Chapter 3
Chapter Three
NYLA
Inhale. Hold. Exhale.
With my eyes closed, I lean against the wall and listen to myself.
In the midst of the hectic activity in the emergency room corridor, that’s not as easy as it is at home.
And I also hadn’t expected that I would already be working today, even though only the introductory meeting with Dr. Franks had been planned.
I thought I would have one more night before things started. But the emergency room was overloaded, and then a colleague came down with a fever, so my boss asked me to help out for a few hours. Of course I grabbed a white coat and a patient file.
Working again, helping people again, is wonderful. I just hadn’t thought it would take such a toll on my body.
Is that my racing heartbeat, or is it the quick steps of the nurse that are causing the pounding in my eardrums?
Do I have a fever, or am I just warm because I’m standing next to a radiator?
Is it my thoughts that are riding a roller coaster, or is it only the voices of my colleagues, the scraping of mobile hospital beds on the linoleum floor, and the beeping of the monitors overlapping and creating this chaos?
I make an effort to block out my surroundings.
Inhale.
I settle down, I am completely with myself.
Hold.
My pulse is normal, just like my temperature. My thoughts are clear and focused.
Exhale.
I let go of the tension, feel that I’m ready, lift my lids and suddenly find myself looking straight into Dr. Franks’s face.
My boss’s graying eyebrows draw together, concern is reflected in his light eyes. ‘Is everything all right with you?’
Even though we haven’t talked about it in detail yet, he knows my medical history and understands what it means for me to be working again, and in a job that is so emotionally and physically demanding on top of that.
The fact that he worries about me makes me smile, even though I definitely share his concern.
I wish it were different, but I simply have to take good care of myself.
‘Yes, I’m okay, thank you,’ I say, because I want to make this work.
‘I’m sorry I threw you straight into the chaos.’ With his gentle gaze and gray temples, he looks like a kindly grandfather.
I shake my head, missing the feeling of my long earrings that ought to brush against my neck when I do, but I can’t wear them at work. ‘Don’t worry, I’ll take care of myself.’
For months I’ve been preparing for this day. I know how to deal with stress, how to stay calm even when everything around me is in chaos. If I couldn’t do that, I couldn’t work here and couldn’t do what I’m passionate about.
Now he smiles as well. ‘Good. How’s the girl with the tibia fracture doing?’
‘The colleagues from pediatrics are about to pick her up,’ I reply. ‘Fortunately, the additional X-rays of her hip, spine, pelvis, and the entire leg axis were unremarkable.’
‘You ordered additional images?’ He tilts his head to the side and looks at me searchingly.
Of course. ‘The little one fell off a climbing frame; I had to check her musculoskeletal system for hairline fractures to be on the safe side.’
He briefly furrows his brow. ‘You were more than thorough there.’
‘You can never be too careful.’ Which is why I’ll also recommend a CT scan in the emergency report—better safe than sorry. X-rays simply can’t make every problem visible.
‘She’s in the best hands in pediatrics,’ he replies, and I can’t shake the feeling that he’s trying to reassure me.
‘Absolutely,’ I say, thinking of my roommate Autumn, who’s having her first day there tomorrow. Who knows, maybe she’ll be the one to continue treating the girl. ‘I’ll get the paperwork for the little one done, then.’
After my boss nods in agreement, I turn away.
‘Oh… Dr. Moore, one more thing,’ my boss calls after me. ‘A few of us are going out for a drink later. Will you come along?’
In five minutes, the colleagues from the evening shift will be here, then this unscheduled stint in the ER will be done. My body has held up; as soon as Dr. Franks and I have caught up on the introductory meeting, I really should go home and rest.
I turn back to him. ‘I can’t today,’ I reply deliberately casually, even though my muscles tense up at the mere thought of going out. At some point it will be possible, hopefully, but not today.
On the way to the doctors’ room, I take several deep breaths.
As I pass the coordination desk, the two double doors that lead outside suddenly swing open.
With a rush of fresh air, three employees in paramedic uniforms come in, together with doctors and nurses from the ER who must have been waiting outside for the ambulance to arrive.
‘Male patient, 30 years old, unconscious, fever, severe abdominal pain,’ reports the man with jet-black hair and five-day stubble, whose dark blue paramedic uniform is covered in wood shavings and dust. ‘He collapsed in a shed.’
