Disaster Status (5 page)

From out of nowhere Sarge hurried over to help, and by the time they’d lifted Heather onto the stretcher, her eyes rolled back and her face began twitching. In an instant, she deteriorated into a full-blown seizure. Head, arms, legs rigid and jerking, saliva foaming from her mouth, lips dusky gray. Urine soaked the sheet beneath her.

“Watch her airway,” Erin called out, protecting Heather’s head as she thrashed. “Suction!”

Judy cranked the knob on the wall suction unit, slipped a stiff plastic tube into Heather’s mouth, and cleared her airway, then fit a high-flow oxygen mask over her face.

Erin cut away the patient’s T-shirt with trauma scissors so Judy could place the cardiac monitoring electrodes and Erin could get an arm exposed for an IV line. Judy ripped open a bag of saline and hooked up the tubing.

Erin wrapped a tourniquet around a flailing arm and uncapped a large-bore needle, trying to synchronize the sharp tip of the needle with Heather’s thrashing. Her lips moved silently.
I’m working . . . on the back of a bucking bronco.
Help me, Lord. Help me help her.

“Let’s get some magnesium on board!” Leigh ordered. “And pull out some Valium and labetalol, Judy. We’ll need a Foley catheter when you can. Dip the urine for protein.” She grabbed hold of the patient’s arm to help steady it for Erin and nodded as the needle slipped into the vein. “Good job. Grab some blood for labs, okay?” Leigh turned and shouted over her shoulder toward the ward clerk, “Page labor and delivery stat. We’ll want this baby monitored. Call respiratory therapy and anesthesia too. This woman’s going to need an emergency C-section, fast as they can. Let’s get it done!”

+++

Scott pulled his chair closer to Cody’s bed, glad they’d stopped all those stat pages from the ER. His nephew had already asked at least twice if the poisoned little girl was going to die and if other people had been poisoned too. And “Are those people with the umbrellas right, Uncle Scotty? Is the air over Pacific Point poisonous?”

Scott glanced at the TV, now playing a sci-fi fantasy DVD he’d brought to keep Cody from having to watch the news. He frowned, angry once again with the media for feeding the pesticide scare. Didn’t his nephew have enough to worry about, being poked and prodded for IV antibiotics, x-rayed, and swallowed up by MRI scanners?
He won’t lose his leg. It can’t happen.

Scott’s breath caught in a familiar jab of pain, and he reached over to pat the ten-year-old’s tousled blond hair. “How’re you doing there?”

“Good.” He turned back to Scott with a smile. The smile widened and was punctuated by a single dimple at the edge of his mouth. Exactly like his mom’s
.
“Thank you for bringing this. TV’s pretty boring during the day. But this is great.”

Scott’s heart tugged at the gratitude mirrored in Cody’s blue eyes despite all he’d been through in the past year. The loss of his parents in the accident, countless hospitalizations after surgeries for his crushed lower leg, physical therapy, and now an exhausting battle against infection. Yet somehow Cody still smiled, still laughed, and—Scott’s gaze moved to a Sunday school workbook on the bedside table—still trusted God.
After all he’s lost. How?
Because of Colleen’s unshakable faith . . . and because at ten Cody was a far better man than his uncle.

“And thanks for this too.” Cody lifted a gaudy fluorescent fishing lure with a rainbow of glittery streamers. “El Squid. I showed it to you at Arlo’s bait shop, and you remembered. We’ll catch big ones, won’t we? Salmon and striped bass—maybe an albacore?”

“You bet. But meanwhile, promise you won’t uncover those barbs. I put corks on them for a reason.” Scott pointed to half a dozen Band-Aids on Cody’s arm. “You’ve got enough holes in you, pal.” He touched his own shirtsleeve and felt a twinge of pain over the wound he’d sustained in his run-in with the rock. He was a fine one to talk.

“I promise. I won’t touch the hooks. And when my leg’s better, we’ll be going out on the charter boat. The big one out of Monterey Bay.” His smile faltered. “You’ll really take me?”

