Washed Away (12 page)

He gave a slow nod as Cheryl continued.

“Everything possible,” she said again. “I’m O negative, Noah, and Beth needs blood if she’s to stand a chance—we have to do this. Have you got the equipment?”

He took time to answer, first staring back at her before nodding resignedly. “I take blood from animals a couple of weeks prior to planned operations if I think they might need a transfusion.” He gestured to a large silver chest of drawers. “You’re sure about this, Cheryl?”

“More than sure.” She nodded, heading for a chair and sitting down as Noah collected the equipment.

“We should go through to the bedroom, you can lie down….”

“That’s not very fair to Flynn,” Cheryl pointed out. “Bring me a stool so I can put my feet up, and after it’s over, I’ll go and have a drink and sit with Flynn while you set up for surgery.”

It was a simple procedure, no drumroll or fanfare needed or wanted as Noah slipped the needle into her arm. As the bag filled, Noah tended to Beth and set up for the impending operation.

“It’s full,” Cheryl called. “You can take one more without causing any problems.”

“You nearly drowned yesterday,” Noah pointed out,
but he knew arguing with her was useless. The fragile woman of yesterday had disappeared, replaced instead with an assertive, confident woman. But strangest of all, Noah mused as he switched the bag for an empty one, checking she was okay for the umpteenth time, then connecting the vital fluid to Beth…Strangest of all was that, as chameleon-like and complicated as the two Cheryls he had witnessed were, he loved them both.

“D
RINK ALL OF IT
.” Noah’s voice was the firm one now as he placed a massive jug of orange juice on the bed table beside her.

Despite her insistence that she’d be fine, the second Cheryl had attempted to stand, tiny white dots had danced before her eyes and Noah had had to carry her through to the bedroom.

“I’m going to make up a bottle for Paul and then we’re going to feed him, and while I do that, I want you to watch Cheryl.” Noah winked at Flynn. “Make sure she drinks every last drop of that juice and eats these biscuits, and don’t take any arguments from her.”

“Can I go to the bathroom first?”

“Sure you can, buddy.” Mindful of the boy’s sore arm, Noah helped him off the bed and led him to the washroom. Once he was safely in, Noah came over to Cheryl, talking in a low tone so that Flynn couldn’t hear.

“All I want to do is repair the artery.” His mouth was set in a hard line, but his voice was firm now that his decision had been made. “No heroics, no fancy work, just repair the artery to restore blood flow. The vascu
lar surgeons can do the rest. I’ve done this type of thing before, lots of times, just not on a human.”

Cheryl knew he was trying to rationalize things, to talk himself through the barriers he faced. Cheryl knew something else, as well.

She loved him.

“I think we should feed the baby and get him settled before we start,” he said. “The last thing we need is to be disturbed, and Flynn will get upset if he’s crying. Anyway, you need to have rest and get some fluid inside you.”

“Noah…” She tried to meet his eyes, but Noah stared somewhere fixedly over her shoulder. She moved her hand to touch him, then pulled away, knowing words were all she could offer at this point.

“Like you said, you’ve done similar types of repairs before,” Cheryl reminded him. “You’ve got a well-equipped surgical room, and I might not be Carly, but you’re about to find out I’m one helluva nurse.”

Something must have reached him—the unwavering support in her voice, the confidence in her own ability—and finally he managed to look at her.

“I could just leave it. I’ve tied off the artery.” That muscle in his cheek was pounding again.

“
I
could have tied off the artery, Noah,” Cheryl said. “But unless the phone lines come on now, unless we get her to a hospital quickly, then she’ll lose her arm.” She paused for effect. “You can do this, Noah. You don’t have a choice.”

“You do, though.” Finally his eyes found hers, but the
earlier tenderness was noticeably absent—no loving look, no warmth in the blue pools. “I understand completely if you want to step aside, Cheryl.”

“I’m beside you.” She didn’t blink, didn’t hesitate, just stared right back at him. “Whatever the consequences, we’ll face them together.”

“H
OW’S HE DOING
?”

There was an expression in Noah’s eyes she couldn’t read as he stood in the doorway, watching as she attempted to feed a fretful baby.

“Not so good,” Cheryl admitted. “He won’t take the bottle.”

“Let me try.”

