44 - EMERGENCY
Lacey
Ricardo had called on Wednesday. "Lacey, I must see you. Come with me to the club this Friday."
"Friday?"
"I don't want to be selfish, but Janice only goes on Saturday." A smile in his voice. "She's never there Fridays. I want you to myself for once, no Janice reading over your shoulder all night."
I'd laughed and said yes before I'd thought about it. I needed a night of fun, and maybe something daring and new.
Thursday, I bought a new dress, one that barely covered my ass, with a neckline that ran almost to my navel. It cost money I shouldn't have spent, but I felt sexy and dangerous when I met Ricardo. I would give him a chance to make up for last time.
He seemed almost manic when he saw me. "Lacey, you're so beautiful," he said, and kissed me.
In rare form tonight, I thought, and laughed.
Then he sat, and got serious, and didn't meet my eyes.
"Lacey. I'm sorry. But you're fulfilling so many fantasies for me." A breath. "It was such a dream of mine, to be seen like that. Really seen! And you loved it too, yes? So maybe it's not so bad?"
What was he talking about?
The guilt stayed on his face, and it was starting to worry me, when my phone buzzed. I wasn't on call. I looked down.
Derek Harrington.
My heart did a little flip. And so did my little lower heart.
I put the phone to my ear, and said, cheerfully, "These aren't my office hours, Derek. I'm going to charge double."
He ignored my joking tone. "Lacey, I was out hiking a little bit with Jessica because I figured it'd be nice for her to enjoy the weather. Anyway, she got a little dizzy, so I carried her back. You know, she gets dizzy sometimes."
Oh fuck. My mind engaged. I got up and grabbed my handbag. "Derek, please get to the point. Tell me her symptoms."
"Well, she just kept getting dizzier, and that's unusual for her. I checked her pulse, and it's racing, and it doesn't feel right. Too fast to count."
Ricardo looked up. I covered my phone and looked at him. "I have to go. Emergency!"
I cleared the front door in almost a run. "Derek, make sure Jessica is sitting. Put the pulse ox on her finger and read me both numbers."
I covered the phone and motioned at the bouncers. "I'm a physician, and I have an emergency. I need a taxi now." One just blinked, the other smiled at me, looking at my dress. I stepped closer and raised my voice. "A child is dying, get a fucking taxi right now so I can save her!"
They both jumped. "Jesus, yeah, sorry," one said. They ran out into the street and practically stopped traffic.
Derek came back on the line. "Her oxygen is 85 and her heart rate is 220."
Not good. Two-twenty in a four-year-old at rest wasn't fear and it wasn't fever. Nothing benign ran that fast. "Get her ready to go to the hospital, Derek. I'll call you back in five minutes."
"Hospital?"
I cut him off. "Derek, listen to me. She needs a hospital right now.
Do not drive her, and don't wait on an ambulance either—Woodford County's fifteen minutes out before they even load her, and then it's Pisgah Pike in the dark.
She doesn't have that. I'm sending a helicopter.
Where can it land on your estate?" I tried to keep my own fear out of my voice.
He said, "Are you sure, Lacey, I mean—"
"Derek, please answer me. Where can they land?" There was a pause. The bouncer had a taxi door open. I ran to it, praying Derek wouldn't be stubborn. Then he said, "North lawn. It's lit up."
Thank God. I got in the cab. "Centennial Hospital, now. I'm a doctor and I need to be there now. A little girl is in trouble. It's an emergency."
The cab driver said, "I'm on it. No problem, lady." He hit the gas and sped forward.
Two hundred and twenty. Come on, Jessica. Hold on for me. I ran the numbers I didn't want to run, the ones that told me how little time a small heart in that rhythm had.
I called the ER and had them pull the attending out of a bay.
I gave him the four sentences that mattered.
Repaired tetralogy, my patient for almost five years, sat of 85 on a home monitor, rate of 220, symptomatic.
Assume VT until proven otherwise. He activated Flight for Life while I was still talking and put me through to the crew.
I gave them the location and the landing instructions and the sign-over: "Four-year-old girl, repaired tet, tachycardia, sat 85 on room air, presyncopal.
North lawn of the Harrington estate in Versailles.
You know where it is?" They confirmed and then I had paging patch me through to the emergency room team.
"I have a little girl coming in with presumed ventricular tachycardia, O2 saturation 85%, heart rate 220 per dad, dizzy.
She's deteriorating. Clear and prep Resus Room 1, and have the peds ICU on standby. "
While I was confirming everything, Derek called back.
"Talk to me, Derek," I answered quickly. Now he sounded very controlled. Too controlled.
"Lacey, Jessica's falling asleep, like she can't stay awake, and her lips are starting to turn blue," he replied.
"Derek, get her outside to the north lawn—the helicopter is inbound. I need you to make sure the lawn is clear. I'll meet you at the hospital."
I could hear him yelling, "Jessica, Jessica!"
"Derek, do you understand me?"
"Yes, I understand. I understand." Pause. "Lacey, I don't think she's breathing."
"Okay, Derek, I need you to get her on the lawn and start CPR," I said as calmly as I could.
"Yes, yes, okay," he came back. Then I heard him breathlessly yelling at Karl, "Get the lawn clear! ER chopper incoming," and seconds later I heard him counting the compressions, with other voices in the background. I heard a woman's voice tell him to move so she could take over.
"Derek, the flight crew will stabilize her. They should be there in less than ten minutes." I said it in my calmest voice. Special ops or not, Derek was under incredible strain.
As we got to the hospital, the driver said, "Just get out! Go save the kid!"
I ran into the peds ER. The team was ready and waiting. The Flight for Life crew was on the radio. "Ventricular tachycardia, Sat 65 on high-flow, she's cyanotic."
I answered the radio. "When you get here, take her immediately to Resus Room 1."
He responded, "Understood. Three minutes out. Over."
The head nurse handed me a lab coat without a word. I slipped it on absently, checking that everything was ready for her arrival.
Three minutes later, the helicopter hit the deck.
The flight crew came out with little Jessica on the gurney, IV already in, bag mask going.
She was pale, lips a terrible shade of blue.
I had flashes of the crayon heart on my board, her hands on my cheeks.
I heard You could be MY mommy! in my head. Not her. Please, anybody but her.
Derek followed the flight team.
I directed the new arrivals. "Resus Room 1 now."
"Lacey. Save her, please. She can't die," Derek pleaded in a terrifyingly flat voice.
He was pale, sweating, jaw set but eyes too wide. "We're going to do everything we can, but you're in the way here and I need you to move."
I sidestepped him before he had time to answer or move, my focus solely on little Jessica lying limp on the gurney.
Our team took over, and my charge nurse announced, "She's in V-fib," and looked up at me expectantly.
I raced into the Resus Room and took over the code from my ER colleagues.
Please, God, help me save this tiny precious girl.