2. CHAPTER 2
Pacing the three feet the cord allows me while waiting for someone from the ICU to pick up the damn phone, I huff out a breath, my fingers flexing around the plastic landline.
“Hello. This is Helen in Intensive Care. How can I help you?” She comes off so cold when you first meet her, but she’s worked at this hospital longer than anyone. She deserves all the respect she demands. I’ve known her since my residency here. She reminds me of my grandma, who would always have a big hug and warm cookies waiting for me.
“Hey, Helen, it’s Wyatt from the ER.” I point at two residents rounding the corner towards the front desk and wave them over, giving them a wait-one-minute gesture while I finish my phone conversation.
“Ooh, Wyatt, sweetie, how’s it going down there?” Her tone immediately shifts to affection.
I can’t help but smile.
“Pretty frantic, to be honest. I’m calling for some help. There was a partial bridge collapse and a multi-car wreck with multiple casualties and injuries. They’re requesting help from the three closest hospitals with assistance on scene. I’m going along with two ER residents,” I point between Nate and Courtney, now standing in front of me, “and I was really hoping you could spare some people, too?”
“Oh, how awful. Yes, we can manage with shorter numbers tonight. I’ll send down two technicians now.”
“Thanks so much, Helen. I owe you coffee sometime. Tell them to meet me at the front desk of the ER as soon as possible.”
There’s a scuffling noise, and I faintly hear her call out a muffled, “Lana. Mateo.”
I went on a date with Lana once. She’s part Korean and cute, but we both quickly realized that besides the hospital, we don’t have much in common. We still get along well but agreed a second date wasn’t necessary. She’s good under pressure and will be a great asset on-site.
Another shuffle as Helen turns back to the phone. “I’m going to hold you to that.” She chuckles softly. “They’ll be down shortly. Take care, honey.”
“Will do. Thank you, Helen. Talk to you later.” I hang up and turn toward Nate and Courtney.
Nate’s nerdy, scrawny, and shy, but he knows his stuff and doesn’t hold back from sharing his thoughts. He’s one of those people that if he has something to say, you want to hear it because it’ll be important.
Pushing the thick frames of my glasses back up my nose, I instruct them further. “They need us on-site ASAP.” Courtney sways from foot-to-foot fiddling with her name badge, her dark eyes never drifting from me. “Once Lana and Mateo join us from the ICU, we’re heading out. I need you both to grab enough supplies for the five of us. We each need triage tags, as well as anything that can help staunch wounds and stabilize patients, and some pain meds.”
“You got it.” Nate turns away.
Courtney nods and follows him to the stockroom. She’s our latest hire and while remarkably smart with a great bedside manner, she’s frozen in some higher pressured situations. It’s an issue that’s come up on a few different shifts. It’s always different learning about things and then living through it. Being the lead down here, I’ve seen it countless times with different residents, and it will either make them or break them. The stress of tonight will test her, for sure, but it’s part of the job. This evening will be a defining moment for her and her career.
The five of us cram into the back of an ambulance, making our way to the scene. Lana’s sitting across from me and brushes back her brown bangs while poking around in the bag of emergency supplies. Mateo’s a good work friend, one I don’t see nearly as often as I’d like to, and he’s expertise at the hospital makes him a great aid tonight. I lucked out with him working this shift. Nate and Courtney are sitting next to me, taking everything in with a quiet but keen interest. Nate looks ready to jump into action, while Courtney anxiously picks at her cuticles.
I pass a set of triage tags to each of them. Mateo places it in his lap while he re-secures his hair into a short ponytail. Flipping through the booklet, I explain the different options. “These are fairly straightforward. We’re going to tag every person to let new arrivals on the scene know where help is needed immediately and what can wait. We need to assess people quickly but effectively. It saves time and lives.” I turn more toward Courtney and Nate to show the different colors, since neither has done this before. “Green is for minor injuries, yellow is for stable for now and delayed treatment, red is for immediate, which is critical and life threatening, and black is for deceased or unsavable. I know we want to save everyone, but we need to be realistic about what we’re going into. I haven’t gotten all the details, but our goal is to tag as many people as we can since we’ll be some of the first on-site. Then we’ll shift our focus to stabilizing red-tagged patients to help them make it to the hospital. Leave the yellow, black, and green tags for later groups. Understood?”
Mateo and Lana nod instantly. I look at Nate, who nods right away, and a moment later, reluctantly, Courtney follows suit.
“Good. Any questions?” I take a moment to look each in the eye, making sure we’re all on the same page. Courtney raises a brow. “How do we determine if someone is unsavable?” Her voice cracks.
“We do our best. We’re human, and mistakes will happen, but generally, if they have no pulse, black tag them. If they’re bleeding out or are too injured to make it to the hospital, black tag them.” Even with her mocha complexion, she visibly pales. “If they’re struggling, but it could be feasible for us to stabilize them to make it back to the ER, tag them red. Anything else gets yellow or green, and isn’t our top priority. Does that help?”
She quietly nods while looking down at her hands.
I stand and approach the back doors, my pulse racing and energizing me. The ambulance pulls up to the scene, and we all look out the back windows at the horror displayed in front of us.
