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“Single car MVA. Starred the windshield. Awake and—”
“Get me the hell off this thing!”
“Combative.”
Dr. Lucy Davidson’s valiant attempt to stay upbeat in the last thirty minutes of her twenty-four hour shift had almost lost its potency, but the chaos of a new trauma patient immediately revived her exhausted body like she’d mainlined a double espresso.
“No loss of consciousness,” Paramedic Amanda Carter continued as Lucy ran with paramedics Amanda and Kyle Cavasos, along Officer Brett Adams toward a trauma room.
A quick scan of the patient told her if there were any immediate signs of distress.
ABC-Airway. Breathing. Circulation.
“I hate these backboards. I need to sit up! My face hurts. Give me something, stat!” The patient rolled his shoulders in an attempt to get out from underneath the backboard’s Velcro straps that kept him solidly in place. He tried to pull the bandage taped to his forehead off. “Why is this crap on my face?”
Lucy pushed his hand away. “Leave it.”
“Why?”
“Leave it.” As they rolled into room one, Lucy patted her pocket to make sure her favorite stethoscope was with her.
Got it.
“It’s a bandage for the blood, sir,” Amanda explained as they positioned the EMS stretcher next to the bed.
Immediately, scribe Ethan Flynn, Nurse Shelly Westbrook, and nurse’s aide Poppy Henderson surrounded the bed. Along with the first responders, each grabbed a handle of the backboard.
Lucy donned a pair of gloves and nodded. “Okay, on three. One. Two. Three.”
Easily, the group lifted the patient and quickly went to work disconnecting him from the EMS monitors.
Lucy jumped into the fray, adrenaline coursing through her veins. With swift efficiency, she palpated his arms, legs, and his abdomen. When the patient didn’t grimace and she didn’t feel any obvious fractures, she breathed a small sign of relief. “Can you feel your legs and arms, sir?”
“I can feel you grabbing me. Kind of like it.”
“Let’s logroll him off the board.” Ignoring the patient’s comment, she helped the members to peel back the Velcro straps and turn the patient to his side.
Lucy ran her hand up and down his spine. “Anything hurt, sir?”
“Nope, but keep rubbin’ my back there, sweetie. Been a long time since I had a good back rub.”
Her teeth clenched at his sexist commentary. There’s one in every town.
“He’s a real smooth talker.” Amanda gave Lucy a sideways glance.
They rolled the patient to his back and Lucy verified the C-collar placement.
Shelly and Poppy reattached the bedside EKG leads to the chest stickers and the pulse oximeter to his finger as Ethan typed everything each medical team member called out.
“I need to sit up,” the man demanded. “I need to sit up now.”
“Work with me, first. Can you tell me your name? Where you are?” Standing at the head of the bed, Lucy grabbed her purple penlight and checked his eyes. “Pupils equal and reactive to light.”
“Got it.” Ethan’s fingers sailed across the keyboard as Kyle pushed the collapsible stretcher out of the room.
The patient turned his head as much as the hard cervical, or C-collar, would allow. “Quit shining that shit in my face.”
Before Lucy could respond, the hard smell of stale alcohol, dried blood, and nicotine slapped her in the nose.
Without warning, the burn of anger danced in her chest, momentarily derailing her momentum. Tears pricked the backs of her eyelids and she turned away, pushing the wicked memories to the far corners of her brain.
Where did that come from?
“You okay, Dr. Davidson?” Ethan asked.
Focus, Lucy. Focus. “Yes. Sorry, thought I was going to sneeze.”
“He does smell like he washes with nicotine.” Brett wrote on his clipboard.
Kyle reentered and added, “The back of the ambulance smells like a morning-after frat party.”
“That’s one way to start a Monday.” Turning back towards the patient and staff, she nodded. “Who did you bring us this morning?”
“This guy was going about forty miles per hour. Icy road. Hit a tree. No other passengers in the car.” Amanda’s voice dripped with exhaustion as she hung a half full bag of fluids on the IV pole. “He was standing outside his car, smoking a cigarette and texting when we got there.”
Brett stood at the end of the stretcher, his police badge hooked to his belt. “When I arrived on the scene, he complained of neck pain and immediately lost the ability to stand.”
