Authors: Charles Martin
Annie smiled, and Cindy covered her mouth with her fingers. Then Charlie stood up and helped Annie to her feet. "And that's pretty cool, but what happens next is even more interesting."
"What's that?" Annie asked, rubbing her eyes.
"Most of the blind folks Jesus healed ran off home and told everybody they could see. `Bingo! Hello, Mom! I'm back in business!' A natural reaction. But Bartimaeus, he walks over to the city wall where he's been hanging out for years, picks up his jacket, and follows Jesus along the road." Charlie knelt down and placed Annie's hands and fingers along his eyes. "Annie, the best and most beautiful things in the world cannot be seen or even touched; they must be felt with the heart."
"Did Barta ... Bartimay ... Bartimmam . . . " Annie gave up.
"Bart," Charlie said.
Annie smiled. "Did Bart say that?"
Charlie shook his head. "Nope, another one of my heroes did. A lady named Helen Keller."
Annie said, "Oh, yeah, I've heard of her."
Charlie held out his hand. "Annie, I had a wonderful date."
Annie hugged his neck, careful not to knock him in the head with her hard plaster cast.
"I may be blind, but I can still see." He turned in my direction. "Sometimes, I see better than those who still have their eyes."
When Annie let go of his neck, her mouth said, "Good night, Mr. Charlie," but her tone of voice said Thank you.
Charlie responded to the meaning beneath the surface. He was good at that. "You're welcome, Annie."
Cindy hugged him, held Annie's hand, and the two walked inside.
Annie was almost through the door when she turned and walked back over to me. "Good night, Mr. Reese."
"'Night, Annie."
Annie walked inside, and I heard her shut the bathroom door.
Cindy looked at us both and just shrugged her shoulders. "Thanks, guys. See you tomorrow, but. . ." She looked inside and then lowered her voice. "We'd better make it a late start. I have a feeling Annie's going to need her rest."
Charlie kissed her on the cheek, said, "G'night," and we loaded up.
When I placed my hand on the ignition, Charlie placed his hand on mine. "Wait a minute." He placed his finger to his lips and rolled his window down. Georgia lay below him, curled up on the floorboard. Her wagging tail made a rhythmic thumping on the mat. Charlie tilted his head, listening, and when I placed my hand on the ignition again, he took the keys and held them in his lap.
A minute later, Cindy turned out Annie's light, and we heard a door squeak. Then Annie coughed. Deep, low, and loud. It was getting worse. A few seconds passed, and she coughed some more. This time, more spastic, almost twenty times in a row.
Charlie looked in my direction and said, "You hear that girl coughing?"
I knew what he was asking.
He shook his head and smacked me hard in the chest with an open palm. "I asked you if you heard that little girl coughing."
I sat back, looked ten thousand miles through the front windshield, and took a deep breath. "Yes, Charlie, I hear her."
Charlie nodded and handed me the keys. "I hope so." He looked out the window and crossed his arms over his chest. "For your sake, for that little girl's sake, and for Emma's sake, I hope so."
he sound of breaking glass jolted me off the pillow. "Emma?!" I looked toward the kitchen and the sound.
"Emma?!!"
I heard a rustling, and then a muted moan. Emma was lying faceup on the kitchen floor, her nightgown twisted around her. Her eyes were open, and she was gripping her chest. Her face was a picture of excruciation. I hit my knees, felt her carotid and distal pulse, and knew she had about three minutes before her heart stopped.
"Charlie!" I screamed out the back porch while digging through the drawer of kitchen utensils. "Charlie! Call 911! Charlie, call 911!"
If I was to give Emma any chance whatsoever, I had to alleviate the pressure on her heart. The only way to do this was to draw off the blood, and the only thing I had that would do it was the meat injection syringe in the kitchen utensil drawer. I found the sixinch needle, the width of a pencil lead, screwed it onto the syringe itself, and kept screaming for Charlie the whole time. Emma's eyes had closed, and her carotid pulse told me her systolic pressure was now less than 80. She was unconscious, from either the pain or the lack of blood flow, but that was good because I didn't want her to remember what I was about to do. I turned the Oz canister on Full and ran the tubes to her nose. Her neck veins were bulging, meaning pressure was backing up in the system.
