Washed Away (11 page)

“Lots of times,” Cheryl said firmly. “That’s why I need to be with her, Flynn. Can you understand that? That’s why I need you to be brave and strong and sit here. I want you to hold the phone, and the second there’s a signal, I want you to call me in your loudest voice. Can you do that?”

He nodded solemnly, and Cheryl’s heart went out to the brave little guy sitting on the vast bed, staring at the cell phone that he hoped would bring help for his mother.

“G
O BACK TO
F
LYNN
.” Noah didn’t even look up as she ran through the clinic and into the operating room.

Beth’s body lay limp and pale on the table, her arm held high by Noah as he wrapped a wad of green sterile cotton drapes over the tea towel Beth had used in an attempt to stop the bleeding. Occasional whimpers of pain were the only noise she made as she drifted in and out of consciousness.

“We need to elevate her legs,” Cheryl said instead, eyes frantically searching for a cushion, pillows, anything.

“The table lifts,” Noah said without looking up. “There’s a lever underneath.” He slipped a tourniquet over Beth’s good arm and slapped at her hands in an attempt to bring up her veins, as Cheryl lifted the bottom of the table. “Get back to Flynn,” he said again, more loudly this time. “I’ll deal with Beth. He can’t be left on his own.”

“I’ve spoken to him,” Cheryl responded, her eyes working the room. In seconds she located the IV flasks
and giving sets, all neatly labeled. Locating a plasma expander that was suitable for humans, she started to run it through. “He understands that I—”

“He’s seven years old.” Noah’s face was an unhealthy gray, and the eyes that turned to her held more pain than she had ever wanted to witness. “He watched me try to resuscitate his brother and now he knows I’m trying to do the same for his mom. That little guy’s been through hell—he
cannot
be left alone.”

“I’m a trauma nurse, Noah.” Her eyes held his. “I can remember everything now—everything!” she added. Cheryl could feel the unspoken questions sizzling in the air, the pain in his eyes as his gaze held hers, but there simply wasn’t time to go there, so instead she shot into assertive-nurse mode, taking action exactly as she was trained to do.

“Everything, Noah,” she repeated briskly, managing to avoid looking at him by turning the connection on an oxygen cylinder and trying to fit a too-small mask over Beth’s slack mouth. “This is what I do every day of my working life. I’ve explained to Flynn why I need to be here, that his mom needs help, and if he can understand that, then you can, too.”

“But Flynn…”

“Flynn needs his mother,” Cheryl said firmly, coming back to his side as he struggled to gain access to Beth’s collapsed veins. “And we’re going to make sure he gets to keep her. Now, have you got an oxygen mask that will fit better?”

A nod in the direction of some drawers was all the
response she was going to get, and Cheryl located a mask that would provide a tighter fit and give Beth a higher concentration of oxygen. She headed for the IV fluids, checking what Noah had that might be compatible with humans and settling for the safety of a liter flask of normal saline—not the ideal fluid for a hemorrhaging woman, but at least it was something. Pulling on gloves, she pushed the IV pole over, hung the flask and connected it, as Noah somehow managed to gain IV access. The liquid seeped down the line, but they both knew it simply wasn’t enough.

“I’ll put in a second line before I take a look,” Noah said, and Cheryl nodded as she tried to familiarize herself with the room, pulling out packs and making a mental note of anything they might need. Their first priority was to resuscitate Beth with fluids, to stabilize her hemody namically, before they addressed her injury. “Do we know any more of what happened?” he asked.

“Just that she cut it on a window.”

The second line was in, fluid gushing into her veins. Beth moaned in agony as Cheryl attempted to get her blood pressure reading. She shook her head as she pulled off the stethoscope. “I can’t hear it.” Her fingers worked Beth’s wrist, inflating the cuff yet again, straining to feel a pulse as she let the cuff down.

“Her blood pressure’s unrecordable, Noah.” She handed him the stethoscope to allow him to check, but Noah shook his head, clearly trusting her judgment. “She needs blood.”

“I don’t have blood.” Noah shook his head grimly. “Just saline.”

“But she’s still losing.” Cheryl gestured to the cotton drapes, dark now with blood despite Noah’s tight wrapping. Attaching Beth to a cardiac monitor, Cheryl chewed her lip as she eyed the tachycardia on the monitor. “She needs blood.”

“Which I don’t have,” Noah said again, frustration evident in his voice.

