Note--this is a bit of a scene from an upcoming story...consider it a teaser, LOL...
It was one in the morning. All I wanted to do was sleep.
So, of course, I could do nothing of the sort.
I'm too old to be working these night shifts, I told myself. Then again, if I don't, who else will? As chief of the emergency room, it's my job to set an example for the staff. And if that means the graveyard shift every so often (more "often" than "so"), well, so be it. Besides, was only another six hours until I could go home. The drunk in Room Five had finally drifted off to dreamland; the schizophrenic in Eight was transferred to Psych. And your friend and mine, Mr. Luis Ramirez, was STILL parroting the staff. He speaks only Spanish (with a smidge of Latin tossed in), but he will repeat anything English anyone tells him. Last I'd heard, a couple of the interns were having him repeat the immortal words every ER staff member soon learns ("Trolls never die"). A drunk can wipe out a family on their way home from the park, but escape without a scratch. Life sucks sometimes. That's just the way things are there. You don't even want to know WHAT I pulled out of a...rather intimate...part of a teen girl's body earlier that evening. I don't want to know how it GOT there. Such is life in the ER.
I slipped into my office to catch a nap. Even though the hours while the moon is up are the busiest for us--as well as the strangest--I was able to spare the luxury, for a few minutes anyway. If the intercom didn't wake me up, I could be sure my head nurse would (and probably gladly, since SHE wasn't sleeping...). Besides, her station is just across from my office...as I fell back onto the couch, I heard her humming along with the radio. The song? "Stuck in a Moment". I felt as though I WAS.
No sooner did my eyes close than I heard the paramedic radio crackle to life. Damn, just as I was getting a break. Maybe I'd be lucky. Maybe it was just a bored and lonely person who called 911 and wouldn't sign the AMA form. Maybe it was one of the BLS "band-aids and boo-boos" calls. If I was really lucky, it'd be something I could delegate to one of the med students. Wait, they'd gone home, now hadn't they? Well, maybe I could hand it to one of the interns. After all, as my nurses have often reminded me, the only difference between a med student and an intern is about two months.
"Rampart, Medic 751 en route with Victim 1 of a
multiple casualty MVA..."
Damn. And damn again. "Multiple casualty" could mean as few as three patients, but the maximum number is unlimited. Station 51 had two medic units now (the 7 designated their battalion). Knowing this, I also knew they had transport capabilities for two patients.
I left it up to my ever-capable nurse to figure out how many more stations had responded, how many victims there were, what their conditions were, and what in the heck we were supposed to do about it. It would probably take her all of five minutes. I could use those five minutes to sleep.
True to form, not five minutes later, Kate stuck her head into my office, grinning widely. "C'mon, Mikey, let's roll!"
I glared at her, even if my heart wasn't in it. "Roll is a term one typically reserves for when one has a vehicle in which to respond." Part of the ER experience is giving your co-workers a hard time. Next to making fun of the patients (out of their earshot, of course), it's the best way to maintain one's sanity in that war zone.
She cocked her head to one side, moving a hand to her hip in a distinctly McCall-like fashion. She'd learned from the best. "Don't be anal, Mike. C'mon, we've actually got a job to do."
"Whatcha got?"
Kate sat down on the edge of my desk, leaning forward. Without the advent of scrubs as a nursing uniform, I doubt that motion would have been socially acceptable. "MVA, four victims. Well, technically five, but Five will pretty much be a treat 'n' street. One and two are resident bait, maybe a mild concussion at worst. They're on their way in. Three's all yours; Trauma Four is ready for you. Looks like a couple of broken ribs; she's a few pints of blood short too. A positive, but we'll do another test to be sure. Nasty concussion, you'll probably want a CT so I called the Rays. I'll find someone to take victim Four once they get her out of the car. I don't expect much, though. Vitals are CTD. GCS is promising, but it's hard to be accurate when your patient is surrounded by twisted metal. Damn those drunks, anyway."
Amazingly, I'd understood all of what she'd just said. The "Rays" are a nickname for Radiology's boys; CTD was an abbreviation for "circling the drain". Didn't look promising. Our slang can be quite harsh, but it's how we keep our sanity. Black humor is the doctor's best order. I couldn't tell what the GCS (Glasgow Coma Scale) was saying, but it wasn't my patient. Therefore, it wasn't my problem. That sounds glib, even to my ears. It's survival, though. The patient is the one with the disease. Kate had mentioned something about drunks, and it caught my attention. "Lemme guess--the drunk is our treat 'n' street?" (A term for a treat and release.)
