Strong and focused since the day she entered medical school, Ann Thomas soon became one of the best emergency physicians in New York City. Her good interpersonal skills and abilities for leadership granted her the position as chief of ER at County General Hospital. The doctor always had a special talent for diplomacy; she knew very well how to talk her way out of stressful situations.
“Peter, what's with the attitude? I know, we have a lot to work on, but you don’t see my blonde hair turning gray, do you? Besides, I got us six months to turn this place around. It’s an improvement!” Ann kept one eye on the status of the elevator as she delicately steered the conversation with her colleague.
“I know…” Dr. O’Neil shook his head in exasperation, “but what's gonna be different in six months?”
“Things change, Pete. Who knows, maybe six months from now you’re the new Chief of Staff,” Ann trailed off as she headed toward the opening elevator doors.
The expression on Peter’s face became one of puzzlement and he hurriedly followed her to the open elevator. “What’s that supposed to mean?”
Ann smiled graciously. “Let’s just say that your friend, Mr. Wilson and I, we tend not to see eye to eye.”
Peter smirked, extending a hand to keep the door from closing. “Does anybody heading up a busy emergency department get along with the hospital manager?” He opened his mouth to speak further on the subject but his pager did it for him. “Damn! I’ve got to go but we’ll finish this up later,” he said leaving the elevator to go.
Ann shook her head and moved back toward the front desk. She examined the board, then picked up a few charts to review.
“Resident evaluations” the words floated on the air. “When are they due?”
Ann looked around for the source of the question. Seeing no one within her five feet, she cautiously replied as she circled the desk. “Next Monday.”
A large mound of shifting papers drew her eye as the mystery of the disembodied voice was solved.
One of her attending doctors came into view, huddled behind the desk, diligently engaged in paperwork. “Dr. Chou, are you hiding from someone?”
“God, I forgot how much paperwork this is,” he mumbled. “I've got really sick patients on my service and every time I turn around there's a resident staring me up in my face.”
“We’ve been there and done that, my dear Chou. That’s how we learned.” Ann cocked her head to a side and smiled sarcastically. “And now, we are on the other side of the desk. That’s the price we pay for being real doctors.”
“When you put it that way, it sounds so logical” Chou grimaced. “But I still don’t have to like it.”
“No one said we did.” Ann put the chart back in place. “It just comes with the territory, like being woken out of a sound sleep at 2am.”
“Help, please somebody help!”
Ann looked up to see a young man carrying a passed out teenager boy over his shoulder. “Speak of the devil,” she muttered.
“I need some help, my brother’s been stabbed. Please help me.” Expressive eyes bore his pain, “Please.”
True to her nature, Ann reacted by grabbing a gurney and pushing it closer to the blood soaked duo.
“Here, put him on this stretcher.”
“Please do something.” He begged as he followed her command.
Ann was touched by the sight of this bulky man crying like a baby pleading over his brother’s life.
“It is okay, Mr.…?”
“Gordon, Jeremy Gordon”
“It’s okay.” Ann stepped away from the stretcher “Go on, Lily.” She nodded to the nurse by her side. “Chou, I need another hand here” She motioned for the nurse to rush the patient into a trauma room and turned her attention back to the hysterical man.
“Mr. Gordon, we’ll do whatever we can to save your brother, I promise”
“He’s only thirteen, doctor, you can’t let him die. He’s too young to die!” Jeremy trailed along after Ann. “Can you stop the bleeding?”
Lily quickly intercepted him when he crossed the threshold of the trauma room. “Sir, you're going to have to step back, right now!” The nurse escorted the man out of the room as another doctor slipped by.
“Hey, Thomas, I need a consult in trauma three.” The white-coated man stood at the door waiting for an answer.
“Sorry, Ben, I have a life trying to bleed out here. Maybe O’Neil can help you out,” Ann offered donning her gloves. “Alright people, what do we have here?”
“Stab wounds to the left neck and chest, with two more to the belly.” Dr Chou declared as he continued examining the injuries.
