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“Blood pressure continuing to drop despite the blood transfusions,” Marianne informed her in a terse tone. “We'll need to start CPR.”
“Give me another minute.” Jillian continued suctioning the blood from the wound, and then carefully packed the area with gauze hoping to buy this kid a little more time.
“Dr. Raymond from CT surgery is here,” Bonnie announced.
Finally.
“We've lost his pressure!” Marianne shoved the IV tubing aside.
No! Jillian stared at the monitor then glanced down at the young man. “Start CPR.”
The cop still kneeling on the gurney placed his hands over the center of the kid's chest and began giving chest compressions. Blood continued to seep from the wound. She didn't waste time telling him to get down—for one thing the strength of his compressions were better than most, and for another, if they didn't fix the hole in this kid's heart soon, their efforts would be futile anyway.
“A bullet punctured the pericardial sac and grazed his myocardium.” Jillian quickly gave Raymond the details. “He'll need to go to the OR.”
Todd Raymond shook his head as he glanced at the vital signs displayed on the heart monitor. “It's no use. He won't make it to the OR, he's lost too much blood.”
Jillian couldn't believe his cavalier attitude. Was he really going to give up that easily? She held onto her temper with an effort. “Are you telling me you're not even going to try?”
He shrugged. “What do you want me to do—open his chest here?”
“Get the chest tray STAT!” Jillian knew their efforts might be useless but this kid was a teenager, for Pete's sake. Didn't this child deserve every chance possible? “Give him some sedation.”
When the tray was open and ready, the cop stopped giving compressions and jumped down from the gurney, knowing without being told that his assistance was no longer needed.
The alarm on the monitor overhead beeped loudly as the kid’s heart rhythm went straight line without the aid of having CPR. Jillian wasn't a surgeon but she didn't flinch when Todd drew his scalpel down the center of the boy's chest, meeting up with the open area left by the bullet. “Hand me the Macmillan forceps,” Todd said as he opened the ribs to expect the damage to the boy's heart.
She did as he asked, but at that moment the fingers of her right hand went numb and tingly, causing her to drop them. For a split second her horrified gaze met the cop’s. Good thing the forceps had dropped onto the sterile field. She quickly picked them up again and handed them to Raymond.
“His left ventricle is severely damaged,” Todd muttered as he used the forceps to trace the path of the bullet. Jillian crammed more gauze into the blood-filled cavity. “The left lung is also a mess—the bullet tore through the upper lobe.”
“Try open heart massage,” Jillian said urgently. “Maybe if we can get his blood circulating long enough to get him on the heart lung bypass machine...” She didn’t finish. Even she understood that likely wasn’t possible. But it would not be for lack of trying.
Todd Raymond did as she asked and messaged the boy’s heart, coaxing it back into some semblance of normal function. But even as they all stared at the straight line where the heart rhythm should have been on the monitor, she knew it was too late.
“It's over.” Todd removed his hands from the kid's chest and turned away. “I'm sorry. But with the injuries he sustained, his chance of survival was less than five percent.”
He wasn't a percentage, he was a child! She wanted to scream, rant and rave at the tragic death but held herself in check. This boy wasn't the first patient she'd lost and unfortunately, he wouldn’t be the last. She opened and closed the fingers of her right hand, trying to shake off the strange tingly sensation. “Thanks for coming down, Todd.”
“Sure.” The surgeon stripped off his bloody gown and gloves, tossed them in a red trash bag and left.
Jillian stripped off her bloody gloves too, then forced herself to turn her attention to the team of personnel working over Anchor Doe, the first victim. She'd left her senior resident in charge, using her expertise on the sicker of the two patients. “How are things going, Jack?”
“Fine. He's stable. The trauma surgery team is taking him to the OR to repair the damage to his intestines.” Jack Dempsey seemed to have everything under control as she watched the surgical residents pack up the gurney and wheel Anchor Doe away.
Good. At least they hadn't lost both of them. Watching one young man die was bad enough.
When she turned back to Evergreen Doe, she saw the cop still standing there, staring down at the kid, seemingly unaware of the nurses who are cleaning equipment out of the way.
When Marianne moved to pick up the remnants of the boy's bloody shirt and pants, the cop glanced up and held out his hand. “I'll take those.”
Marianne glanced at Jillian for confirmation. She nodded, granting her permission. Their hospital policy was always to cooperate with law enforcement when they accompanied a patient to the emergency department. Gunshot and knife wounds were an automatic report to the police, and they had the right to secure evidence. Marianne dropped the bloody clothes in a plastic bag and handed them over. He took the bag absently, staring at the boy, not appearing to be in a huge hurry to leave.
Now that the worst of the emergency was over, she cast through her memory for the cop's name. Alex? No, Alec. That's right. Alec Monroe. He'd come in about two months ago with a serious knife wound slashed diagonally across his flank requiring a good twenty stitches.
Embarrassed at how she remembered his name over the dozens of other patients she treated over the past few weeks, she wished she could slink away, especially knowing he'd taken note of how she'd dropped the forceps. Did he wonder what was wrong with her? Or had he attributed the action to pure clumsiness?
“Thanks for going above and beyond with him,” Alec said in a low tone, still gazing at the dead boy.
