Wake the Dawn Read online

  “None of us can do the job we’re doing. That’s the way emergencies go. So hang in there and just keep doing what you can’t do.”

  Yelling wasn’t getting anywhere. Frustration equaled his anger now. So they wanted a hospital administrator, did they? By glory they’d get one. “We’re gonna get some FEMA funds out of this, right?”

  “We’re in line for their whole fiscal budget. Did you see what it’s like out there?”

  “I drove back in it, remember? And it hadn’t really gotten going yet.”

  “Then, Bucky, you ain’t seen nothing yet.” His voice was so soft and sad, so heavy with meaning, Ben’s fury almost melted.

  But not quite. Over there across the room. “Hey, you! Kid!” Ben crossed to a gangly teenager with acne. “Aren’t you the Culpepper kid?”

  The kid quailed. Almost whispered. “Yes, sir.”

  “You know how to mop a floor?”

  “Sorta.”

  “Then you’re about to learn. Follow me.” He started off for the custodial closet, calling over his shoulder, “Ten dollars an hour cash for as long as we need you. You’ll clean up the examination rooms and minor surgery between patients.”

  “I—I don’t know how to…”

  “Join the club, kid. All of us are doing jobs we don’t know how to.” He thrust the mop and squeeze bucket into the boy’s hand, uncapped the disinfectant and showed him how much to pour in. They filled the bucket out of the slop sink. Ben handed it to him. The kid was strong enough to hold it without a problem. “We’ll use three for practice.”

  Ben waved a hand as he entered three. “Kid, this is Roy and Denise Abrams. You’re going to have to work around us sometimes.” He put a cuff on Denise and grabbed a stethoscope out of the drawer. “First you pick up any litter. Wrappers mostly—anything sterile comes in a wrapper and we toss it when we’re busy—blankets, everything.” He pumped up the cuff, pressed the stethoscope bell to Denise’s arm. “Then you mop the floor. When the table here is vacated, you go over it with a rag wet with disinfectant water. Go get a rag out of that closet we were in.” He let the pressure down slowly, waiting, listening. Down. Down. Eighty-five. He pulled the stethoscope out of his ears and stood up straight. “I’ll go get Esther.”

  Roy nodded. Denise vomited.

  Ben left the room in a stately manner but broke into a run the moment he was out of sight of the door. He burst into two. “Esther, you better check this one quick.”

  The look on her face stopped him cold.

  Chapter Four

  I lost him.” Her face; Ben had never seen a face that said—well, said all that. Esther looked stricken, absolutely stricken. But it was much more than that, infinitely more. She was tired. She was horrified. She was furious and terrified and heaven knew what else. She was at the end of her rope. Past the end of her rope.

  “She didn’t lose him, he was beyond help, at least here in our limited facilities.” Rob pulled the sheet up over an older man’s head. “I’m sorry, Esther, but you can’t go blaming yourself. Right now we don’t have time for that.” He must not have looked at her face, or he would have known his words, intended for encouragement, were harsh.

  Now what? If Ben was administrator he might as well administer. “Rob, will you see to a kid out there with a broken arm? He doesn’t look bad now, but kids that age compensate, and he could crash. Ask Barbara.”

  Rob nodded and hustled out.

  “I have another one out there, Esther. Her BP is eighty-five and I quit looking for the bottom. Her husband fears internal bleeding. I think he’s right.” Ben moved in closer, lowered his voice. “You look ready to check out on us. This isn’t like you.”

  “Give me a minute.” Esther took a deep breath, another, and shook her head. Her pasty white skin remained white. The sweat stood in beads on her forehead. “Nothing a little time won’t cure. What do you think we should do with the body? I hate to be so callous, but it’s taking up room and we have other lives out there we may be able to save. What did our emergency plan say to do?”

  “Call the mortuary.” He grimaced. “No one is out on the roads other than emergency vehicles. I suppose we can call over there and see what they say.”

  She was grimacing, too, staring vacantly at the floor. “If they have a phone. My cell can’t get out, I suppose the tower’s down. They say nearly all the landlines are down.” She wagged her head. “Ben, I thought I had him stabilized, and all of a sudden his heart just quit.” She was nearly shouting. “Just quit! Lord, what did I do wrong?”

