CHAPTER SEVEN
CHAPTER EIGHT
CHAPTER NINE
CHAPTER TEN
CHAPTER ELEVEN
CHAPTER TWELVE
CHAPTER THIRTEEN
“DR. DARCY TO Trauma One. Dr. Darcy to Trauma One.”
As always her heart began to pound and her attention became focused only on the task ahead of her. Traumas were the scariest and most rewarding part of emergency medicine. By moving and thinking quickly you could become the difference between life and death, and chief emergency resident Chloe Darcy was always half terrified and half exhilarated by the challenge.
She ran to the trauma bay and arrived as the paramedics were wheeling a patient in on a gurney. She took in the unconscious pale thin girl as the paramedics gave their report.
“Twenty-two-year-old female found unconscious by her roommate with bilateral lacerations to the wrists. Estimated blood loss at the scene was minimum one and a half liters. No signs of other trauma or drugs at the scene. She left a note. Apparently heartbroken over a recent breakup. Valentine’s is the worst reminder.”
Foolish girl, Chloe thought to herself. What love or man could possibly be worth killing yourself for?
“What has she been given for resuscitation so far?” Chloe asked, focusing on the medical care of the young woman.
“Two liters of intravenous crystalloid and five hundred milliliters of colloid expander. Her pressure has improved marginally and the pressure dressings have stemmed some of the loss.”
“Thanks, we’ll take it from here.”
The trauma team was a well-oiled machine, with a nursing team and a respiratory therapist working with Chloe to stabilize the young woman. It took thirty minutes and a lot of blood products and fluid before her blood pressure started to improve and her pulse lowered. Chloe felt her own do the same. Once she was confident the resources were in place to deal with additional bleeding, Chloe unwrapped the first wrist pressure bandage.
The deep lacerations exposed multiple cut vessels, tendons and nerves. The girl had really meant it, and if hadn’t been for her roommate she would have succeeded.
“Page whoever is on call for Vascular and tell them we need them now.” Chloe didn’t have time to talk on the phone. The unwrapping of the wound had led to another half-liter blood loss and she had to focus on getting her as stable as possible prior to the operating room.
As Chloe stood above the girl, holding as tightly to the pressure bandage as she could, she felt a change in the room and calm passed over her. She looked up as Dr. Tate Reed entered. As always, her heart stopped momentarily as she took him in. His tall stature and muscular frame was surprisingly well defined beneath the hospital scrubs. His most striking features, his cool mineral-green eyes, were directed right at her.
She was surprised to see him. Normally she would have gotten the general surgery resident responsible for the vascular service, not the attending vascular surgeon. She swallowed and tried to focus on her responsibility and duty to her patient.
“What do you have, Chloe?” His voice was both confident and undemanding. He walked over to stand directly beside her while she continued to hold pressure on the volatile wound.
“Twenty-two-year-old female. Attempted suicide with bilateral wrist lacerations. Total blood loss estimated at two liters. Both cuts are deep and involve all the major vessels, nerves and tendons.”
She began to unwrap the wrist so he could examine the patient for himself, when his hand came down on her bare forearm.
“Don’t unwrap it, I trust you,” he confided.
He looked at her one more time before moving his hand and speaking to the room. “I’ll book her as level E0 emergency. Please have her ready for the operating room in the next ten minutes. I’ll need another five units of blood typed and crossed and sent directly to the operating room.”
With a final glance in her direction he left. She stood still, focused only on holding pressure for several moments before she regained her momentum. “Type and cross for the five units. She’ll need a Foley catheter to monitor urinary output and we need to notify the plastic surgeon on call that he will be needed after Dr. Reed finishes the vascular repair.”
As promised, the operating room was ready for her patient within ten minutes, and only as the young woman was being wheeled into the actual operating theater did Chloe let go her hold on the injured wrist.
When she returned to the emergency department she was grateful that there were only twenty minutes left of her shift and that she wasn’t obligated to start with any new patients. It hurt her to think about the girl. How bad did you have to feel before you would go to that length to escape? How much pain did you have to be in to make the idea of cutting yourself open feel better? The only comfort Chloe had was that the girl was with Tate now, and he would at least be able to make her physically better.
Chloe finished her charting and paperwork and then went upstairs to the operating room waiting area to wait for news. The only part of emergency medicine she struggled with was the lack of continuity. She would often see patients, diagnose them, arrange for their care, but rarely learned about outcomes—and it bothered her. It was like starting a book but never finishing it, and she never felt able to accept the not knowing. Some of her evaluations had cited this as a criticism. The amount of extra time and effort she spent following up on patients was not insignificant, but it was always her own time, so those who did not like it just had to deal with it—it was who she was.
It was eleven in the evening before Tate emerged into the main operating corridor. “Why am I not surprised to see you?” he commented as he came to sit on the chair next to her, pulling the scrub cap from his head and running his fingers through his short-cropped dark blond hair. There was no censure in his voice, and he looked tired but not displeased at the sight of her.
“How is she?” Chloe asked, focusing on the reason she was there—for the girl, not for Tate.
“Stable. She was well-resuscitated prior to arrival, which helped. They were all clean cuts, which made the re-anastomosis easier. Plastics is with her now. They will be there for a couple of hours, then time will tell how much function she gets back in her hands.”
“Damn,” she said aloud, unable to comprehend how this girl was going to cope both physically and emotionally when she awoke.
“Any idea why she did it?” Tate asked, once again demonstrating the compassion that set him apart from many of his surgical colleagues.
“Happy Valentine’s Day,” Chloe responded, unable to keep the sarcasm and scorn out of her voice.
“Ah,” Tate replied, obviously oblivious to the holiday. “I didn’t get you anything.”
The
