Verge of Extinction (Apex Predator Book 3) (12 page)

“Follow me!”  He led them away from the road and around the next building.  They had about thirty meters of open ground to cover, but they were about one-hundred meters away from the road.  He hoped the distance would cause the motorcyclists to look in the wrong spot.  It didn’t.

The second guy looked right at them when SSgt Brown was in the middle of no-man’s-land.  The guy broke so hard his bike almost fell to one side.  As the man tried to get off the bike, SSgt Brown fired a short burst, catching the man under the right arm.  Bloody flowers formed on the man’s white tee-shirt.  His dead weight pulled the motorcycle on top of him.

The man behind him swerved to miss his companion and succeeded in laying his bike over on its side.  Jackson and Theresa both fired at the man.  He didn’t move.  They could see a pool of blood growing under the still running engine.  The forth man never slowed down; but roared by, sliding to a stop on the far side of the church.

SSgt Brown changed directions and ran towards the road.  “Let’s go!”  As he reached the corner, he came face to face with the big bald black man. His arms were covered in dark ink tattoos.  In his right hand he held a shiny chrome pistol.  SSgt Brown threw himself to the right and brought his own rifle to bear on the man.

Several shots rang out.  SSgt Brown was pleased to see the man fall and the chrome plated pistol clatter off the concrete.  His pleasure was short lived.  One of the women screamed.  He turned to see Ms. Hebert as she slumped to her knees.  The front of her shirt was wet and discolored from blood.  Her eyes pleaded for help.

He glanced at the others.  Jackson was pulling a field dressing from his combat gear.  Theresa and Kerry seemed to be frozen.  He looked at the road.  There were three motorcycles, two of which were still running and had dead men either still on them or underneath them.

“The bikes!” he ordered.  Jackson, you take her.  He asked Kerry and Theresa if either knew how to drive a motorcycle.  Kerry said she had some dirt bike experience.  He ordered her to grab a bike and Theresa to ride with him.

They helped Jackson load up Ms. Hebert.  She was still conscious, but no one knew how long that would last.  The others mounted their rides and sped north towards the water and Sgt Procell’s boat.  Several bullets followed them down the road, but none were accurate enough to cause them any concern.

The Island

Jen was having trouble shaking off her funk.  Deep down, she knew she was doing some good for people.  She and Indira had been able to get most of the people on the island the medications they needed, including Alberto’s blood sugar meter, and some anxiety medicines for Carmen.  Everyone who came into the clinic was grateful to the two.  One man even referred to them as his angels of mercy.  By the end of the day everyone on the Island took to calling the clinic Mercy.

Jen and Indira were in the supply room, inventorying the supplies Jen had helped to liberate the previous day.  She was pretty sure they had what they had asked for, but they wanted to refine the list.

“We need to secure the controlled drugs better,” Jen was saying.  “Someone is eventually going to figure out that we have meds in here that make you feel really good, and we aren’t going to have them anymore.”

Indira hadn’t thought about that.  In her mind, it was good enough just to have them.  But Jen had worked in the medical field far longer than she had, so she would defer to the older woman’s experience.  She also knew that today was not the day to argue with Jen.  Donaldson had already found out the hard way that Jen was in no mood to be trifled with.

There was a sudden commotion in the patient care area.  “Keep pressure on it!” someone was shouting.  Jen realized the booming voice belonged to SSgt Brown.  Her heart sank.  She bolted from the supply closet, followed close behind by Indira.

The scene before them was utter chaos.  People were crowded around one of the litters.  Jen could see larger globs of blood on the floor.  In other places the blood streaked the floor.  The scene was a menagerie of gore.

She quickly scanned the faces she could see.  Jackson and Kerry were both on the opposite side of the table, staring at her intently.  SSgt Brown was standing, the back of his army camouflage uniform towards them.  Donaldson and Joe were on either side of SSgt Brown.  They were busy treating…  Who?  She couldn’t see who it was.