  “You don’t have to do anything wrong for the world to go to crap.” Allie, gone. “I know from experience.”

  She inhaled, shuddered, grabbed her elbows with her shaking hands. “Enough, Esther. That’s enough! Get a grip. You have no time for a reaction like this.” Another shudder. “Can you find me a cup of coffee?”

  “If there’s coffee in the building, it’s yours. What do you put in it?”

  “Nothing.” She was taking deep, sobbing breaths. “I know; stash the body in the hall closet for now, where we store the backboards and water rescue stuff.” She seemed to have clicked back into her professional mode. Her face softened, she stood straighter. “I’ll check on the baby first and then we’ll bring that woman in here. All the surgical instruments are here if we have to go in. Is there anyone out there who will clean up?”

  “A kid named Culpepper is—”

  She didn’t seem to hear him. “We can’t bring her in here like this.” She gestured toward the wrappers on the floor, a spent syringe, vials of something scattered around the room. The place was a mess, agreed. But it was powerful testimony to her heroic efforts to save this guy. “I’m going to go look in on her; clean up in here.” And she gestured toward the body as she left.

  How strong was he? He could bench-press 250, but this was, literally, deadweight. He’d need the sheet; he whipped it off and threw it over his shoulder. He yanked the floppy corpse to sitting and twisted under the fellow, ruched the guy up on his shoulders in a fireman’s carry, and schlepped him down the back hall. Ah! Here came the Culpepper kid out of the employees’ men’s room. “Open that closet door for me.”

  The kid’s mouth dropped open and he stood stock-still a moment, then dived for the door. He swung it open and Ben carried the body inside. “Is—is that a dead man?”

  Ben let his burden down and covered it with a sheet. The fellow was more knotted than laid out, but he probably didn’t care anymore. “It is. We’re likely going to lose a couple more, but we’re doing the best we can.” He stepped out and closed the door. “I don’t want to go all night calling you ‘the Culpepper kid.’ What’s your first name?”

  “Gary.”

  Dang, he needed a beer! Might as well administrate some more. “Gary, Dr. Hanson is doing a magnificent job, but so are you. Cleaning up is just as vitally important as the rest of the operation. We really need you and you’re coming through like a champ. We’re grateful.”

  The kid seemed to soften a little. “Thank you, sir. I was just coming out to tell you I quit, but I guess I won’t.”

  “Good man! Can you get the mini surgery right away? We need it.”

  “Yes, sir.”

  Yet another crisis averted. The kid wasn’t Mr. Clean, but he was doing okay, and Ben wasn’t lying about needing him.

  He stopped by the break room to pause at the drawer that held their tiniest patient.

  Esther was standing there gazing at her, too. “Still too far out to get dependable vitals. I slowed the drip a little more anyway. She’s looking better.”

  The back of his hand touched her cheek. Baby soft as only a baby’s cheek could be. “I thought so, too. She’s not so cold anymore.”

  “She’d do even better if we could find someone to hold her.”

  Hold her? “I’ll ask.”

  Esther headed off to the Abramses and their internal bleed, and Ben walked out into the waiting room. “Barbara? Can you start coffee? Esthe
r was asking.”

  From over by the wall, Barbara called, “Sure.”

  This reception area was still totally stuffed full, still standing room only. He felt like he hit a wall, almost the way Esther’s face had looked. So many injuries. He called, “We have a baby that needs to be held and kept warm. Will any of you volunteer?”

  An elderly, heavyset woman in one of the clinic’s wheelchairs raised her hand. “I can’t walk, but I can hold a baby.” She extended a trembling hand. “Hannah. Dr. Hanson knows me, but you don’t.”

  “Ben. Thank you, Hannah.” Ben wheeled her off to the break room and set her brakes. Gently he picked up the infant and, trundling the IV pole with his other hand, brought her to the woman. “Sorry, Hannah, but the dog here is part of the package. His name’s Bo. Long story, I’ll tell you sometime.”

  “No problem as long as he doesn’t need to be let out.” Hannah reached out and gathered the baby into her generous bosom, murmuring gently as if she’d known the girl since birth.

