Not Quite Enough(10)

Monica’s station was a second level of triage. The first wasn’t even manned by someone with a medical degree. A receptionist of the hospital had been elevated to triage nurse in one day. She separated those with lacerations that could wait outside. Broken bones, so long as they weren’t open fractures or cutting off circulation, were sent to the same holding area. There were thousands of them.
“Help… please. Someone?” The voice rose above the chaos of the room; moans and desperation filtered thick in the air.
Monica twisted toward the voice.
Two Jamaican men rushed in a twentysomething man on the back of what looked like a plank door. A woman stood over the man screaming for help.
Their desperation alone made Monica’s legs move. Behind the band of newcomers was the poor receptionist-made-nurse. “You said to let through cold feet.”
Monica shook her head. “Cold feet?” Her eyes moved over the man on his back. His head shook from side to side. His ebony skin was ashen.
“His leg. It’s cold.”
Monica moved closer.
“You a doctor?” the woman by the patient’s side asked.
“A nurse.” Monica was reaching for her trauma shears. “Do you speak English?” she asked the man on the door.
He nodded, but didn’t say anything.
“He needs a doctor!” the woman screamed.
Monica felt herself folding into the woman’s drama.
“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.