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Sara was sure she'd misunderstood. "She was raped and hit by a car?"
Mary didn't explain. Her hand was like a vise on Sara's arm as they jogged down the hallway. The door was open to the emergency triage room. Sara saw the gurney, three medics surrounding the patient. Everyone in the room was a man, including Will Trent, who was leaning over the woman, trying to question her.
"Can you tell me your name?" he asked.
Sara stopped short at the foot of the bed, Mary's hand still on her arm. The patient was lying curled on her side in a fetal position. Surgical tape held her tightly to the frame of the stretcher, pneumatic splints binding her right arm and leg. She was awake, her teeth chattering, murmuring unintelligibly. A folded jacket was under her head, a cervical collar keeping her neck in line. The side of her face was caked in dirt and blood; electrical tape hung from her cheek, sticking to her dark hair. Her mouth was open, lips cut and bleeding. The sheet they had covered her with was pulled down and the side of her breast gaped open in a wound so deep that bright yellow fat was showing.
"Ma'am?" Will asked. "Are you aware of your condition?"
"Move away," Sara ordered, pushing him back harder than she intended. He flailed, momentarily losing his balance. Sara did not care. She had seen the small digital recorder he had in his hand and did not like what he was doing.
Sara put on a pair of gloves as she knelt down, telling the woman, "I'm Dr. Linton. You're at Grady Hospital. We're going to take care of you."
"Help . . . help . . . help . . ." the woman chanted, her body shivering so hard the metal gurney rattled. Her eyes stared blankly ahead, unfocussed. She was painfully thin, her skin flaky and dry. "Help . . ."
Sara stroked back her hair as gently as she could. "We've got a lot of people here and we're all going to help you. You just hang on for me, okay? You're safe now." Sara stood, lightly resting her hand on the woman's shoulder to let her know she was not alone. Two more nurses were in the room, awaiting orders. "Somebody give me the rundown."
She had directed her request toward the uniformed emergency medical techs, but the man across from her started talking, delivering in rapid staccato the woman's vitals and the triage performed en route. He was dressed in street clothes that were covered in blood. Probably the bystander who had given aid at the scene. "Penetrating wound between eleventh and twelfth ribs. Open fractures right arm and leg. Blunt force trauma to the head. She was unconscious when we arrived, but she gained consciousness when I started working on her. We couldn't get her flat on her back," he explained, his voice filling with panic. "She kept screaming. We had to get her in the bus, so we just strapped her down. I don't know what's wrong with . . . I don't know what—"
He gulped back a sob. His anguish was contagious. The air felt charged with adrenaline; understandably so, considering the state of the victim. Sara felt a moment of panic herself, unable to take in the damage inflicted on the body, the multiple wounds, the obvious signs of torture. More than one person in the room had tears in their eyes.
Sara made her voice as calm as possible, trying to bring the hysteria down to a manageable level. She dismissed the EMTs and the bystander by saying, "Thank you, gentlemen. You did everything you could just to get her here. Let's clear the room now so that we have space to keep helping her." She told Mary, "Start an IV and prep a central line just in case." She told another nurse, "Get portable X-ray in here, call CT and get the surgical on-call." And said to another, "Blood gas, tox screen, CMP, CBC, and a coag panel."
Carefully, Sara pressed the stethoscope to the woman's back, trying not to concentrate on the burn marks and crisscrossed slices in the flesh. She listened to the woman's lungs, feeling the sharp outline of ribs against her fingers. Breath sounds were equal, but not as strong as Sara would've liked, probably because of the massive amount of morphine they had given her in the ambulance. Panic often blurred the line between helping and hindering.
Sara kneeled down again. The woman's eyes were still open, her teeth still chattering. Sara told her, "If you have any trouble breathing, let me know, and I'll help you immediately. All right? Can you do that?" There was no response, but Sara kept talking to her anyway, announcing every step of the way what she was doing and why. "I'm checking your airway to make sure you can keep breathing," she said, gently pressing into the jaw. The woman's teeth were reddish pink, indicating blood in her mouth, but Sara guessed that was from biting her tongue. Deep scratches marked her face, as if someone had clawed her. Sara thought she might have to intubate her, paralyze her, but this might be the last opportunity the woman had to speak.
That was why Will Trent would not leave. He had been asking the victim about her condition in order to set up the framework for a dying declaration. The victim would have to know she was dying before her last words could be admitted in court as anything other than hearsay. Even now, Trent kept his back to the wall, listening to every word being spoken in the room, bearing witness in case he was needed to testify.
Sara asked, "Ma'am? Can you tell me your name?" Sara paused as the woman's mouth moved, but no words came out. "Just a first name, all right? Let's start with something easy."
"Ah . . . ah . . ."
"Anne?"
"Nah . . . nah . . ."
"Anna?"
The woman closed her eyes, gave a slight nod. Her breath had turned more shallow from the effort.
Sara tried, "How about a last name?"
The woman did not respond.
"All right, Anna. That's fine. Just stay with me." Sara glanced at Will Trent. He nodded his thanks. She returned to the patient, checking her pupils, pressing her fingers into the skull to check for fractures. "You've got some blood in your ears, Anna. You took a hard knock to your head." Sara took a wet swab and brushed it across the woman's face to remove some of the dried blood. "I know you're still in there, Anna. Just hang on for me."
With care, Sara traced her fingers down the neck and shoulder, feeling the clavicle move. She continued down gently, checking the shoulders front and back, then the vertebrae. The woman was painfully undernourished, the bones starkly outlined, her skeleton on display. There were tears in the skin, as if barbs or hooks had been imbedded under the flesh, then ripped out. Superficial cuts sliced their way up and down the body, and the long incision on the breast already smelled septic; she had been like this for days.
Mary said, "IV's in, saline wide open."
Sara asked Will Trent, "See the doctors' directory by the phone?" He nodded. "Page Phil Sanderson. Tell him we need him down here immediately."
He hesitated. "I'll go find him."
Mary supplied, "It's faster to page him. Extension 392." She taped a loop from the IV to the back of the woman's hand, asking Sara, "You want more morphine on board?"
"Let's figure out what's going on with her first." Sara tried to examine the woman's torso, not wanting to move the body until she knew exactly what she was dealing with. There was a gaping hole in her left side between the eleventh and twelfth ribs, which would explain why the woman had screamed when they tried to straighten her out. The stretching and grinding of torn muscle and cartilage would have been excruciating.
