Fuck it, I’ll need the caffeine—I toss the cold, bitter coffee back in three swallows, chucking the empty cup in the small wire basket under the desk on my way out.
It's go time.
I hustle to the ER, arriving just as the first victims are wheeled in by the medics, and then I sink into the familiar flow of emergency medicine.
It's the only career I’ve ever even considered—other than out in the wilderness, the ER is where I'm most comfortable. My life has been shaped by trauma, defined by violence. It's just where I live. I move and breathe and exist in the chaos.
My current victim is a twenty-year-old female with an open femur break, multiple contusions and lacerations, and most concerning, free fluid in the belly from an internal injury. She's screaming in agony despite having received the max dose of fentanyl in the field, thrashing and howling. I FAST her belly and find the injury, but she's thrashing too wildly to be able to set her leg.
I grab her face with my bloody-gloved hands and fix her pain- and fear-maddened eyes. "Jen!" I shout. "Jen. Look at me. Look at me."
Her eyes find mine, panicking, frantic. "Jason—Jason—where's Jason? Jason!”
I scan the ER and see Tammy and Mario working on a young male with a massive piece of glass in his belly—I lock eyes with Mario, who gives me a shake of his head. Fuck.
I go back to Jen. "They're doing everything they can for Jason, but you need to stop moving. You can scream as loud as you want, but you have to hold still for me so I can set your leg."
She grits her teeth, nodding. Reaches blindly for someone’s hand to hold as I line up at her foot and prepare to set her femur.
Kelly, the charge nurse, takes Jen's hands. "Squeeze my hands, honey. We’ve got you." She looks at me, nodding her head in a three-count.
In synch with her, I grab hold of Jen’s leg, hold her frantic eyes. "Ready? On three. One…two…THREE." I pull her fractured leg straight away from her, and the jagged pink-white spur of bone slips back within the sheath of flesh and muscle. A bedside X-ray shows that it's correctly set and ready for ortho to cast it, but first, we have to get her to surgery to stop the internal bleeding.
I leave Kelly to arrange for Jen's surgery and take the next incoming patient—a sixty-year-old male with a closed skull fracture, GCS 6.
And so goes the shift—another two-car collision, a stab victim, several GSWs, an intentional opiate overdose. I lose a GSW victim—he'd simply lost too much blood, and we couldn't stem the bleeding in time, despite the field medic's heroic attempts en route.
By the end of my shift at eight the following morning, I’ve been on my feet without a break for sixteen hours, sans the forty-five minutes I spent in that broom closet doing paperwork.
I'm thoroughly exhausted and ready to get home, shower, and crash. I trudge out of the ER on aching feet, my brain racing with things I could’ve, should've done differently. How I could’ve saved Gus, the GSW who died. I reach my car after what feels like an hour of walking, even though I only parked on the second level of the garage. Unlock the doors and slide behind the wheel. Let out a long sigh of relief—I absolutely love what I do, but it's exhausting, physically, mentally, and emotionally, especially these forty-eight or seventy-two hours on call shifts spent at the hospital, grabbing shut-eye when and where you can, living on old coffee and vending machine garbage.
It's a scent that catches my notice, first. Body odor and old cigarette smoke.
I don't smoke, and while I may smell like three-day-old ass at the moment, this is not my scent. Warning bells go off in my head, and I'm already reaching into my purse for my bear spray. Anselm drilled a lot of lessons into me over the years, but the one he impressed on me as being the most important was to trust my gut. If something feels off, believe yourself and act immediately. Never second-guess, never hesitate.
I don't.
I squirt the bear spray over my shoulder blindly, and I'm rewarded by a howl of masculine rage and pain. A heavy blow from a fist crashes into my temple, sending white sparks dancing across my vision. My sparring sessions with Anselm prove their worth, then, because I know how to take that punch and keep fighting despite the dizziness. I spray wildly into the rear seat; my attacker bats at my hand, knocking the bottle out of my grip. I lash out with my fist, then catch flesh and bone with a satisfying crunch, but it's not enough. I twist in the seat for a better angle, catch a glimpse of furious pale blue eyes and angular features, and then something sharp punctures the side of my neck. I still get off a good punch though, despite the blackness flooding my system, the weakness spreading through me.
I feel myself slumping. Drowsing, being dragged under.
"She fights like animal,” I hear a heavily accented male voice say. "But she is out."
Not quite, fucker.
My phone is in the back pocket of my scrub bottoms. With the last of my strength, my sight fading, I work it out and get off a text to Anselm—911. I hear my phone hit the floor with a thump.
"Fuck," my attacker mutters.
I fight my left foot up, up, off the floor. Crush it down onto my phone's screen so he can't unsend it.
The darkness wins, then.
Consciousness returns in fragments, slowly. First, there's pain, a headache infinitely worse than my worst hangover: that time, Rin, Bryn, Cal, Killy, and I got wasted together on Cal's parents' yacht down in the Caribbean, the summer I finished med school. For a long while, I just languished in the sharp throbbing agony occupying my skull.
And then I become aware of thirst—cotton-mouth times a billion
The need to urinate, badly, is next.