At this point, the brain-damage clock started ticking. I spread her out flat on her back, stretched her limp arms above her head, angled the needle, and pressed it into my wife. The tip pierced the pericardium; I drew on the syringe, started the flow, and unscrewed it from the needle. The result allowed a free-flow stream of oxygen-depleted blood to spray across me and the opposite kitchen wall. Almost a liter of blood painted the kitchen walls and floor before the flow slowed and began to pump with the now-regular beat of Emma's heart.
As the pressure subsided and the flow continued up her throat, Emma's eyes opened. This did not mean she was necessarily conscious, but it did mean that oxygen was reaching her brain. If I could get to her heart, sew up the hole, and Life Flight got here in time, we could make it to the hospital, where I could place Emma on a machine that would keep her alive for twelve hours while we found a heart. It was all possible.
I never doubted. I had done it a hundred times. All I needed was enough fluid and to keep one lung expanded and her heart pumping. I looked her in the eyes and said, "Emma, I'm here. Stay with me."
She nodded, closed her eyes, and faded again.
Charlie rushed in with a cell phone held to his ear, and his eyes grew as wide as silver dollars. "What are you doing?!"
I cut him off. "She's okay, but we've got about two minutes."
As his eyes scanned the scene in the kitchen, he screamed wildly into the cell phone for Life Flight.
I put my finger over the end of the needle, stopping the flow, hoping to force some volume out into Emma's body, and said in as calm a voice as I could, "Charlie, IV fluids and toolbox in the trunk."
He looked at me, unsure whether I was helping or hurting. I said it again, calmly, "Now, Charlie."
Charlie flew out the front door, emptied the trunk, and came tearing back into the kitchen. As he did, his heels hit the wet, slippery blood on the linoleum and sent him airborne five feet. His feet flew toward the ceiling while his head aimed directly for the doorjamb. Rather than protect his head, Charlie consciously cradled the fluids in his arms and broke his fall with his head. He should have been out cold, but the adrenaline kept him going. He sat up, turned his head as if he were trying to see with one eye, and held out the IV fluids.
I rigged a drip, handed it to Charlie, and said, "Squeeze this as hard as you can."
I pulled an intubation tube from the emergency kit I kept at the house and ran it down Emma's throat, clearing the airway.
Charlie wrapped his strong hands around the IV bag and began force-feeding the fluid into Emma's heart. His gaze was lost somewhere above her face. As he pumped fluid into her arm and, hence, her heart, the fluid coming out the end of the needle turned pale, and at times, clear.
"Razor blade and wire cutters," I said to Charlie.
Charlie dug one hand through the tool bag and came out with a large pair of Channel Lock wire cutters and a box of regular razor blades.
I turned Emma on her right side, stretched her left arm over her head to pull apart her rib cage, and switched the Plasmalite bag for Charlie. Just before I cut her I looked at Charlie and said, "Turn your head."
He said, "Do what you got to do."
I handed him an eight-ounce bottle of Betadine from the kitchen counter, held out my hands, and said, "Cover me."
Charlie did as he was told and painted my hands and forearms brown. I smeared the over-pour across Emma's chest and ribs and then had Charlie douse the razor blade. Timing my touch with Emma's inhalation, I felt for the radial pulse. It disappeared completely when she breathed in, a symptom called pulsus paradoxus- meaning "paradoxical pulse."
I pulled the pouch from my pocket, threaded a needle, and laid it across Emma's bare chest. Then I cut an eight-inch incision horizontally between ribs four and five, snipped a six-inch section of the rib with the wire cutters, and placed a rolled kitchen towel at either side to both sop blood and hold the ribs apart. I sliced the pleura-the sac that holds the lung-deflating the lung, and pushed it out of the way. I reached in, saw the pericardium, touched it with the tip of the razor, and blood and water flowed.
