Fuel the Fire

by Jamie Garrett

  “Scootch over, ma’am,” Rachel said, grabbing onto the door handle and lifting one foot into the cab.

  It was a stretch for Rachel too, but she climbed up and nudged herself into the seat beside the older woman while he moved around the truck to the driver’s side. The woman tucked between them. They rode to the hospital in silence, the engine rumbling softly as the three of them gazed with wide-eyed and horrified fascination at the destruction all around.

  The streets to both sides of the road they took to the hospital were strewn with debris of all types and sizes; roofing shingles, car parts, trees, bits of furniture and papers . . . lots and lots of papers. From a nearby office building? Jeremy didn’t know and didn’t care, focused only on weaving his way around the debris. He and Rachel scanned the streets, the houses, looking for injured survivors. It was eerily deserted along this stretch of road, perhaps just a mile from the hospital now.

  No one said a word. Rachel covered her mouth with a hand and swung her other over the woman’s chest as Jeremy rolled over a large tree branch, his truck navigating the streets like a Sherman tank. All three of them swayed to the left, then the right, in the cab of the truck.

  “I’d like to go home now.” That from the old woman, who looked up at Jeremy with growing alarm. “Will you take me home now? I have to see if it’s still standing.”

  “Let’s get you checked over real quick at the hospital first,” Rachel suggested, placing her hand over the woman’s pale, wrinkled, blue-veined hand. “They’ll patch up your head, and if you’re okay, I’ll call for a taxi myself to get you home. Okay?” She gently squeezed the elderly woman’s hand. “We’re almost there anyway.”

  The woman frowned, then shrugged. “Fine. If you think it’s necessary.”

  Jeremy doubted that any taxis would be out and about but said nothing. He knew Rachel needed to keep the woman calm. The last thing he needed was a panicked old lady in his truck.

  “It is,” Jeremy said. He was torn. He wanted to stay with Rachel as long as possible and make sure she was safe, but he was also anxious to drop both women at the hospital and get back out there, meet up with his squad and get down to the business of saving people. The town would need all of them out there, rostered on or not. The hospital was one of the largest buildings in the area. He just had to hope she’d be fine there.

  He glanced at Rachel. “It’s gonna get crazy.” The truck wove this way and that, all three of them leaning into one another at times, bouncing on the seat as Jeremy rolled over debris, avoiding anything metal, power lines or, when possible, anything that might have a nail or jagged edge to it. His radio crackled and he picked up the mic. “Miller.”

  “Jeremy, where the hell are you?”

  He had just pulled into the west parking lot for the hospital. It was already filling with cars and the walking wounded, some more serious than others. He shook his head. The disaster would be far reaching in a small community like Monroe. He glanced up at the hospital, not really surprised to see more broken windows, some already being boarded up by staff. The loud whack of hammers echoed down into the lot. Around the grounds, shrubs had been yanked from their roots, tree branches downed, and several cars damaged in the staff parking lot, three of them with their roofs caved in by a fallen pine tree. He glanced at Rachel and saw her quick gaze taking in the damage as well.

  “Pulling into the hospital parking lot,” Jeremy answered, recognizing Mason’s voice. “Dropping off a walking patient, and then I’m on my way. You?”

  Rachel was already reaching for the door handle as he pulled up to the Emergency Room entrance.

  More crackling. “Head over to the Barrows Complex . . .” Static garbled the message. “. . . roof collapse. A cop is on his way to the hospital. So is one of the EMT crew—”

  “Who?” Rachel gasped, turning toward Jeremy as she helped the older woman from the truck.

  “Name?” he asked.

  “The EMT is David Kinkaid,” came the response. “Not sure . . . the cop. They got him out and transported just before we . . . here.”

  “David! What happened?” Rachel asked, but Jeremy gave her a quick shake of his head and replaced the mic in its slot.

  “They’ll be here soon. They’ve already transported. You all right? Need help with her?”