  “She’s stable. Let us know if she wakes up or something changes.”

  “I will. Can you raise my right leg on this contraption? Getting mighty painful.”

  He dropped to one knee and fumbled the lock gizmo. “What happened?”

  “Fell down the stairs trying to get to shelter in the basement. Tom brought me in, says he thinks it’s broken. I think it’s just a torn ligament. He had to get back home to take care of the others.”

  Ben nodded. “Have you been given anything for pain?”

  “No, but you go take care of those others that need you worse. I’ll keep on praying.”

  Ben finished adjusting the leg, flinched with her when she groaned as he lifted the leg rest. “Be right back.” He grabbed some painkillers from a cabinet. No time to get an ice pack going or go searching for inflatable splints, but with a paper cup of water, he gave her the pills. “If you need something, tell Bo to find Ben. That’s the command to use. Find Ben.”

  “I will, you go.”

  He heard the ambulance blip as he returned to room three.

  Esther’s ’scope was draped around her neck and she was flicking and tapping possible sites on Denise, searching for a functional vein. Esther was known for her ease in finding veins—look how she’d tapped into the baby—but you wouldn’t guess that by her lack of success just now. “Ben, you try.” She unbuttoned the woman’s blouse and plugged in her ears, listened to Denise’s heart and lungs, probed the abdominal area desperately seeking the bleeder.

  She glanced up at the woman’s husband. “What happened?”

  Ben would try the right side first. He tied a loop of rubber cannula around her upper arm to raise whatever veins were left.

  Roy drooped, woebegone. “The dog was tied up out back. She went out to bring him in and a piece of something blew into her and knocked her down. Never seen wind like this. And rain. She’s on Coumadin for her blood pressure and something else, I forget what. Sorry.”

  “Got one. Her right hand here.” Ben fingered a barely discernible vein. “You want to take over?”

  “No, you’re doing fine. Go in with a butterfly. Mr. Abrams, do you know her blood type?”

  “Uh, no…I guess I oughta, but I don’t.”

  From her gurney, Denise murmured, “O positive.”

  “Good. We have no means here to type blood, so I’m very glad you know. Ever had an adverse reaction?”

  Denise’s voice dropped to a whisper. “Roy, where’s Tuffy?”

  “Safe in the house. It’s okay.”

  Esther waved a hand. “Ben, there should be a defibrillator in the corner there, every room is supposed to have one.”

  In the corner there. It took him a moment; the defib was stuffed between a cabinet and the wall. And it was dusty. He popped the case open and brought three electrode pads to the table. He applied them as Esther fiddled around with her ’scope. By shoving Denise over a few inches he made room to lay the machine on the bed beside her. He connected the leads. “Turn it on?”

  “Yes. All we want it for is to monitor her heartbeat. What’s the battery life?”

  “Supposed to be four hours continuous use—at least that’s the one I carry in my van—but there’s a converter, so I’ll plug it into the wall. Good forever.”

  Their cleanup guy had finished but was watching intently, then picked up his mop bucket and headed out. Ben called to him, “Thanks, Gary! Good job.”

  The kid bobbed his head and almost smiled.

  In a cold, flat voice, the machine announced, “Reading.” Moments later, “No shock indicated.” Ben turned the volume down to mute.

  Whatever was wrong with Esther before—and something very obviously was—it had apparently eased off. She seemed back to her normal crisp self. “Ben, I think we have a unit in the cupboard. Get one to start with, maybe we’ll have to switch to dextran then, at least for a unit or so. Mrs. Abrams, where exactly were you struck? Can you show me?”

  Ben finished setting up the transfusion, hanging the bag, setting the drip. With the IV up and the lifesaving fluid dripping into Denise’s arm, Esther heaved a sigh and managed a smile at Roy. “We’ll leave you two in here for now and check in frequently. If you see any change, holler. I mean that: Just start yelling. One of us will come.”

  Ben followed her out into the hall. “Know what we’re missing?”

  “I know a thousand things we’re missing—enough blood, for starters. What?”