"You got it."
As they say, trolls never die. I shook my head in disgust and headed for the Trauma division of our ER. Kate dutifully followed.
"Give me more on the third victim," I told her.
"Female, twenty-eight. Previously healthy, I'm told. For looking so bad, she actually looks good. I think she's got a good chance." Kate nodded thoughtfully, and tossed a silver-streaked brown ponytail over one shoulder. I know the years she's spent in the Pit, as we've come to call the ER, have contributed to those grey hairs.
I smiled. "Kate, what would I do without you?"
"You probably wouldn't be able to find your ass with both hands...and a map."
Many doctors would have been offended, but I had to smile. She was probably right. The most common complaint I hear of ER nurses is that "they think they're such hot stuff". Well, that's for a very good reason--they are. Truth is, Kate holds the insanity to a manageable level; she keeps the ER in one piece. Dixie taught her well. "Thank you, Ms. Michaels, I'll keep that in mind."
"You're quite welcome, Dr. Morton--any time."
Oh, and she would too.
No more time to play; our trauma had arrived. I dispatched a couple of residents to take care of the two minor injuries, who were on their way. I almost considered taking one of the businessmen in the waiting room to play doctor to the drunk--clean up his scratches and turn him loose. I also considered the possible lawsuit (and Murphy's law says it WOULD happen). An intern could handle him. Issuing orders as I jogged over to meet the paramedics, I again acknowledged that adrenaline was, in fact, a beautiful thing. Hadn't I been dog-tired just a few minutes earlier?
There we were again, set to wage another life-and-death battle. It'd be the same thing again the next night, and the night after that. I must have been crazy for choosing this line of work, but I loved it. I still love it.
I turned to Harris, the paramedic who had brought my victim in. "What's she got on board?"
"Just some D5," he replied, "wide open. Airway's still good." He gave me a quick report on the vital signs as we headed to the trauma suite. I offered up a silent thanks to whoever it was that had decided paramedics could operate under standing orders, no longer needed direct orders for every little thing. I wanted to erect a monument to that person--right next to a shrine in honor of the creator of Haldol. For the first time, I glanced down at my patient, taking her features into assessment. Long, curly black hair; California-tanned skin; chocolate brown eyes that were thankfully reactive to light. "Liz?!"
Harris nodded. "Yeah, her and Jen both. Jen looks okay." He was referring to Jennifer DeSoto, Liz's partner. The two were scarily like John Gage and Roy DeSoto, in more ways than just their looks. And they were also two of the best damn paramedics in the County. It wasn't fair that something as stupid as a drunk driver on their day off would take them out of commission that way. It wasn't fair that the drunk was only scratched at worst. Then again, I had to remind myself that the ER is no place for me to play God. I had a job to do, and I would do it well--never mind that it had just become personal. But there were two other victims unaccounted for, one minor...and then the one that probably wouldn't make it. What about them?
"You know anything about the other victims?" I asked, trying to sound casual as I pushed a syringe into the IV port.
Liz was going to make it; I could tell even now. There are days I really love my job.
The paramedic looked distinctly uncomfortable. "Um, well, the one kid...he's okay. Broken arm...I don't even think he has a concussion."
"Kid?" I frowned--kid could mean actual child, or it could mean someone younger than Harris. I needed to know, because I had the most eerie feeling that the other two victims were both "kids"...at least I would always think of them that way. Liz and Jen were rarely alone, even together, on their days off.
Harris squirmed, causing my fears to escalate. "Jake's gonna be fine; I'm sure..." His words came out in a rush.
My heart clenched. Jake. Jake Brackett--he'd be the only one by that name who'd be out with the two paramedics. Jake...and his sister. I suddenly knew who our fourth victim was, but some part of my mind needed confirmation. "And Sophie...?"
Harris looked to the floor. "Well, she's a fighter."
That was all I had to hear. As I finished up my work, and sent Liz upstairs to ICU...I could take no pride in even the job I'd just finished. It was all overshadowed by a sense of grief, and dread. Grief, in that it seemed almost certain that we'd lose our fourth patient, who was no longer a nameless stranger. She was a vibrant young woman, with a full life ahead of her. I'd watched her grow up. I felt an indescribable anger toward the drunk who'd wrecked her life--our lives. The dread came later, as I realized that her parents would hear the news and arrive shortly. How could I tell Kel and Dixie that Sophie was fighting for her very life? How could I tell two of the closest friends I've ever had that their little girl might not survive?
There are days I really hate my job.
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