Disaster Status (4 page)

Chapter Four

Scott waded deeper into the surf, blinking as the chill and briny water slapped against his sleeveless wet suit and splashed his face. A translucent green swell lifted his bare feet from the sand, and he thrust forward into it, stretching his arms in powerful strokes while kicking against the strong, insistent pull of the Pacific.

The tide was higher than he liked, but he could still get in a good half-hour workout before the sea reclaimed the rocky cove and its stingy stretch of sand. He needed the exercise, not only as training for the Pacific Point Ocean Rescue Team, but because it was better than slamming his fist against a fire station wall. He’d done that last year and spent six weeks in a fiberglass cast. Both humiliating and stupid. And Scott wasn’t going to be stupid anymore; he’d keep everything in check. Move on with his plans, his life.

He sucked in a deep breath, then rolled his face back into the salty water as he swam farther out, telling himself to forget the TV reporter’s unexpected and unwelcome question.
“Aren’t you the son of Gabe McKenna, the hero . . . ?”
His stomach churned. He couldn’t count the number of times he’d heard that. Along with comparisons to his own accomplishments, his career. He’d been living in that shadow since he was twelve years old, but . . . Scott’s stomach tensed. He had no doubt that the reporter’s next question would have been about the other McKenna family tragedy. The accident almost a year ago along a darkened stretch of desolate coastal highway . . . with no hero to be found. Rain-slick road, intoxicated driver versus unyielding power pole. His younger sister, Colleen, her abusive husband, and their innocent son, Cody.
Could I have prevented it—saved them?
If only he’d returned her call that night
. . .

Scott tore at the water’s surface, straining his muscles until he felt a stab of pain deep in the shoulder joints. Still so much less than he deserved. The truth was, there was more than a chance that he’d failed his family that night.
Failed my own family
. The thought of it ate at him every day, devoured his sleep at night. And became unbearable whenever he looked into the eyes of his orphaned nephew.

So he’d thrown himself into Ocean Rescue, welcoming the challenge—the risks. He began volunteering for paramedic shifts in San Francisco, finding some measure of relief in the physical distance from Pacific Point. Enough to convince him to apply for a permanent position there as well as in several other neighboring cities.

And Portland? How
will I explain that to my family?
He pushed the thought aside. He’d interviewed for a position as Portland Fire’s chief of emergency medical services but knew his chances for that position were slim. And even if his family didn’t know about it, they’d long accepted his career ambitions. But right now all plans were on hold. Because of Cody’s infection.

Scott kicked harder, pulling his arms through the dark water and keeping an eye out for floating beds of rubbery kelp. He swam parallel to the shore, pushing himself toward the limit of his endurance, until his pulse pounded in his ears and his lungs begged—burned—for air. Good. Just what he needed.

He’d swim another fifteen minutes, then towel off, pull on his nylon warm-up pants and a polo shirt, and grab some hot coffee at Arlo’s Bait & Moor on his way to Pacific Mercy Hospital. Cody would have eaten breakfast by now and be awaiting another exam by yet another orthopedic surgeon.
To decide if he can keep his leg.
Scott fought a shiver.
My fault?
He stopped swimming, gulped for air, and treaded water, his body rising and dipping at the whim of the ocean’s power. Guilt washed over him far more relentlessly than the swell of the rising tide.
No, don’t do this. Think, don’t feel.

He’d get back to the hospital and visit with his nephew. Stay away from the merciless media. They could feed on speculation all they wanted to with the other agencies, but Scott’s part in the pesticide incident was nearly complete. All that remained was completion of the crash site cleanup and the interagency review. He frowned. Not that the ER was going to like his take on their part in the incident; they could have handled things better.

He sputtered as a swell of salty water covered his mouth. Erin Quinn wasn’t going to like the memo he’d be sending around today. His lips tugged toward a smile as he remembered the feisty charge nurse trying to force her way past him at the barricade, her fervor in defending her grandmother. And the way he’d had to take hold of her arm when she’d stumbled during the onslaught of reporters.

