Chapter 37
Chapter Thirty-Seven
NYLA
Jaden’s hedge trimmer howls. He curses, I look up. Slightly bent forward, he’s standing next to a gnarled shrub, the hedge trimmer is lying on the ground, and he’s clutching his shoulder.
There’s blood.
Slowly it wells out between his fingers. My stomach clenches.
‘Jaden!’ I drop the loppers and start running.
‘I slipped, no idea how. It all happened so fast.’ He sucks in a sharp breath.
My gaze sticks to his shoulder. ‘You need a pressure bandage.’
Jaden jerks his chin toward the street. ‘There should be an emergency kit in Ray’s car, the key’s in my pocket,’ he forces out.
I help him sit up, take the key, sprint to the car, pull the first-aid kit out from under the driver’s seat, rush back, disinfect my hands, pull on rubber gloves, and grab the gauze bandage.
‘On three,’ I say.
He grits his teeth.
‘One… two… go.’
With a face twisted in pain, he takes his hand away. I rip his shirt open and check the wound. It looks bad. If dirt or bits of plants got in there, it could turn into a nasty infection. With growing concern, I start on the initial treatment.
‘This needs to be cleaned and stitched.’ Looking around for something to secure the gauze with, I spot my belt. That should work.
Jaden says nothing, and my gaze flicks to him. He’s pale, too pale.
Hurriedly, I loop the belt around his shoulder and fasten it. Then I grab the phone to call the ambulance. Jaden doesn’t protest, and that’s when I know how serious it is.
Until the ambulance arrives, I monitor his vital signs as best I can without equipment, check mobility and sensation in his arm, watch his overall condition, keep him conscious. Then, finally, I hear the siren.
His colleague Alex is the first one I see. With the emergency backpack in hand and a serious expression, she appears on the sidewalk.
‘Deep laceration on the shoulder, possible tendon or muscle involvement, contamination likely,’ I call to her as she forces her way through the overgrown garden. ‘Mild circulatory problems, pulse 120, respiratory rate elevated.’
Jaden groans a quiet greeting, Alex drops to her knees beside me and takes off the emergency backpack. I help her carry out the initial assessment and insert an IV line.
Five minutes later we’re in the ambulance and there’s nothing more I can do for Jaden. Jaw clenched, he lies on the stretcher, his eyelids keep drooping shut, but he fights against it.
‘Man, Jaden, how many times have we told you not to play the hero all the time?’ Alex winks at him while my thoughts are on a roller coaster.
What if that was a deep-lying artery? Slow blood loss can be tricky. We definitely need an ultrasound check.
‘Looks like it’s one–nil for the hedge trimmer.’ Jaden’s voice is quiet, but at least the muscles in his face slowly begin to relax.
The painkillers are working. Still, with every meter we get closer to Halifax Harbor Hospital, I grow more uneasy.
If a hematoma forms or the swelling increases, it can raise the pressure in the tissue and cut off the blood supply. Then there is a risk of tissue death.
I know it’s only a cut, yet one horror scenario after another flickers through my mind, and by the time we reach the emergency room, my thoughts are on a roller coaster.
We take Jaden inside, I accompany him into the examination room and it doesn’t even occur to me to leave the treatment to anyone else.
As if in a trance, I administer a local anesthetic, clean and disinfect his wound, and apply a fresh bandage.
The whole time he is far too quiet. He has lost a lot of blood.
‘We’ll do X-ray, CT, MRI and ultrasound, a full blood count, coagulation factors and CRP,’ I say to the nurse who is assisting me with the treatment. ‘He also needs antibiotic prophylaxis.’ A tetanus booster isn’t necessary; he gets that regularly in his job anyway.
Jaden doesn’t deny it. A bad sign.
‘And call a surgeon as soon as the images are ready, have them take a look at his shoulder.’ I nod to the nurse, who immediately gets to work.
When she leaves the room, I sit down next to Jaden and take his uninjured hand. ‘How do you feel?’