“Right.”
Even if I’m living somewhere else.
Scott raised his fist, and Cody responded with a grin and an enthusiastic fist bump. Then the smile faded. “Hey, what’s the matter, Cody?”

“I was just thinking . . .” The boy’s eyes met his, and their vulnerability made Scott’s heart ache. “If I can’t stand up, I can still go on the boat, can’t I? I could sit in a chair, and you’d help me pull the big one in?”

“Yes,” Scott managed, summoning a reassuring smile. “I’ll always help you.”

When the tech came in to help Cody shower, Scott left the room and promised to come back the next day with a stack of charter boat brochures. Scott’s mother would be in to visit tonight after she finished work. Scott’s stepfather, Gary, wasn’t feeling well, but he was still going to try to come for a while. Cody wouldn’t lack company.

He’d grabbed his half-full cardboard cup of coffee, deciding to finish it in the elevator, despite the fact it was lukewarm. Then he’d go back home and shower off the sea salt and the sand that had been grating against his skin for the last hour. Afterward, he’d let one of the paramedics look at his arm, then make some phone calls to the county disaster agency to see how things were going with the cleanup. He was glad that, so far, there had been few reports of new victims—only a handful of people without symptoms wanting to be checked just in case. He’d also make sure Chuck, his firefighter paramedic, had an extra day off. Chuck’s wife, Sandy, was being discharged today. Ana Galvez, however, remained in critical condition. He hated to think how frightened her family must be.

Scott took the last swallow of coffee just as the elevator door opened at the first floor. To reveal Erin Quinn. For some reason, his breath caught.

“Uh . . . hi,” he said, reaching out to the hold the elevator door. “Are you getting on?”

Erin shook her head, and a tendril of her copper-colored hair slipped free from her topknot to trail along her jaw. Her cheeks were flushed and green eyes bright. “I’m headed down to OB. We just had a baby boy. Six pounds, four ounces.”

“Baby?” Scott caught the door again, realizing he’d been so busy staring at the charge nurse he’d forgotten to step off the elevator.

“Teenage mother. Came in with a headache she thought was caused by the pesticide spraying. But it turned out to be eclampsia, with sky-high BP and seizures. We got her stabilized and into the OR for a C-section. That’s the only cure, of course. Mom and baby are both doing fine. But remind me to strangle the next person who says the
Q
word in my department, and—” Erin tipped her head and pointed to Scott’s cardboard coffee container. “Arlo’s Bait & Moor?”

“I’m not much on fancy coffee.”

Erin laughed. “Arlo’s has great coffee. I just meant that I live maybe half a block from there. Bait and bakery and open until eight thirty. You don’t know how many times I’ve run down there for emergency cookies.” She moved out of the way of an X-ray tech pushing a gurney and ended up closer to Scott. “But it’s such a hole-in-the-wall spot; how’d you know about it?”

“I lease a house about a mile down the coast from there, but the beach below Arlo’s is better. For swimming,” Scott added, realizing all at once that it was probably obvious, since he hadn’t showered and probably reeked like a sea lion. “Training for the Ocean Rescue Team. I was doing that today, so I grabbed the coffee and came here because . . .” He hesitated, then decided he didn’t mind telling Erin about Cody. “My nephew’s up on pediatrics.” He caught a sudden alarmed look on Erin’s face. “What?”

“You’re bleeding.”

Chapter Five

“This is going to sting a bit.” Leigh Stathos raised the syringe and squirted a short stream of local anesthetic toward the ceiling to clear the air bubble, then looked at Scott McKenna. “You ready?”

“Go for it,” he replied, glancing down at his arm exposed under the rolled-back sleeve of the patient gown. “I’m sorry about the sand. The hospital laundry won’t like it.”

