22. Dump and Run
Dump and Run
NORA
Andy's words had been sitting with me for two days.
There's a limit to what you can control.
She meant it as reassurance. A way of telling me I was doing enough, that I couldn't hold Ian's life together by sheer force of will.
But I heard it differently. Because what kept me awake at night while Knox slept beside me and Ian was behind his closed door down the hall was the part she didn't have to say out loud.
If the people on Tropicana could box in a firefighter on a motorcycle in broad daylight, what chance did a seventeen-year-old kid have?
Ian had a curfew, a probation officer, and a sister who checked his phone. That was it. That was everything standing between him and a world that already knew his name.
The locker room door opened. I straightened up.
Lori walked in with her bag over one shoulder and her hair still damp.
"Hey." I turned around. "How are you doing?"
She dropped her bag on the bench and opened her locker. "Better. A lot better, actually." She glanced at me. "Josie talked to Sullivan."
I stopped adjusting my badge. "She did?"
"Yesterday. Pulled him into her office after rounds and told him what happened with that lab wasn't a nursing failure.
I followed protocol. The flag never generated.
There was nothing in the working chart when I took the endorsement, and she pulled the audit trail to prove it.
" Lori hung her jacket and reached for her scrub top.
"She told him the incident report needs to reflect the system failure, not the nurse. "
"What did he say?"
"He listened." Lori shrugged one shoulder. "She also told him she's looking deeper into Liz and Jen. Third time something hasn't added up on charts that passed through their hands. She said it's getting out of hand."
I pictured Josie across from Cliff Sullivan in the huddle room, four-ten and unflinching, laying out the audit trail with the same steady authority she'd built over twenty-two years on this floor.
"I'm glad, Lori."
Lori closed her locker and looked at me. The relief on her face was real.
"Nora, Lori." Gracelyn's voice from the hallway. "Huddle room. Two minutes."
We followed her out.
The shift was quiet. Uncharacteristically quiet.
A light board, manageable bays, no one crashing, no one coding.
I was actually staying ahead of my charting, which almost never happened in this department.
On any other day, I would have been grateful for the breathing room.
Today it just meant there was nothing between me and my own head.
I couldn't stop thinking about Ian.
Andy's voice was still in my head. He walks out that door every morning and he makes his own choices until he walks back through it. And somewhere between charting and meds, the worry settled into my chest and stayed there. I couldn't turn it off.
On my break, I sat in the break room and checked my phone. No texts from Ian. No missed calls. I called Knox.
He picked up on the second ring. "Hey."
"Hey. How are you feeling?"
"Sore. The wrist is better than yesterday."
"Are you icing it?"
"Yes, Nurse Avery." I could hear him almost smiling. "Ian left on time this morning. Seven forty-five. I heard the front door."
I closed my eyes. "Good."
His voice shifted. "Are you okay?"
"I'm fine."
I wasn't. But there was nothing Knox could do about the feeling sitting in my chest from across town, and telling him would only move the weight from me to him. He was home, recovering. Ian was at school. Everyone was where they were supposed to be.
"Okay," he said. "Call me if you need anything."
"I will."
I put my phone in my pocket and went back to the floor.
Kip fell into step beside me in the hallway.
"Hey." He glanced at me. "Are you okay? You seem off today."
"I'm fine." I clipped my badge back on. "Just thinking."
"About what?"
I couldn't tell Kip that I'd been sitting in the break room thinking about my seventeen-year-old brother who'd been arrested for stealing cars. So I gave him something else.
"The discrepancies," I said. "In the charting. They keep popping up and I can't figure out where they're coming from."
Kip nodded slowly. "It's Liz and Jen, Nora. You know that."
I looked at him.
"A lot of these errors are on charts that went through their hands. Administration has to see the pattern at some point. They need to let them go."
I didn't say anything. He wasn't wrong. The errors tracked to charts Liz and Jen touched. Josie was already looking into it.
But I didn't know how to feel about it. I hated Liz and Jen, hated what they'd done to me, to Lori, to every shift they poisoned just by being on it.
But wanting someone to lose their livelihood, even someone who'd spent months making mine miserable, still felt wrong. I couldn't explain it. It just did.
"Maybe," I said.
Kip studied me. Then he smiled. "You're too good a person, Nora."
He squeezed my shoulder and walked back toward his bays.
