to them.
“God, god, god,” she was whispering.
For the first time in ages, Philip felt his heart pounding.
The metallic scent of blood filled his nose as he thought about how he needed one more bandage to stem the blood flow. He stood up.
“Philip,” Sandra said, but he had already left the room. He ran down the steps out to the ambulance. He found a tourniquet and ran back up the stairs with the strap in one hand. When he returned to the room, he saw that Aida had crawled into the fetal position in one corner of the sofa and was hugging a pillow so hard that her knuckles were white.
He placed the tourniquet around the woman’s left arm and began to twist it to tie it more tightly. Just as he was about to tie it off, he heard a voice.
“Mommy...”
The voice didn’t belong to the teenager. It was softer.
Philip lost his concentration when he glanced up and saw a little girl standing in the doorway, a scared look on her face. Her bangs were swept to the side, and her hair was messy. She was wearing a light blue nightgown with Princess Elsa from Frozen on the front.
“You were supposed to stay in our room,” Aida said, getting up. “Go back in there, Sara!”
Aida pulled the girl’s arm, but she resisted.
Philip and Sandra exchanged glances again before returning to the woman.
Philip was resolute as he released the zip tie.
“Help me now,” he said, signaling to Sandra to get hold of Shirin’s limp, heavy body.
They counted to three.
“One, two, three.”
They placed her carefully on the stretcher, working silently, knowing what was at stake. Her condition was critical.
“The hands...” Sandra said, nodding toward the severed body parts still lying on the floor.
“We need to bag them and put them in an ice water bath,” Philip said.
He opened the medical bag, pulled out two resealable bags. “Here, see if you can fill these in the kitchen.”
He slipped on a pair of latex gloves, then reached for the hands. But because of all the blood, he lost his grip on one of them and it slipped to the floor.
“Shit, shit, shit,” he said quietly and tried again as Sandra came back into the room with the bags filled with ice water.
His face was stony as he placed each hand into its icy bath and sealed the bag, then laid the bags next to Shirin’s body. He and Sandra counted to three again and lifted the stretcher.
Then the younger girl peed. The puddle spread under her bare feet.
“Mommy!” she cried, beginning to stomp her feet in the puddle.
Aida picked her up and carried her out of the room.
“We have to go,” Philip said to Aida. “The police are here now.”
“Go, then,” she said. “I’ll stay here. With Sara.”
Philip felt the bulk of the weight of the stretcher in his arms as he led them down step by step.
In the entryway, they met two uniformed officers who immediately continued up to the apartment.
As soon as they had gotten the patient into the ambulance, Sandra got behind the wheel as Philip connected the third wire of the EKG. He shook his head at the slow frequency. Usually he would have inserted an IV, but because of the severe blood loss, there was no chance he would find a large enough vessel.
He looked at the patient, studying her rib cage. It was hardly moving.
He considered using the intraosseous drill for access to the venous system through her bone marrow, but then folded the blanket back and looked at the tourniquet. He checked the strap multiple times and realized something wasn’t right. It was loose.
It wasn’t until then that he realized he hadn’t tied it properly.
As he threw the blanket completely back, he saw the last sight he wanted to see. Blood flow to her arm hadn’t stopped after all. It had continued to flow from her left wrist and collected under her body on the stretcher.
“For Christ’s sake!” he exclaimed.
“What’s going on? How is she?” Sandra shouted through the cab window.
“I can’t stop the bleeding!”
She met his eyes in the rearview mirror, then swerved to avoid a truck that hadn’t bothered to pull over for the flashing lights of the ambulance.
Philip pulled the tourniquet tighter, but the vehicle swayed and he lost his grip.
“Can you drive straight, please!” he screamed, reaching for the strap again. He pulled and pulled. He knew that every second counted now. Sweat beaded up on his forehead and his mouth was dry, but he was finally able to get the tourniquet in place. Just as he tied it off, he became aware of the sound from the EKG.
A single, solid tone.
And he knew. For the second day in a row it was the sound of a patient’s death.
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