He took the restless baby from her, and Cheryl watched in admiration as somehow he managed to get the infant to suck on the nipple. She’d been trying for ages, the whole time Noah had been setting up the O.R., Cheryl had been wrestling with a baby who wanted nothing more than his mother.

“How did you do that?” she asked, watching as Paul hungrily gulped the formula Noah had prepared.

“Years of practice.” Noah shrugged. “Mind you, this is the first
human
baby I’ve ever fed.”

“Flynn’s sound asleep.” Cheryl gestured to the little guy curled up on the bed beside her. “He made sure I drank all my juice before he dozed off. How’s Beth?”

“Better. The blood did the trick. Her pressure’s up and she’s more rousable now. I’ve set up the O.R. and
changed into clean blues, so I’m going to give her the local anesthetic. If you’re ready, we should probably get started. Do you think we should bring Paul in so we can keep an eye on him?” Noah asked, waiting as he gently laid the infant in a makeshift crib he had fashioned from a drawer and some towels. He offered his hand as she stood.

“He’s a healthy baby, Noah,” Cheryl pointed out. “If we keep the door open we’ll hear him if he wakes. We’ll hear Flynn, too.”

Still she sensed his hesitation.

“Noah, this isn’t ideal, none of this is ideal, but Beth’s surgery is intricate. You need all your attention to be on her. Paul’s been fed and changed, he’s asleep. I can duck out and check on him, but you have to focus on repairing Beth’s arm, not look out for a sleeping baby. He’s warm and safe and he’s got his brother watching over him.”

She eyed his worried face in concern and ached to put her arms around him, comfort him, somehow convince him of the confidence she had in him. But Cheryl knew it wasn’t her place now, and after one final check on the sleeping brothers, she followed him quietly into the operating room.

He’d been busy.

A massive cart was covered in sterile drapes. On another, packs and suture material lay waiting to be opened once the two of them were gloved and gowned. Local anesthetic and the sedative were already neatly drawn up on the crash cart, and Cheryl checked her pa
tient, noting with quiet satisfaction that even though her pulse was still rapid, her blood pressure was no longer dangerously low. If Cheryl had had any doubts as to the necessity of this procedure, they were eliminated when she looked at Beth’s dark blue fingers peeking out from the drapes.

They had no choice.

No choice at all.

As Beth’s eyes opened, Cheryl smiled down at her. “How are you doing there, Beth?”

“Scared.”

“I know,” Cheryl said gently.

“I think I remember Noah saying something about an operation.”

Cheryl felt him come behind her, could feel the warmth of his body as he stood over her shoulder, his masculine scent mingling with the antiseptic, his voice tender but firm. She was acutely aware of his hand at the small of her back, moving her gently aside as he spoke to Beth.

“I did say that, Beth,” Noah said clearly. “And now you’re awake, I want to go over everything with you, if that’s okay.”

He dragged the stool over again, and Cheryl decided if he ever wanted a career change, becoming a medical doctor should be at the top of his list. Cheryl felt a lump in her throat, watching as he explained the procedure to Beth, calming her, yet somehow managing to impart the gravity of the situation.

“Like I said before, you do need surgery, Beth, and
soon. Ideally you need to be flown to Houston, to a major trauma center, where skilled vascular surgeons can repair the artery and tendons. It’s a deep wound.”

Beth nodded, no fear in her eyes, all her energy focused on listening as Noah spoke. “But the phone lines are down, and there’s only sporadic cell phone coverage. At the moment we can’t get a line.”

“You know that the roads are blocked?”

“I heard it on the radio. They said it could be a few days. We need to fix your arm, Beth. Not completely, just to get the circulation restored. We can leave the rest for the big guns in Houston.” Noah’s voice was gentle but firm. “Maybe we’ll pick up a signal soon, I don’t know. But the longer we leave things, the longer your arm goes without blood flow…”

“I could lose it?”

“You could,” Noah said quietly, “and even with surgery there are no guarantees. But if we don’t do anything…”

“Then fix it.” Beth stared right back at him, her voice matter-of-fact, a stark contrast to that of the vulnerable tearful woman Cheryl had faced yesterday. “Fix it,” she said again. “I really need my arm, Noah.”

