Chapter 5
Robyn
Six months later…
The turnoff to my house is less than a mile ahead.
I yawn. It’s been a long day. I can’t wait to take a hot bubble bath and to sip on a glass of cold pinot noir.
I recently started a new romance novel, and it’s waiting for me where I left it next to my bed.
I haven’t had nearly enough time for reading in the last couple of months. It’s been a whirlwind.
My stomach growls, reminding me that I haven’t eaten since shoving down half a sandwich right before lunch.
I think I’ll put a mac and cheese into the microwave when I’m done with that bubble bath. Not exactly gourmet, but it’s what I feel like, so I’m doing it. I might even add extra cheese because I’m feeling particularly indulgent this evening.
Everyone’s nerves are completely rattled, my own included. I plan on doing my best not to think about what’s happening on the island right now.
I’ve just activated my turning signal when my phone lights up on the dash, and a ringtone sounds over my speakers instead of the radio.
It’s the Shifter Care Emergency Line.
I groan because it can’t be good.
I tap the screen. “This is Dr. Keller.”
“Hi, Dr. Keller, it’s Tim from dispatch.
” His voice is clipped. “We’ve got a Code Red inbound, ETA nine minutes.
It’s a severe blunt force trauma, with suspected internal bleeding.
The individual is unable to shift back into human form.
They’re bringing him in by flatbed because he’s too injured to airlift. ”
Shit!
I take my turnoff, but only so that I can head back to work.
“Who’s the attending?”
“Dr. Patel will be closing up another patient shortly. He will assist, but needs you in here right away. It’s a severe case.
A male was caught in a rockslide on the north cliffs during a training flight.
It looks like he may have broken both of his wings, there’s possible spinal involvement, and he’s more than likely bleeding internally. They’re pushing fluids.”
I put my foot down on the gas. I’m a good ten minutes from the hospital, if I stick to the speed limit, which I won’t.
“Who’s in the OR?”
“Brody is prepping. Hannah is the anesthesiologist. We’ve paged Lena to scrub in with you.”
“Good. Tell Hannah I want a full dose of etorphine drawn up and a second one ready on the tray. If he’s been down this long and he’s still fighting the shift, his adrenal load is going to burn through sedation fast. I don’t want surprises.”
“Copy that.”
“And Tim, get imaging warmed up. I want a CT the second he’s stable enough, and I want the ultrasound in the theater with us from the start. If he’s bleeding internally, I’m not waiting for a scan.”
“Already on it.”
I end the call and reach for the hands-free earpiece.
Carla picks up on the first ring, which is one of the many reasons I poached her from the front office the day I got promoted.
“Hey, Dr. Keller, is there something you needed? I thought you left already.” She sounds unsure.
Although Carla and I are friends outside of work, at the office, it’s always formal titles and strictly business.
“I have a Code Red incoming.”
“Oh no!”
“I know. I need you to push out my eight a.m. and cancel the morning staff meeting. Looks like I’m going to have my hands full for a good, long while. I might even have to pull an all-nighter. At best, I will be in late tomorrow, at worst, I won’t make it in until lunchtime.”
Her tone shifts immediately. “On it. Do you need anything else, Doc?”
“Call Helen at the front desk and tell her to keep the lobby clear when they bring the patient in.”
“Got it. I’ll organize coffee and a pizza delivery. You haven’t eaten since lunch. Bacon and pineapple?”
I groan. “You’re a godsend. Leave it in the fridge in the staff room, but be sure to put my name on it. I’ll get to it when I can.”
“Done. Go save a life, Dr. Keller.”
The hospital appears at the end of the access road, low and wide and lit up against the dusk.
It was designed by someone who understood what we do here.
Every doorway is oversized; the main surgical bay is built to the scale of a commercial aircraft hangar.
Most of our patients arrive in their human form.
There is a three-story building to the side that houses them.
The “hangar” is for the critical ones who are stuck in dragon form.
I pull into my reserved bay and slow-jog through the side entrance, already shedding my jacket.
“Dr. Keller.” Carla materializes in the corridor with a coffee in one hand and my white coat in the other.
“Status?”
“They’re one minute out. Hannah has the induction room prepped. Lena is scrubbing. Dr. Patel is wrapping up in OR 2. Imaging is standing by.”