I step aside to make room for the team. Something tells me that this paramedic doesn’t notice me. He’s too focused on what he’s doing.
Quickly he pushes the stretcher farther down the corridor, his expression concentrated, his muscles tense. ‘Temperature 39 Celsius, pulse 130, blood pressure 80 over 53, respiratory rate 27. Ringer’s lactate infusion is running.’
He passes me, and a mix of wood scent and aftershave wafts into my nose. I don’t even really know why I do it, but I watch him go.
Wait a second.
Is that blood on the back of his head?
‘No abnormalities en route, condition poor but stable,’ he now informs the attending physician.
I catch up with him. And in fact, he has a laceration, quite a large one, actually.
‘Trauma room three is ready,’ someone calls. An orderly runs ahead and opens the doors.
The team pushes the gurney inside. ‘Suspected appendicitis, possibly perforated.’ His deep voice is full of emphasis.
Suspected diagnoses from paramedics are actually not part of the handover.
He should be focusing on the facts; the doctors are responsible for diagnosis and treatment.
Besides, he doesn’t even seem to notice that he himself is injured.
With a peculiar mix of fascination and incomprehension, I watch as he now also refuses to leave the room, even though the handover is finished.
‘Thanks, we’ll take care of him.’ An orderly steps up beside him with a warning look.
Now the blond paramedic grabs his injured colleague’s arm and pulls him out of the room. ‘Come on, Jaden, we’ve got a lot to do.’
So the guy’s name is Jaden. Is he new to his job and hasn’t internalized the procedures yet? Or is there another reason why he’s having such a hard time tearing himself away from the patient?
The doctor gives the first instructions for further treatment, an orderly closes the doors to the trauma room. As if a storm had just swept through and then suddenly died down, calm returns. Jaden’s shoulders slump forward, and he lets out a long breath.
The blond paramedic pulls him away from the door and spots me against the opposite wall. ‘Do you have time? There’s a head wound here that needs stitching.’
‘It’s just a scratch,’ this Jaden says to me, shaking off the blond guy’s hand. ‘Give me a compress, that’ll do.’
‘Believe me, you need more than a compress.’ I point to treatment room five at the end of the hallway, its door standing open. ‘In here, please, I’ll patch you back together.’
Despite his protest, the blond guy with the full beard steers him into the room. ‘Hi, I’m Ray,’ he says to me on the way. ‘Are you new here?’ Searching for my name, his gaze wanders to my lab coat, but doesn’t find anything there. I won’t get my name tag until tomorrow.
I nod. ‘Nyla, nice to meet you.’
He points at my patient. ‘And this is Jaden.’ With a conspiratorial look, he glances at me. ‘He thinks he’s a superhero, but—spoiler alert—he’s not.’
‘I do not, I can just tell the difference between a serious and a minor injury,’ Jaden replies, amused.
We reach the treatment room; Ray doesn’t let go of Jaden until he’s seated on the examination table. ‘I’ll make sure a file gets opened for him,’ he says to me. ‘And you’—he points his index finger at Jaden—’you are going to let yourself be treated, no ifs, no buts.’
‘Yes, Dad, I’ll be good, I promise,’ Jaden replies, sounding anything but repentant.
Ray grins. ‘Good, then you’ll get a lollipop afterwards.’
I can’t help but laugh. Those two are really something. ‘All right, let’s get started.’
While Ray leaves the room, I pull on gloves and step behind Jaden to take a closer look at his wound. About five centimeters long, dead straight, no fraying, but full of wood splinters.
‘How did this happen?’ Carefully, I push his dark hair aside.
He shrugs. ‘A wooden board decided to throw itself at me while I was treating the patient.’
‘That wasn’t very nice of the board,’ I say, amused, and gently feel his head. ‘Were you unconscious?’
‘It was a tiny wooden board, not a steel girder several meters long.’ There’s an easygoing note in his voice.
The board was definitely not tiny. I walk around the examination couch he’s sitting on and pull the flashlight from my coat pocket. ‘I see. And did this tiny board only get you on the head, or anywhere else too? Your back, for example?’
‘No idea.’ Our gazes meet, and in his green eyes I can see that he really doesn’t know.
