sorry, but we have to,” she soothed, swallowing hard. As though her blouse mattered one iota under the circumstances. She stroked Emma’s hair then reached to squeeze her hand. Could she hope it was a good sign Emma had even thought about it? “I’ll get you another just as pretty, I promise.”
In mere seconds, the team had Emma set up with blood-pressure cuff, IV, and cardiac leads to the monitor as the surgical resident examined every inch of her, and Bree was so thankful again that they weren’t in that smashed car anymore, or the ambulance, as good as the EMTs had been, but finally here, getting Emma the help she needed.
“Tell us where you’re hurting,” Kurz said as the X-ray tech got ready to shoot films.
“My chest, my stomach.” Emma moaned. “My arm and leg. My baby—oh, please make sure my baby—”
“I promise everyone’s going to take good care of the baby, Emma,” Bree managed to say. Question was, would it be too late? “Let’s get a monitor on him, check how he’s doing.”
A nurse got the monitor on Emma’s belly. The infant’s heartbeat showed up strong and steady, and relief made Bree’s knees so wobbly, she gripped the side of the bed to hold herself up. Whether he was ready or not, baby had to come into the world soon, in case he or Emma took a turn for the worse.
It took every ounce of restraint Bree could muster to just stand there and watch the team work instead of assisting in some way. But right now, she had to remember her training as an ER physician who was used to trauma just like this and let the team do their job. Pretend the woman on this bed wasn’t her close friend. Wasn’t the sister of the man she’d been in love with not so long ago, no matter how unsuited they’d proved to be for one another.
Thinking of him and how devastated he’d be by this accident ratcheted her adrenaline even higher. Had her chest tightening at the thought that he might blame Bree, and maybe she deserved it. “Anyone know if Dr. Sean Latham is in the hospital? This is his sister. He needs to be notified right away.”
Kurz’s attention swung to her in surprise before he barked more orders.
Bree closed her eyes, thinking of Sean hearing the overhead paging him to Trauma Two. He’d be so unprepared for what he was about to walk into. Sean got frustrated with Emma sometimes, but he adored his little sister.
Bree glanced at Emma’s monitor and her stomach lurched. “Heart rate’s one-sixty.”
“Blood pressure’s dropping, too,” a nurse said.
Kurz had his stethoscope and fingers on Emma’s poor, bruised chest. “Hemothorax. Hold on X-ray. We need the chest tube tray—you got this?” he asked the surgical resident.
Bree didn’t like the shaky affirmative of the resident’s answer, and anxiety rose in her own chest as she prayed the resident had the confidence and experience to get the tube inserted into Emma’s lung fast. Steadily stroking Emma’s hair, she couldn’t say for sure if she was trying to calm Emma or herself.
Kurz continued barking orders, sending techs and nurses scurrying. “I want Anesthesia down here now, and why the hell isn’t OB here yet? And get the NICU team.”
“Bree, what’s happening? NICU team?” Emma’s eyes were wide and scared, and Bree took her hand and squeezed it gently.
“Got to get you fixed up and deliver the baby. You’re going to meet your little guy today. Can you believe it?” Somehow, she managed to keep her tone light. “You still going to go with the name you told me you’d decided on?”
“What? I’m not ready! I—”
“We’re going to help you be ready. It’s going to be okay.”
“I... Bree,” Emma whispered, her words slurring. “I feel...funny. It’s... Is it getting dark? Where...?”
Just like that, Bree saw her eyes close, her head go limp and her skin turn as white as pure, pearly beach sand.
“Emma!” Oh, no. Please, no. “Emma, stay with me!” Her shouts were punctuated by the cardiac monitor alarm, heart rate forty, thirty, fifteen, then asystole. Flat line. The sight of that neon line felt like a sharp knife blade slicing right through Bree’s heart as the screech of the monitor filled her ears. Air didn’t seem to be getting to her lungs. Watching hands pumping on Emma’s chest, hearing Kurz’s voice demanding Epi and oxygen, felt utterly surreal.
“What the...?”
Bree whirled. Sean. Standing there in the doorway, staring at his sister in shock.
“Pulmonary injury. Right hemothorax.” It was hard to choke out the words, and the next were even harder. “Coded twenty seconds ago.”
“About to place a chest tube,” Kurz said as he worked. “We’re going to OR Three. When we can get her there.”
Before one more second ticked by, Sean moved into action. He shouldered the surgery resident aside to get the tube placed as quickly and efficiently as possible. Immediately the blood began to flow, releasing the pressure on her lungs and heart.
Bree watched him secure the tube to the chest wall when the startling beep of the cardiac monitor cut through the fog in her brain. Emma’s heart’s back! She’s back! But each beat was so far apart. Slow. Too slow. She must have some other serious injury. Needed more blood circulating. Needed for her heart to pump harder. Needed it for both her and her baby.
Bree knew what had to be done and drew on reserved strength to get the words out. “We have to take the baby.”
“Not yet,” Sean said, a tortured fierceness on his face she’d seen only once before—the day they’d broken up. “Is OB on the way? We can wait till then.”
“We can’t wait. We have to do it now or we’ll lose both of them.” She hated that her last words came out in a near sob. How emotional. How unprofessional. But Emma was her friend, and for a split second Bree had seen the overwhelming love in her eyes as she’d cupped her belly, so happy to soon be holding her baby in her arms. If they couldn’t save Emma, they could at least save one life. Bring this precious baby, a part of her, into the world.
“A few more minutes. Emma’s got a strong heart. She—”
“Dr. Donovan is right,” Kurz said. “You take over chest compressions while we do a crash and burn C-section to get the baby.”
“I’ll do the prep and assist,” Bree said as she snapped on gloves. For Emma. For Sean. For the baby who might never know his mother.
Kurz nodded and Sean opened his mouth to argue more, but the look on Kurz’s face was clear, and, as he was senior ED doc running the code, the call was his to make. Wordlessly, Sean took over compressions, rhythmically pushing on his sister’s chest. As she saw the mix of determination and anguish on his face, Bree’s heart cracked.
“You ready?” Kurz asked Bree as she quickly swabbed Emma’s belly with antiseptic.
“Ready.” It wasn’t true, she wasn’t ready for them to bring this baby into the world without his mother, but it had to be done. Saving this child was at least one thing she could do to try to make up in some tiny way for driving her car into harm’s way.
Barely
