Sophie’s eyes were wide as she depressed the defibrillator’s button again. The monitor jumped.
This time the man’s body arched only slightly.
“Epinephrine!” Nate barked, holding out his hand for the vial that Sophie knew was the last hope.
Sophie reached over to the stainless steel tray where one of the nurses had already prepared the syringe. She grabbed it and properly placed it in Nate’s hand the way she did with all his surgical instruments. They worked well together. She knew it. And she knew he knew it, too.
Nate jammed the long needle straight into the patient’s heart and depressed the plunger. Sophie watched as the lifesaving serum left the syringe and hopefully did its job.
She checked the monitor.
Flatlined.
She hit the blood pressure machine hoping it would show even the tiniest indication of life.
Nothing.
Nate put his stethoscope to the man’s chest. Sophie knew what he was hoping to find—a blip. An echo. A whisper of life.
Nate straightened. He shook his head.
“I need you in the next bay, Doctor. She’s cardiac contusion I believe, with a history of dysfunctional coronary arteries from birth,” Sophie said to Nate.
“How old?”
“Twenty-one. Punctured lung. We’re doing thoracentesis now. She’s A-fib,” Sophie explained in soft but professional tones as they walked over to where Aleah clung to life.
Sophie struggled not to glance over at Jack, but noticed he was now sitting on the side of his gurney, legs over the side, hands clenched on the edge of the bed. He looked like a man ready to bolt.
His eyes were dark with anger, pain and confusion. She saw his mouth move. She realized that the word he kept saying was “Please.”
Bart handed the catheter over to Dr. Hill. They had now siphoned over a quart of fluid from Aleah’s chest cavity.
“Sophie,” Dr. Hill said. “Take over for me. Bart, get Donna back here.”
Bart bolted from the bay.
Sophie went to work while Dr. Hill and Nate conferred. Nate listened to Aleah’s heart.
Sophie depressed the button on Aleah’s blood pressure machine, which squeezed the cuff on her upper arm. “Ninety-five over sixty.” She looked up at Nate. “She should be improving with the tube in her chest. Not getting worse.”
Sophie needed Nate’s brilliance to take the lead in Aleah’s case. The girl’s lips were turning blue. Sophie took her pulse and then her blood pressure once again to be certain. “She’s dropping.”
Suddenly, the heart monitor flatlined.
“Get me those paddles!” Nate motioned to the defibrillator at the head of the gurney.
Sophie grabbed the paddles, lubricated them and handed them to Nate, who placed them on Aleah’s chest.
Just as she’d done only minutes ago, she pressed the button to send the electrical current into Aleah’s body.
Sophie felt as if she were falling over a rushing waterfall. The sounds in the room, the alarm of the heart monitor, Dr. Hill’s voice and Nate’s commands swam together and created an undecipherable cacophony. Her motions were rote.
Sophie could almost feel Aleah’s soul leaving her body. She glanced above Aleah’s head to see if there were any odd lights in the room. Her grandmother had told her that souls exited the body through the top of the head. Probably an old wives’ tale from Italy. But something was happening here. Sophie could feel it.
Nate shocked Aleah’s body a second time, but to no avail. Again, he called for the injection of epinephrine and Sophie watched as he rammed it into Aleah’s small chest.
Aleah was completely lifeless, but Nate didn’t give up. He placed the paddles again and commanded Sophie to hit the button.
The heart monitor was still flatlined.
They’d lost. Death had won. The monitor’s long, droning alarm was telling her she hadn’t performed her duties correctly.
Dark thoughts filled her mind, putting an acrid taste in her mouth. She couldn’t find the strength to beat them back to their cave.
She felt utterly inadequate. She wished she’d continued with school. She should have become a doctor. Maybe with more knowledge she would have known how to save this young woman. Though she was certain that Aleah’s chances had been worse than the man in the next bay, and he hadn’t made it, either.
Sophie blinked slowly. Time trudged forward as though she was moving through a thick gelatin. She felt weightless and leaden simultaneously. She would have liked to sit right down on the floor and go to sleep.
“Nurse Mattuchi!” Nate shouted.
“Yes, Doctor?” Sophie snapped out of it. Whatever it was.
“Are you okay?” He pulled off his latex gloves.
She looked down at Aleah’s lifeless body. “She...”
“Never had a chance,” Nate said. “I’m surprised she lasted this long. Your assessment was on target. So was Dr. Hill’s. I also think she was anorexic.”
Sophie’s eyes flew to Aleah’s body. She understood what Dr. Barzonni was saying. The improper balance of electrolytes alone, in an anorexic person, was enough to bring on a heart attack. Aleah had a congenital heart condition, anorexia and blunt chest trauma. “I thought she was rather thin. It just didn’t register.”
“This was a massive trauma. She was hit very hard. I’ll get more about it from the cops outside. But with her birth defect and the punctured lung...” He shook his head and put his hand on her shoulder. “You did all you could.”
“I wonder...” she started.
“No,” Nate said and turned to Dr. Hill. “Eric, you and I will have a lot of paperwork. Do you know if either family is here?”
“Just the girl’s,” Bart interrupted. “We’re still searching for the John Doe’s family. He was driving without a wallet or any papers. Maybe the cops have an update.”
“I’ll talk to the police,” Dr. Hill said.
“And I’ll handle Aleah’s family,” Nate volunteered.
“We still have Mr. Carter here overnight,” Dr. Hill said. “Nurse Mattuchi, you’re on duty?”
“Yes, Doctor. I’ll see to him.”
“I want a CT scan. I want no other—” He swallowed hard. “You know what I mean.”
“I
