Yearnings: A Paranormal Romance Box Set (43 page)

Sal had to be shoved forward, but once her feet were moving, the adrenaline served as a tonic, flushing from her bloodstream whatever irrational fears her mind had conjured.

She summoned a smile when Maria said, “Man, now I’ve got a craving for In-N-Out. We should get it for dinner.”

As they caught up to the gurney, Sal shook her head. “Sorry. I’ve got my big date tonight, remember?”

“
Well, if it’s not as ‘big’ as you recollect, you can always swing back by here. Or maybe we’ll do Fatburger. They’ve got bacon and that fried-egg thing to go on the cheeseburger.”

“
Give me the cholesterol count on that one.” Buoyed by their shared enjoyment of Maria’s hypocrisy, Sal felt the terror-filled memory snap loose and sink from her consciousness.

They reached the gurney as it burst through Trauma One’s swinging doors. “Whatcha got, Frank?”

“
Somebody sliced and diced this guy, bad. Head to toe.”

The sight of the injured man snuffed out any lingering cheer. Even in the flickering penlight, copious amounts of blood stood out starkly red against the man’s T-shirt. It lent the ER’s stagnant air a tang of iron. They could taste the man’s blood loss with every breath.

“
Run, before he gets you!” the man screamed, his pasty lips pulled back into a snarl.

“
I’m hanging four units off the top, unless anyone’s got a problem with that,” Maria more announced than asked as she squeezed past them to the cold storage.

Given that her friend could run a code better than most interns, Sal only added, “Let’s order a blue plate special to go with that blood.”

Paul, their slightly effeminate—yet highly efficient—trauma nurse, organized the stream of other nurses, interns, and med students that followed the wounded addict like hyenas to a kill.

Examining a profusely bleeding wrist wound, Sal was surprised to find the cut so superficial. It barely rated paper cut status. Somehow, though, it had cut down to the artery. If she’d been shown the wound without the volumes of blood, Sal would have bet a month’s salary that the tiny nick would heal without even a scar.

And there wasn’t just one such injury. There were nearly a dozen thin-edged wounds that cut into the worst possible blood vessels. One transected the jugular, and another, the cubital artery, with more scattered over the body. Nobody hit this many major vessels by chance.

“
Somebody really wanted to bleed this guy dry,” Paul commented, voicing Sal’s concern.

“
Hey, maybe your mystery man is a vamp!” Maria said with a wink.

Frank snorted. “A really wasteful one.”

The EMT was right about that. Blood saturated the man’s clothes.

“
Maria, does the pattern remind you of anything?” Paul asked.

“
These are our last two bags of O negative.” Maria finished hooking up the pint of blood to the rapid infuser before she answered. “Damn, but it does. Those boring-ass slides from ‘history of phlebotomy’ class.”

“
Want to fill the resident in?” Sal prompted.

Paul nodded toward the wounds. “These cuts are placed in exactly the same pattern that medieval physicians used to blood-let.”

Maria nodded enthusiastically. “Yeah, yeah. Something about how the cuts represented the five alchemistical axes,” Maria added. “Or Hogwarts’ lines or—”

“
Got it,” Sal said before Paul could go into a rampage over Harry Potter getting more press than Tolkien. “Do we have a central line in yet?”

One of the interns who Sal didn’t yet know by name shook his head.

“
His pressure is for crap. He’s never going to survive this much blood loss.”

True, what poured out of the victim’s veins was now more Lactated Ringers than blood. That didn’t mean they couldn’t turn the tide, though. This wasn’t the Dark Ages. They had more than poultices and potions to counter this man’s mortal wounds.

“
Maria?”

“
On it,” the nurse said as she nudged the intern out of the way.

“
But I was—”

“
Giving up on him,” Sal said, catching the younger doctor’s gaze. “I don’t care how bad he looks. I don’t care what his vitals are. As long as the patient has a heartbeat, we work our asses off. Understood?”

“
Yes. Of course. Can I try again, then?”

“
No,” Sal and Maria said in unison. Normally they were all about the instructing. Working at a teaching hospital, Sal felt it was important to instill in her students a respect for the nature of disease. Medicine was not a panacea, but a mechanism to help the body’s own healing potential.

But with this much blood loss? They didn’t have a moment’s leeway.

They needed the
A
team on this one, and way more O-negative blood.

Sal instructed the intern, “Go downstairs and get another six units.”

The guy just stood there, flustered.

“
Down in the basement. The blood bank. Go!” Paul barked.

Finally, the intern’s feet worked, and he rushed toward the stairwell.

“
I’m in!” Maria announced as she pulled the central line’s guide wire out so fast that it whistled past her ear. “Let’s hook up that second bag.”

The patient grabbed Sal’s wrist. “He’s here!”

Whether it was the man’s chilling tone or the movement along her peripheral vision, gooseflesh raised along Sal’s collar. Instinct snapped her head to the right. Just outside the trauma bay’s door, the edge of a coat disappeared around the corner.

A leather coat.

* * * * *

CHAPTER 4

At the sight of that damned coat, Sal’s memories flooded back. Still, they were more a jumble of images than a coherent picture.

Sal turned to Maria. “Did you see him that time?”

“
Hell, yes! That was a Grade-A piece of ass.”

Maria’s sarcastic tone rang false. There was nothing lighthearted or trivial in Sal’s recollection of this man. Dread constricted her stomach.

Sal called to an orderly walking past the trauma room, “Get security!”

“
Why?” Maria asked. “So they can charge him with illegal hotness?”

“
Hey,” Frank exclaimed. “That’s what you used to say about me.”

“
That’s when you still fit the description,” the nurse teased.

