shoulder and the other on his hip. When he was in position, she walked to the other side of the bed, pulling out her penlight as she moved. The lamp on the bedside table didn’t provide as much light as she would like, but it was better than nothing. The man waited for her nod, then pulled in a fluid motion, rolling her patient to his side and triggering a groan from the young man.
Jillian ran the light along his back, noting the hole the bullet left behind when it had exited his body. It was fairly small, indicating he hadn’t been shot by hollowpoint ammunition. It was also almost directly in line with the entrance wound, which meant the bullet hadn’t taken any detours on its way out. Both were good indicators, but he wasn’t out of the woods yet.
She gave another nod and he lowered Tony to his back. She pulled out her stethoscope and placed it on the man’s chest, listening intently. Breath sounds on the left, none on the right. Given the young man’s labored gasps for breath, she’d suspected a pneumothorax, and this confirmed it.
“I need occlusive dressing. Two of them.” He had air in his chest cavity, which prevented his right lung from expanding normally. The first order of business was to seal the bullet holes to keep more air from getting in. Then she could work on restoring his breathing.
She held out her hand, but the expected supplies didn’t materialize. Annoyed, she glanced up to see her kidnapper digging through the bag of supplies.
“Give me that,” she said impatiently, snatching it from his hands and dumping the contents on the bed next to her patient. Gauze, Band-Aid bandages, tape...no occlusive dressing.
“Do you have any plastic bags?”
The man shook his head. Of course not. Fabulous.
“Okay,” she said, thinking out loud. What else could she use to seal off the wounds? “I need you to cut off two squares from the shower curtain liner. Make them about this big—” She held out her hands to demonstrate. “Can you do that?” It was a long shot, but it just might work.
As he left to procure the requested material, Jillian collected the jar of Vaseline, several gauze squares and the roll of white tape. She spread a liberal coat of the petroleum jelly on the gauze, saturating it completely before moving on to the next stack of white squares. By the time she was done, the man had returned from the bathroom with her liner.
“Lay them on the bed. I need you to roll him again.”
Her patient moaned as he was repositioned. The kidnapper grimaced in response, and she realized with a shock that he was upset by the sounds. She was so used to people moaning, crying or screaming that she’d become desensitized, no longer bothered by the sound of a person in pain. In fact, she much preferred it if they made noise—it told her they were still alive and breathing.
“If he’s crying, he’s still here,” she told her kidnapper, uncertain why she offered him such reassurance. Maybe because his unguarded reaction to his friend’s pain made him seem more human, not the dark monster she had painted him as after he’d thrown her in the car.
Moving quickly, she placed the soaked gauze over the hole in the young man’s back, applied the square of shower curtain liner and taped down three edges. She leaned back, gesturing, and her patient was returned to the bed, giving her access to the chest wound. She repeated the process for his front, studying the dressing with a critical eye. It wasn’t ideal by any stretch, but it would have to do. Now to restore his breathing.
A large-bore IV was the safest way to decompress a patient, but she didn’t recall seeing those supplies in the bag. Still, best to double check. She scanned the paraphernalia on the bed, clenching her jaw in frustration as she realized she was going to have to employ a more dangerous, and painful, method of treatment. She hesitated, but there was no help for it.
“Give me the chest tube kit.” She held out her hand, gratified when the man passed her the bundle right away. “We’ll make a nurse out of you yet,” she murmured, laying the kit on the bed and ripping open the package. It was slightly different than what she was used to—the diameter of the tube was much smaller, for one thing—but she was pleased to see a valve on the end of the tube. Since she didn’t have access to a drainage system, the ability to seal the tube was critical. She put on fresh gloves and picked up the scalpel.
“Hold his right arm above his head.”
The man moved forward, grabbing Tony’s arm and raising it as instructed. “Keep hold of him,” she said, meeting his eyes for a brief second so he would know she was serious. “Don’t let go.”
Jillian bent to make the first cut. “Wait,” the man said. She looked up at him to find his eyes wide and his face pale. “Aren’t you going to give him something first? Something for the pain?”
She gritted her teeth, unused to having her actions questioned in an emergency. “I can’t,” she explained with a patience she didn’t feel. “He’s lost too much blood and I can’t risk sedating him when I don’t have control of his airway. You didn’t steal me any local anesthetic, so I have nothing to give him to numb the area. Now, hold him down.”
Tony’s eyes flared open and he grunted as she sliced quickly and cleanly through the skin, making a small cut to insert the tube. She stuck her finger inside, probing through the deeper tissue until she felt the bone of his rib. Keeping her finger in place to hold the incision open, she picked up the plastic tube and positioned the tapered end.
“Now it’s really going to hurt,” she warned, and thrust the tube through the opening she’d created. Tony let out a guttural scream and writhed on the bed, trying to wriggle away from the pain. “Hold him.” She bit the words out, working fast to push past the resistance of muscle and connective tissue until the tube broke into the free space of his chest cavity with a pop she felt in her fingertips.
There was a soft hiss as the air in his chest began to escape through the tube, a sound that always made her think of opening a soda bottle.
Jillian held her breath, looking for a flash of red. If the bullet had nicked an artery and his chest cavity was filled with blood, it was unlikely the man would live. She couldn’t treat an internal hemorrhage in a motel room.
Fortunately for him, the tube stayed clear. She kept one eye on the dressing that covered his bullet hole, gratified to see the gauze suck into the wound as Tony’s chest cavity decompressed. The shower curtain liner seemed to hold, as well, creating a seal to prevent air from re-entering his body. As the gas left his chest he began to cough, gasping in great lungfuls of air between the racking spasms that shook his thin frame. Jillian bared her teeth in a fierce grin, the familiar rush of satisfaction washing over her as she rode the high that came from saving someone’s life.
When the hissing sound stopped, Jillian twisted the stopcock on the end of the tube to seal it off and picked up her stethoscope. Normal breath sounds on the left and the sweet sound of slightly labored, but functional, breathing from the right. His heart sounded good, too, the frantic cadence settling into a steady rhythmic pulse as his breathing evened out. Excellent.
She leaned back, looping the stethoscope around her neck. “We’ll leave the tube in place for a few hours, make sure the dressings don’t leak. If he still looks good, we can take it out.” She taped the tube in place to keep it from moving too much, then picked up the gauze and petroleum jelly. Time to make another dressing. It wouldn’t do to have air re-enter his chest through the hole she’d just created.
“I need another square of the shower curtain.”
The