Leigh chuckled behind her plastic shield mask. She’d been the one to insist the firefighter wear the gown after half a dozen young women—from the registration staff to housekeeping to an X-ray tech—had casually wandered by to ogle her patient. She’d never had so many offers of help. McKenna was incredibly fit and had come out fairly well in his encounter with that rock. And according to the nurse he’d dated in San Francisco, he had survived plenty of personal tragedy too. First his father, then his sister and her family in that car accident last year. Not that Leigh had ever asked for those details. The last thing she wanted to do was invade anyone’s privacy. Some pain was too personal. Her own troubles stayed between herself . . . and herself, now that she’d let God off the hook.

Leigh’s lips tightened behind the mask. This was no time to think about her marriage. There were no answers. She was relieved Scott hadn’t asked why she’d left Golden Gate Mercy Hospital.

“Sand we can deal with. Just spare us the organophosphates.” She sighed. “I want all that to be over with.”

“Same here.” Scott grimaced slightly as she inserted the needle of the syringe along the ragged edge of his wound and injected the first half-cc of lidocaine with epinephrine. “I haven’t heard the final report on the cleanup, but we should have things completed today.”

Leigh lifted the needle and reinserted it a short distance away, extending the injection through the already-numb tissue to lessen the pain of the stick. “I imagine if that pilot had survived, he’d be facing criminal charges. There have been ongoing protests against ag spraying for years. And valid concerns—yesterday proved that.” She wrinkled her nose. “I heard that our Safe Sky folks have asked some of the national groups to fly in for a show of strength.”

Scott snorted. “And you can imagine how much the media would love that. But I don’t think this incident came from deliberate negligence. The pilot was freelance, and the sad fact is that he may have been willing to take some risks to get the job done quickly and move on to his next contract. We’ll probably never know. But in this economy, I’d be surprised if his income hadn’t dropped off. Hardships everywhere. Business and housing. Makes me glad I’m leasing my place.” His eyes met Leigh’s. “Did you and your husband have to sell a home in San Francisco before you moved here? He’s a police officer, isn’t he?”

Oh no.
Leigh’s stomach sank and she stopped, holding the needle forceps midair, nylon suture dangling. “No. I mean, yes, he’s an officer. And we do have a house there, but—”

Judy arrived at the side of the gurney, and Leigh exhaled in relief. The truth was almost a corny cliché and still way too raw to talk about
. I left my heart, my home . . . and my husband in San Francisco.
She blinked and nodded to the efficient middle-aged staff nurse. “Perfect timing. Pour me some saline, would you?”

+++

Erin glanced at her watch as she crossed the last stretch of lobby carpeting on her way to the gift shop. She still had ten minutes left on her break, and she’d grab a sack of trail mix to surprise Arlene. Never a bad idea to keep the registration clerk happy when you’re stuck in the badlands of triage. All in all she’d made the most of her short break from the ER, seeing that Heather and the baby were doing well and checking on the status of little Ana. Erin’s throat tightened. The child had worsened considerably.

She’d also briefly visited the ICU. Sandy would likely be discharged this afternoon. But there’d been a look in her eyes that worried Erin and a way-too-chipper quality to her voice when she tried to joke about being on the other side of the stethoscope. A bravado that somehow fell flat. Erin would check back with her later today.

Across the lobby she spotted Sarge Gunther, his gaze on the TV mounted overhead. He leaned his hip against the wall and then flinched with what looked like a spasm of pain. His expression was solemn, his eyes rimmed by shadowy circles. Erin wondered how difficult it was for Sarge to perform his duties—mopping, pushing heavy bins of linen, hauling sacks of trash—while dealing with the cumbersome prosthetic limb. Below-the-knee amputation, right leg. A land mine in the Gulf War, she’d heard through the grapevine. He never talked about it. Hardly talked at all, in fact. But he was always there to help—any shift, anytime he was needed. Maybe that helped Sarge too. People needed to be needed. God had an amazing way of orchestrating things like that.

Now, trail mix and then back to the ER to see if Rambo McKenna had traded his duct tape and paper towels for stitches and a tetanus shot. She shook her head. The incident commander wasn’t quite as much in control as he’d thought.