“Pulse ox is eighty-three.” Lily informed them.
“Alright, let’s intubate him. Number eight ET tube, please.” Ann requested. “Better call respiratory while you’re at it.” Ann concentrated on inserting the breathing tube. “I’m in. Bag him.”
Chou looked to his chief of staff. “Chest tube?”
“What’s his blood pressure?”
Lily checked the monitor. “Its 90 over 50.”
“Central line first, then the chest tube.” Ann replied. "Hang two units of O negative blood for the patient on the rapid infuser." Ann commanded then looked up to see a nurse standing at the trauma room’s door.
“Dr Thomas, they need a doc in radiology for an IV contrast injection. Patient’s name’s Dennis.”
“I think Rosenberg’s,” Lily piped in, spiking a bag of blood, then hanging it.
“Sorry, but I’m a little too busy right now. You’re going to have to find him.” Ann probed the incision she’d just made on the left side of the patient’s chest to insert a chest tube. She glanced over to her colleague. “How are you coming with that line?”
“I’ve got it,” Chou reached for the IV tubing in Lily’s hand.
“Make it quick, Chou. This kid doesn’t have all day. Lily, call the OR and tell them we’ll be up in less than five.”
“Minutes or hours?” Chou said with lilt.
“Minutes, Lily.” Ann glared at the man opposite her. “Always minutes. And for that remark, Dr. Chou, you just won a nice trip upstairs to accompany the patient.” She connected the chest tube to its container and secured it in place. “Come on, Chou, tic-toc, tic-toc!”
“I’m done, I’m done!” Chou hastily tied the last knot and clipped the suture material.
“Good, that will give you just about three and a half minutes to get there.” Ann turned toward Lily as if prompting her.
“OR will be prepared and waiting for us.” Lily grabbed her portable monitor and within seconds, the patient was connected to it. “I’m all set.”
“Ready or not, I’m coming,” Chou grimaced as they started out of the room. “Enjoy your rest, Ann.”
Ann snapped off her gloves, shooting them into a wastebasket and snorted. “As if!” She then turned to see a stretcher surrounded by paramedics and police officers rushing in through the emergency doors.
“What do we have here?” she questioned approaching the group.
“Police Officer with a gunshot wound to the back. No exit wound.” One of the paramedics informed while rolling their patient into a trauma room followed by two nurses and a resident.
“All right, on my count,” Ann donned a new pair of gloves and positioned herself at the head of the patient. “One, two, three, go.” She helped the paramedics move the lifeless body from the stretcher to the bed. “What happened?”
“We got a call for an officer down,” one medic started.
Mark stepped forward trying hard not to shake. "We were making a bust when all hell broke loose.”
“I’d say that’s pretty apparent.” Ann visually assessed her newest patient. The doctor’s gaze fell on the woman’s face. God, she’s beautiful. Ann’s eyes traced every line, every contour of the brunette’s strong features. In that moment, all the noise and chaos of the emergency room just faded. Ann felt a sudden, powerful urge to touch the patient. She reached out and felt the woman’s neck. The pulse seemed to be growing weaker by the second.
“The perp got the drop on one of our guys and Sam here” Mark nodded toward his co-worker and friend lying motionlessly on the stretcher “tried her best to get him out of harm’s way.”
“Me! It was me Sam was trying to save.” Jake shrugged off a supportive hand and stepped forward from the crowd of officers. “I don’t deserve it. I’m not her partner. I’m only a rookie,” he began to trail off. “It all happened so fast."
The outburst snapped Ann out of her reverie and back into doctor mode.
“How long has she been down?”
“I…I lost all sense of time when…” Mark hesitated, starring off into space.
"Twenty minutes,” Jake supplied the information as best as he could. “A half an hour at the most since she threw herself in front of the bullet that was meant for me."
"Did she fall? Hit her head perhaps?" Ann’s questions were direct as were her fingers moving from one pulse point to another on her patient.
