One of the nurses read from notes on a computer terminal. “This guy was found in the parking lot of a closed bowling alley. Speculation is that he took a trip or two through the pin setting machine and got badly torn up.”
“Well, that’s a first.” I turned toward the operating room table. The light was so bright that hardly any shadows were cast in the room. They focused on the unholy mess on the middle of my table.
This. I’m supposed to fix this.
A man lay, unconscious, on the table. His chest was torn open, flaps of skin oozing onto wads of gauze and a paper sheet. His face was a mass of blood, now being daubed at with sponges. The anesthesiologist had found his mouth to thread a tube down, and someone had managed to get an IV started in one of his scraped-up arms.
My nose wrinkled under my mask. “What do the X-rays show? How deep does the damage go? Did he get a CT?”
A nurse clicked on a flatscreen monitor that displayed a carousel of CT images. I squinted at them, muttering dark oaths.
“Radiologist says it looks like a lacerated pancreas, punctured lung, and two rib fractures,” the nurse said. The image switched to the head, and he said: “Also the bonus of a fractured orbital bone.”
I stared at the CTs. “Let’s start with that lung. We leave the pancreas, and call plastic surgery on that orbital bone. This guy’s going to need all the king’s horses and all the king’s men to put him back together again.”
“Will do.”
I gazed down at the poor suffering bastard. I liked seeing the imaging, but I preferred to get a good visual with my own eyes on my patients. Sometimes X-rays and CTs didn’t tell me everything I needed to know about what to start sewing where. Something about seeing where the blood moved and pooled in an injured person gave me an idea of where to begin. The blood always led me to where I needed to direct my attention. Where it spurted required my immediate expertise. Where it clotted or moved lazily, I could wait a bit. When blood drained out of a limb and had left it white, I needed to add more. I noted with approval that he was already receiving a transfusion. As long as blood was moving, there was a chance for him
I frowned at his chest and touched the edges of the rends in his flesh with gloved fingers. Those were ragged and would have to be cut clean before I sewed him back up. I could see the edge of one of those protruding ribs, sticking up like a finger. I glanced over his limbs, counting the usual four. Hey, it pays to count. Count twice, cut once. I mentally cataloged bruises and scrapes, nothing that needed my immediate attention, though I flagged the palms of his hands to get a few stitches from the surgical resident. Looked like defensive wounds, like the guy had tried to fight the pin machine, but lost.
My eyes moved up to his face. One blackened eye was swollen shut. My fingers and gaze wandered over his scalp, checking for major wounds, when I spied a laceration at his throat.
I gently probed it with gloved hands. Some kind of puncture...the machine must have caught him near a seeping vein. It had nearly dried up, smelling rusty and not like the bright, coppery blood of his more critical wounds. It could still take a few extra stitches.
I stared down at the unfortunate guy’s oozing chest. Peeling back a flap of skin, I felt around for the collapsed lung. My finger quickly squished around and found the hole, and I extended my free hand for a scalpel. Time to get this party started...
...when the patient sat bolt upright on the table. His good eye was open, rolling.
I yanked my hands back and yelped at the anesthesiologist, “Curt, what the actual hell?”
The OR erupted in a flurry of activity. The anesthesiologist arrived at the patient’s side with a syringe, while nurses tried to push the patient back down.
But he was flailing, windmilling with his arms like a pro wrestler in the ring. The IV ripped out of his arm, and the line slashed back at the anesthesiologist, whipping across his face. The patient reached up and ripped the tube out of his throat. His foot caught an instrument tray, sending scalpels flying. His blood line yanked away, spewing crimson all over the floor.
I held my hands out, using my most calming voice. Not that I had a particularly calming voice; I was a surgeon. We don’t talk to patients. But I tried: “You’re safe. I’m your doctor, Dr. Conners. If you just lie back, we’ll make you comfortable and—”
The guy shrieked and launched himself off the table. The paper sheet tangled around his legs, and he grasped it around his waist as he put his shoulder down and aimed for the door. His shoulder hit me in the arm, and I slipped on my booties, landing on my ass on the tile floor. The patient launched through the swinging doors and disappeared down the hall.
I swore and ripped my booties off my sneakered feet. I clambered to my feet and punched the intercom at the door with my elbow. “Security, code orange at OR 6.” I couldn’t say: I’ve got a runner taking off down the hall. Please send somebody to stop him, because anyone listening to that would freak the hell out, and I would get a talking-to from HR.
I straight-armed the door and took off after the guy. I had no idea how the hell this man was still walking around. Those injuries should have flattened him, and he’d been anesthetized. I had graduated med school with Curt a few years ago, and knew him not to be a careless anesthesiologist who played on his phone in the OR.
The patient skidded down the hallway, landing at a dead end, where a window overlooked the parking lot. The sun had just set, and the sky was the violet color of a fresh bruise. I approached him slowly, like I was herding a feral cat. I tugged my mask down to try and give him a human face to look at.
“Hey, it’s okay. It’s gonna be okay,” I murmured soothingly. I wanted to keep him here until security arrived. If he got even further loose and hurt himself, that would be one obnoxiously long incident report. And an even more involved surgery after that.
“No, no,” he said, shaking his head. “It’s not gonna be okay. The bloodsuckers found me...and the Lusine couldn’t protect me.”
“I don’t know who that is,” I said, thinking that the guy had probably run afoul of some loan sharks. Maybe the mob? “But you’re safe here. We can protect you.”
“No,” he gasped, his face twisted in agony. “No one can protect me. And no one can protect Emily.”
He turned toward the window, backed up a few steps.
“No, wait...” I could see what he was trying to do, and I was helpless to stop it.
He rushed the window, aiming for it with his shoulder. All the latches on the hospital windows on patient floors were welded shut, but this wasn’t an area where conscious patients had access, and the window was not secured against suicide attempts. The glass buckled under his shoulder, the window crumpled away, and he pitched through in a hail of glass into the falling darkness.
I rushed to the window and stared down at the parking lot in horror. Three stories down, the patient sprawled on the parking lot blacktop, flattened like a bug under a shoe.
Curt had come up behind me. “Oh, my god, Garnet...did he...”
“He jumped,” I said, my heart in my mouth. I turned and ran to the stairwell, barking at him. “Get a gurney and the ER team.”
I burst into the stairwell, taking the steps two at a time. As I rounded the third curve, my path was blocked by a tall, dark-haired man in a brown velvet blazer and jeans. He was the type of guy that I might have liked to meet in my off-time—he had a kind of scholarly intensity in his hazel gaze and a bit of roguishness in the stubble that covered his sharp jaw.