Oh, God!  No!  She stopped abruptly, her hand flying to her mouth.  Where was she?  She couldn’t find the girl in the crowd.  Where was Theresa?  Her anxiety was bordering on panic.  Her mind began to race.  Thoughts, horrible thoughts, came and went in an instant.  Her heart was pounding in her chest.

“What happened?” Indira asked quickly.

“They shot her!” a voice called from behind the crowd.  Jen’s heart skipped a beat.  That voice, it was her.  She’s ok!  Theresa stepped around the litter, tears streaked her face and blood caked her hands.  “They shot her Miss Jen,” the girl repeated sobbing.

With a single glance, Jen could tell that Ms. Hebert was in trouble.  Her face was pale and sweat was dripping off of the ends of her matted hair.  Her breathing was rapid, almost like she was gasping for every breath.  Her eyes danced from person to person.  To each they pleaded for help.

“Miss Hebert,” Jen said in her ER nurse’s voice.  “Ms. Hebert, can you hear me?”

“”Ye…  Yes,” the woman stuttered.  Good.

She moved her hands down the woman’s body.  Blood immediately covered her hands as she reached the abdomen.  She pulled the woman’s shirt up to find the field dressing that Jackson had placed over the wound.  She took note and continued her assessment.  When she found nothing else, she ordered Donaldson to roll the woman on her side so she could expose the back.

It never occurred to Jen that the doctor is usually the one responsible for a trauma assessment.  She would later learn that the only doctor in the room was happy to let the experienced nurse do it.  As Indira would later point out, she hadn’t made it to her ER rotations yet.

She found a three inch hole in the woman’s lower back.  Blood continued to pour from the wound as they returned her to the supine position.  She looked to Indira and nodded her head, mouthing word “big.”

Jen could see the look of utter and complete fear in the young doctor’s eyes.  She felt for her.  She knew the feeling.  She remembered a time, not too long ago, that she was forced to save someone’s life by doing things she hadn’t been trained for.   The woman wasn’t moving. She was just watching.

“Get me a couple of large bore IV’s if you would please gentlemen.” Jen ordered the two medics.  To the others, “she’s going to need surgery.”  She then marched quickly to the supply room, leading Indira by the arm as she went.

“I can’t do this,” the younger woman said meekly.  Jen was searching for supplies.

“What?” she asked, not stopping to talk.

“I said I can’t do this.  I don’t know how to operate on someone’s gut.  That woman needs a surgeon.  I’m not even a real doctor yet.”  There was fear in her voice.  She was pleading with Jen.  But Jen didn’t have the power to change anything.  Indira would just have to do the best she could.

“What happens if you do nothing for her right now?”

Indira let her head hang, staring at the ground.  “She’ll die,” she whispered.

“Right,” Jen announced excitedly.  “So, you can go in there and be the worst doctor in the world and she’ll be no worse off than she is now.”

“I just…”  Jen cut her off.

It was time for a tactics change.  She put on her stern face.  “You don’t have a choice.  That woman is dead without you.  You’re going to go out there.  You’re going to do your best to save her life.  And, you’re going to quit whining about it.  Now,” she said in her most cheerful tone.  “What exactly do we need?”

A few minutes later the two women walked into the room with two buckets full of supplies.  The two medics had started their respective IV’s, and there were two bags of fluid running wide open.  Jen threw the supplies on the table, and began arranging them as she anticipated they would be needed.

As she worked, she thought about how bad of shape they were truly in.  They were going to have to sedate Ms. Hebert.  That meant that they would have to breathe for her.  In order to do that, someone would have to put a plastic tube in her trachea, a procedure called intubation.  This usually requires a special tool with a light and metal blade used to move the tongue for better visualization.  They had neither the tubes nor the laryngoscope.  That means that someone was going to have to manually breathe for Ms. Hebert.  She thanked her lucky stars that one of the pieces of equipment that was left by the previous tenants was a bag-valve-mask.

She ordered Donaldson to ensure that Ms. Hebert’s airway remained patent, and for the young medic to breath for her if her breathing became too slow or shallow.  Joe would be the circulator, the nurse who runs for extra supplies and equipment and is not sterile during a surgical procedure.  She would assist the young doctor, and would therefore get sterile and stay that way.