  Rachel shook her head. “No, we’re fine.” She moved to close the door, her eyes lingering on his for several seconds. “You be careful out there,” she said.

  He nodded. As soon as the door shut, he drove away from the hospital, his mind spinning, his heart racing, adrenaline once again pumping through his veins. Finally, he was back at work. He felt ready, physically and mentally, to dive in, to do what he had to do. What he’d been trained to do. Lots of people would be depending on him and his crew.

  9

  Rachel

  It was chaos on top of more chaos. Controlled chaos, but chaos nevertheless. Janitors were sweeping up broken glass and other debris, several trashcans with liners already filled with glass, pieces of drywall, and chunks of ceiling tiles that had fallen. It seemed like every window was broken or cracked, and this was thick glass, much thicker than the windows of her apartment. Her heart thudded with the power of the tornado. Even walking in, she’d overheard comments about the continuing stormy weather, and that they might be in for another twister.

  Rachel shook her head. She couldn’t worry about that now. She watched an orderly wash blood from the floors of the Emergency Room’s waiting room. He’d already been in the trauma bays. He was going to keep working like that for hours, back and forth, back and forth.

  People appeared in clusters, the first wave having come through immediately following the twister. Thank God, it was mostly just cuts and bruises, but a few broken limbs, ribs, and possible concussions were mixed in. Most of the patients came in private cars, including a large number of trucks like Jeremy’s, and even a few monster trucks with massive, thickly knobbed wheels. Never again would she joke about the number of people out here who drove such big trucks. Today, they were lifesavers, the ambulances stretched thin, in addition to blocked roads.

  Rachel hit the floor running, first taking the elderly woman to one of the Emergency Room bays to get checked out. She waited with her as a nurse assessed her vitals and declared her stable but needing stitches, and then Rachel headed to the nurses’ lounge and locker room to change her clothes. She always left a clean pair of scrubs in her locker for emergencies. You never knew when a patient would bleed, pee, or throw up on you. She quickly changed into her mauve-colored scrubs, grabbed her must-haves, and left, heading back toward the ER to be of help wherever she could.

  There, along with a nurse that she recognized but didn’t know her name until she glanced at her name tag, they did what they could to get the Emergency Room ready and restocked for yet another influx of potential casualties.

  “They’ll be coming,” the tired but still cheery Filipino named Dalisay said. “Count on it.”

  Dalisay hadn’t been kidding. That had been an hour ago. Since then, doctors, nurses, and even support staff kicked into high gear, everyone pitching in to help. Those without medical training or certifications such as the receptionists, volunteers already at the location when the tornado struck, and ancillary staff from all departments tried their best to keep up with making sure supplies were well stocked and patients were wheeled where they needed to go, whether it be upstairs to X-ray, surgery, or private rooms that were no longer private.

  Blood donations were underway on the third floor, in a room not far from the Radiology and the Dialysis departments of the hospital. There was a huge turnout, mainly from relatives who brought in their loved ones, most, thank God, with non-life-threatening injuries.

  The influx of patients walking in on their own, brought by family members or strangers or emergency personnel seemed endless. The hospital’s Emergency Department overflowed with voices asking for help, soothing the injured, or crying. Coupled with the near constant annou
ncements from the PA system, constantly sending a doctor here, a technician there, equipment needed there, everything soon grew into nothing more than white noise in Rachel’s ears.

  She was pulled away from the Emergency Room to set up her own physical therapy room just as a large expanse about the size of an Olympic swimming pool was transformed into a type of waiting room for those patients with stable vitals and minor or non-emergent injuries waiting for stitches or a cast. That helped decrease the crowding in the Emergency Department, but they just kept coming.

  Finally, Rachel managed to stop one of the ER nurses and ask about the cop who had been injured in the roof collapse, the one that Jeremy was headed to, or had been when he left. The nurse gestured upstairs. “He’s in Radiology getting a CAT scan.”

  “And David?” She didn’t have to give the nurse his last name. Everybody knew David. He was a nice guy. Rachel admired his calm, friendly demeanor even when dealing with the most difficult of patients.

