NINE
CALLUM
The ED commotion hits me like a freight train the second the lift doors open—the familiar cocktail of alarms, shouted instructions, a dropped chart skidding across tile, and someone swearing under their breath about a blown cannula.
And Jordie, standing rigid outside the Resus Bay. Arms clamped around her body. Eyes locked on the glass. She is all hard edges and restraint, concern and rage wrapped tight around something dangerously close to panic.
“Mitchell!” I call out.
Jordie’s head whips towards me. She closes the distance fast, as if waiting another second wasn’t an option.
“I don’t think Hart can tube her,” she blurts, breathless, falling into step beside me.
I follow her gaze through the glass. Hart at the head of the bed. Clumsy. Swapping laryngoscope blades. A nurse squeezes the Ambu bag, but the patient’s chest stays still.
“He’s going for a third,” Jordie says.
Unbelievable.
This should’ve escalated the second Ludwig’s was on the table. Anesthetics. ICU. A real airway plan.
Two attempts should’ve been the limit.
A third is ego. A third is how people die.
“Callum . . .” Her voice cracks on my name.
“I’ve got it.”
Steel. Controlled. Because I don’t fail at this.
I shove the doors open, stepping into the mayhem. The air is thick with the stench of panic. Everyone is moving, but no one is in control.
“Third pass!” Hart growls, sweat slicking his forehead, hands shaking around the laryngoscope.
The monitor blares. Oxygen levels plummeting.
“Dr. Hart.” I snap on my gloves with a sharp pull. “Step aside. I’ll take it from here.”
Hart’s face contorts—disbelief, irritation, ego. “I’m handling it, Dr. Han.”
“The fuck you are.” I shoulder him aside and claim the head of the bed. Because this isn’t about hierarchy anymore. It’s about getting oxygen into a dying woman.
I reposition the patient’s head, tilting the jaw to open the airway as much as possible. I hold out my hand, gaze locked on the patient’s mouth. “Mitchell. 7.5 tube. Hyper-angulated blade. Video laryngoscope.”
The equipment is in my palm before I even finish my exhale.
“Let’s get this done,” I mutter, sliding the laryngoscope into the patient’s mouth.
The view on the screen is nothing but a swollen mess—red, inflamed tissue blocking the airway entirely.
Jordie’s got the suction in place before I ask. When I shift, she’s already supporting the head. No fumbles. No delays. Just absolute efficiency.
I glide the blade deeper, eyes locked on the screen, tracking every millimeter like it’s a high-stakes game of chess. A breath of space opens up—just enough.
I thread the tube forward.
Resistance.
Shit.
I pull the tube out. A flexible introducer is already in my hand. Jordie has read my mind. Focused. Steady. Precise. The most reliable person in this room.
I advance the introducer, feeling for that telltale give. That subtle resistance where I’ve found the trachea.
There. A flicker of ease, the faintest slide past inflamed tissue.
“Railroading, tube size down.” Her voice is calm, the perfect counterbalance to the chaos as she threads the tube over the bougie, our fingers grazing in the handoff.
I push the tube through. No give. I adjust. Different angle. Still nothing.
Shit.
“Failed,” I grit out, yanking the bougie free, cursing under my breath.
Next plan: supraglottic attempt. Laryngeal mask airways are not ideal in Ludwig’s—the anatomy’s all messed up and the seal will be shit—but if I can get even a whisper of air in, it might buy us seconds.
“Get me an i-gel,” I snap.
She hands it to me before the words fully leave my mouth.
I insert it. Too much swelling. I was right. I can’t get a fucking seal.
“LMA failed.” My voice is more clipped now.
We’re down to seconds.
Jordie passes me the bag-valve-mask. I seal and squeeze. No chest rise. No air movement.
Think, Callum.
I could attempt a bronchoscopic intubation, but that takes time, and we’re fresh out of it. Maybe blind nasal intubation, but with this inflammation? The tube won’t pass.
Can’t intubate. Can’t oxygenate.
I glance at the monitor. 42%. She’s dying right in front of me.
Time’s up.
I make the call. “Let’s crike.”
Jordie nods, hands flying, setting up the cricothyrotomy kit. The scalpel is in my hand in seconds.
This front of neck access technique is the last resort. The usual landmarks are buried. But I’ve done this enough times to know what to look for, even under extreme conditions.
Cut. Spread. Membrane. Tube. Then—
The hiss of air is the sweetest sound I’ve heard all day.
“Ventilate!”
Jordie connects the bag-valve to the tube, hands firm, movements sharp. She squeezes.
“Chest rise,” she confirms. “Saturations climbing.”
I nod. “Get her on the vent. Set tidal volume to three-forty. FiO? one hundred. Keep PEEP at five.”
She’s already moving, swapping to the tubing, locking it in. The ventilator kicks on. A breath. Then another. Numbers rising.
By the time I look down, Jordie’s already secured the tube. She moves like a machine; every motion is clean and precise.
A thread of relief barrels in my chest. We’re not out of the woods. But at least we’ve got a goddamn way out.
“We’re taking her up to theater,” I announce. “Get me ICU.”
We push toward the lifts with single-minded urgency. Jordie should be right beside me, keeping pace, ventilator in tow. Should already be moving in sync with me, because that’s just how she is.
But when I turn, she’s standing frozen.
“Mitchell.” My voice cuts through the hallway as the team moves. “You coming?”
She shakes her head. Lips parting, then pressing shut. When she finally forces out words, they scrape out, “No . . . I can’t.”
Her hands tremble. She shoves them into her pockets like that’ll hide it. It doesn’t.
Hart’s voice rips through the air. Loud enough for people to look. Loud enough to make my blood boil. “Mitchell, there’s a pecking order in here! You don’t go over my head to call for a consult from another department.”
Jordie flinches. It’s small. Almost nothing.
Hart’s footsteps are predatory, voice curling into something ugly, “You’re done here! Understand? You’re banned from my ED!”
The sheer nerve. If it weren’t for Jordie, this woman would be dead.
And he has the nerve to punish her for saving a life?
I nearly step out of the lift. Nearly grab him by the collar and make him say it again to my face. I don’t even realize my nails are digging into my palms until pain sparks up my hand.
Jordie just stands there. Takes it. No sharp retort. No fire. No fight.
Her eyes meet mine for a split second before the doors slide shut.
And all I can think is—I’ll deal with him later.
Because right now, there’s still a life to save.