doxepin, amaryl, aspirin.”
“Pulse ox is 96 on 2 liters. I’ll run an EKG. It could be tricyclics.”
“She’s tachy at 120,” Katya said.
Rachel bent over the girl. “Julie!”
“Sats down to 81.”
“Okay,” Amy said, “She’s lost her gag reflex.”
“Let’s intubate.” Rachel grabbed the tube and got it into position. “Push flumazenil, .2 mil.” Just as she prepared to open the girl’s mouth, Julie stirred, then sat up.
Rachel took a quick step back. “All right, then. That’s good.”
“What’s going on?” Julie asked.
“Do you remember taking pills?”
“What?”
“Let’s give her charcoal and get her something dry to wear, please. Amy, you take it from here.” Rachel walked out of the trauma room, shedding her gown and gloves. It had been like this for almost ten hours now, only most of the patients had storm-related injuries. Blunt trauma, electrical shock, traffic accidents. Which wouldn’t have been so bad if any of the damn medical staff were here.
She wasn’t completely alone, but every doctor who had made it in had been pushed to the limits of endurance, literally running from patient to patient, and there was no end in sight.
“Incoming!” John Wilkins yelled as he stepped on the floor pad, activating the automatic door. A man in a uniform stumbled in carrying a drenched woman. She had passed out or was dead.
Rachel ran to the woman while Wilkins and two others got a gurney. “What happened?”
“She’s pregnant,” the man said, gasping for air. “She was in my cab and she started having seizures. She passed out about ten minutes ago. Before that, she said her head was killing her.”
“Thank you,” Rachel said, shoving the Good Samaritan aside. She’d immediately recognized the symptoms of preeclampsia.
Katya came running to help, and as they pushed the gurney, Rachel told her to get a CBC and do a chemstrip. “And get me an OB.”
Thunder rumbled as they headed toward Trauma 3. The girl, name unknown, roused when they transferred her from the gurney. She looked very young, pasty and full-term. She opened her eyes briefly, then shut them tightly as if the lights were terribly painful.
Rachel moved to the bedside. “What’s your name?”
The girl mumbled incoherently.
“That’s okay. We’re going to take care of you and your baby.”
The ghost of a smile flickered briefly as the nurses, Lydia and Katya, got busy with her vitals.
“BP is 250 over 70, and oh—”
The girl went into a seizure, her body spasming as if she’d been hit by a live wire.
“Give her 5 milligrams Dilantin. And get respiratory down here. We have a precipitous delivery, people, so let’s get the kit and the crash cart. Where is my OB?”
“There is no OB.”
Rachel looked up to see her resident, Amy Sherwood, at the door, donning her gown. “They have no one to send. We have to do it here.”
Rachel held back her curse. She could do this. She would do this.
Lydia, one of the best E.R. nurses Rachel had ever worked with, moved in close, preparing the woman for a C-section.
“Amy, work on her BP,” Rachel said, as she picked up the scalpel. “Where’s anesthesia?”
“Right here, Dr. Browne.”
Rachel didn’t even look up. She knew it was Dr. Reid, and he could handle the next step. She pushed a stray hair from her young patient’s face. “You’re going to be okay, honey. What’s your name?”
“Heather. Heather Corrigan.” Even those few words seemed an appalling effort for her and Rachel had to lean close to hear.
“Hello, Heather. I’m Dr. Browne.”
Heather’s lips curled in a faint smile and she half nodded before her teeth clamped again as another labor pain hit.
Rachel swabbed her forehead while Lydia prepped her belly. “Who’s your doctor, Heather? Do you have an OB? An obstetrician?”
Heather rolled her head back and forth in a negative response that obviously cost her. “Haven’t seen a—a doctor. I need to see…” Her already weak voice faded into nothingness as another wave of pain swept her body.
Katya raced into the cubicle carrying the FHD–100—a portable fetal monitor that ran on batteries. “I’ve got another orderly coming down,” she said. Then Reid covered Heather’s mouth with the mask.
“All right then,” Rachel said, putting on rubber gloves. “Let’s be on top of this, people. Everything’s going to be fine.”
ONLY, EVERYTHING WASN’T fine.
Rachel peeled off her paper scrubs and threw them furiously into the trash. She never got used to losing a patient. At least the baby would live, although his heartbeat was irregular and his jaundice was advanced. If only Heather had seen an obstetrician when she’d first gotten pregnant. Or even come to the hospital a few hours earlier.
Desperate for some coffee, Rachel headed toward the call room, but John Wilkins flagged her down from the other side of the hall. She stopped wearily and waited for him to reach her.
“Sorry, Doc. EMTs are bringing in a guy who had a roof cave in on him in the storm. They’ll be here in five.”
“Oh, Lord. Okay, when he gets here, can you get him cleaned up and into X ray and then come get me?”
“Sure, Doctor.” He paused midturn. “You okay?”
She looked at her watch. Almost 3:00 a.m. She’d been on duty for nearly seventeen hours. “I have to be, John. There’s nobody else.”
He nodded sympathetically. “I’ll take care of it.” He turned and hustled down the hall.
This time, Rachel made it to the coffee machine. She practically guzzled the first cup and was halfway through the second when John returned.
“He’s in X ray, Doctor. Whoa. They need you, stat.”
“That bad, huh?”
The orderly nodded.
Rachel slugged back the remainder of the coffee. “Well, let’s hit it.”
As she and John reached the X-ray room, the technician was just wrapping up. Rachel nodded and smiled at her, then approached the body lying on the gurney.