Which reminded her that she needed to read the last of his memo; maybe she’d have a chance to go over it with him before he left the ER. She pulled it out of her tote bag as she walked through the doors of the gift shop. Then scanned it while she waited below a silver cloud of Mylar
Get Well Soon
balloons while the senior-age volunteer helped the customer in front of her. She traced a fingertip down the captain’s neat outline of items he intended to bring up for discussion at the countywide review. The last several notations referenced the ER:
Need for additional public
information officer
.
Need for training with the decontamination tent
. Erin grudgingly agreed with both.
Failure of basic security measures by emergency department staff (example: charge nurse, E. Quinn, identity badge).

Her mouth dropped open. He was making a public issue about her missing name badge? Called in on her day off to work like a dog . . . and get reprimanded?

By the time she reached the ER, Scott was sitting upright and bare-chested on the gurney, awaiting his bandage and diphtheria tetanus booster. Erin couldn’t think of anything she’d rather do more. She waved to Judy. “I’ll finish up here.”

He had sand in his hair. And she wished to goodness he were wearing a shirt. But she wasn’t going to be distracted; she was having her say. Erin returned Scott’s casual nod, pulled on a pair of gloves, and reached for a packet of antibiotic ointment. “I’ll just bandage this up and give you your shot. And you can get out of here.”

“Thanks. I need to do some paperwork at the station.”

Erin’s teeth clenched. She spread the ointment on the flat end of a forceps and smeared it along the dark line of sutures on Scott’s upper arm. “Paperwork for the disaster review?”

“Right.”

“I read your memo.”

“Mmm.” A muscle twitched along his jaw.

Erin tore open a package of gauze. “Your assessment of the ER’s response.” She motioned for him to lift his injured arm away from his side and began wrapping the gauze around his bicep. “Most of that was accurate. I’ll be honest; we haven’t used that inflatable tent before. And it would have been good to have at least one other PIO—the media was rabid.” Erin smoothed the last of the gauze around his arm. “But that last bit about basic security failures. That wasn’t fair.”

“Security is a prime issue. ‘Fair’ doesn’t figure in.”

Erin tried to stay calm as she fastened paper tape across the bandage. She uncapped the syringe of tetanus vaccine and expelled the air. “Did you have to mention me by name?” She recapped the syringe.

Scott exhaled, his gaze following as she set the syringe back on the tray.

Erin crossed her arms. “Look. I was called in on my day off. I got here as fast as I could and had no idea there would be a barricade. With you manning it. Security knows me. I wouldn’t have been stopped. You wouldn’t have even been there yet if I hadn’t asked my ward clerk to call for help.”

“You’re right. And you were eventually identified. But it took time. Which is a problem in those situations.” Scott’s brows drew together. “The memo’s already out. Nothing I can do about it now.”

Erin reached for an alcohol swab. “You can promise me you won’t bring my name up at the meeting. Spare me that.” She tore open the packet and gestured for him to turn so she could swab his opposite shoulder. She’d inject the medication there so any soreness could be differentiated from the tenderness of a possible wound infection.

He watched as she carefully prepped his deltoid for the injection. His gaze moved to the syringe in her other hand. “Under the threat of . . . ?”

“Oh, c’mon. I’m not threatening anything. I’m just saying, professional to professional, that we can have some respect for each other. We’ll get through the review; we’ll each go back to our own departments. We’ll never have to cross paths again. One meeting. All done. No more drama. We’ll both survive.” She uncapped the syringe and stretched the skin taut across his shoulder. “I’ll even sleep in my name badge from now on. Deal?”

Scott opened his mouth to speak just as Erin plunged the short needle into his muscle.

At the same instant Sarge hurried over to the ER desk. He was breathless and sweating. “Have you heard?” he asked Leigh. “They found a bunch of sick animals. Horses, cows, dogs, and even deer out at the crash site. When that ag pilot lost control, he hit a chemical storage shed and the spill contaminated a stock pond and a creek that feeds into the river. Our water supply.”