When they were ready to start, they shooed everyone else out of the room.  She looked to Indira, then to Ms. Hebert.  She gave each a smile and nod.  Indira ordered Joe to give the sedatives.  The woman’s breathing became more and more shallow.  Finally she was asleep, Donaldson slowly breathing for her.  Joe kept a finger on her wrist and counted her pulse.

Jen had never been a surgical nurse, so they were all in uncharted territory.  The closest she had come was when she saw post-operative complications come in to the ER.  Occasionally she could glean some information from both patient and doctor alike.  In this case all she could remember was that the bowels need to be kept moist or they would cause adhesions.  Then another surgery would be required.

She watched closely as Indira cut into Ms. Hebert’s abdomen.  She took note of the amount of blood in the woman’s abdominal cavity.  She used a bulb syringe, like one would use to suck out a baby’s nose, to suction the blood.  It was a slow process.

She watched as the neophyte doctor found bleeding blood vessels and applied a stitch or two.  She would then run her gloved hand over the area looking for more blood.  She would move on.  Occasionally, Joe would replace one of the IV bags, or add more gauze pads to the slowly diminishing pile in the sterile field.

About forty-five minutes into the surgery, just as Indira seemed to be hitting her stride, Joe was just coming back from making a run for more gauze.  After replacing his hand on the woman’s wrist, he muttered a quiet uh-oh.  “What?” Indira asked.

“Her pulse is getting real fast and thready.”  He had only been away for a few moments.

“How fast?” the doctor asked.

“About 150,” he told her.  Jen could hear the anxiety in his voice.  She took a glance at the hanging IV bags.  They represented numbers four and five, and both were dripping at a rapid pace.  But, it wasn’t enough.  The woman’s circulatory system was failing to keep up with the demands.  And, there wasn’t much they could do about it.

Indira had been right.  They had no business cutting into this woman.  It would have been more humane to just drug her and let her drift off.  But, Jen had bullied the young doctor into something she wasn’t qualified to do with less than the bare minimum of equipment.  She looked at her gloves.  Instead of sterile gloves, the women were wearing non-sterile gloves that they had doused in alcohol.

“Joe, find something to shove under the feet at the foot end of the table.  Maybe putting her in Trendelenburg will help.”  She wished there was something else they could do.  She looked to Indira.  Her mocha colored skin was rapidly becoming slick with sweat.  She was concentrating on her task, but she also heard Joe’s report.  “We should have gotten some pressers,” she mumbled.  “We didn’t know we’d need them this fast.”

Joe returned with a couple of pieces of shelving.  With one hand he lifted the end of the litter stand she was on, and with the other he shoved the shelving under it.  This had the effect of putting Ms. Hebert in a head-down position.  The idea of Trendelenburg’s position is to allow blood to flow more easily to the brain, heart, and lungs; while effectively keeping it out of the less important legs and genitals.  Jen suctioned out another bulb syringe full of semi-coagulated blood.

Suddenly a small fountain of bright red blood squirted from somewhere inside the woman’s abdomen.  Jen couldn’t see where it was coming from, but she knew it was bad.  She’d seen arterial bleeding before.  Usually the blood squirts up in a fine red arch, like a thread of blood.  This was not a thin thread of blood.  This was a large amount of blood and it had some force behind it.

“Shit,” Indira exclaimed; “The renal artery!”  She tried to grab the slippery artery between her delicate fingers.  Every time she did, it would slip out and resume its rain of sticky blood.  She finally corralled it with a piece of sterile gauze.

As she did, Jen heard a commotion outside of the door.  SSgt Brown was telling someone that they couldn’t come in.  He repeated himself several times before the door finally burst open.

The Bishop’s face was beet red.  “This operation has been cancelled!”  He barked.  “Please step away from that body!”  There were two other men with him.  Both were armed and didn’t look happy.

It was Indira who spoke first.  “No.  This woman is dying.”  She could feel the gauze slipping off of the artery.