“I’m O negative,” Cheryl responded. “My blood can be given to all groups.” She carried on as Noah shook his head. “It’s no big deal. I’m a regular donor—”

“No,” Noah broke in. “No way, Cheryl. You’re still weak from yesterday, and anyway, I need you here, helping me.”

Finally he admitted that he needed her, but even though it was what she wanted to hear, his argument did nothing to sway Cheryl. “One liter of blood won’t debilitate me, Noah. You know that as well as I do, and it will improve Beth’s chances tenfold.”

“No, we’ll just have to get her pressure up with the saline.”

“So she can die with diluted blood and a decent blood pressure.” Cheryl’s sarcasm was unmistakable. “For God’s sake, Noah, she’s got cerebral and myocardial hypoxia with tachycardia. She’s prearrest—a transfusion will buy us time.”

He didn’t answer, just glanced up at the clock. “It’s been ten minutes since I reinforced it, and given we don’t know when she first applied a tourniquet, it needs
to be loosened now. I can have a quick look at the same time. Pull the lights down, Cheryl. There are swabs over there.”

She didn’t need to be asked twice. Grabbing a stainless steel trolley, she rummaged for sterile packs and swabs as Noah opened a surgical pack and pulled on a gown. He washed his hand as Cheryl set up.

“A quick look,” Noah reiterated, dragging a stool over with his feet and lowering his large frame onto it. “I just want to see what we’re working with. You be ready with swabs. Check her radial pulse once the tourniquet’s off. There are some protective eye shields in the drawer over there.”

Grabbing two pairs, she put hers on. Careful not to touch his gown, she slipped the second pair over his face, seeing the lines of tension around his eyes.

“Let’s have a look, then.”

“I need to change my gloves first.”

He waited patiently while she did so, both taking a steadying breath as Noah released the green cotton drapes he had used to reinforce the crude tourniquet poor Beth had made from a tea towel. “Shit.” He cursed as he drew back from the injured arm, blood spurting high in the air, confirming what they already knew—the bleed was arterial.

“She’s severed her brachial artery.” Noah studied the wound as Cheryl skillfully used the gauze. The seconds between her removing the pressure and the wound refilling were the only chance Noah had to get a decent view, and he used it wisely, calling out his findings as
Cheryl looked on. “Has she got a pulse with the tourniquet off?”

“No.” Cheryl eyed the pale, lifeless fingers, her body absolutely still as she strained to catch a pulse.

“Okay, I’ll try to clip off the severed artery and then we’ll work out what we’re going to do.” He took the artery forceps Cheryl handed to him, and they both winced as Beth let out a guttural moan when Noah managed to clip the severed artery.

“She’s coming to a bit—this must be agony.” Cheryl moved to the head of the bed as Noah applied a sterile wad of soaked gauze to the exposed wound. “It’s okay, Beth. We’ll get you something for pain very soon.”

Beth’s eyes flicked briefly open, her face contorted in agony. Her lips moved as if she wanted to speak, then she dipped back into unconsciousness.

“I’ll wrap up the arm if you can get her some morphine. It’s over there.” Noah pointed to the drug cupboard. “The combination’s eight, four, six, two.”

Cheryl nodded, but paused halfway there. “Don’t wrap it, Noah. The arm should be cooled for better limb viability. That’s what we usually do.”

He gave a grateful nod. “There’s an ice machine in the clinic. If you can grab some and deal with her arm, I’ll get the morphine. At least we’ve stopped the bleeding.”

She set to work as Noah delivered the analgesia, wrapping the arm first before she stacked ice bags around it. Not for the first time she marveled at the equipment Noah had available. His clinic was almost as well equipped as some of the trauma rooms she’d worked in.

Except for the lack of blood—

“We’ve got a six-hour window to repair her arm before she loses use of it.” Noah’s voice broke into her thoughts. “That’s six hours from when she injured it, so let’s assume the accident happened an hour ago.”

Cheryl nodded at his estimate and checked Beth’s blood pressure again.

“So we’ve got five hours. But even if the phone lines come back on in the next few minutes, from what I’ve heard on the radio, the rescue teams have already got their work cut out. There isn’t going to be a helicopter standing by, just waiting for me to call them. Add on flying time…”

“Flynn brought a cell phone.” Hope flared in his eyes, but the grim shake of her head doused it immediately. “There’s no signal, but he’s got the phone, Noah. The second he gets a signal, he’s going to let us know.”

“He’s seven years old. He shouldn’t have to be going through this again.”

Again.

