Chapter 2 #2
"I’m a doctor!" Jax announces, shoving a panicked flight attendant aside gently but firmly. "Max, get in here."
"Hypoxia," I say, my brain snapping into diagnostic mode. The world narrows down to the patient. The noise fades. "Look at the jugular distension. He’s not moving air."
"Panic attack?" the flight attendant asks, trembling. "Because of the lace documentary? I feel like I’m having one too."
"No," Jax says, ripping the man’s shirt open. Buttons fly across the cabin floor, pinging off the plastic tray tables. "Look at the trachea. It’s deviated to the left. The right side of his chest isn't moving."
I look. The man’s chest is asymmetrical. The right side is inflated and rigid, like a drum.
"Tension pneumothorax," I confirm. "His lung collapsed. Probably a bleb that popped from the pressure change. Air is trapped in the chest cavity. It’s crushing his heart. He’s going to arrest in less than two minutes."
"We need to decompress it," Jax says. "I need a tube. And something sharp."
"Steak knife!" Jax yells, grabbing a metal knife from a passing tray. "Airline grade. Serrated!"
"It’s dull as a spoon," I warn, testing the edge against my thumb. It doesn't even break the skin. "You can’t cut through intercostal muscle with this. I need a trocar. I need something rigid."
The man in the seat wheezes, his eyes rolling back.
"Jax," I say. The sensory overload is clawing at the edges of my vision again. The wailing of the passengers, the hum of the engine, the smell of fear. It is too much. I look at Jax’s hands. They are steady.
Jax looks at me. He sees the panic. He grabs my shoulder, squeezing hard. Deep pressure. It grounds me instantly.
"You are the best anatomical surgeon in the state," Jax says, his eyes locking onto mine. "I am the blunt instrument. You are the precision. Look at the cart. Find me a tool."
I force myself to look away from the dying man and scan the service cart. Napkins. Soda cans. A ballpoint pen.
The pen.
"The pen," I say, grabbing a heavy, metallic pen from the flight attendant’s pocket. "Unscrew it. Take the ink cartridge out. The casing is metal. It’s hollow."
"It’s a Montblanc," the attendant protests, clutching her pearls. "That cost two hundred dollars! It was a gift for ten years of service!"
"Put it on Catherine York’s tab!" Jax shouts. "She owns the airline now! She can buy you a factory!"
Jax smashes the pen against the armrest, shattering the top mechanism. He strips out the ink. He is left with a hollow, metal tube.
"Sanitize," I order.
Jax dumps a miniature bottle of gin over the man’s chest and the pen casing. The smell of juniper fills the air.
"This is going to be medieval," Jax warns. "Max, hold his head. I’m going in."
"Second intercostal space," I recite, my voice robotic. "Mid-clavicular line. Above the rib to avoid the neurovascular bundle."
"Go," Jax grunts.
He takes the serrated steak knife and saws—brutally—into the man’s chest. The skin resists. The man jerks, unconscious but reacting to the pain.
"Deeper," I say. "Pop the pleura."
Jax pushes. Pop.
"Tube," I command.
Jax jams the two-hundred-dollar pen casing into the hole.
HISS.
The sound is audible three rows back. It sounds like a tire deflating. The trapped air rushes out through the luxury writing instrument. The man’s chest instantly deflates. He sucks in a jagged, desperate breath.
“Colour is returning," I report, feeling the man’s carotid. "Pulse is thready but strengthening."
Jax slumps back against the bulkhead, wiping blood on his designer jeans. "That," he pants, "was the most expensive chest tube in history."
"Good news," the Captain’s voice crackles over the intercom, sounding absolutely terrified. "We’ve been cleared for an emergency landing at JFK. A full medical team is standing by. And… uh… Mrs. York has sent a personal message to seats 4A and 4B."
We all freeze. Jax looks at the pen sticking out of the man’s chest. I look at the speaker. The entire cabin goes silent, waiting for the verdict.
"The message reads," the Captain clears his throat nervously, "'To my son and future son-in-law: That was a valiant attempt.
I have calculated the fuel costs of your little rebellion and deducted them from the floral budget.
We are now landing. If you attempt to take a train, I will buy Amtrak.
If you walk, I will purchase the pavement.
Do not test me again, or I will have the reception on a boat.
And Jackson? I know you get seasick. See you at dinner. '"
Jax stares at the ceiling. He looks defeated. He looks horrified.
"She threatened to buy the pavement," Jax whispers. "Max, she threatened to buy the ground we walk on."
"We’re going back," I say, helping the patient sit up. "We have no choice. She has the high ground. And the low ground. And the air."
"I hate her," Jax says. "yet I respect her. But I’m pretty sure she’s a Bond villain."
In row 4, Preston turns the page of his journal.
"Told you," Preston says to Luke. "They seem much more relaxed now."