Wake the Dawn (6 page)

“Surely we have albuterol,” Ben muttered as he searched the cupboards; in all of his looking for stuff, he had not checked these cabinets. No meds of any kind.

He turned to the patient. “You have any sort of bronchodilators with you?”

No response.

Dennis said, “We didn’t find any, but we didn’t look far. Wanted to get him here.”

“Dennis, go ask Esther. She’s in the next room, or at least she was. If she’s not, Barbara is in the restroom, cleaning up Mrs. Unfeld. Barbara will know.” Barbara, a registered nurse, knew everything. Nurses knew more than doctors did, at least regarding the practical stuff. Might as well check under the sink; it was the only door left. “Oh, for pete’s sake.”

Who would stash a big plastic box of meds under the sink? But there it was, and rifling through it Ben found albuterol. He bit the cap off the vial so he could pour it into the nebulizer.

Dennis came back in. “Under the sink. And the clamp is over the sink.”

He opened a cabinet door above the sink, dragged out a plastic bag of various gizmos, poked through it with one finger, found a clamp. “Now we get to find out whether this thing works.” He slipped the little black clamp over the patient’s middle finger, fiddled with it, studied it. “Okay; at least now we know his oxygen level. Up the saturation, can you?” Ben had no idea where his stethoscope had gotten to. “Need your ears.” He pulled Dennis’s ’scope off his neck and shoved the bell against the victim’s chest. With the guy’s shirt on he wasn’t going to hear much, but the heartbeat was all he was looking for anyway.

Slowly but surely the man’s breathing eased. At least they didn’t have to do a tracheotomy. He’d done a couple of trachs in the past and dreaded attempting another.

The heart rhythm eased as the oxygen flowed more freely. The deathly blue pallor faded.

“Where’s Yvette?” Ben had not even been aware she’d left the room.

“Someone needed another set of hands. Is there any coffee?”

“I’m not sure but if you find some, please bring me a cup, too. We need to get some food in here for these people.”

Dennis took out his cell phone and thumbed buttons.

“Who you calling?”

“My mother heads the church ladies’ group. They’ll get some food in here. We can go pick it up with the ambulance if need be.” He put his cell to his ear a couple of times and shook his head. “No signal. By the way, your house is still standing. Doesn’t really look damaged, like the roof is still on. That birch out back went down.”

“Thanks.”

Dennis’s radio howled his code. “Looks like we’ll be on our way. Now I get to go look for Yvette.”

“The place isn’t that big. Probably the ladies’ room.” Ben checked their patient’s vitals again. Here at least was one they’d been able to save. The man’s eyelashes fluttered, and he started to sit up. Gently pushing him back down, Ben nodded. “Just take it easy, we’re through the worst. What happened?”

“Power went out, no nebulizer, panic.” His voice rasped.

“Well, they got to you in time. I’ll be moving you out of this room because we need it, but you can rest here for a minute. Okay?”

The man nodded and let his eyes close again.

Ben turned at a knock on the door.

“How is he?” Yvette asked, handing him a cup of coffee.

“Good. Where did you find this?” Coffee, third on his list of beverages, behind beer and whiskey.

“Barbara said someone brought over a can of coffee.”

“But no one is supposed to be out in this storm.”

“Just say thank you and enjoy it.” She turned away. “Oh, and mother and baby are sound asleep on some quilts someone else brought in.” She raised a hand. “Don’t ask. Call them our guardian angels.”

Guardian angels. Where were they two years ago when Allie needed them, out having a beer?

Ben followed her down the hall, careful to not trip over sleepers. They’d need to start hanging hammocks next. He peeked into the break room. Ansel looked up from checking on the man on the gurney. “Everyone in here is sound asleep but him and me. Thank God for the quilts.”

Beth was curled up near her daughter, the new son nestled in a quilt. Someone had slipped a sock over his head in lieu of a newborn cap. Hannah’s head had dropped forward, but the baby slept in her arms.

Grateful for a moment of respite, Ben listened to his stomach growl and grumble from the coffee. Too bad, at least it would help him be alert again. Someone had swept up the glass from the vending machines at some point, but they were now empty of snacks and drinks. He left the break room and stopped behind the front desk. “What’s the weather report?”

Barbara glanced up with a smile. “No letup on the rain, but the winds are now at strong breeze, not gale. You’re familiar with the Beaufort scale, right?”

“Right. Twenty-five to thirty.”

She smirked and continued. “You can be sure the power crews are out there. And the highway trucks, moving the trees off the roads. If they can get us clear one way, we could send the ambulances with our bad ones to the hospital. Perhaps the choppers can fly come daylight. We’re all praying for that.”

Ben felt his jaw tighten. Why waste your time praying to a God who kills women and babies? At the look on her face, he realized she’d guessed what he was thinking.

She laid a hand on his arm. “No easy answers, I know.”

