“The doctors are busy. Tell me what’s wrong.” Monica started at the feet since that was where the receptionist said the problem was. The man’s right leg, above the knee, was bent in an awkward position. It didn’t take an X-ray to tell it was broken.
Monica cut from the bottom until she exposed the entirety of the problem.
“He was under the rubble. Two days my boy.” The woman hovered over the patient.
“He’s your son?” Monica asked in attempt to get information and calm the woman.
“Yes, just seventeen. Help him.”
He looked much older. “What’s your name?”
“D-Deon,” he said through chattering teeth.
Airway… Breathing… Circulation… Monica placed her fingers on a pulse point below his injury.
Weak. And cool.
She looked around and hoped her poker face was intact.
The kid was pale, his pulse rate at his wrist too fast.
Femur fractures could bleed. Excessively. And what other damage could the rubble have caused? If she didn’t try to correct the fracture and restore this kid’s circulation soon he could lose his leg.
Monica had never had to do this on her own. In fact, she’d only assisted doctors and only in extreme circumstances. Yet paramedics were often put to the task in the field. Life or limb and all that.
“Help him!” the mother cried.
Walt was in surgery and Tina was two rooms away with just as many severe cases as Monica.
“Deon? Does anything else hurt other than your leg?”
He shook his head.
Monica ushered the men holding Deon to a nearby desk and pushed everything on top of it to the floor.
The men holding the door Deon lay on were older, too old to help Monica with what she needed. The mom was hysterical and virtually useless.
Ignoring the mother, Monica positioned herself over Deon’s face. “Deon, listen. I need to straighten your leg.”
His eyes grew wide, his nostrils flared. “It’s going to hurt. You’re going to want to fight me.” He would fight her… he wouldn’t be able to stop himself. Although he may only be a teenager he outweighed Monica by a good forty pounds.
How the hell am I going to do this?
She looked up and frantically swept the room with her eyes.
Dark hair, Ray-Bans… “Barefoot?” she yelled at the pilot who’d delivered her to hell.
He shifted his gaze toward hers.
“You. Come here!”
Barefoot glanced behind him then back.
“Yes, you. I need your help.” His strong shoulders and lack of relationship with the patient were exactly what Monica needed.
Monica found a towel and wrapped it around Deon’s leg while Barefoot moved to her side.
“I need to straighten his leg.” She gathered the edges of the towel and handed the ends to him. “You,” she looked at the men who had carried Deon in. “Hold his shoulders down. Mom… talk to him.”
The mother nodded. “You know what you’re doing?”
“Yes.” No. Monica hated the self-doubt. But she knew this boy could lose his leg if she did nothing.
Monica lifted her gaze to Barefoot. He’d taken off his sunglasses and she met his dark, piercing gaze. He saw her doubt. She knew it.
“What can I do?” Barefoot asked. His voice was a rough timbre and the opposite of all the panicked calls inside the room. It grounded her.
“Hold this. I need traction so he doesn’t slip.”
Monica crawled up on the table with Deon and wiped the moisture from her palms before grasping his leg.
Just touching him caused pain. Normally, in an ER, this wouldn’t be done without heavy sedation, but that wasn’t going to happen here. Not only did they lack cardiac monitoring, they didn’t have the drugs to accomplish the job. Besides, they didn’t have time for that. As it was, there was no guarantee what Monica was about to do would save his leg.
Because it wasn’t completely cold or mottled she knew he had a chance of saving it.
“Ready?” Barefoot asked, bringing her attention back around.
Monica nodded. “Hold him,” she told the others.
Deon tensed, waiting.
Monica grasped him above his leg, supported his calf on her thigh. She waited until Deon took a few deep breaths. She glanced at Barefoot and mouthed the words, three, two… one.
It wasn’t a jolt, but more of a pull. Even though Deon screamed out Monica kept pulling his leg, feeling as best she could through his skin as the bone attempted to move back into place.
Her arms shook as she fought the patient and the displaced fracture.
Barefoot held traction and watched her as she struggled to keep her grip on Deon’s leg. Monica shifted her position, attempting to pull the bone through muscles and tendons.
This is just as hard as it looks when the doctors do it.
Deon screamed when the bone moved, but it still wasn’t in place.
“Hold up.” Monica instructed Barefoot as she lost her grip. The femur was closer to being in place, but not right.
Deon was moving on the makeshift gurney, making it even harder to set his leg.
Monica rubbed her hands on the towel and leaned into Barefoot so only he could hear her. “Pull harder.”
He nodded once.
She leveraged one leg on the table and sat taller.
Monica counted down again. Three… two… one.
Deon filled the room with his cry.
Monica pulled with every muscle she owned. Her hands started to slide, she repositioned again and felt his leg move.
Monica ground her back teeth together. Her arms started to shudder under the strain. Finally, Deon’s leg shifted and she manipulated it into line.
“Thank God,” she said.
Barefoot eased his pressure off and she set Deon’s leg on the table. She located a pulse behind his knee, felt a beat. Lower, his pulses in his foot were still faint, but better. Much better.
“We need to splint this to keep it in place.”
The receptionist who’d watched the entire procedure left the room.
Deon was already more comfortable.
“I’m sorry I had to do that,” Monica told him once she jumped off the table. The swelling and bruising were evident. She couldn’t rule out a critical bleed. She removed a permanent marker from her pocket and flexible ruler. She marked Deon’s leg in two places and measured the circumference. There wasn’t a chart to write on so she did the next best thing… she wrote the numbers right on the boy’s leg. Then at least she would have a starting point when she checked on him again.
He attempted a smile.
“Wait with him,” she told the mother. “We’ll splint his leg and have a doctor look at him as soon as we can.”
Soon could be the next day if his pulses held and the leg didn’t swell, but Monica didn’t want to tell the mother that.
“I’ll try and get him something for pain. Is he allergic to anything?”
Monica added the letters NKA to Deon’s leg in pen. No known allergies… such a simple fact written on a chart. Here it could be life or death.
Monica turned away from the patient, her shoulders slumped slightly. The room was packed. If she could split into five people, she still wouldn’t be able to manage what all of them needed.
A strong hand rested on her shoulder. “Good job back there.”
She glanced over her shoulder and up. Barefoot was tall and surprisingly broad. Unlike anyone else, he smelled good. Sandalwood and man. Such a relief from blood, sweat, and dirt. “Thank you for helping.”
“You did all the work. Have you done that before?”
“You made it look easy.” He smiled and for a brief moment, the room slid away. Something curled in the pit of her stomach and heated. Was it desire or was it hunger?
The weight of his hand never left her shoulder. It would have been too easy to lean on him.
She shook off the yearning and moved out of Barefoot’s reach. Unable to stop herself, she glanced at his feet. He wore a pair of running shoes.
“I’ve got to keep moving. Thanks for your help.”
Monica took a few steps away only to hear her name. “Monica?”
“The name’s Trent. Not Barefoot.” He lifted a leg and wiggled his foot.
Monica felt her face heat. “Good to know,” she said with a rare smile before turning away.
“I need a volunteer.” Donald pulled Monica aside twelve hours after she’d set foot in the blazing inferno.
She rubbed a clean hand over her face and blinked a few times. “Volunteer? Isn’t that what I’m doing here?”
Donald offered a half smile. “I need a nurse to go over one county to the east, it’s a fishing village, Port Lucia. The clinic there is bursting. The local doctor hasn’t been seen since the quake.”