Sophie's Path. Catherine Lanigan
Jack wanted to talk to somebody who knew what had happened to him and his employees in the fog on Highway 421 tonight. Had he gone off the road? Had he fallen asleep? Was this his fault? What could have caused all this suffering?
Just considering that he could be responsible in the slightest degree was intolerable. Guilt flooded him like a tsunami, taking over his thoughts and causing more agony than his physical pain.
His whole life, he’d tried to do the right thing in every circumstance. From striving to live up to his marine father’s demanding and impossible expectations to taking care of his sister and mother after his father’s death. He chose insurance as a career to help others protect their lives and their possessions. Jack Carter was a guardian.
In the blink of an eye, he had placed the people in his charge in jeopardy.
Now Jack had to face his darkest hour.
Just then, the air was split again with screams of human pain that Jack would never have imagined, even in his worst nightmares. He heard a man, a young man, yelling for help. Then he screamed again with such agony, Jack thought he must be torn in two. Jack wanted to cover his ears, but even if he could have, he knew he would never forget that scream for the rest of his life. It was so terrifying it sounded inhuman.
But above it all, he heard the high-pitched wail of a young girl’s terror that turned his blood to ice.
“That’s Aleah!” Jack growled as tears burned his swollen and bruised eyes.
A voice came over the loudspeaker. “Code Blue. Code Blue. Dr. Barzonni to the ER, stat.”
Sophie glanced back at Jack with pleading eyes as she burst away from his bedside. She flung back the curtain and said, “I want to help you, but I have to go to her.”
Jack reached out his aching arm to Sophie and motioned her away. “Save her, Sophie. Save her.”
SOPHIE RUSHED AROUND the nurse’s station to the ER bay on the opposite side. Bart Greyson, an RN with a decade of ER experience, had just gone in there with a stainless steel defibrillator cart.
Bart ran the ER with an iron fist and more stamina than the entire staff combined. He could pull over forty-eight hours on duty with only a half dozen, ten-minute catnaps while sitting at his computer. Bart had brains, insight and skill...and a case of Red Bull in his locker. He was a legend at Indian Lake. No one second-guessed Bart or his orders.
“You’re the first of the cardiac team here,” Bart said to Sophie as he shoved a medical chart into her hands.
“Dr. Barzonni is on call?” Sophie asked, never taking her eyes from her patient.
“I just got word he’s upstairs with an emergency surgery. We’ve paged Dr. Caldwell. I left a message at the nurse’s station, as well. I don’t know who will show up,” Bart replied with a huff of exhaustion. He stuck his hands on his hips. “Figures. It’s a full moon. It’s always an asylum here during a full moon.”
Sophie gently lifted Aleah’s eyelid and examined her. “I heard her scream but she’s unconscious,” Sophie observed.
“She was unconscious on arrival and except for that one time, she’s been unresponsive.”
Sophie turned to the defibrillator. “She’s in arrest?”
“No. Arrhythmia. The Code Blue was for the other victim. Dr. Hill had to leave Aleah and see to the John Doe. He was the driver of the other car. The cops are working on getting an ID for us.”
Sophie had worked with Dr. Eric Hill nearly every weekend since she’d begun her ER duties six months ago.
Dr. Hill was five years past his internship and residency at Cook County Hospital in Chicago. He’d told Sophie that in those five years, he felt he’d seen everything emergency medicine could throw at a person. He’d come to Indian Lake for a change of pace. Well, he’d gotten it. Unless there was a major accident like this one, most weekends in the ER were run-of-the-mill household accidents—falls or injuries with tools—and relatively minor illnesses where the patients or their parents didn’t have medical insurance.
Sophie watched Dr. Hill and three nurses work on a tall, overweight man in the next bay. He appeared to be in his late thirties. “He’s hardly got a scratch.”
“Drug overdose. Cops said he had heroin in the car with him and as the paramedics were tending to the three other victims, he shot up.”
“How are they bringing him down?”
“Paramedics gave him naloxone on site. Nasal spray was all they had. They didn’t get to him right away because he didn’t seem injured, just confused. It wasn’t until he dropped to his knees and passed out that they noticed the dilated pupils and white patches on his mouth. Once they got him here, we gave him more naloxone by injection. What a mess.” Bart shook his head but continued to work.
Sophie scanned Aleah’s reed-thin, very still body while two other members of the ER team hurried in to assist. Donna Jessup was one of Sophie’s coworkers on Dr. Caldwell’s team and worked one weekend a month in the ER. With her was Rob Seymore, a lab technician who quickly began drawing blood for the usual tests.
Aleah’s brown hair was matted to her head with glass and blood, much like Jack’s had been. She was still in her street clothes, though her blouse had been cut away and twelve electrodes had been placed on her chest.
“Donna, did you run an EKG yet?” Sophie asked.
“We had another cardiac patient just after these accident patients. It’s been bedlam, but I’m on it. I’m on it.” Donna attached the leads and turned on the EKG machine. She held the printout. “Infarction and atrial fibrillation.”
“A-fib?” Sophie circled the gurney and studied the printout. “Did Dr. Hill order an echocardiogram?”
Rob continued, “Yes. He was in the middle of examining her when the other patient started convulsing. And his heart stopped.”
Sophie flipped the pages of Aleah’s chart as Bart continued.
“Dr. Hill said Aleah’s suffered a blunt chest trauma which is quite obvious from the bruising. He ordered the requisite round of tests.”
“Did he mention cardiac contusion?”
Bart and Donna shook their heads.
“No, but it’s my guess...” Donna winced. “Sorry. It’s not my place to—”
“Don’t apologize.” She held up her hand, though she didn’t take her eyes off the chart. “If she’s ruptured the cardiac chamber or if there’s a disruption of the heart valve that could be the cause of her dysrhythmia.”
Sophie assessed more of Aleah’s condition. Her skin was growing more pale and gray by the second. The bruises on her chest were turning a deep purple. Sophie pressed lightly on Aleah’s ribs. “She’s broken nearly every rib on the right side.”
“Dr. Hill thinks her lung may be punctured,” Bart said. “He ordered thoracentesis.” He began inserting the catheter into Aleah’s chest while Sophie went around to the other side of the bed.
Sophie stuck the earpieces of her stethoscope into her ears and listened to Aleah’s chest. It rattled like a freight train and Aleah’s breathing was labored. She was bleeding internally, but until all the tests were run, they wouldn’t know the extent of the damage.
In the meantime, they had to get her stabilized. Aleah’s chest cavity was filling with blood and fluid, which would be putting pressure on her heart and lungs. Sophie didn’t want to guess how much time they had to prevent respiratory arrest or another—this time deadly—heart attack.
First, she needed do a thorough examination. In a trauma case like this, every nanosecond counted.