Ben turned away and thought about Mrs. Unfeld curled up on a quilt in the corner of the break room. Bessie Unfeld, a church leader for years, and look how God rewarded her. He almost said something but kept on going; he’d not seen Esther for how long? He opened the doors to the examining rooms, peeked in. Rob was cleaning two, apparently having just handled a case. Denise, the internal bleed, was sleeping on her table, Roy stretched out on the floor beside her. Culpepper was cleaning one, working around their asthma guy.

Here was Esther, in the mini surgery with a patient on the table. “I could use another pair of hands here.”

“Scrub?”

“Get the gloves on.” She wiped the sweat from her forehead with the back of her hand. Strange, it wasn’t that hot in here.

Though she had snapped at him before, he decided to try again.

“What’s wrong?”

“I can’t keep the blood out of the field.”

Ben didn’t mean what was wrong with the patient, but he said nothing.

Ben looked from her to the child whose compound fracture of the tibia lay exposed under the lights. Sure there was blood, but not a bleeder, or else she had already stopped it. The man hovering at the head of the table looked up at Ben. He poured a bit of water on the wound, irrigating it, keeping the bone moist lest it die.

“Hi, Jensen.” Ben turned to Esther. “You going to try to set that?”

Jensen nodded. “Hi, Ben. It was bleeding pretty bad, but she got that stopped.”

“How’s the rest of your family?”

“Safe. Down in the basement. With all this rain, that’s starting to leak, but I got a pump and a generator.”

“Okay, here we go. Jensen, you hang on to your son.” She gave Ben orders and together they pulled the bone back into place. She picked out small bone fragments and blew out a breath. “Thank God for anesthetics. Clear the field for me again, and I’ll go searching.”

Ben recognized the gauze sponges as having come from the OB kit. They were using every bit of supplies, and now these were used up as well.

They placed a drain, Esther did some fancy sewing to close it up, they bandaged the wound. Slipping an inflatable splint onto the leg was the easy part. Ben blew it up by mouth, since he had no idea where the pump was. At least their supply of inflatables was still adequately stocked.

Jensen was smiling a sad, weary, grateful smile. “Just as good as the big city.”

Ben chuckled mirthlessly. “That’s what we told some other guy. He didn’t want quacks working on him.” That was long ago, so very, very long ago! Ben looked up at the clock. Seven
A.M
. He’d been on the go for twenty-four hours and he knew others were functioning on even less sleep. Dennis and Yvette, and…

Let’s insert a ray of sunshine here, Ben, boy.
“Barbara thinks the choppers might be flying now that the wind has died some.”

Esther stepped back and pulled off her gloves, the ones that had been in the OB kit. Or had she raided other OB kits to get more? “Please, God, I hope so. The woman…”

Ben knew she meant Denise. “I looked in on them a few moments ago. Want me to check again for you?”

“No, you stay here until the anesthetic wears off and I’ll go see.”

Ben watched her tilt and thump against the doorjamb as she went through the door, lurch erect, continue on out. How much longer could she keep functioning? Were the rest of them in as bad a shape as she was?

Chapter Six

E
sther sagged against the wall behind her office door.
Come on, woman, you know the tools to deal with this. Stay with it. Breathe deep, again. Again! Shut it out! Focus!

The orders marched through her mind but for some reason, they didn’t connect with her body. She knew lack of sleep and meals was part of the culprit, but since neither was available…

She sucked in another breath, shrugged her shoulders to release some of the kinks, and rotated her head. Holding one hand out, she could tell from the reduction in quivering that she was doing better.
As soon as you get home, you can get back on your sertraline, but now you just keep going. You know what’ll happen if someone figures out what is wrong.

She knew, all right. She couldn’t shake the memory of the night one of these attacks caught her in the middle of an examination in the ER where she had worked some weekends. She’d been working anywhere she could, anything to bring in enough money to keep going. Her dream of med school started to die that night.

She dug a clean lab coat out of the nearly empty supply cupboard and headed back for the break room. At least in there she would find new life and hope. Two babies, one with two doting parents and one who would be given over to social services. Parents unknown.

She glanced toward the waiting room as she passed, checked her watch; after seven
A.M.
and the waiting room looked just as full. A small child whimpered and was shushed by a parent.

“But I’m hungry!” rose from a different part of the room. It seemed like a lifetime ago that Ben had picked up the chair and slammed it into the glass door of the drink and snack machines. The contents disappeared quickly after that. If there was a complaint from the vending company, so be it. But he hadn’t signed the lease agreement for those machines; she had.