There’s a partially collapsed bridge, with cars crashed on what remains, but the biggest wreckage is under the bridge. Countless cars, two semi-trucks, a bus, all smashed into one another. Cops are blocking and directing highway and bridge traffic the best they can. Firefighters are already addressing a few of the flaming vehicles. And we’re the first ambulance on-site.
“Don’t go near the burning cars. Leave that to the firefighters but be prepared to assist them if they can remove survivors. Stick to tagging people until otherwise directed, and if you have questions, don’t hesitate to ask.”
They all nod and stand.
I hand each of them a bag of supplies as the ambulance parks close to the wreckage. My gaze immediately latches onto the upside-down bus, and I instinctively step toward the ambulance doors. My gut twists tightly, an urgency calling to me.
Déjà vu hits me with images of Hope’s motionless body.
Her lying limp in my arms. The glass on the asphalt cutting into the bare skin of my shins.
My chest tightens and caves, my shoulders scrunching near my ears as a cold numbness spreads to every part of me. Shaking my head, I desperately attempt to clear the images. I can’t lose myself in them right now.
Get it together!
Drying my damp hands against my pants as I roll my shoulders back, straightening my spine, and standing taller. I’m no longer helpless like I was that night. I can deal with those memories and emotions after this shift. If I’m going to save these people, I need a clear mind.
I’ve mastered the art of compartmentalizing. I take a deep breath while forcing the thoughts and feelings back into their place deep inside of me, the place I don’t allow myself to explore until I’m alone at home.
Feeling in control again, I turn back to my team. “Courtney and Lana, go left and start tagging people. Nate and Mateo, you go right. I’m heading down the middle to the flipped-over bus. Remember, tag as many people as you can. More ambulances are on the way from other hospitals and will jump into action based on our tagging. Let’s go.”
The back doors creak as I shove them open and hop out. The smell of charred metal and burning plastic, along with the cries of people, pushes the last painful memories temporarily out of my mind. They’ll come back. They always come back. But my mind clears for now, and I focus on the bus ahead of me.
I sent them off in pairs, one experienced and one still learning. Lana and Courtney move from car to car, tagging them greens and yellows. Over to my right, Nate’s jaw trembles, and he places a black tag on the windshield of a smashed-up vehicle. I tag individuals along the way, but my focus remains on the bus. A physical, almost tangible weight in my chest is pulling me, urging me forward faster.
I place two yellow tags, while planning the best course of action. Should I circle the bus and see if anyone was thrown from it? Or head straight for the door and check inside first?
A gust of wind blows, and my gaze snaps to auburn hair dancing with the breeze. I’m ten feet from the bus’s entrance. My gut clenches, drawing me closer to the middle rear of the bus and the woman limply hanging out a busted window. Blood trails down her motionless arms and a growing wet spot matts her hair to her head.
Please don’t need a black tag.
I reach up to check her pulse, my breath catching, but immediately let go when a weird jolt shoots through my body. Not an electric shock; something deeper in my body, a spark or buzz?
I shake my head and recheck her pulse. Her skin’s shockingly warm, and her pulse is strong. I turn her wrist, examining her flayed and torn palms. There’s no movement or reaction to my touch. Looking in through the busted window, my hand still wrapped around her wrist, I see people sprawled inside.
“Mateo. Nate. Over here,” I yell in their direction, straining my voice to be heard over all the ruckus surrounding us. The blaring sirens from more ambulances arriving echo through the night.
Mateo stops next to me, peeking through the window. “Shit.”
“Yeah.” My voice comes out rougher than normal, and Mateo arches a brow at me. I swallow to clear my throat and reluctantly release her wrist while Nate tags a person thrown from the bus with a black tag. He jogs over, stopping next to Mateo.
“There are more people inside this bus. We need to assess them and move them out of the bus. This entire area isn’t safe from that bridge.” I nod toward the girl next to me. “She has a strong pulse but is bleeding out quickly. She needs to be removed, and a tourniquet set.”
They nod and follow me to the front door. The back side is so crushed it wouldn’t be possible to open it without the jaws of life. A wrenching screech follows as I pry the damaged doors open fully. I use the frame for support and hoist myself up inside. My feet thud and slide on the dented metal roof. Taking one tiny step after another, I grab onto random things to remain balanced while the bus wobbles with our movements. They’re both on my heels, navigating the wreckage and stopping to tag people along the way. Most are being tagged black, but there are a few reds here and there. I’m traversing the carnage with a single-minded focus on the girl hanging from the window.
I call out over my shoulder, my eyes locked on her. “Can you both start lifting the red tags out of the bus while I continue to examine people?”
“You got it,” Nate answers, bending carefully to lift the legs of a man while Mateo positions himself to raise the man’s shoulders. “Sorry, sir. This will probably hurt some, but we’ll be as gentle as possible.”
“It’s fine. Just do it,” the man gurgles through clenched teeth. He grunts and moans on his way to the exit. The bus rocks and sways when they step off.
This invisible pull to the woman gets stronger with every step. I need to help her, but I can’t even get to her with everything in the way. I chuck items to the side, the broken seats and luggage making it an obstacle course to reach her. My chest squeezes tightly. I can’t clear the path fast enough. I have to save her. My pulse races, my gut telling me she’s running out of time.
