the paddles to Lukas.
“Clear,” he called, and made sure everyone was out of touch with the bed, then pressed the paddles to the patient’s chest. The body jerked into an arch with the sizzle of electric current, then fell back onto the bed. Everyone looked at the monitor. The rhythm had changed.
“All right!” Tex exclaimed. The v-fib had stopped, and now the blip danced across the screen with more powerful strokes.
Lukas pressed his fingers against the woman’s throat, feeling for the carotid artery, and the hope that had flared within him died painfully. There was nothing. “Oh, no. Pulseless electrical activity.” This was worse! They couldn’t break this new rhythm with a shock. What was happening here?
“Sandra, bag her again,” he said.
The nurse from upstairs came rushing into the room, and Lukas gestured to her. “You’re just in time. I want you to do chest compressions.” What could be causing this? “Let’s intubate now, Tex. And let’s get some fluids in.” What would cause respiratory arrest and pulseless electrical activity in such a young woman?
“Dr. Bower,” Sandra said softly, “the bra we cut off her was a nursing bra.” She indicated the young woman. “She’s been nursing. She was all alone outside the apartment building.”
Lukas felt as if he were on a treadmill going twenty miles an hour. He had to keep up. “Carmen, contact the police,” he called toward the secretary as he worked. “They need to check the area for a baby!” He had to focus. If the woman was recently pregnant…severe respiratory distress…pulseless electrical activity…He caught his breath.
“Oh, no, Dr. Bower,” Tex groaned. “That sounds like massive pulmonary embolism.” Lukas nodded. A blood clot in the lung was deadly.
Quinn came rushing back into the room, puffing from exertion and wiping his eyes with the back of his hand. “I’m sorry, Dr. Bower. That won’t happen again. I mean it. I’m sorry. I was just so—”
“Can it, Quinn,” Tex snapped. “We don’t have time tonight for your theatrics.”
Lukas ignored the interruption. “Let’s get her set up for a pacer, and get me dopamine.” Now he knew what to do. But was there time?
Marla drifted in a dark fog, for a few moments far from the pain and cold and terror. But the drifting didn’t last. Her baby…Jerod! She could hear echoes of his cries, and she couldn’t get to him. He needed changing. He would have to be fed again soon, and there was no one to help him.
And then another voice reached her from some distant place…. “We’ve got a pulse….” Marla’s chest hurt again, and somebody was pushing her, hard. Her throat hurt. She felt the pressure in her ribs and heard more people talking around her…. “We’ve got a blood pressure, Dr…” She felt something hard pinch her arm…. “The helicopter’s landing, Dr….”
Something brushed across her shoulder, and light beamed past her closed lids. But she couldn’t open her eyes. She felt the rise and fall of her chest, and the continued sharp pain under her ribs, as if someone was stabbing her from the inside out.
The pain was too much. Even with the echoes in her memory of Jerod’s cries, she couldn’t force past that barrier of pain. She tried to form words on her lips, but something was in her way. She couldn’t speak. Jesus, take care of Jerod. He’s so little and helpless.
She could almost hear her baby’s cries again, wished she were back in the cold, grungy room with wet diapers and neighbors banging on the wall for silence.
And then, as if from somewhere besides the room where she lay, a strong, familiar voice reached her, a voice different from the ones that shot around her with businesslike efficiency. This one was unhurried, calm, even joyful. “It’s time to come home, Marla. I’ll be here with you.”
The sound of the voice permeated her and gave her a feeling of warmth, and she wondered if she were in a coma. But that voice… Dad? She thought the word and heard her own voice, though her mouth did not move.
“Remember the verses I read for you so often when Mom died? ‘The righteous perish, and no one ponders it in his heart—devout men are taken away, and no one understands that the righteous are taken away to be spared from evil.’”
You mean I’m dying? she asked.
“‘Those who walk uprightly enter into peace—they find rest as they lie in death.’”
But, Dad, I’m not righteous, she said sadly. Look what I’ve done.
“Your righteousness has been purchased. It’s time to come home.”
But my baby…
“Dr. Bower, I’ve lost the pulse,” came a brisk voice from nearby.
The wall of pain slipped down and pulled away. Marla felt as if a blanket of comfort were being wrapped around her. She could see again. Her father was holding out his hand.
“No blood pressure,” came another voice, this one receding, growing fainter. “Doctor, we’ve got asystole…flat line!”
But the alarm in the fading voices did not disturb her. Dad spoke again. “I have some people for you to meet.” And he took her in his arms and led her home.
Lukas called the code long after they lost the pulse and the rhythm flattened, battling his own sense of horror and pain as he’d battled to keep death from taking this young mother. He called time of death for the record, then took a deep breath and willed himself to be composed.
Sandra sniffed with silent tears as she gathered the trash that had collected on the floor. Tex muttered under her breath as she disconnected the monitor from the leads. She paused and glanced at Quinn, her green cat’s eyes narrowed with angry disgust. She shook her head and resumed her work.
“What’s your problem, Texas, can’t take the pressure?” Quinn reached over to remove the equipment from the body of the deceased. “No wonder you couldn’t handle your resident training.”
“No!” Lukas reached out to stop Quinn’s movements. “Don’t touch anything on her.”
Quinn raised his hands in an exaggerated show of obedience. “Hey, Doc, lighten up. I’m just trying to help out. After all, she was alive until we brought her to you. ”
Sandra gasped and looked over at her partner.
Tex shoved some trash into a biohazard container and straightened to tower over the man. “Breathing into her belly all the way here was what killed her. We might have saved her if you’d given her a chance in the first place, but no, you didn’t even bother to check.”
“Tex.” Lukas was too tired and grief-stricken to break up any more fights on this shift. “Quinn, everything has to stay in place in case the coroner wants to have an autopsy performed. Tex, will you go call him?” Maybe that would get her away from Quinn long enough to get her temper under control. To see that she did so, he walked out with her.
“That man shouldn’t be allowed to touch patients,” she muttered to him as they left the curtained room.
Lukas