+++

Scott stood, despite the fact Erin was holding the alcohol swab against his arm. He took a step toward the nurses’ desk.

“Hang on. The injection site’s bleeding a little.” Erin held pressure on his deltoid with the swab, then lifted it away. “Did Sarge just say what I thought he said? The water supply’s contaminated?”

“That’s what I heard.” He watched the big man with the ponytail and rumpled tan scrubs move across the trauma room toward the door. “Is that guy one of the ER staff?”

“Not really. He’s a tech with housekeeping. And he’s assigned mainly to this first floor: ER, OR, radiology, and ICU. And up on second floor when he works nights. You know, taking care of the trash and biohazard bags and stocking the linen. But the staff counts on Sarge to do way more than he’s required to.”

“Sarge?”

Erin nodded. “I think his real name’s Richard.
R
on his badge, anyway. But everyone calls him Sarge. He’s a Gulf War vet. And disabled. Hard not to notice that limp. Frankly, I don’t know how he manages all the heavy work with that prosthesis.”

Prosthesis
. “He had . . . ?” Scott bit back the rest of the question. He didn’t want to know.

“An amputation of his lower leg,” Erin answered, obvious compassion in her eyes. “Probably twenty years ago, but I don’t imagine time makes it any easier. Something like that changes your life forever.” She grasped his arm as he tried to step away. “Hang on. I’m going to put a Band-Aid on your shoulder.”

“Don’t need one,” Scott said, fighting a sudden wave of nausea.
“Amputation . . . changes your life forever.” Not Cody . . . no.
“I’m fine.” He pulled his arm from her grasp and reached for his polo shirt. “But I need to get out of here. Am I finished?” He saw by the look on Erin’s face that his tone had been gruffer than he intended. “I mean, I appreciate everything you’ve done. But I need to go. I have to confirm that information about the pesticide contamination.”

Dr. Stathos arrived beside him. “Do you think it’s true? Sarge said it was on the local news, but I couldn’t pull up anything on my laptop.”

Scott lifted the cell phone attached to his belt. He switched it on, despite the hospital rules. He’d be out of here in a minute anyway. No messages. Good sign
.
“I don’t know. But even if it’s only media speculation, that still needs to be stopped. The last thing we want is a citywide panic. My station provides incident command and coordinates with the Monterey County Health Department on issues involving biological and chemical agents; we’ll get official information first. I’m heading over there now.” He glanced toward the door. “I need to check with my nephew too. He’s been upset about that little girl. I don’t want him worried by this talk of dead animals.”

Leigh grimaced. “Good idea. And I should make a call about my horse. He’s boarded at a stable not far from the river.”

Erin moved beside Scott. “Your nephew—that’s right. I forgot. You were telling me that he’s up on peds?”

“Yes, Cody’s getting some IV antibiotics for an infection. Probably won’t be there long.”
Because he’s going to be okay. He is.
Scott unfolded his shirt and began pulling it over his head, struggling a bit because of the bulky bandage. Erin reached out to help him. “Thanks.”

He’d taken the instruction sheet from Dr. Stathos, agreeing to watch the wound for signs of infection and get the stitches removed in ten to fourteen days, and was turning to leave when his cell phone buzzed against his waist. The fire station. Before he could ask, Erin told him he could safely take the call from the outer hallway.

“McKenna,” Scott answered, jogging out the trauma room doors. He leaned against the wall by the ambulance bay doors, looking up for a moment as the big housekeeping tech limped by, pushing a bin loaded with red biohazard bags. He listened to what the chief had to say, inhaling slowly with a small measure of relief. “Okay, Chief. Did animal control fax the information?” He nodded at the confirmation. “Good. How many barrels is he admitting to now? Is there any paperwork?” Scott spotted Erin walking toward him. Then listened as the chief relayed the last of the information. “I’m on my way in.” He disconnected and turned to Erin, noting the worry on her face.