“You need to notify the family.”
“Our patient, Onyx’s, next of kin is a brother who has been notified, and he’s on his way, but he won’t arrive for at least an hour. Onyx’s rider is being transported to the human facility in critical condition.”
I down half the cup of coffee and hand what’s left back. “Thanks. Can you stay and meet the brother? Get him to the waiting area, and the night shift can take over from there.” I lift my brows.
“Of course.”
“What would I do without you?”
“You’d suffer.” She smiles.
I smile back. “I’d better get to it.”
I push through the double doors into the surgical wing. The lighting here is a bright, clinical white. The air smells like disinfectant and that particular ozone tang that always hangs around when we’ve had to power up the heavy monitoring equipment.
Brody is at the scrub sink with his arms lathered to the elbow. He’s the best surgical tech I’ve ever worked with, which is saying something after eight years at the exotic animal facility on the Mainland before coming here nearly four years ago.
“He’s here, Dr. Keller,” Brody says without turning around. “The flatbed just cleared the gate.”
I nod and start to scrub my hands. Nails first, with water as hot as I can stand it, going through the motions step by step.
Lena joins me at the adjacent sink. “Hannah wants to know whether you want isoflurane or sevoflurane on the table?” she asks.
I throw out some orders, then I rinse, glove, and gown up. Brody is at my elbow with my headlamp as I walk.
“Incoming,” Hannah calls from the theater. “They’re rolling him in.”
The sound of the transport reaches me before I see it. There is the soft, deep drag of the hydraulic flatbed being guided into the cargo bay, and the murmur of the crew. Under all of that is the hollow rasp that comes from a dragon’s lungs when he’s in serious trouble.
Crap! It’s going to be a long night.
I hope I can save him.
He fills the bay. Black scales striped with darker bands that run from the plates above his eyes down the length of his spine, tail curled tight against his body. Both wings are clearly broken. His eyes are closed. His flanks move, but it’s too fast and shallow for my liking.
“Vitals?” I ask, crossing to the head of the table where Hannah is already threading a catheter through a vein the diameter of my thumb.
As expected, they’re not great.
I shout some orders, and Brody wheels in the ultrasound, and we get to work.
I run the probe against the distended area. The image blooms on the monitor.
“It’s an active arterial bleed,” I say. “If we don’t open him up and ligate it in the next ten minutes, we’re going to be writing a report, not doing surgery.”
“Patel is on his way in to assist,” Lena says.
“Good. Tell him to scrub fast. Hannah, how’s his plane?”
“He’s under. Reflexes are absent. End-tidal reading is where I want it.”
“Keep him there. If he so much as twitches, I want to know about it.”
These bastards can be tricky when it comes to keeping them sedated. Too much and they die, too little and we do. It’s a delicate act with very little wiggle room.
“Yes, Doctor.”
Brody draws a dotted line in surgical marker along the flank, following my instructions, mapping out the incision.
“Scalpel.”
The blade is in my hand in the second.
I make the first cut long and deep, through the scaled dermis and into the muscle beneath. Blood wells up. Brody is at my shoulder with suction. Lena has retractors in her hands, and I dive in.
I’m working by touch as much as by sight, my gloved hand deep in the cavity, tracing the curve of the descending aorta toward the bifurcation.
There.
I feel it.
There’s a ragged tear along the lateral wall of the artery, and the awful rhythmic pumping of blood into the cavity.
“Vascular clamp. Make it the long-handled,” I bark.
The dragon’s flank jumps under my hands.
It’s a small movement, the kind that means a reflex arc is firing somewhere deep in his spinal cord. In a human patient, it would mean almost nothing. In a six-ton apex predator, it means everything.
“Hannah.”
“I see it. I see it. Deepening him now—”
The second flinch is bigger. His tail shifts against the floor with a dull, heavy sound. His chest hitches. The beast under my hands is trying to climb out of the anesthesia.
“Hannah, talk to me.”
“He’s metabolizing the meds faster than I can deliver them.”
I have the clamp seated. I have the bleed controlled. But the tear in the aorta is still there, and if he wakes up with my hand inside his body, he will kill me. He will kill all of us. And he will die doing it.