  The nurse frowned. “He’s in ICU for now.”

  ICU? Before Rachel could ask any questions, the nurse rushed off. Normally, Rachel didn’t venture into the ICU. While she was a fully registered nurse, she had very little ICU or cardio training. Still, she wanted to check on David, and then she would check on the cop so that when she talked to Jeremy, she could give him an update. She planned to head upstairs after she took another armload of blankets and bedding to the nurse’s station on the second floor. While the laundry and housekeeping department generally took care of that, the members of their staff were also stretched thin, and she didn’t mind pitching in to help. Anywhere she was needed, she’d be there.

  Pride surged through her. Every employee, from volunteers to the administrator and the DON, the Director of Nursing, were pitching in where needed. Answering call lights from patients who had already been there when the tornado hit, working on rescheduling consultations or surgeries, taking patients to the bathroom, working in the cafeteria . . . whether they wore scrubs or suits, they helped. She’d never seen such teamwork. It warmed her heart. Despite the tragedy of the day, it made her glad she’d chosen this hospital to work in—and that they’d hired her.

  Cots had been hastily set up for family members in the rooms of more seriously injured patients. On the way up to ICU, she took the stairs to the third floor and checked in with Radiology. After a couple of questions, she learned that the police officer in question was undergoing a CAT scan, but for the moment he was stable. She didn’t bother asking too many other questions, as the frazzled technician was incredibly busy juggling numerous patients. He couldn’t tell her much more regardless, because of privacy laws.

  She’d thanked the tech and turned to leave when the nurse handed her a handful of papers and a sleeve of digital images. “These still need to be scanned in to the EMRs,” she explained. “Would you mind taking them down to Medical Records for me? I’m just—I’m swamped here.”

  “Sure,” Rachel said, taking several patient folders and a handful of 3-D images and printed images, plus two discs containing more.

  While the hospital had an excellent reputation for its fine staff of physicians and surgeons and was rated one of the best in the region for trauma care, its medical records department was still catching up with digital technology. Even in Rachel’s office in the Physical Therapy Department, she often kept paper records, as the staff down in Medical Records was still inundated with transferring over hundreds if not thousands of paper records into digital format for their updated EMR systems and software. With old cases, it was especially backed up. It was the one downside to moving into a rural area where county budgets for hospitals, schools, and government services were often spread thin and left wanting. Then again, the hospital had to make choices: paying for updated and newer surgical technologies—a four-hundred-thousand-dollar Tesla MRI that left little budget left over for a forty-grand-plus updating of EMR software systems for medical records. It was a no-brainer for most. Emergent care and technology over paperwork.

  Rachel stood alone in the elevator, the doors swishing softly shut. Just as the doors closed, she had second thoughts. What if a second tornado struck while she was in the elevator? What if the electricity gave out? Would the backup generators of the hospital run the elevator, or would they only service the ORs and patient rooms?

  It was too late to get out now. She sighed and kept her fingers crossed as the elevator started on its downward journey. In an attempt to distract her wayward thoughts regarding tornadoes, she idly glanced at the files she’d been given. One caught her attention. She frowned, deciding whether to peek. It would be unethical maybe, but it wasn’t like she had any intention of misusing the information. Plus, he was deceased.

  It was Brian’s file, plus an image of his brain, along with the ER physician’s notes, the radiologist’s observation . . . she tried to think back to the moment the doctor had given Louise the news. What had he said about cause of death? Had he? Had she heard anything about it from Jeremy in the couple of days following the news? She could have sworn it was something like smoke inhalation, or had it been internal bleeding and a punctured lung? She was pretty sure that the lungs had been involved in his cause of death. And yet, looking at the sloppy, handwritten notes scribbled by the ER doctor, she saw mention of brain contusions, possible subdural hematoma, bleeding into the cranial cavity, resulting in brain swelling.