“It wazzzzn’t my faullllfff.” The patient slurred, then laughed. “I’m kidding. I’m slurrin’ on purpose.”
Lucy’s jaw clenched at the man’s flippant attitude of driving while intoxicated. The bulky, blood-soaked bandages on his forehead covered up part of his unshaven face. “I’m sure that tree jumped right out in front of your car. Happens all the time.”
“Screw you.”
Just what I wanted. A lying, drunk jerk at the end of my shift.
“Have some respect.” Kyle growled as he handed three vials of blood over to Shelly. “Here you go.”
“Thank you, Kyle. You always bring the most thoughtful gifts.” Shelly held it up and Ethan nodded, but when she turned the bag upside down, all the blood fell in clumps in the vials. “Ugh, these have coagulated.”
Kyle let out an aggravated sigh before picking up his metal clipboard. “Sorry. It’s freezing out there. It took a while to get him secured on the backboard. He wouldn’t cooperate.”
A wicked cackle escaped from the man. “I’m cooperative. I’m cooperative all damned day.”
“Please draw another round, Mrs. Westbrook.” Lucy added, as she pulled out her stethoscope and listened to the patient’s lungs. “CBC, chemistry series, recreational levels.”
“You can’t get my alcohol level unless I say you can.” The patient smirked as if he’d been through this before.
“Sir, we draw vials of blood in the field to get a baseline at the scene.” Kyle shook his head in disgust. “The doc decides what tests to run when we get here.”
Draping her stethoscope around her neck, Lucy smiled sweetly, “If you want anything for pain, I have to know what you’ve already got in your system. Otherwise, you’ll cold turkey it. Either way, I’m gonna get my job done. Lungs clear.”
He swallowed hard. “I’ll sue.”
Without losing a bit of sweetness in her voice, Lucy responded, “Cold turkey it is then.”
Yeah, I can play that litigious game too, buddy.
The man gritted his teeth. “When you see I’m clean, you’ll give me morphine.”
How she hated liars, especially ones who endangered the lives of others. “Clean? You smell like a distillery.”
“So what? I had a few beers.”
“And?” Anger simmered under her skin at his arrogance.
“A few shots of whiskey.”
“And?”
His lips went thin.
Checkmate. “Clean indeed.”
Lucy looked at Ethan, relieved to see he typed as he appeared to watch her and the patient’s interaction. Having a scribe had been a game changer. It freed Lucy up to take care of patients without being weighed down by documentation after the fact. Quoting the patient in real time would help if he came back later insisting something else had occurred. Especially a patient who would certainly alter the truth.
Brett shuddered and rubbed his hands together. “Wish I could take Duke with us on runs like this. He would have gotten this guy in line much faster than we did.”
Lucy had met Brett’s large German shepherd, Duke, a few different times when she visited the Main Street Diner. Brett would often park in front and run inside to get a to-go order and say hi to his sister, Casey, who worked there.
“Duke is always a happy guy.” Lucy slowed down the rate of the IV as the patient’s heart rate held a steady tempo on the monitor. “When he sees me, he presses his wet nose against the window of your truck and barks.”
“He’s a sucker for smart women.”
Brett’s subtle flirtation made the corner of Lucy’s mouth curl up. “Well, thank you, Duke. I thought German shepherds could easily handle the weather like this. I slowed the IV rate down. Site appears patent.”
“Duke does okay for short sprints, but with the slush and ice, he’ll run around until his paws are soaked, frostbitten, and bleeding.”
“What about booties?” Ethan asked as he furiously documented.
Brett laughed. “I tried that and he ate two of them. I ended up having to give him laxatives until he got rid of them.”
“Gross.” Ethan grimaced, yet his fingers never broke tempo.
“What’s the temp outside?” Even as Lucy counted the minutes to the end of her shift, she dreaded walking out into the frigid air of the Montana morning. A hard change from Jupiter, Florida in spring.
I miss the beach.
“It’s seventeen degrees before wind chill. Too cold for Duke to be out for as long as we have to be.” Brett’s twenty-four hour shadow was more obvious under the fluorescent lights of the ER than it had been when they ran in.
He must have been working since yesterday too.