Peeling away the tough sac exposed Emma's heart and showed me what I was looking for-a transmural rupture. I stuck my finger in the hole, stopping the flow. The heart had begun a ventricular fibrillation. In short it's called V-fib, meaning it had stopped beating and was now quivering. This was both bad and good. Bad in that it had stopped beating, but good in that it would be easier to sew and wouldn't need much help to get going again.
Charlie had emptied his second bag and figured out how to rig the third himself. He closed his eyes and squeezed his palms together, his neck straining under the pressure. He was in pain, the back of his head was bleeding a good bit, and he was both screaming and crying at once. I couldn't tell if his body hurt, his heart hurt, or both.
I placed my flashlight between my teeth, pointed it inside Emma's chest cavity, and stitched an eight hole purse string-a stitch that does exactly what it sounds like. When I pulled it closed, the tissue tore in three places, so I had to reach farther across the tissue of her heart and start over. I pulled again, and it held.
Something outside of me told me I was hearing a helicopter, but whatever it was lied to me. With the stitches holding, I reached in and palpitated Emma's heart with my hand, easy at first, then harder. That's when I realized she had quit breathing.
No problem, I told myself. Sometimes the body just needs reminding. With my hand still palpitating her heart, I breathed forcefully through the intubation tube and filled Emma's lung. The heart took its cue and began beating on its own. I pulled my hand out, Emma breathed by herself, and I checked the carotid pulse. Low but present. The clock was ticking. We were only seconds ahead of the Reaper, but we were ahead.
Charlie finished his third bag, and we were still a long way from getting to the hospital. I propped Emma's feet up, hoping to drain whatever fluid I could into her chest, and checked her pulse again. This time there was none. I turned her again, massaged her heart, and kept breathing into the tube coming out her mouth.
Charlie was covered in red, screaming at the top of his lungs, and looking toward the ceiling. Whatever he was looking for, he couldn't find. Inside myself, I knew we still had time.
As I was leaning over to breathe again, a young paramedic dressed in blue and wearing rubber gloves came flying through the front door. He looked at me, saw nearly five liters of blood and fluid splattered and puddled across the kitchen, and his jaw dropped.
I screamed, "I need two pads and charge to 200! Now!"
He shook his head as if dazed.
"Charge to 200! Now!"
The paramedic dropped his bag, pulled out two pads attached to long wires, and stuck them to Emma's chest and back. I massaged, breathed again, and he charged the machine. When the green light told him we were go, he said, "Clear!"
I pulled my hand, and he shocked Emma. Her body stiffened, relaxed, and I felt for a pulse. Nothing.
I reached in his bag, pulled out what I needed, and said, "Highdose epinephrine! Shock at 300!"
The paramedic, now joined by the driver, had connected a fresh IV bag and was continuing to force-feed Emma. He did as he was told. I expunged the air bubbles, slammed the syringe into Emma's heart, shot in the entire dose, and pulled my hand away. The paramedic yelled, "Clear!" and I watched Emma's chest rise and fall.
Nothing.
"High-dose epinephrine and shock at 360! "
"Clear!"
Nothing.
Charlie began screaming, "Emma! Emma! Emma!"
I looked at the paramedic and screamed, "Shock at 360!"
He said, "But sir . . . "
"Shock at 360! Now! Do it now!"
He looked to his partner, who had quit squeezing on the bag and was just looking at me.
The driver said, "Sir, the patient is asystolic. By protocol, we're in the V-fib algorithm and-"
I grabbed him by the throat and squeezed as hard as my hand would allow. "The patient is my wife! Charge and shock at 360!"
I shoved him out of the way, charged the machine, shot in more epinephrine, and shocked Emma at 360. She convulsed one last time, her arms twitching almost as if she were hugging herself or trying to keep warm, and fell limp.
I was charging the machine and pounding on Emma's chest with both my hands when Charlie tackled me off her, slamming me to the floor and sliding us across the linoleum where he pinned me and held me down.