Mateo and Nate return to the bus, and I point toward the other side of the bus. “There are two women tagged red over there.”
“On it,” Mateo says, and Nate murmurs reassuringly to them.
I grab a metal frame as they step off and the whole structure shifts.
I make it to her and immediately jump into the examination. Her left foot is trapped under a large suitcase and a destroyed bench seat. I move the seat out of the way and twist back to scoot the heavy case to the side, revealing her injuries. My breath rushes out. Her ankle is at a 90-degree angle and a metal bar juts from her upper right thigh. She’s hanging limply over a window frame, the glass and metal cutting into her abdomen, chest, and arms. The creamy color of ribs, is a sharp contrast to her olive complexion and the blood coating her skin.
The bus rocks when the guys step back on.
“I’m going to need your help with this one.”
They follow the slightly cleared path I made.
“Her worst injuries are the head wound, a bar through her thigh, and open fractures with exposed bones at her ribs and ankle. We’ll have to pull her in through the window to not disrupt the bar then carry her out the door.” Nate is super helpful but scrawny, so I turn to Mateo. I’m pretty strong, but he looks like a linebacker and puts me to shame. “I need you to go out and lift her upper body and feed it through the window to us.”
“You got it.” He heads out of the bus to the other side.
I gesture to Nate. “I’m going to pull her back this way as he pushes her through, and I need you to lift her midsection so she doesn’t get more lacerations.”
“Yup.” Nate nods and positions himself, lifting his arms to hold and support her weight.
My back goes rigid and my gut tightens at the thought of either of them touching her.
What the hell? I can’t do this by myself. I need their help.
Get a grip.
I sigh and move near her ankles, shaking out my hands just as Mateo appears through the open window.
He steps up to her. “Tell me when.”
Tension tightens my shoulders as I bend over. “Okay, on the count of three, we all lift. I’ll pull. Mateo, you slowly push her through, and Nate, you help lift and guide.” They both nod, and I swallow the thickness in my throat. “One. Two. Three.”
I hold my breath, and we lift together. Mateo maneuvers her inch by inch through the window. Nate’s struggling but still managing to raise much of her upper body. Once most of her torso has cleared the frame, I move to help Nate support her body.
I nod to Nate. “Lift her legs, and we’ll carry her out. Mind the exposed bones.” We cautiously pick our way through the wreckage, ensuring we don’t lose our footing on the metal roof. Stepping off into open space, Mateo’s already pulling out the supplies and arranging them to address her wounds when we settle her on the ground next to him.
Nate takes her pulse as Mateo examines her ribs. My stomach constricts and an itchiness coats my skin. I don’t like them touching her. It’s stupid, especially given the situation and the fact that she’s a complete stranger, but I can’t shake it. “You guys keep tagging people, and I’ll stabilize her.”
They both nod and head off to assess more patients.
Reaching up, I brush her hair from her face to examine the head wound and pause. My hand halting, as I take in her rosebud lips and a light dusting of freckles across her high cheekbones. Uh. I roll my eyes. Why am I freezing in the examination? Why am I focusing on things outside of her injuries? So not the time or place.
With a deep breath, I move her hair further out of the way. Her scalp is clotting well, but there’s still a lump and she probably has a concussion. Her hands and thigh are still bleeding steadily, but her pulse is just as strong. While she looks beaten up, she’s doing well. She’s a bit warm to the touch, though, so fever’s a possibility. I tag her red and move down to bind her ankle and wrap a tourniquet above the bar protruding from her thigh.
I call out to Courtney and Lana. “Can you find me one of the more severe yellow tags?” It’s the process to only take one critical patient in an ambulance in case they code during transit. “I’m taking her and one other back with me for treatment. And I need to prepare the ER for more arrivals.”
I should stay and help, but I can’t pass her off to someone else. Something’s wrong with her. My gut is hyper-focused on it, and I just can’t leave her. I do also need to prep the ER. That wasn’t a lie. A lot of these people will be taken there for care and after getting a look at the damage, I have a better idea of how many beds and gurneys we need.
Lana points to a guy fifteen feet away. “I think that one over there is the best yellow candidate. He’s responsive, but his heart rate is increasing drastically, and he’ll probably flip to red soon.”
“Perfect. I’ll grab the EMT and get them loaded. You four stay here until everyone’s tagged and help stabilize others after that, if you can. Then grab a ride back with one of our ambulances. We’ll need all the help we can get in the ER.” I rake my fingers through my hair. “And if you need me, call my cell.”
“Will do. And I’ll fill in the guys,” Courtney answers with more confidence than I’ve seen in her this entire time. Maybe she’s finally coming around.
I look back at the beautifully broken woman lying in front of me and mentally make note of all her injuries. She has obvious ones like the open fractures, the bar in her leg, and then there’s all the pieces of glass embedded in her skin, the flayed open hand, her head wound… Her eyelashes, rosy lips, her auburn hair, her lean but curvy build…
Wait, what? I shake my head. I only need to be focusing on her medical condition.
What the hell is the matter with me tonight?