Cheryl acknowledged the pain behind the word, but this was no time to dwell on the past.

“Push the fluid through,” Noah said. “I’ll go and grab the radio, then check the boys and see if I can find out anything.”

He didn’t await her response, just headed out the door as Cheryl checked her patient. Although Beth desperately needed blood, the elevated legs, IV fluids and oxygen were temporarily having an effect, rallying her slightly. Her pulse was stronger, and her eyelashes flick
ered as Cheryl gently called her name, urging her back to a world that to Beth must seem so cruel.

“Flynn…Paul?”

“They’re okay,” Cheryl quickly reassured her. “They’re in the lounge. Noah’s gone to get the radio so we can see how the roads are doing.”

“I didn’t know what to do….”

Her head was lolling around on the hard table and Cheryl scanned the room. Pillows were clearly not needed for pets. She settled for a foam wedge and, covering it with a drape, she placed it under the woman’s head.

“You did everything right,” Cheryl soothed. “You did an amazing job to get here.”

“I knew I had to.” Beth’s eyes closed with the horror of it all, her words coming out in short phrases as her weakened body struggled to draw breath. “A branch came through the window. I was trying to put up some plastic sheeting. I couldn’t just leave it.”

“It’s okay, Beth.”

“The rain was coming in, the noise was awful. I just slipped.”

“Don’t think about it now.”

“I can’t
not
think about it. There was so much blood, Flynn was screaming—we both were. But you know what that little guy did?” A look of wonder spread over her face, and her voice was a shallow whisper as she tried to speak. “He ran and grabbed a tea towel, told me I should keep the arm up. He’d been along to the fire lectures with Hal. Seven years old and he was telling me what to do!”

“That’s quite a guy you’re raising.” Cheryl smiled. “He takes after his mom.” She watched as Beth frowned. “You drove here, Beth.” Cheryl’s voice wavered with emotion. “I don’t know how, but somehow you had the presence of mind to get in the car and drive.”

“We nearly didn’t make it.”

“You did make it, though,” Cheryl said more firmly now. “You got your babies and yourself to safety. You did an amazing job.”

“If Hal goes home, sees the blood…” She was starting to cry now, and Cheryl hushed her.

“Stop worrying about Hal,” Cheryl said firmly. “Right now we need to concentrate on you for a while. I need to ask some important questions. Do you know your blood type?”

Beth nodded, but her eyes were closing now as she drifted back into unconsciousness. Cheryl was having none of it. Pulling Beth’s earlobe, she called her name to rouse her.

“What’s your blood group, Beth?”

“O positive.”

“Are you allergic to anything?”

Again she shook her head, but Cheryl wanted firm answers. “Beth, are you allergic to any medications. Are there any antibiotics you can’t take?”

“No.” Beth’s eyes closed again, and this time Cheryl rubbed Beth’s sternum, forcing her back to consciousness.

“Any medical problems, Beth—diabetes, epilepsy, anything we need to know?”

“No,” Beth moaned. “I just want to sleep.”

“What did she say?” Noah was back now, but waited until Cheryl finished attempting to get a blood pressure reading.

“That she was trying to push a branch back through a window and slipped.”

“I wonder if she has any allergies.”

Cheryl shook her head.

“You asked?” Noah instantly regretted the question when she flashed him a dark look.

“Of course I asked. She’s O positive and she said she’s had no serious illnesses in the past.”

He took a deep breath, stared at the clock as if wishing it would stop ticking for just a while. “I’m going to have to attempt a repair.”

“There’s no point.” Cheryl’s matter-of-fact voice forced his attention. “Not if she doesn’t get blood first. You know that as well as I do, Noah. Her blood pressure’s sixty over zip, she’s tachycardic. She simply won’t make it through an operation without blood.”

A muscle was pounding in his cheek.

“Like I said, I gave blood a couple of months ago,” Cheryl insisted. “Nothing’s changed since then. I haven’t taken any drugs or had a tattoo, and I haven’t slept with anyone since then except…” She swallowed. “Except you, Noah.”

“I had an insurance medical last month.” Noah gave a tight shrug. “I had all the bloodwork done, and apart from you…”

“Then there’s no reason we can’t transfuse Beth with my blood,” Cheryl said deliberately. Sensing his hesi
tation, she took a deep breath and played her final card. “I know about Cody, Noah. I spoke to Beth about it, and she told me that everything possible had been done for him. That gave her some comfort. Surely that comforts you, too.”