Lucy peeled back the bandage on the patient’s head, revealing a large bruise and multiple small cuts. “His forehead is even. No obvious fractures, but a lot of small lacerations and a large hematoma. Nothing sutureable. No obvious foreign bodies. You said he starred the windshield?”
“Looks like. No one else appeared to be in the car.” Amanda nodded and yawned before sitting behind the central desk and picking up the phone. “No footprints going away from the vehicle. Just his around his car. Gonna call in to Betty, tell her we’ve given y’all a report.”
The patient’s eyes went wide as though he’d just processed their previous conversation. “You keep your shit eatin’ dog away from me Adams. Last time, he bit me in the ass.”
Lucy stifled a laugh while she pulled out her stethoscope checked the patient’s lungs again. “Glad to know you and Officer Adams are already acquainted.” And that you’re about ten seconds behind the rest of us.
“Looks familiar, but I can’t place him. Always hard to identify people when they’re beat up and don’t have any ID.” Brett narrowed his eyes. “Or won’t tell you who they are.”
“Quit yer yappin’.” The patient yanked on the C-collar, a thick, silver ring with jagged edges sparkled on his finger. “I hate these plastic contraptions. Gonna break someone’s face if you don’t let me up!”
Lucy rolled her eyes. “You can try, but you won’t get very far.”
“You think you can take me, little girl?”
What a total jerk. “Well, I haven’t used my black belt since I’ve been here. If you want to go there, I’m game if you are.”
Everyone in the room gave a lighthearted laugh as though none of them believed her, but the man’s lips went thin when he looked up at her.
She raised an eyebrow. “You wanna do this, we can do this.”
He clenched his jaw as though her words caused him to think again.
“Need me to get Dr. McAvoy?” Nurse Shelly Westbrook leaned toward the doorway.
“No, Mrs. Westbrook. I don’t need Dr. McAvoy.” No matter where she’d worked, this always happened the first time Lucy got an obnoxious patient. Immediately, the staff would assume because of her size or gender or whatever, she needed backup and that always hit Lucy the wrong way.
If they knew what I’d already fought, they wouldn’t be so quick to assume.
Shelly held her hands up in surrender. “Yes, ma’am.”
Well, that came out harsher than I intended. “Sorry, Mrs. Westbrook. Let me do my assessment. Trust me. Things will be okay. Besides, Officer Adams is here.”
A look of cautious understanding washed across Shelly’s face. “Sounds fair.”
“I ain’t afraid of Adams.” The patient attempted to turn his head, but the hard neck brace kept him from moving more than an inch. Apparently, he’d finally processed who she was. “You’re my doctor? What are you, twelve?”
If any of the male physicians walked in here, he wouldn’t be so disrespectful.
“No, sir. I’m more than old enough to take care of you. Don’t move.” Lucy opened the c-collar and palpated the man’s neck, gently moving her fingers along his spine. “Am I hurting you?”
A look of bliss replaced anger and he let out a long, overzealous groan. “You can hurt me like that all day, sweet cheeks.”
What a gross individual. “I’m Dr. Davidson, if you please.”
Poppy rolled her eyes. “Ugh, I might know who that is.”
“No step-offs in the spine. Okay, sir, I’m going to move your head from side to side. Let me do this. Don’t move.” Cupping his head in her hands, Lucy gently turned his head to the right. “Please tell me if anything hurts when I move you.”
She hadn’t turned it two inches when he dramatically grimaced. “That hurts. It hurts soooooooooo bad.”
I’m dubbing you Mr. Obnioxious.
“This stays on, then.” She rested his head to center and reapplied the C-collar. “I need a spinal series.”
Ethan nodded and tapped the screen. “Ordering.”
Mr. Obnoxious’s eyes went wide. “What? No. No wait, I mean it hurts so good.”
“I’m not going to play this game with you. You hit the windshield. Were you even wearing your seatbelt?”
“Don’t like them.”
“Spinal series it is.” Lucy stepped away and stood next to Ethan to get a few breaths of non-alcohol filled air. “If you do that same crap when I check your belly, you’re ending up with a CT scan and potentially an I and O catheter to check for blood in your urine.”
“Whatever…wait. No catheter.”
Amanda gave Lucy a thumbs-up as she spoke on the phone.
He snapped his fingers as he gave her the side eye. “I meant you hurt me so good. Do it again.”