His eyelids look heavy. ‘Give me five minutes, then we can get back to work in the garden.’
‘That’s probably not going to happen today.’ I give him a smile. ‘Maybe tomorrow.’
‘Maybe tomorrow,’ he agrees with an extended yawn.
The shock seems to be subsiding. I glance at the monitoring screen. Sure enough, his readings are edging back into the normal range.
I grab a pillow and place it under his head. His eyes close, I gently kiss his forehead, then I sit back down on the stool and lace my fingers through his.
Two hours later he’s already feeling so much better that he even protests half-heartedly against the prescribed tests, and as twisted as it is, I’m glad about that.
‘Well, unfortunately I’m the doctor here, so only what I say counts,’ I reply with a wink and signal to the nurse to take Jaden for X-ray, CT, MRI, and ultrasound.
It wasn’t easy to get Dr. Franks’s approval for all the tests, but I argued cleverly and in the end he agreed.
Maybe he sensed that this is something personal and has nothing to do with some generally overblown sense of medical duty of care.
Jaden gets up from the wheelchair he was supposed to be transported in. ‘Fine by me, but I can walk on my own,’ he says, grabs an IV stand, and hooks his IV bag onto it.
The nurse throws me a questioning look. Reluctantly I nod; Jaden should be able to manage that. The most important thing is that he gets his tests.
‘All right then, you superhero,’ I say, whereupon Jaden chuckles in amusement.
We leave the room; Jaden and the nurse turn right, I turn left. Only now do I notice how tired I am. It’s no wonder—after all, I’ve got an ambulance shift, the gardening, and then Jaden’s accident and treatment in my bones.
It’s been a demanding day. I briefly listen to my body. Does my head feel feverish? Is my heart beating too fast all the time? Am I sweating or shivering?
No. I’m just tired.
Hopefully Jaden’s tests will be finished soon and the results will be good enough that we can go home and get some rest.
Stifling a yawn, I step up to the emergency coordinator’s desk. ‘Has the lab sent over the bloodwork for patient P140424-069 yet?’
‘You mean for your lover, Jaden?’ he asks with a wink.
Wow, that rumor spread fast. ‘That’s exactly who I mean,’ I reply—after all, relationships between doctors and paramedics aren’t forbidden. And everyone’s allowed to know how happy I am.
My thoughts are with Jaden and the garden where we’ll sit together one day.
A dog is romping around between the apple trees, we’re eating crazy stuff.
Then I’ll count the stars in the Greenland sky with him, walk hand in hand with him over hot coals, and get up in the middle of the night to watch the sunrise from a mountaintop with him.
Once we reach the top, we dance a tango.
I want to believe in all of that, despite my doubts that never completely fall silent. We’ll make it, make Lilly’s dreams and our own dreams come true. One after another.
‘Nyla?’ Someone clears their throat.
‘Hm?’ I say absentmindedly.
‘The test results.’
I look up, recognize the emergency coordinator and right after that the file in his hand. ‘Thanks a million.’
Shaking his head, he hands me the documents. ‘Love must be wonderful…’
Oh yes…
Grinning broadly, I take the file from him. Hemoglobin slightly lowered, lymphocytes slightly elevated, blood coagulation minimally altered. With an injury like this, that’s to be expected, no cause for concern.
I let my gaze wander further down. The bilirubin looks good too, but the CRP level gives me pause.
As a reaction to the injury, a slightly elevated level would be expected, but it is markedly elevated.
As if he had an active infection, something systemic perhaps. But then he would also have to have a fever or chills, and he doesn’t. At least I hadn’t noticed anything.
That’s odd.
Confused, I check the platelet count. That too is higher than would be expected.
Nervousness rises within me.
Where is the LDH level?
There – elevated.
Suddenly I can’t breathe.
This is…
This could…
No, no, no, don’t you dare panic now, I scold myself, but only a fraction of a second later it crashes over me like a thirty-foot wave.