvring bulky equipment was difficult and time-consuming.

  Fletch had taken up the position where voice contact was clearest. He had introduced himself to the pharmacist and was directing him to assess the injured as best he could. Kelly could hear the faint shouting from beyond the barrier of the wall.

  ‘It’s a head injury. It was bleeding badly but we’ve almost stopped that with pressure. He says he’s got a bad headache and feels sick.’

  ‘See if he can tell you what day it is and where he is. Are you able to check his pupils and see if they’re equal sizes?’

  ‘It’s pitch black in here,’ the pharmacist responded. ‘We’re in the dispensary and there’s no windows. The lights went out when the explosion happened. Do you know what caused it?’

  ‘No. Nobody does yet.’

  ‘Was it a bomb?’

  Kelly blinked. The idea that this disaster could have bee
n deliberately caused hadn’t even occurred to her. That sort of thing didn’t happen here in New Zealand, even if the terrorist threat was international these days. Bali had been close but, then, that was a popular tourist resort. Why would they pick an ordinary suburban shopping mall in a city like Christchurch? No. There had to be another explanation. A mains gas leak, probably.

  ‘How’s the young woman?’ Fletch asked.

  ‘Lisa? She’s unconscious again. She’s still breathing but I can’t feel a pulse on her wrist any more.’

  ‘And the man with the chest pain?’

  ‘He’s a bit better. I gave him some of the GTN spray he’d come in to collect and he’s had some aspirin.’

  ‘You’re doing a great job,’ Fletch told him. ‘How’s everybody else?’

  ‘Scared. How long before you can get us out?’

  ‘We’re nearly ready to start cutting this wall. Can you move people back as far as you can?’

  Kelly also had to move away to let the fire service start work. She went as far back as the entrance to the bookshop. A Stokes basket was there, laden with supplies. She crouched beside it, checking its contents and keeping out of the way of an increasing number of rescue workers. The gap they had crawled through from the first mall had been expanded. Timber shoring was being used to strengthen the sides and loose debris was being shifted to leave a clearer accessway. Kelly had no idea of the time but it all seemed to be taking far too long. She hated being kept from treating an emergency. The longest she had ever had to wait had been over an hour once, when it had been a major operation to cut victims clear of a car wreck, but the extrication had been full on and she had been able to get close enough to touch her patient. She had been able to start oxygen and an IV. The pace was so slow now. Every move had to be considered and deemed safe before continuing.

  ‘Here we go.’ People near Kelly moved forward as a woman was led out of the bookstore. She was stumbling. Her skirt was ripped and her face and hair almost white with a covering of thick dust. Her tears were leaving tracks through the layer of dirt. A blanket was quickly draped around her shoulders.

  ‘Come with me.’ Someone was supporting the woman. ‘We’ll get you out of here.’

  An older woman was carried out next. ‘She’s not injured,’ Kelly was told. ‘Just exhausted and frightened.’

  Two teenaged girls came next. One was silent and staring blankly ahead of her as she was guided through the debris. The other girl was sobbing hysterically. Kelly wanted to get back to the front line of the operation. Was Fletch on the other side of the wall yet? Able to assess the injured? She had to wait as another dust-covered man carrying a child was helped over the rough ground surface.

  ‘Let one of us carry your daughter, sir. It might be safer.’

  ‘No. I’ll carry her myself. Just show us the way to get the hell out of here.’

  Kelly could move in now. Owen helped her with the Stokes basket. Fletch was crouched on the floor as Kelly crawled through the breach that had been created in the wall.

  ‘The sooner we get you out to the ambulance area the better.’ Fletch was nodding at the man in front of him. ‘That broken wrist can wait for splinting. I’m more concerned about this chest pain you’ve got.’

  ‘I can still walk. It’s just my angina.’

  ‘I think it might be a bit more than that this time.’

  ‘I’ll be fine. I just want to get out of here. The rest of this place could come down any minute.’

  ‘We wouldn’t be in here if that was the case.’

  Kelly edged past Fletch, hoping he was right. In any case, the fear would not be helping this potential cardiac patient’s condition. Fletch turned to an older man who appeared uninjured.

  ‘You need to get out now, too, Bob, and get yourself checked.’

  ‘I’m fine. I can stay here and help you. There’s two more people hurt in here and they’re a lot worse.’

  ‘I’ve got the help I need now.’ Fletch flashed Kelly a grim smile as she eased past. ‘Bob’s the pharmacist who’s been doing such a great job in here,’ he told her. Kelly nodded. She was focused on the two patients nearby, one of whom was lying motionless.

  ‘Airway’s clear and breathing’s OK,’ Fletch said. ‘And the man who’s sitting beside Lisa there is conscious. We need to collar both of them before we move them.’

  Kelly nodded again. The pharmacist and the man with chest pain needed to be taken out to give them room to get the more seriously injured people out. She bent over the unconscious woman to reassess her airway and breathing.

  ‘Lisa,’ she called. ‘Can you hear me? Can you open your eyes?’

  The woman’s eyes fluttered and then closed again. Kelly leaned closer. At least there was some response and she could be heard.