His low chuckle bubbled against the seawater as he began swimming back toward the cove. The beautiful redhead had a surprisingly powerful bicep. He’d be wise to keep that in mind. Not that he planned to see her again. Relationships were nowhere on his horizon now, and—

Whoa, what’s this?
Scott stopped swimming, his pulse quickening as he scanned the shoreline. The rocks? How’d he get this close so fast?

His body rose and fell on a set of larger swells, and he gulped air, then held his breath as a wave propelled him toward the small patch of remaining sand in the water-filled cove. The tide was coming far faster than he’d expected, and the surrounding rocks loomed way too close. The biggest one just yards away now. He kicked hard, hauling at the turbid green water with his arms, but he was slammed down, getting a mouthful of gritty, brackish water . . . and made little progress forward. He dived under, kicked furiously, and rose again, expecting to find his footing in the sand. Slipped under. And finally found the bottom, his feet clumsy, legs cramping.

He began jogging through the waist-deep water toward the diminishing patch of sand, but a wave broke over his head from behind. He staggered, belly flopped onto the water, and slid against the huge rock, shoulder first. Blunt impact, skin against stone, and pain—first sharp and then searing—as the frothy salt water sluiced across his torn skin. Blood streamed down his upper arm.

Scott regained his balance and stood, breath heaving as he steadied himself against the enormous algae-covered rock. Then he slogged through the water to the remaining sand before another wave could catch him. So much for his vow against stupidity. Did he think to check the tide table
?
He shivered in the morning air and rolled his shoulder to inspect the damage. After grabbing his half-soaked beach towel, he dabbed away the blood and looked at it again. A ragged avulsion below his right deltoid, embedded with sand. With any luck he could get one of the paramedics at the fire station to clean it and pull it together with butterfly bandages.

Meanwhile he had some duct tape and paper towels in his truck. That would stanch the bleeding for a while. Time enough to get his coffee and see Cody. And next swim he’d remember to check the tide tables. He wasn’t going back to the ER.

+++

“Triage!” The registration clerk’s bellow—like head wrangler on a cattle drive—echoed up the hallway and into the ER. It was followed immediately by a blinding red strobe light positioned above the nurses’ desk.

Erin turned to Leigh with a groan . . . followed by an incredulous grin. “How on earth does Arlene do that? What does she weigh, eighty pounds?”

Leigh chuckled over the brim of her Golden Gate cup. “Yeah, after a quart of Starbucks. But then she’s worked ER admitting for twenty years. Probably has calluses on her vocal cords.” She pointed to the computer in front of them. “What’s the triage?”

Erin ran her finger down the census screen. “Nineteen-year-old female. Headache.”

She scanned the trauma room. Twelve gurneys with striped privacy curtains, one enclosed code room, a casting room, and an ob-gyn exam room. Twelve gurneys and only four patients by 8:15. Merciful, since they were one staff person short with Sandy still a patient in the ICU. But that meant Erin, in addition to her duties as charge nurse, was expected to handle triage. Still, it was nothing like the chaos of yesterday with all those victims, media, and agencies swarming.

She glanced at Leigh. “I’m going out there. You okay for a few minutes?”

“Sure.” Leigh took one more sip of her coffee before rising from her chair. “I’m in a holding pattern for lab results, so take your time. The ward clerk’s got the phones, and I’ll call Judy from the break room if I need anything. Plus, Sarge is here somewhere if I need military muscle.” She rubbed her neck and sighed. “Regardless, you won’t hear any complaints from me. This is so much better than yesterday. I really needed a . . .” She didn’t finish her thought.

A quiet shift.
Erin nodded.
Quiet
—the
Q
word. No ER veteran ever said it out loud. Immediate jinx. Nothing made emergency department staff squirm more than a clueless rookie surveying a calm trauma room and quipping, “Wow. It’s so quiet in here.” It begged for a Code 3 ambulance. But Erin couldn’t agree more with Leigh’s wish. After yesterday, they all needed a breather.