Ben. Intriguing in a way. Cute guy. Dark, though. Grumpy. A couple of people said he drank too much, but she had never seen him drunk at all, and those times he came in for his service-mandated physical, he tested out just fine. When she’d arrived in the Pineville clinic six years ago, the old women were still talking about the wedding over a year before. “Oh, Esther, you missed the wedding of the century!” “Loveliest wedding I’ve ever been to, and I’ve attended many a one.” “Such a cute couple! Just perfect for each other.” Ben and his Allie. The whole town, absolutely the whole town, had turned out for it. Chief Harden had proudly given the bride away, Allie’s own father having died.

Esther only met Allie once and to her, the girl seemed a little vapid. Not real deep, not interested in weighty stuff, not much ambition. But Ben was obviously smitten with her and she with him. Then the whole town turned out for Allie’s funeral, too, every person stunned, grief-stricken. Esther was handling the clinic full-time by then, and she was accustomed to the taciturn, easygoing nature of Pineville’s citizens, so the outpouring of vivid grief surprised her.

She stepped around those on the floor, some sleeping, some with pain-glazed eyes. How long since the ambulances last arrived? She made her way down the short hall that felt like a mile. Was she really ricocheting off the sides of the doorway or did it just feel that way? She was afraid to stop in the restroom and look in the mirror. Some things were better left unknown, but since several people had asked if she was all right, it must be bad.

The ambulance siren wailed again; she was beginning to abhor the blip signal that they needed to be on the move. She tapped on the door to the room where Denise and Roy had spent the night. No answer. She peeked in; they were both still sound asleep. She hesitated. Disturb them or wait until…? Without entering, she looked over at the hanging bag. Empty. They had nothing left to give her. She shut the door so gently, it did not even click.

Rob came out of the break room. “Can we do Hannah next? She has to be in terrible pain, but she soldiers on.”

“Is the mini surgery clear?”

“I think so.”

She heard laughter and a rise in conversation coming from the waiting room. Now what? She continued on to the waiting room. With grins wide enough to stuff a controlled-substance report into, Dennis was carrying a big plastic bin and Yvette was shoving a gurney through the door. No patient, though—plastic and cardboard boxes took up the space, with a large coffee urn jiggling dangerously at the foot.

Behind them, Gerty Larson and Ellen Jackson came trooping in. Esther knew them, had treated them both. Why were they up at this hour and smiling?

Dennis called, “All you folks stay where you are, and these angels of mercy will bring this around. We have sandwiches, coffee, and juice for the children.” He put his plastic bin down and popped the lid. Yvette opened the boxes on the gurney.

Ellen gestured with a plastic pitcher. “I’m doing the juice. Children first, and then adults can have what’s left. We’re preparing more over at the church, so don’t worry about taking the last of anything.”

Gerty pulled out a plastic tray, put a creamer and sugar jar on it, and began pouring coffee into paper cups.

Rob appeared in the hall entry, swore a very happy Anglo-Saxon epithet, and gathered juice and sandwiches in both hands. “For the Gustafsons in two!”

Esther let herself sag against the wall. Thank God for church women who would feed people no matter how the storm raged. How they had done this, she’d probably never know, but when Dennis handed her a sandwich she simply took it and thanked him.

Dennis wasn’t losing that glorious smile. “They have that refugee shelter set up in our church basement. Really chugging along. Harry in the power truck went to the grocery store and stocked them up with food and stuff; grocery didn’t even charge them. Thank God for their oversize generator; it’s big enough to handle all this. We can move some of these people over fairly soon, I would think.”

Esther bit into her sandwich and accepted the cup of coffee.
One more minute, if I can have just one more minute.
Seven forty-five. Maybe she was going to make it. Maybe they were all going to make it.

“Esther?” Ben beckoned her from the surgery. “We have Hannah ready.”

“Did you take an X-ray?”

He shook his head. “I’m a border patrol officer and a hospital administrator, remember? I don’t know how to use that machine.”

“Wheel her down to radiology and we’ll start there.” Radiology. Sounded so big-city, and it was essentially a closet pressed into use because it was big enough to hold the machine.

Ben was asking, “No X-ray technician in this town?”

“One, but I haven’t heard from her all night.” Surely if all were well, Susan would have checked in.

Ben was sure chatty. Annoyingly so. She didn’t need noise, not even his rat-a-tat monologue. “The repeater’s down and our only radio communication is with each other. Local. The ham operators, though, they’ve been bouncing signals around and made contact with a friend of a friend…you know how they do. Minor miracles sometimes.”

No, Esther did not know how they did or what they did. And she didn’t want to. But she anticipated that she was about to find out.

Ben rolled on. “They made contact with Minneapolis, who put the word out. Choppers are lined up to come in as soon as the weather permits, and half a dozen ambulances are waiting until the roads are cleared enough for them to get here. And they told ’em we’re out of blood and saline and everything else. So we have blood and bags coming, lots of units.”

“Good.” She finished her sandwich and tossed the plastic bag in the trash, then headed down the hall as Ben went off to fetch Hannah. Three people stirred from their places against the wall or on the floor.