  ‘I’m Kelly,’ she told her patient. ‘I’m a paramedic with the rescue service. We’re going to get you out now.’

  The woman mumbled words that were unintelligible. Bob turned back from the hole in the wall that Fletch was guiding him through.

  ‘She’s frantic about her kids,’ he said. His voice caught. ‘She’s got two little girls. They were both in a pushchair. Lisa was buried. I dug her out but I…I couldn’t find the children.’ Bob was sobbing now and Kelly could see that the skin on his hands and arms was shredded. The pharmacist had clearly been desperate to locate Lisa’s daughters.

  ‘We’ll look for them, Bob,’ Fletch said. ‘We have the experts here now. And the equipment. You’ve done all you could—and you saved Lisa.’

  Kelly listened to Lisa’s chest with a stethoscope. She pulled the remains of the woman’s clothing aside to look for chest and abdominal injuries. Lisa was in shock, her blood pressure dangerously low—probably hypovolaemia due to internal bleeding. Kelly hadn’t been able to find any evidence of major external haemorrhage from her body sweep. The breathing was rapid and shallow but clear. There were no serious chest injuries interfering with respiration. Kelly looked up a moment later.

  ‘Lisa has a fractured pelvis,’ she informed Fletch. ‘There’s no radial pulse and the brachial’s barely palpable. I’m going to start an IV.’

  ‘Great.’ Fletch had brought a cervical collar back from the Stokes basket after seeing the last two patients evacuated. He was fitting it to the man who was sitting with his back against a pile of debris. Incongruous bright sparkles from hair clips and headbands shone in the beam of her headlamp amongst hot water bottles, hairbrushes and shampoo bottles.

  Kelly unzipped her pouch and tied a tourniquet around Lisa’s upper arm. She selected a wide-bore, 14-gauge cannula. This woman urgently needed fluids to bring her blood volume up. With a pelvic fracture she could be bleeding out internally and Kelly could only hope they weren’t too late. How long since this injury had occurred? It had been more than three hours since the explosion before the USAR teams had entered the mall, and how long had they been inside now? Kelly had lost all track of time.

  Two IV lines were up and running by the time Fletch had packaged the patient he was working on. A still bleeding head injury had been dressed, a cervical collar put on to protect the patient’s neck and the Stokes basket had been used to move him due to the lowered level of consciousness and potential spinal injury. Kelly had a portable oxygen cylinder with her now. Lisa’s eyes opened again as the high-concentration mask was fitted to her face.

  ‘It’s OK, Lisa. I’m just giving you some oxygen to help your breathing.’ Kelly had to pull the mask away as the sounds her patient was making became increasingly distressed.

  ‘Tiffany…’

  Kelly could barely made sense of Lisa’s words.

  ‘She wanted the scrunchy…the one with the teddy bear…She’s…she’s with Chloe…’

  ‘We’re looking for them.’ Kelly tried to sound reassuring. ‘We’ve got to move you now, Lisa, and then we’ll keep looking until we find the girls.’

  It was a truthful promise. Rubble and debris would be removed with painstaking care by a buc
ket brigade until all victims had been located. Alive…or dead. It seemed a forlorn hope that anyone close to Lisa would have survived, however. There had been quite a few uninjured people at the back of the pharmacy and they would have been assisting Bob in trying to find the children. If they were alive, surely someone would have at least heard them and would have had some idea of their whereabouts.

  Fletch had a collar in his hands. ‘Hold her head, Kel. I’ll get this on.’

  Kel. Nobody had called her that since Fletch had gone from her life. She steadied Lisa’s head as Fletch brushed long, blonde hair out of the way and put the collar on.

  ‘They’re bringing a scoop in. We’ll use that to try and stabilise the pelvic fracture and then put her in the Stokes basket.’ Fletch lifted Lisa’s eyelids to shine a torch into her eyes.

  ‘She was talking to me a minute ago.’

  ‘She’s not responsive now,’ Fletch said grimly. ‘We need to get moving.’

  They had to pull debris out of the way to get the scoop stretcher close to their patient. Kelly put her heavy leather gloves back on over her surgical gloves to protect her hands. Broken bottles and pill containers littered the surfaces. It was just as well she had the knee pads on. The leather gloves made it impossible to refasten the stretcher clips or thread the straps through the sides but Fletch seemed to be there every time it was too awkward. They worked fast together despite the incredibly difficult environment.

  Fletch shook his head as he picked up his stethoscope to check Lisa’s breathing once more. Then he felt for a brachial pulse. ‘It’s hard to see anything properly. You did a fantastic job, getting those IVs going.’

  ‘Thanks.’ Kelly wanted to tell Fletch that he was doing an amazing job as well. That his calmness and focus were making it easy for her to do her part. That she wasn’t even frightened, being in a tiny space inside a crushed building that could collapse further at any time, because he was in there with her. But she said nothing. The thoughts were only half-collected and there was no time to think about how she felt. Fire service officers were squeezing into the space to help lift the stretcher and strap it inside the basket. Kelly moved aside but not far enough. She found herself pushed by a large shoulder as a man bent to lift Lisa, and she fell sideways.