I went back to the floor. The rest of the shift moved without incident.
I discharged a patient, picked up a new admission, ran a set of repeat labs.
The worry in my chest didn't go away, but I worked around it.
I'd learned a long time ago how to function while the worry sat there, how to keep my hands steady when the rest of me wasn't.
Outside, tires screeched on the ramp.
A car door slammed. By the time I reached the bay doors, the car was already pulling away and someone was on the concrete in a spreading pool of blood.
Gracelyn was at the doors. "Gurney! Now!"
I ran. The kid was curled on his side, both hands pressed against his abdomen, his shirt soaked through. I dropped to my knees on the pavement and reached for his hands to see the wound.
He looked up at me.
Ian.
"Ian." My voice came out wrong. Too high, too thin. "Ian, look at me. Look at me."
His eyes were glassy. His mouth moved but nothing came out. Blood was seeping between his fingers, dark and steady, soaking through his shirt into the concrete underneath him. I pressed my hands over his and pushed down. He made a sound that went through me like a blade.
"I need a gurney! I need help over here!" I was shouting. I didn't recognize my own voice. "Stay with me. Ian, stay with me."
"Nora." Gracelyn's hand was on my shoulder.
"He's bleeding out, Gracelyn, I need to get pressure on this, I need—"
"Nora." Her grip tightened. Her voice dropped low, steady, the voice she used in Trauma Two when everything was falling apart and someone needed to hear the calm through the noise. "You need to step back."
"He's my brother."
"I know. That's why you need to step back." She was already kneeling beside me, her hands reaching for Ian's abdomen. "I've got him. Let me work."
I couldn't let go. My hands were on his stomach, his blood on my skin.
Every part of my training was telling me to hold pressure, maintain the airway, assess the wound, do my job.
But the rest of me was looking at my little brother's face and seeing the baby I used to carry around the house, the one I promised I would take care of forever.
"Lori." Gracelyn didn't look up. "Take her."
Lori's arms were around me from behind. She pulled me to my feet and held on. I let her pull me back because somewhere underneath the panic I knew Gracelyn was right. I couldn't do this one.
They got him on the gurney. Gracelyn was calling out vitals while Kip ran the IV setup beside her, his hands fast and sure.
They wheeled Ian through the bay doors. The fluorescent light hit his face, and he looked so young.
Seventeen. A kid who should have been in third period right now, sitting at a desk with a notebook open, bored out of his mind and safe.
Lori held my arm as we followed them inside. I couldn't feel my legs.
Cliff Sullivan came through the trauma bay doors. He looked at the gurney, looked at the patient, and stopped.
He looked at me.
"Dr. Sullivan," Gracelyn said. "Seventeen-year-old male, stab wound to the abdomen. Dumped on the ramp. He's tachycardic, pressure's dropping. We need to move."
Sullivan's eyes met mine. Then he turned to the gurney and his hands were already reaching for gloves.
"Get me two units O-neg and prep for a FAST exam. Page surgery and tell them I need them down here now."
The trauma bay doors closed. Ian was on the other side of them. Gracelyn was on the other side of them. Sullivan was on the other side of them.
I was standing in the hallway with blood on my hands and Lori's arm around my waist, and I couldn't go in.
Lori sat with me. She held my hand while I stared at the trauma bay doors and waited for them to open.
Knox came through the ER entrance twenty minutes later. I saw him before he saw me. He was moving fast, his left wrist still in the brace, scanning the department until his eyes found mine.
I stood up. He crossed the floor and pulled me into him. I pressed my face against his chest and felt his arms close around me, tight, like he was trying to hold me together by force.
"How bad?"
"They took him to surgery." My voice broke on the last word. "Stab wound. He lost a lot of blood."
Knox didn't let go. His hand came to the back of my head and held me there. His heart pounded through his shirt, fast, faster than it should have been.
"He's going to be okay," he said.
I didn't answer. I couldn't make my mouth say something I didn't know was true.
The surgery took two hours. I watched the clock above the nurses' station count every minute.
Knox sat beside me with his hand on my knee.
Lori brought me water I didn't drink. Gracelyn came out once to tell us they were still working.
She looked at me with steady eyes and said, "He's holding on, Nora. "
Josie cleared me from the floor for the rest of the shift.
Sullivan came through the trauma bay doors and looked at me.