“I’ll be back in a few minutes, then,” Erin said, striding toward the door. “And maybe we can go over that memo from the fire department. See what McKenna had to say about our day. Then we’ll need to put something together for our part of the incident review.”

Erin traveled the short hallway, popped her head into Arlene’s cubicle, and switched off the strobe. “I’ve got it.” She sniffed the air. “What’s for breakfast?”

The clerk, hunched over her Tupperware, grinned. “Sausage and cheese biscuits. Two. And a prune Danish. I know; I know. I must have tapeworm. Everybody says that.” Arlene’s grin faded and her thin, penciled brows drew together. “Your teenager’s eight months pregnant and is worried this headache has something to do with the pesticide spraying. She says she can’t wear shoes because her feet are too swollen. But I couldn’t fit all that in the chief complaint space on the census log.” She pointed to the patient’s information on the computer.

“Pesticides?” Erin asked, checking the patient’s name. “That wouldn’t cause swelling, but . . .” She stepped farther into the cubicle and squinted through the glass into the waiting room. “Who’s her OB?”

“Nobody local. She just moved here from Oakland. I gave her a list. And some paper surgical booties for her feet. Why do people think hospital floors are clean?”

Erin scanned the few occupants and spotted her patient in an instant. Dressed in striped pajama bottoms, a man-size T-shirt, and the elasticized paper surgical booties. She was pale, glistening with perspiration, and holding her head like it was going to explode. On her lap were a dish towel and a plastic wastebasket. Vomiting props.
Preeclampsia?
How high was her blood pressure?

Assessments already swirling in her mind, Erin jogged down the short hallway to the triage office and yanked the door connecting to the waiting room. “Heather?”

As the young woman stood, an elderly couple arrived through the automatic doors into the waiting room. The gray-haired woman carried a straw tote overflowing with yarn and magazines. She studied the room, grinned broadly, and turned to her husband. Her querulous voice carried over the noise of the TV. “Oh, look, Henry, no excuses for waiting this time. It’s quiet as a tomb.”

Erin flinched, then told herself that the superstition was ludicrous. She beckoned quickly. “Right in here, Heather. I’m ready for you.”

When the lumbering teenager hesitated, Erin stepped out into the waiting room and guided her through the door and into the triage chair. She fitted the automatic blood pressure cuff around her patient’s arm while studying her face. Then punched the Start button as she noted, with increasing concern, that the teen’s lips and eyelids were also slightly swollen. As were her fingers. Had she had any prenatal care at all? “What’s going on today? You said something about pesticides to the clerk. Were you near the spray area?”

“No, I live in town. But I got to thinking about it after I heard what those Safe Sky people were saying. How dangerous it could be if you’re pregnant, and—” Heather groaned. “My head hurts. And I can’t see very well . . . keep seeing sparkly lights. Can’t think straight either.” She rubbed at her nose ring, then squinted at the cuff on her arm. “Ouch, that’s so tight. Do you have to . . . ?” She paused, and her eyes rolled upward, just as the alarm on the blood pressure machine began to shrill. The red digital display read 200/120. Critically high. Her eyelids fluttered again, and her head bobbed.

Erin ripped the Velcro away and shouted out into the hallway, “Arlene, get me a wheelchair—quick!” She patted Heather’s arm. “Take a deep breath and hang in there with me. I’m taking you to see the doctor right now. We’ll get you feeling better. Deep breath. Attagirl.”

In scant moments Erin backed the wheelchair out of the triage office and hustled down the short hallway into the ER, managing to obtain a mumbled allergy status, medications, and due date on the way. She would likely get little other information. Heather’s head sagged forward onto her chest. Erin headed straight for the code room, shouting breathlessly to Leigh as she passed by, “Hypertensive, 200 over 120, pregnant, severe headache, visual disturbance, and confusion. I’m thinking preeclampsia. Judy, give me a hand getting her on the gurney.”

Leigh grabbed her stethoscope and followed. Everyone reached for the box of exam gloves and pulled them on.