Sal couldn’t take their banter. “Could we please stay focused?”

“
Um, no matter what it sounds like,” Maria said as she indicated the dressing that she tightened. “We’re doing our jobs, Sal.”

Of course they were. Frank applied pressure to an inguinal wound while helping Paul place a Foley catheter. Sal knew that the staff’s levity didn’t affect their efficiency at all. Anyone who thought Maria couldn’t joke and do her job well at the same time didn’t know the punk-haired nurse.

“
That’s not what I meant,” Sal said.

Frank raised a questioning eyebrow. “If you weren’t busting our chops about patient care, then why the dig?”

“
I … I’m …” Sal struggled to bring her previous concern into focus.

Something had weighed heavily on her heart. She could feel the pressure on her chest, making it hard for her to breathe. Yet for the life of her, she couldn’t remember what had made her feel so agitated.

Her best friend hooked up EKG leads as she grinned. “I think somebody’s getting the precoital jitters.”

“
Maria …” Sal warned.

Her friend just shrugged her shoulders, feigning innocence.

As the patient’s pressures slumped, Sal had to get her head back into the game. “Do we have a current hematocrit?”

“
Twelve percent, with total solids of three point zero,” Paul answered.

“
Damn it, we’re going to have to add Hetastarch to the fluids.”

A skittish med student asked, “Hetastarch? That doesn’t make any sense. He’s losing blood, not fluid.”

Even though her nerves were still jangled, Sal steadied her voice.

Traumas, especially ones this severe, could easily overwhelm the greener students. No matter her own trepidation, it was her job to pull it together.

“
We have to think of blood in three components—the red cells themselves, the water they swim in, and the protein that surrounds them. Without this protein to hold the fluid close, the water would leave the veins and flood the lungs and brain,” she said.

Sal placed a pressure wrap over the man’s shoulder as her eyes flickered over to make sure that the intern kept up.

“
With sharp trauma blood loss, he is losing all three. We are replacing the red cells and the fluid rapidly enough, but not the protein, which is far harder to restore. The Hetastarch acts as an artificial molecule to hold the water for us until we can replace the protein itself.”

“
Oh, that does make sense,” the student answered, much calmer.

Sal was about to expound on the principles of hydrostasis when an orderly popped his head into the room. “Security is coming down, but they’ve got some whack job cornered in the cafeteria. It could be a while.”

“
Yeah, okay,” Sal answered tentatively as the orderly hurried along.

Maria scoffed. “Doesn’t he think we’ve got things under control?”

“
I’ve already got him in soft restraints,” Frank stated. “Why would we need security?”

They both looked at her, but Sal had no idea why the orderly thought she had asked for a guard.

“
Maybe he’s having some jitters himself,” her friend suggested.

Suddenly the addict grabbed Sal’s arm. “Don’t let him take me.”

“
Sir, please. Just lie back down—”

The man’s eyes flared with mania. “Promise me!”

Sal squeezed the addict’s hand, trying to keep her own from shaking in panic. “I won’t let anyone take you. Promise.”

As the man flatlined, Sal feared that she couldn’t fulfill her pledge.

* * * * *

CHAPTER 5

Without a word, everyone changed gears into crash mode. Frank compressed the man’s chest while Maria tore open the intubation tray.

As Sal gloved up, the intern rushed back in. “The blood bank said they don’t have enough type O to spare.”

“
That’s just bullshit,” Maria retorted as she got the tube ready for Sal.

“
Tell them to stop hoarding it for freaking surgery.”

“
You’ll have to wait for the cross-match for type-specific blood,” the intern stated.

“
Does he look like he can wait?” Maria asked.

As the intern glanced down at the bloody, flatlined patient, he blanched an unnatural white. “I …They won’t … I mean …”

“
Oh, seriously, grow a pair before you graduate!” Maria snarled, and then turned to Sal. “Chica, can you spare me?”

Sal opened her laryngoscope. “Just make sure it gets done, stat.”

“
Stat, my ass. How about right fucking now?”

“
That sounds just about perfect.”

As Maria exited, she bumped into someone entering. “Hey, look who’s here. Dr. Uptight.”

“
Updike,” Sal and her fiancé corrected in stereo.

“
And next you’re going to tell me that he’s not a Dick.” Maria had to have the last word as she trotted down the hallway.

“
Sorry,” Sal murmured. But seriously, what were his parents thinking? Naming their son Richard Updike? Did they
want
him to get beaten up his entire adolescence?

Richard nodded knowingly. “She’s just using sarcasm to create a false sense of intimacy, since she can’t achieve it in her personal life.”

Which was probably true, but it didn’t make her friend any less funny.

“
You know what Maria says?”

Her fiancé frowned. “Blood happens.”

Somehow, with Richard’s delivery, the line lost its humor. Or maybe it was the addict she couldn’t get tubed because his throat had swelled shut.

“
Paul, can you give me a little articular pressure?” Sal asked.

“
Yeah, sure,” the nurse answered.

With Paul’s assistance, Sal passed the tube smoothly into the patient’s trachea. “Let’s bag him at twenty.”

Quickly, she handed out another half-dozen orders. However, the urgency to her tone had died, along with her patient. Certainly, Sal would perform her due diligence. They’d run through three epinephrine rounds and shock up to three-sixty. Beyond that, she wouldn’t pursue any more heroic measures, such as cracking his chest open. That would no longer be treating the patient, but rather her ego. After a severe anemic event like this, once the heart gave out, the brain had no hope. Even if somehow you coaxed the pump to beat again, the mind was gone, never to return. What was the point?

If the man had any family, Sal would have them make their peace now. To her, the patient’s soul had already left. Whatever horrible, pain-filled life this man had was now past.