“No.” Reviewing what the best course of action would be for her mental toddler of a patient, Lucy dreaded examining his abdomen. He’d already made gross sexual innuendo, but if he had a liver or splenic laceration, she had to know.
“Shit. Can I have a drink of water?”
“No.”
“Why not?”
“Because if you’ve got any internal bleeding, you’ll need to go to surgery and you need an empty belly.” Lucy answered without a hint of compassion.
“This sucks.”
“Be grateful it only sucks for you.” As she pressed on his stomach, she said a silent thank you when he didn’t even flinch with her examination.
The flippant demeanor of her patient had been one thing, but knowing he made light of driving intoxicated sent a burning sensation up and down her esophagus. “You could have killed someone tonight.”
The patient rolled his eyes, but the rest of the staff’s faces fell in shocked surprise, making Lucy realize how fiercely the words had escaped her. Embarrassment warmed her cheeks, but she refused to apologize. Instead, she focused on the bedside monitor and how stable the man had been since his arrival.
Lucky bastard.
Shelly pulled a tourniquet out of her pocket and wrapped it around the patient’s arm.
“What are you doing?” He growled as he attempted to crane his neck, but got nowhere.
“The last blood clotted. I need another sample.”
He began to pull away. “I don’t want my blood—”
“Cold. Turkey.” Without looking at him, Lucy replied with the compassion of a school marm, but caught him throwing daggers at her with his eyes.
The room remained silent except for Ethan’s typing, Kyle writing on his clipboard, and Amanda on the phone.
Brett leaned against the desk and appeared to be documenting as well.
From needle insertion to applying the Band-Aid took Shelly less than a minute. “I’ll get these processed.”
“Thank you. The croupy kid in room five, okay?”
“Last I checked, but I’ll peek in on him.”
“I’d appreciate that, Mrs. Westbrook.” Lucy stripped the gloves off, washed her hands, and took out her stethoscope to listen to the man’s belly. “Bowel sounds active. No guarding on abdominal exam. No distention.”
Before she left the room, Shelly nodded to Kyle. “Tell Gabby we said hi.”
Despite the bags under his eyes, a wide grin spread across Kyle’s face. “I sure will.”
“She making any of that orange cinnamon bread today? Freddie and Tia were hoping I could bring some home. They eat it for breakfast.”
“I hope so. I could use a good meal.” As Lucy backed away to rescan the patient for subtle and obvious signs of guarding or fractures, her stomach growled at the mention of food, especially anything from the Main Street Diner. “Been basically living there for the past six weeks.”
“They still don’t have your furniture here, Dr. Davidson?” Amanda asked as she handed Poppy something off her clipboard.
“No, ma’am, they don’t. My furniture is somewhere in Michigan right now.” She rubbed her neck, hoping to work some of the kinks out from her twenty-three hour, forty-five-minute shift.
Kyle pointed. “Is that why you’ve been there so much?”
“I like the bread.” With lungs now full of non-alcohol fumed air, Lucy grabbed a clean pair of gloves as she approached the stretcher again.
“Not that I’m complaining. Gabby’s loving having someone to talk to in Spanish.”
“It’s nice to keep my skills up. I took every Spanish class I could to get that fluent. I’d sure hate to lose it. Sir, I’m feeling your skin for obvious pieces of your windshield.” Running her fingers tenderly across the patient’s forehead, around his face, and his neck. She felt nothing but a few scratches and dried blood. “I feel a couple of bumps here, but looks like, so far, you didn’t fare too badly.”
“Hey, assholes. Quit talking about bread. I’m hurtin’.” The guy slowly snapped his grubby fingers before laughing at his own joke.
“Guess he’s paying attention even though he’s about ten seconds behind us. Concussion it is.” Lucy ran down her mental checklist again as the hard scent of cheap whiskey and cigarettes hovered in the air around him like a cloud.
The bitter taste of anger coated the back of Lucy’s tongue.
Another selfish drunk driver.
Without thinking, she tapped the scar at the base of her neck, making her flinch. The want to let her hair out of the clip to cover the spot hit her unexpectedly hard, but she pushed the idea away.
Despite time having faded the wound, right now, it felt as raw as the day she got it.
And her life changed forever.
End of Excerpt