  Her frown deepening, Rachel glanced at the attached CT scan. While the light in the elevator wasn’t the best, she didn’t see any signs of internal bleeding, brain swelling, or subdural hematomas. She wasn’t a neurologist, but she’d viewed plenty of x-rays and scans in her career and knew the difference between normal brain tissue and brain damage of any kind. It was part of her job, assessing brain injuries, spinal cord injuries, in order to determine what kind of therapy to set up for her patients.

  This didn’t make sense. Why would—

  The door swished open and Rachel quickly closed the slim file, her heart thudding as Dr. Moeller stepped into the elevator. The elevator had arrived at first floor without her noticing. Should she get off? Had the doctor seen her looking in the file? “Hello, Dr. Moeller,” she said, hoping to head him off at the pass.

  “What are you doing?”

  “Taking some files down to the Medical Records Department. They’re really slammed up there in Radiology.” The doctor eyed her and she thought for sure that he’d seen her peeking at a patient’s medical record. A definite no-no. Would he report her?

  Dr. Moeller said nothing. He too pushed the button for the basement and she frowned as the elevator continued down. “You going to Medical Records, too?” Why was he heading down instead of up to the ICU or surgery?

  “Morgue,” he said, then ignored her, head down, looking at his shoes.

  She felt uncomfortable and, as was often the case when nervous, she babbled. “I hear you had a couple of first responders come in a little while ago. A cop and an EMT. You know David Kincaid, don’t you? How are they doing?”

  This time the doctor did look at her, annoyed, a pinched expression on his face as he glanced down at her. “Why?”

  Why? “They’re friends of mine,” she lied easily. Well, only half-lied. She knew David in a professional sense, as she’d seen him around the hospital numerous times, talked to him on occasion. “Any news on their condition?” she pressed.

  “Don’t you have your own patients to worry about?”

  Uh-oh. “Of course,” she said. “I’m just concerned, is all. Several of my close friends are first responders, and when any of them gets hurt, I—”

  “The cop is up in ICU with internal injuries,” he said shortly. “As far as I know, David Kincaid is still in Radiology.” He looked at the files in her hand, then back at her face. “I could have you written up for that, you know.”

  Rachel said nothing as a guilty flush crept into her cheeks.

  “You know better than that,” he said, eyeing the name tag on her left shoulde
r. “Ms. Sorensen.”

  “I—yes, I do, but he’s a friend of mine, I mean, he was a friend of mine,” she stammered. “I was on my way to a fundraiser for his pregnant widow when the tornado hit.” No reason to lie about that part anyway. “I just—”

  “No excuses, Ms. Sorensen. Don’t let me catch you doing that again.”

  “Yes, sir,” she said, just as the elevator door swished open.

  Dr. Moeller turned left toward the morgue while Rachel turned right toward the Medical Records Department. He was right. She didn’t have any business looking at medical records that didn’t belong to her patients, but now that she had, her curiosity was piqued. The brain swelling thing bothered her. A lot. Had Moeller misdiagnosed Brian? It was highly unlikely. He was a skilled and respected ER doctor who had never made a major mistake like that. She’d never heard any scuttlebutt about anything. More likely the brain swelling had come later. But no, he’d written it in his ER notes, and there been no mention of brain swelling in the ICU doc’s notes. Why not? An incomplete record? She frowned. The only way her curiosity would be assuaged was to get a look at Brian’s complete file, including his labs. Rachel walked slowly toward the reception area for the Medical Records Department. Did she dare?

  Jeremy would want to know, and so would Brian’s fellow crew members. Didn’t they deserve to know exactly how their friend had died, or was it better just left alone? He was gone and nothing they could do now would bring him back.

  She approached the reception desk to the Medical Records Department and recognized Cindy, an older woman nearing retirement age. Cindy knew the department inside and out.

  “Hey Cindy, is your family okay?” Rachel asked as the old woman looked up from her keyboard.

  “Yes, thank the Lord,” Cindy replied. “We have an old root cellar from back in the day. I managed to talk to my husband for a minute before cell service went out. He said there’s a lot of damage up there.”