"I don't think so." Jake looked away from Sam as a nervous smile flickered across his lips. "You might say I cushioned her fall. It should be me lying on that table, not her. You got to help her, Doc." Tears started to well up in his eyes. Suddenly Jake stripped his shirtsleeve from his arm. “Here, take my blood if she needs it.” He looked over to Ann as did the rest standing in the police ranks, some reaching to roll up their sleeves as well.
“Its okay buddy, you did nothing wrong.” Mark placed a comforting hand on the young cop’s shoulder. Visually shaken, the rookie was enfolded by a wall of blue as his colleagues reached out to steady his resolve.
“Come on guys let’s get out of the doctor’s way. Let her save Sam.” Mark felt his guts turning as he took another glance at his friend and saw her getting paler. “You will, won’t you Doc?”
"We'll give it our all." Ann reassured him with a nod as reluctantly, one by one, the police officers and paramedics filed out of the room until there was only Mark standing by the door. Ann watched Sam’s pulse weakening gradually as if her life had been hanging on her colleagues support. The moment Mark stepped out of the room the heart monitor displayed nothing but a flat line.
"We've got a traumatic arrest here, people.” Ann quickly enlisted the aid of her staff. “Mike, get two units of blood running with more on the way. David, cut her clothing off, it’s time to see what we’ve got going on inside. Sarah, set up a thoracotomy tray, then call the OR and tell them to assemble the Thoracic team. We'll be coming up as soon as we have a pulse back."
Ann positioned herself at her patient’s right side. Once Sam’s chest was bared,
The doctor used a scalpel to make the incision. “Rib spreader.”
Ann quickly maneuvered her fingers until they reached her ultimate goal, Sam’s heart.
“There’s no blood in her heart. Run everything we got wide open. I need more volume and space, so I can see.”
The team reacted, giving Ann exactly what she asked for. After a few more cranks of the rib spreaders and a little help from the resident, Ann was able to view the organ.
“There’s our problem,” Ann declared noting the stream of blood coming out of Sam’s heart. Without a second thought, Ann used her pinky to plug up the hole. The blood started filling up Sam’s heart again, giving it a more normal appearance cradled in Ann’s hand.
“Beginning heart massage,” Ann declared as she squeezed and released trying to establish a rhythm. “Come on, dammit! We need more volume.” Her will was evident in the tone of her voice. “I’m not losing you again”
“Do you know this patient Dr. Thomas?” David asked curiously
“Me? No. Why?”
“You said ‘again’”
The resident and the two nurses in the room nodded positively.
“I don’t know where that came from,” Ann shrugged musing more to herself than anyone around her as she fought of the intriguing feeling that threatened to overwhelm her. “Come on, we’ve got a job to do.”
Seeing the nearly empty bags of blood, Mike spearheaded the battle to increase the volume by spiking a bag of Ringer’s Lactate and hanging it on the rapid infuser, then reaching for more. “Two units of blood in and another one on the way,”
“OR’s ready when we are,” Sarah alerted the team.
“Now all we need is …” Ann held her breath when she saw the electric impulse flash across the heart monitor. “Life,” she whispered watching the irregular pulsations slowly develop into a precarious rhythm.
“Sterile drape,” Ann motioned toward the gapping hole in Sam’s chest. “Let’s pack her up. We’re heading to the OR,” Ann declared triumphantly, as she scrambled onto the stretcher and straddled her patient’s hips, all the while plugging the hole in Sam’s heart.
* * *
The sound of the trauma room doors opening startled the group. Mark’s eyes almost came out of their sockets at the sight of the petit blonde doctor straddling Sam as the gurney was whisked into an awaiting elevator.
“You’ll be ok my friend. You’ll be okay” Mark repeated the wishful sentence over and over again. However, the lieutenant’s mantra wasn’t soothing at all to Jake. Instead, it made his stomach churn. For a split of a second the rookie felt as if the angel of death himself had passed by and gone straight to the ghostly pale Sam. Tears started cascading freely from the young man’s eyes at the realization of what could have been. “That should have been me.”
To be continued…
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