He explained the procedure to her carefully in layman’s terms. A local block would numb her arm, and an injection given through the IV wouldn’t knock her out but put her into a light sleep. She wouldn’t remember anything.

“Can I speak to Flynn first? He’ll be so scared.”

“Sure,” Noah agreed, “but first let’s clean you up a bit.”

Cheryl set to work, snipping off Beth’s drenched pajamas and as Noah had done for her, she slipped some
cotton surgical blues over Beth’s legs. But given that one arm was injured and the other connected to various pieces of equipment, Cheryl settled for a couple of strategically placed cotton drapes to cover her from the waist up. She hastily cleaned away the multitude of swabs and wiped down the floor. Even though Beth looked awful, with sunken eyes and a drawn face, Cheryl did her level best to ensure that the mother who greeted her son would look a lot better than when he’d last seen her.

“I’m so thirsty.” Beth ran a tongue over her dry lips.

“You’re still dehydrated,” Cheryl explained, “but we can’t give you anything to drink just yet. You’re getting a lot of fluid through the drip.” She looked up as Noah came in, a navy duvet and pillows in hand. Cheryl gave an appreciative nod at his foresight. The homey touches were exactly what Flynn needed now.

“That looks better.” Noah gave Beth’s good hand a squeeze. “I’ll go and bring Flynn in, but not for too long, Beth. We need to get working on that arm.”

“Can I see Paul, too?” Her eyes darted around anxiously. “I’m breastfeeding. He’s due—”

“Don’t worry about that now,” Noah broke in, and again Cheryl marveled at his ability to comfort the anxious woman. “We gave him some formula. I’ve got bottles and teats—new bottles and teats,” he added as Beth opened her mouth to protest. “You’re in no condition to feed him now. Cheryl’s changed him,” Noah added. “He’s warm and fed, so please don’t worry. Just lie there and try to relax. Cheryl will stay with you, and I’ll go and get your boys.”

“Poor Noah.” Beth let out a helpless sob when Noah had left. “That poor guy must rue the day he got us as neighbors.”

“He cares about you, Beth,” Cheryl assured her, “and when you care about someone, you take the good bits as well as the bad…” Her voice trailed off. He hadn’t made a sound, but she knew he was in the doorway. She could feel his presence in the room.

“Hey.” Somehow Beth managed a smile. She lifted an arm just enough to gesture to her son, and Cheryl watched as a sleepy Flynn tentatively walked over, Noah’s firm hand guiding him. Beth soothed her scared son, then Noah carefully lowered Paul in his arms. Beth rubbed her cheek against her infant’s downy head, and all of a sudden Cheryl felt like crying, not just for the beautiful man she had inadvertently hurt, not for herself and the painful memories that had clicked into place, not even for the proud, tortured woman lying on the table. She wept for Cody, a baby she’d never met, a baby who had touched the lives of everyone in the room.

There should be three.

Beth’s tear-laced words came in total recall now, and for a second Cheryl shared Beth’s pain, her fear as Beth kissed her sons goodbye, then watched Noah lead them from the room.

“R
EADY FOR THE HAPPY JUICE
?” Noah smiled when the local anesthetic had finally taken effect, and despite the needle in her forearm, Beth couldn’t feel a thing.

“Nearly.” Squeezing her eyes closed, Beth took a
deep breath, clinging to Cheryl’s hand beneath the drapes. “Tell Hal I’m sorry….”

“Tell him yourself.” Noah smiled, then injected the medication through her IV, talking comfortingly until finally her eyes closed in sleep.

The hand that had been gripping Cheryl’s slipped free now, and Cheryl tucked it beneath the drape.

“Ready?”

Cheryl nodded. “Ready.”

After scrubbing her hands and forearms for the mandatory period, she stepped back from the sink, murmuring thanks as Noah helped her into a gown and tied her mask, then headed off for his own scrub. Cheryl took the time to familiarize herself with the instruments, opening packs, filling stainless steel bowls with saline and attaching a catheter to the suction equipment.

“Can you help me with my gown?”

