Page 19 of Doctor Enemy

“I don’t know,” she says. “It didn’t say.”

I shake the papers a little bit, and then glance up at the man.

Thomas Devaunt is almost sixty, with a skull fracture and a serious concussion. There’s no brain bleed at the moment, but he’s at risk for one once the swelling starts to go down, and the pressure lessens. “The things that people do… It’s crazy to me. You know, my first year as a resident, I had to take care of someone that tried to do a stunt course, fifties style. Snapped his own neck doing it.”

“Some people just don’t think about how dangerous life is. Or they don't care,” Cara says. She finishes fixing the man’s IV. His face is a mottled mess of bruising. “The moment you walk out that door, anything could get you.”

“Wrong. It’s not anything,” I correct. “It’s a chronic case of being unable to think further than the end of your nose.” I hang the chart back up. “Keep him on the respirator for now. If it gets worse, let me know and we’ll move him to a hyperbaric oxygen chamber.”

“His blood pressure’s pretty low,” says Cara, frowning. She leans forward, adjusting the stiff, white blanket that’s been draped over him.

“The swelling’s stopping the oxygen from getting where it needs to go. Get him on a norepinephrine drip.”

“Not isotonic crystalloid?” Cara asks, sounding surprised.

“No. The man’s not in shock. He’s just–stopped up,” I explain, gesturing at the patient. “Might need to be changed if it gets worse.”

I’m about to explain a little bit more about the difference between the two solutions when my pager goes off. And so does Cara’s. Out in the hallway, from the nurses’ station, I can hear the intercom blaring.

ER, coding patient. ER, incoming crowd.

I turn on my heel without a word and start hurrying down the hallway, toward the ER. Cara is hot on my heels. Thomas is stable for the moment, and the nurses on his floor will keep an eye on him while we’re elsewhere.

“At least the time’s passing fast,” mutters Cara. Her brows are pinched down.

The joke lands. I snort. “Could pass a little slower. I wouldn’t complain.”

We hit the elevator, and it takes us down to the first floor. The halls seem endless tonight. The patients are in such high numbers, they threaten to blend together. Maybe that’s just because I’ve been doing this for too long. My father always said that when you couldn’t keep the patients separated from each other, it was time to look into a new career.

The way I see it, that’s only half true.

If you’re in the middle of treating someone, then it can’t matter who the patient is. Keeping them separated only matters for the aftercare.

There’s a gurney already rocketing down the halls, toward surgery. I can hear a commotion near the intake doors. The other part of the rush crowd getting brought in, I assume. I fall into step behind it. “What do we have?”

“Car accident, out on East Madison. We’ve got two others injured, but she’s the worst,” rattles off Maddie, in her soft voice. The fact that her voice is quiet doesn’t prevent her from sounding serious.

I glance at the gurney, taking the patient in. The sight is enough to have me trip over my own feet, and struggle to get them back underneath me.

“Shit.”

It turns out that I won’t be having any problems keeping this patient separated from the others.

It’s Lori Lange, face bloodied, and hair soaked. The deep purple bruising that laces over her forehead is indicative of a bad knock to it, but it’s the bulbous swelling taking place there, and dripping down toward her left eye socket, that really has me concerned.

“Two broken ribs. Jason—" He’s one of the EMTs. “Says that it’s a brain bleed. Multiple contusions on the arms and legs.”

Cara makes a soft sound in the back of her throat when she finally catches up to us. We’re walking fast, our footsteps turning to thunder. One of the nurses runs ahead to get the wide doors of the elevator opened.

The gurney goes first, and we push it straight through, and crowd in around it. Maddie is already hooking up an IV. Cara helps get it set up.

“Who’s the attending?” I ask.

Maddie says, “You are. I’ve got Nate on one of the other drivers.”

“Who’s at fault?” Cara asks.

“Doesn’t matter,” I say. “Right now, you don’t know her.”

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