Chapter 38 #2
“You’ve got Momma and her thirty-one-week boy.” Hunter didn’t stop bagging. “Eira is waiting in the OR for severe chest trauma. Major blood loss. Possible lung involvement.”
Sam nodded sharply. “Flynn, take the momma.”
Flynn moved past them toward Nadya, who stood clutching the plastic bin with the newborn inside. “You’re with me.”
Nadya nodded weakly.
Sam looked down at the tiny infant. “Alright, little man,” he said gently. “Let’s get you warm.”
They moved quickly toward the neonatal transport unit waiting beside the dock. Meanwhile, the Eagle’s Talon operators closed in around Ford’s stretcher. “Lift.” They moved as a unit.
Ford was carried straight into the waiting Defender. Hunter climbed in beside him and continued squeezing the bag. “Go!”
The vehicle roared up the road toward the clinic.
When the Defender skidded to a stop, the rear doors flew open. The operators grabbed the stretcher and ran up the steps, through the doors, down the hallway and straight toward the operating room.
OPERATING ROOM
The doors burst open, and the stretcher rolled in. For a split second, Eira froze.
Ford looked worse than she imagined. He was pale, with blood soaking through the field dressing.
Hunter was still bagging air into his lungs. He looked straight at her. “This is your clinic,” he said firmly, squeezing the bag again. “Your OR.” Another breath was forced into Ford’s lungs. “You know how to operate on this island.”
The words snapped something back into place inside her. Eira stepped forward. “Hartt, intubate and put him under.”
The anesthesiologist moved instantly.
Eira turned to Hunter. “Scrub in.”
Hunter nodded.
She pointed toward the blood cooler. “Hang the O-negative. Both units. Squeeze the bag.”
A nurse grabbed the blood and moved. “On it.”
Liana stepped forward with scissors. “Cutting bandage.”
The soaked gauze peeled away, and everyone in the room went still. The wound was worse than expected. A jagged tear ran from Ford’s armpit toward the center of his chest, deep and still bleeding.
Eira leaned closer under the surgical light. “Scalpel.”
Liana placed it in her hand. Eira made the first incision to explore the wound. The moment the tissue separated, she stopped. Inside the cavity, something dark protruded through the muscle. It wasn’t bone. It was wood—a splintered piece of tree branch driven deep into the chest.
Eira inhaled slowly. “Foreign body.”
Hunter stepped closer. “Hell.”
“Hunter,” she said calmly. “Chest tube.”
His hand moved instantly to the tray. Within seconds, the tube slid between Ford’s ribs and into the pleural space. Air hissed through the suction line. The right lung began to re-expand.
Eira focused entirely on the wound now. Everything outside the room disappeared. There was only the surgical field. “Forceps and cautery.”
Liana passed them to her.
Blood swirled up the suction line as Eira worked deeper. “Hunter.”
“Yes?”
“We need another couple pairs of hands.”
Hunter leaned over the table. “Liana, hang Ancef.” He backed out from the table and yelled out the door, “Marsh, Keller, scrub in.”
Liana grabbed the antibiotics. Eira’s hands moved steadily now. Piece by piece, she began the complicated work of removing the embedded wood, stopping the hemorrhage and repairing the damage around Ford’s lung and ribs.
The monitors beeped steadily. The room moved in calm coordination. The room smelled of antiseptic, cautery smoke, and blood. Eira’s world narrowed to the open wound beneath her hands. Behind her, the door opened briefly.
A nurse stepped inside with them. “Mr. Marsh scrubbed.” A man’s back, face masked with hands up followed. “Dr. Keller scrubbed.”
Flynn entered the room already gowned and gloved. He moved quickly to the table, eyes scanning the field. “Mom’s stable. Resting comfortably. Antibiotics on board. Sam has the baby under control.”
Eira gave the smallest nod. “Good.”
Dr. Keller moved beside Eira. “Doctor?”
Flynn stepped beside Hunter and leaned over the surgical field. “What have we got?”
“Penetrating chest trauma,” Hunter answered while holding the retractor steady. “Foreign body. It’s a damn tree branch. Right lung is expanding with help. But there’s deeper bleeding.”
Eira continued dissecting the torn muscle toward the diaphragm. “Something below the rib margin is bleeding.”
A nurse ran in. “Hemoglobin 4.8.”
Eira chewed her cheek—5.0 was often fatal. She shook it off, carefully dissected the damaged tissue, and lifted another chunk of branch. The moment she lifted it, blood exploded upward. A bright arterial fountain surged from the wound and sprayed across the drapes and Eira’s face shield.
“Arterial bleed! Lap pads!” Hunter barked.
Nurses shoved sterile pads into his hands. He packed them into the wound to slow the flow.
Flynn grabbed the suction catheter, pulled the plastic catheter and dropped the tube into the cavity. “Got suction.” The line filled instantly with dark red blood. He leaned closer. “Source is below the wood.”
Eira pushed the pads aside just enough to see deeper. Her breath caught as she saw it. The wooden fragment had torn through the diaphragm and lacerated the top of the liver. Blood pulsed from a severed vessel.
“It’s phrenic vein and the left hepatic artery,” Flynn said sharply.
“Clamp!”
Hunter grabbed a vascular clamp from the tray and slid it into the wound. “Clamp going in.” He angled the instrument carefully through the blood and suction. “Got the artery!” The arterial spray slowed but didn’t stop completely. “There’s something on the back of the liver.”
Eira didn’t look up. “Suture. Two-zero Prolene on a needle driver.”
Liana placed it into her hand.
“Got the phrenic vein.” Keller blew out his mask below his face shield.
Behind them, Hartt’s voice came from the anesthesia station, “Pressure dropping.”
The monitor alarm began to chirp. “Seventy systolic… sixty-eight…”
Hunter glanced up. “Hang two more units!”
Blood flowed faster through the transfusion line, but Eira didn’t rush. Her hands remained steady as she leaned deeper into the wound. “Retract the liver.”
Flynn adjusted the suction and lifted the lobe carefully. “Exposure good.” Blood continued pooling into the suction tube.
Hartt’s voice again: “Losing pressure.”
Eira remained calm. “Not for long.” She guided the needle through the torn artery wall. One stitch, then another, carefully reconstructing the vessel where the wooden fragment ripped through it.
Hunter held the clamp steady. Keller held the other clamp, and Flynn kept the field clear. The room moved in tight, silent coordination around them.
Finally, Eira tied the knot and looked at Hunter. “Release.”
Hunter and Keller slowly eased the clamps.
For one terrifying second, nothing happened. Then the bleeding slowed and stopped.
Hartt looked at the monitor. “Pressure climbing.”
“Seventy.”
“Eighty.”
“Ninety.”
Eira let out a breath. She forced her eyes not to tear up.
“Nice work, Scout.” Hunter slowly lifted a lap pad. “Irrigation.”
Eira didn’t look up. She was already moving to the next repair. “We have more work to do.”