His request was more polite than that of any surgeon Cheryl had worked with in a long time, but she didn’t want politeness from him. She wanted to talk to him, wanted to go over her past, to explain, to pray he’d understand. And she would, Cheryl consoled herself as she lifted out a sterile gown. Once the operation was over, she would talk to him. So instead of saying anything, she did the strange dance that had been taught them long ago, holding the tie to his gown as he twirled into it. But there were none of the old jokes about roses and tangos today, just an aching silence as she tied on his mask, then waited for him to position himself on the stool before applying his magnifying glasses and changing her gloves.

“We’re going to struggle with just two of us.”

Again she felt as if he were voicing his own concerns rather than reassuring hers.

“A sterile field’s essential. I don’t want Beth going off to Houston with some raging infection. We’ll need lots of glove changes and…”

His eyes met hers then, and even though she couldn’t see his beautiful mouth, she knew he was smiling apologetically.

“You’ve probably done this more than me,” he said.

“I’ve assisted in a lot of emergency procedures,” Cheryl admitted, “and I’ve done my required stint in surgery, but I’ve never been a vet’s scrub nurse, so you’ll have to excuse me.”

“We’ll get there.”

Noah took a deep breath, and Cheryl watched as he forced his shoulders down into a more relaxed position.

“Operation commencement 08:05 hours.” Cheryl handed him a massive wad of swabs before snapping a cover over the light handle and pulling it down. She positioned the light till Noah was satisfied he had a clear view, then changed her gloves yet again.

Cheryl was amazed at his professionalism as she watched him work, first irrigating the wound and clearing it of debris. Delicately he removed the tiny shards of glass, being careful not to cause further injury. Cheryl dabbed at his brow and moved his glasses an inch up his nose between breaks.

“Now that it’s clean, we can have a look at the damage,” he said. He probed the artery ends with his forceps,
taking in every detail of the trauma, then carefully transposed the median nerve as Cheryl tractioned the bicep muscle back.

“I’m going to attempt an end-to-end anastomosis,” Noah said finally. “If they want to graft her later, that’s fine. All I want to do is control the bleeding and return circulation to the affected limb.”

He looked up briefly, and Cheryl could see the question in his eyes. He needed her support.

“Sounds good.”

On he worked, again, liberally cleaning the wound to prevent infection. Carefully he heparinized the damaged artery. Blood clots were the very last thing Beth needed. Cheryl could only marvel at his skill as he joined the arterial ends, an intricate task by any standard. The sutures he used were no wider than a human hair, and sweat poured off him in the oppressive heat. The backup generator, already overworked by the lights, barely provided enough energy for a breeze from the fan. But not once, not even for a second did he snap at her. Every request was delivered in a polite tone as he concentrated on working a miracle.

F
INALLY IT WAS OVER
and time to see if the exhaustive procedure had actually worked. Noah nodded at Cheryl to release the cuff to find out.

They both watched in grateful awe as Beth’s veins perfused, and her fingers pinkened. Cheryl probed Beth’s nail beds, checking for capillary refill.

“I can feel a radial pulse,” she cried. “A strong pulse.”

“Good.” It was the understatement of the millennium, but his work wasn’t finished. Releasing the retraction, he carefully repositioned the ulnar nerve before finally looking up.

“I’ll put in a drain and do a loose close.”

The elation hadn’t hit him yet. Cheryl knew the numerous risks that lay ahead for Beth clearly weighed heavily on him, but he worked on, closing the wound for the surgeons who would undoubtedly be following in his footsteps.

“She’s waking up.” Cheryl moved closer, vial on hand, ready to plunge Beth back into her twilight zone, but Noah stopped her.

“Let her come to. I’m just finishing up.”

He applied a back slab to Beth’s arm, checking her fingers to ensure circulation was still restored before finally pulling off his glasses and peeling off his mask. He threw his sweat-laden gloves into the bin without comment.

“She’ll need vascular obs every fifteen minutes for the next couple of hours.”

“Done,” Cheryl commented without looking up, counting the swabs they had used. Old school nursing habits kicked in despite the bizarre circumstances.

“I’ll cover her with strong antibiotics.”

Paul’s piercing cries brought them back to concerns outside the O.R. Noah still concentrated on Beth, while Cheryl dealt with the more basic practicalities: changing the bed and preparing it for Beth, then moving Flynn and Paul through to the main house, which looked as if
a bomb had hit. Even with the tarpaulin Noah had secured to seal off the stairs, the wind shivered through.