“Is it morning?” one asked. The wrapping around her leg was bloody and she groaned when she tried to scoot back against the wall.

“It is. There is food available in the waiting room if you can make it down there. Or send someone and they’ll come to you.”

The others woke and hobbled or helped each other down the hall, two with obvious wounds and the third assisting.

Esther pushed open the door to the X-ray room, heaved a sigh, and turned on the machine. “What did you do with the baby?” she asked as Ben pushed Hannah’s wheelchair into the room.

“Ansel is holding her. He said to tell you that the guy on the gurney needs to be knocked out again.”

“Maybe we should just put him outside. Get a shower and clean up his act.” Esther clamped her teeth. Talk about inappropriate. She heaved a heavy breath. “Sorry, Hannah, that just slipped out.”

The woman rolled her lips together, laughter dancing in her eyes. “I thought just that. Makes me feel better that someone else feels the same.”

“I think Ansel would rather take on a roomful of snakes than put up with the likes of him. The dude’s not happy he’s tied down.” Ben studied their patient. “Hannah, we have to get you up on that table.”

Esther closed her eyes. “Get some help in here.” She pushed the machine on the overhead track into place and slapped two lead pads on the table.

“Sorry to be so much trouble.”

“Oh, Hannah, you might be the one who saved that baby’s life last night. We just have to work out some logistics here.”

“Get me on my feet, er, foot, and let me lean on Ben. We’ll manage.”

Ben came through the door with Rob on his heels. Between the two of them they got Hannah prone on the table and stepped back when Esther told them to leave. “No, I mean outside the door.” She slammed the negatives into place, positioned the overhead with the marks on the table, and stepped behind the shield. “Hold it; no movement, don’t breathe.”
Click.
“Okay, Hannah, breathe.” By the time they took one more and got Hannah back in the chair, tears were streaming down her face.

“I’m sorry.” She sniffed and patted her pockets for a tissue.

Esther handed her the box from the shelf by the door. “Let me check these. It will take a moment to develop them.”

Develop X-ray films. That had gone out with buggy whips and horizontal-control knobs on TV sets. A good, modern, digital X-ray machine didn’t cost all that much, provided a high-resolution picture, and she could have the results instantly with no trouble at all. Snap the shot and look at it, just like that. Snap another if you need a different angle. Then send it all to the monitor in the surgery. But no. The Frugal Fathers of this burg didn’t want to buy an X-ray machine when the clinic already had one that still worked. She really, really wished she could strangle the Frugal Fathers.

Back in the mini surgery, she snapped the X-rays into the light box on the wall. Rob and Ben peered over Hannah’s shoulder, so she explained to them all, pointing. “Here is an obvious break in the lower tibia.”

“Not obvious to me,” Rob interrupted.

“Well, it would be more obvious were the swelling not so bad. This is going to require surgery, but by a good orthopedic surgeon, not us here. And it can’t happen until the swelling goes down. An inflatable splint might help, but we don’t have one of the appropriate size and shape. We may try taping it. So, Hannah, we’ll get you set up with ice packs and more pain meds and…”

“And I can have my baby back?”

“Yes, you can, with all our gratitude.” She looked to Ben. “You can do this?”

“Taping it as in taping an athlete’s ankle before the game?”

“That kind of tape job.”

“We’ll take care of it. Can’t be harder than diapering that baby.”

Hannah punched him on the arm. “Keep your priorities right, son, or I’ll sic my dog on you.”

“Doctor!” The call came from down the hall.

Esther spun and headed out the door. Denise. There must be a change. “Coming, Roy.” She jogged instead of running because a casual jog was the absolute greatest speed she could muster anymore. She entered without knocking.

Rob looked worried. “She’s awake or at least conscious, but…well, look at the machine there. It’s different, sort of.”

Loud and clear, the green line tracking across the screen told the world that Denise’s heart was struggling desperately. Even Roy, probably untrained to read an EKG, could see that. Some of the spikes were starting to lose their sharp points, the wrong spikes you wanted doing that. And there was a short straight line where a line of gentle wiggles should be.

A knock at the door. Barbara poked her head in and her voice bubbled. “Choppers are on their way!”

Oh, thank God! For the first time in—well, in forever—a wave of happy relief washed across her. Esther smiled at Roy. “You heard her.”

Roy closed his eyes and nodded. “Please, God, that she makes it.”

“She’ll make it now. Those birds are equipped with all kinds of fluids and better monitors than ours.” Esther turned to see Ben at the doorway.

He was grinning. “Heard the news? Gimme your car keys. We’re clearing the parking lot by the side doors for them to land.”

“Good choice. No power lines there.” She dug into her pocket and handed him her keys.

“No power lines anywhere.” He jogged out.

The cleaning kid came in. “Did you hear?”

“We did! Go find me a gurney. This one will be first in line to go.”