“Give me the etorphine. Full dose, IV push, through the second line.”
Hannah’s eyes meet mine across the drape. She’s already reaching for the syringe, even though she knows it’s risky.
I nod, and she pushes the drug.
Three or four seconds tick by, and his flanks keep twitching.
Shit!
His back leg jerks, claws scraping the padded surface beneath him. He’s still trying hard to wake up.
Craaaap!
The drug finally hits, and his breathing slows, and his flanks stop jumping. The beast under my hands goes still.
I push out a heavy breath.
“He’s down,” Hannah says. “His pressure is holding. We’re good.”
“Good. Stay on him. We need to finish up. Lena, suction.”
I start on the repair, putting in a series of sutures. They will close the wall. I work as quickly as I can.
“Last one,” I say, setting the final throw. “And…tied.”
“Pressure holding,” Hannah reports, giving me the rest of his stats.
“Releasing the clamp,” I tell them.
I open the jaws slowly. The vessel fills. The repair holds.
I let out a breath.
“Okay,” I say. “That was the part that was going to kill him. Now that he is stable, we can tackle everything else.”
It takes another two hours. Patel scrubs in partway through and takes over the broken wing. Lena handles the abdominal closure under my supervision.
When I step back from the table, my gown is soaked through from the chest down. My headlamp battery is on its last red bar. The monitors are showing numbers that make me hopeful.
“The patient is stable,” Hannah says with a tired smile.
“Thank you. All of you. That was beautiful work.” I strip off my gloves, drop them in the bin, and pull off my mask.
“Lena, walk the post-op orders through with Dr. Patel. I want our patient in the monitored recovery bay.” I give the rest of the instructions.
“Call me if his stats start to trend down.”
“Yes, Doctor.”
“Thank you, team.”
“Excellent job, Doc,” Brody tells me, smiling.
Out in the corridor, Carla is waiting on one of the benches. She has been there, I suspect, for most of the surgery, even though I told her she could go home. She stands up when I come out, and her eyes do that quick head-to-toe check she does whenever I come out of a bad one.
“He’s alive,” I tell her.
“I heard.” She nods. “Onyx’s brother arrived a little while ago. He’s in the family room. Do you want a minute before I bring you to him?”
I look down at my bloody gown, at the smears of blood across the fabric from where I’ve pressed my arms against my own sides during the long closure.
“That would be a good idea.”
She turns to go, then pauses.
“Dr. Keller?”
“Hmm?”
“That’s your fourth Code Red in six weeks, which is terrible, but it may end up being your last for a while…which could be terrible too. I mean, it would be great…but, um…”
“I know what you mean, Carla.” I look at each of my staff in turn.
“The Council is meeting with the Mistveil representation the day after tomorrow. We’ll know more then.
For the time being, it’s business as usual.
” I push out a breath. “Carla, I think it would be best if we still had our staff meeting. Maybe move it to late afternoon. I will do my level best to put everyone’s minds at rest.”
“We are concerned about our positions here at the hospital and rightly so,” Dr. Patel says, looking worried.
“I know you are. My job is just as much at stake as all of yours.”
“It’s great that this war is finally ending, but we’re afraid.” Brody pushes his hands into his pockets. “I like living on Draig Island.” He shrugs. “I had hoped to stay. It sucks that we might no longer be needed here. With the war ending, we will more than likely become obsolete.”
“Let’s wait and see what happens,” I tell them. “Change is here. We can’t do anything to stop it, but it might take longer than you all think for it to happen. Besides, there will always be shifters who need us.”
“The number of injuries will drastically reduce…” Dr. Patel says, holding up a hand. “Don’t get me wrong, it’s a good thing, just not for us.” He shakes his head.
“I hate being in the dark.” Lena looks down at her feet.
“We all do, but there is nothing we can do about it except to keep going. Well done, everyone. I will see if I can get any more information for each of you for that meeting tomorrow. Schedule it for three, Carla.”
She nods once, looking concerned.
“I’ll probably be here for half the night, so don’t expect me in before mid-to-late morning,” I tell Carla.
“Okie dokie.” She nods.
“Back to work, everyone,” I say before heading to my office to change. “Let me know if anything changes with our patient. I will be back to check on him as soon as I have spoken to his brother.”