  “Clipboards. With forms to fill out. I asked for someone to help take notes, but no one offered, and I forgot. We haven’t the slightest idea how many we’ve treated so far.”

  She snorted. “Sure we do. What’s the population of this county?”

  They walked out into the waiting room. It was still packed.

  Barbara was by the front door talking to a teenage girl with her arm wrapped in a dish towel. She’d know what was going on. She was telling the girl, “I’m sorry, Jennifer, we’ll get to you as soon as we can.” The kid nodded glumly and sat back down against the wall, holding her injured arm to her chest.

  The front door blew open, sucking the fury of the storm in with it. Beside Ben, Esther jumped straight up and cried out. She sort of froze in place, got that terrified look on her face again, started breathing heavily. It was raining on her but she just stood there. Barbara leaped over and shoved the door shut again.

  Ben grabbed Esther’s elbow and led her forcibly back to the mini surgery. He closed the door behind them. “Okay, what’s going on?”

  She yanked her arm away and burst out, “Stop it! Stop treating me as if something was wrong with me! I’m fine! Do you understand that?”

  “I understand you’re yelling at me, and I didn’t do anything wrong.” And not too long ago, I was doing exactly the same thing to Chief.

  She looked ready to light into him some more. Instead, she said, “I’m just so frustrated! I begged them for years to get a working hospital in this area, showed them plans, tried to get it on the ballot, nothing! Now we have this and people are dying because they were so cheap and pigheaded! Let ’em die. Let ’em all die, the b—”

  The doors slammed open and she yelped and jumped again.

  Yvette and Dennis came in pushing a gurney. On it was a man maybe Ben’s age.

  “Something happened to our radio,” Yvette said. “And I’m pretty sure it’s our radio, because we can’t pick up the local frequency. And there’s no antenna on our roof anymore. Whatever knocked it off, boy, was that a loud clunk!”

  Ben helped them transfer their patient to the operating table. They had a line going, but the fluid bag was already pretty low. The wound was obvious with all the bright red blood and the tourniquet above the rip on the inside of the man’s leg. Femoral artery. You could bleed out in two minutes flat from a femoral artery. These two were pretty darn good at handling a potentially lethal situation.

  Dennis’s belt radio squawked a tone-out. “That’s us. Here we go again.”

>   Yvette waved good-bye as she followed him out, shoving the gurney ahead of her.

  The fellow opened his eyes. “I’m gonna be okay, right?”

  “Right. Ben, can you assist? They did a good job; bleeding is slowed enough the first thing is to get that tourniquet off, or he’ll lose his leg.” Esther was sweating so much it was dripping now. It wasn’t that warm in here. “Loosen it a little, I’ll tell you when to loosen it more.”

  “Hey, I put that on because I was bleeding so bad.” The fellow looked panicked.

  Ben pretended to smile. “We’re controlling it now. It’s all right.”

  She waved toward a cabinet as she plugged her ’scope into her ears. “Put on scrubs and scrub, hands and arms up past the elbows.” She bent over the fellow, staring off into space as she listened to his lungs and heart. “Deep breath, please.”

  Scrubs. No bottoms here, so he slipped into a top and tied it behind. And to think some people put these on every workday. Washed up. The latex glove boxes were all empty; the only gloves left were some of those blue nitrile gloves in extra-large. When he slipped into them, a quarter inch of glove extended beyond his fingers. He hoped he wouldn’t have to do anything delicate. He crossed back to her.

  She was cutting the fellow’s pants off. “I can’t believe this. Second femoral artery accident in forty-eight hours. You know the Herr kid?”

  “Gavin? Yeah. One of our pre-felons, runs around with the Barton delinquents.”

  She nodded. “You ever assisted in a surgery before?”

  “Nothing like this.”

  “Can you handle the anesthesia?”

  “If you tell me what to do.”

  “Wait a minute! You saying this guy doesn’t know what he’s doing?” The patient started to sit up.

  She shoved him back, not gently. “I can stitch your femoral artery back together without any anesthesia if you wish. And cutting down in to work on it, of course.”

  “No, wait!” He struggled, so Ben pressed his shoulder to the table. “I don’t want no small-town quack cutting me up!”