He might have been briefly unconscious after all. Worried, I step closer. ‘What exactly were you doing when the board hit you?’ I ask, switching on the flashlight and checking his pupillary response.
The green of his iris reminds me of coastal grass, the dynamics of his gaze resemble the sea on a stormy day. For a fraction of a second I’m caught by those eyes. I blink quickly.
‘Well, you know, the usual when a patient is lying unconscious on the floor in front of you and could die any second. I was taking a nice, relaxing break and lit up a cig to unwind.’ He winks at me cheekily.
Not funny. Not at all. He could be seriously injured.
‘Your pupillary response is normal.’ Very good. At least a little relieved, I lower the flashlight. Our gazes meet again, there’s a lively sparkle in his eyes. I raise my index finger. ‘Follow my finger only with your eyes.’
My finger moves to the right, but he keeps looking at me. ‘Come on, I’m fine, a neurological exam isn’t necessary.’
‘An undetected and therefore untreated brain contusion can lead to permanent damage,’ I reply urgently.
‘Brain contusion? That’s really far-fetched.’ Instead of letting me continue to check him over, he tries to get up from the cot. ‘That’s enough now.’
If he thinks I’m going to let him leave with this injury without thorough checks and treatment, he’s gravely mistaken.
Firmly, I place my hands on his shoulders.
‘You could also have a cerebral haemorrhage, which can lead to paralysis, loss of consciousness, and in the worst case, death from brainstem herniation.’ And with that, I’m not telling him anything he doesn’t already know because of his job—which makes his behavior even more paradoxical than it already is.
He spreads his arms. ‘Come on…’
With a shake of my head, I signal to him that I won’t make any compromises.
His expression turns uncomprehending. ‘I’m a paramedic, I know that the risk of a cerebral haemorrhage with this kind of injury is virtually nonexistent.’
Probabilities. So that’s what it’s all about for him. ‘Unfortunately, life doesn’t always stick to probabilities.’ Melancholy fills my voice, but he doesn’t seem to notice.
He looks at me imploringly out of his green eyes. ‘Just stitch up the wound. I have to get back to work.’
I try to read in his expression what’s going on inside him. Why is he resisting the examination so much? It’s necessary; his life could depend on it, and he knows that.
He must be a very special specimen of a one-percent person. What did Ray call him? A superhero?
Earlier I thought that was a joke, now I’m not so sure. And I don’t understand it. Day after day, he sees in his job how quickly a life can change. That it can be only fractions of a second, a few breaths, sometimes not even a single blink of an eye—and nothing is the way it was.
He knows that. He knows that none of us is safe. How can he be so reckless?
I lean over him until there are only a few centimeters between our faces. His woody scent envelops me, I hear his breathing, feel the warmth radiating from him.
‘I want to examine you thoroughly. It’s only for your own good.’ I fix him with an emphatic look. ‘Please.’
He briefly furrows his brows, then tries to get up again. But I’m faster and take his chin in my hand. That’s when I see the surprise in his eyes.
It doesn’t seem to happen very often that he doesn’t get what he wants.
Out of nowhere, a knowing smile plays around his lips.
‘You know, I really think it’s sweet how much you worry about me, and I get that you can’t keep your hands off me, but this is going a little too fast for me.
’ Now he moves toward me, the distance between us so small that the tips of our noses almost touch.
‘Do you always come on this strong when you like someone?’
All at once I feel hot, even though there’s no reason for it. Still, I don’t let it rattle me. No matter what he tries, he is not leaving this room without an examination.
‘Didn’t you just promise your daddy you’d be good?’ I hold his gaze. ‘You want the lollipop, don’t you?’
A cheeky sparkle appears in his eyes. ‘He doesn’t have to know. It could be our little dirty secret.’
Needlessly, my pulse speeds up.
Now he looks me over, and he looks way too hot doing it—unfortunately. ‘Come on, you want it too.’
Absolutely not. ‘Um …’
His lips curl into a pleased little smirk. I stare at them—probably, I don’t really know, but I think I do.
Why am I doing that?
I quickly straighten up to interrupt whatever this is and get back to the reason we’re both here: a thorough examination that might just save his life.
With a deliberately serious expression and, unfortunately, a heart that’s still pounding, I raise my index finger. ‘Follow my finger only with your eyes.’