“Details are sketchy,” Linda replied, handing Tristan a radio headset with a microphone. “It’s the governor’s daughter-in-law. MVA. Reports are she’s in bad shape.”
“Shit.” Tristan could see it now. Not only would they have to deal with a critically injured patient, they’d probably have news people crawling all over them, documenting everything they did or didn’t do. It was a PR nightmare, and as the physician on scene, she was going to get all the attention.
“No kidding,” Linda said.
“I’ll take a quick look at her airway,” Tristan said, “then you two concentrate on securing the victim, just like you would if I wasn’t there. Anything you need me to do, tell me. I guess you know not to talk to anyone.”
Linda grinned. “Oh yeah, we know all about that. HIPAA HIPAA hooray.”
A lot sooner than she expected, Tristan realized they were landing at the edge of a field adjoining the turnpike. The accident scene below pulsed with a life of its own as the lights of a dozen emergency vehicles beat against the night sky. Two other helicopters were setting down simultaneously, hovering like menacing behemoths over the ring of patrol cars, ambulances, and fire engines whose headlights illuminated a jackknifed tractor-trailer and three mangled automobiles. Two forlorn, white-tarp-covered forms lay alone on the oil-stained highway while rescue workers swarmed around the wreckage, tending to the still-living.
The instant the helicopter touched down, Tristan jumped out behind Linda and Juan. Following Linda’s directions, she helped unload a stretcher and rapidly piled emergency equipment on top. Then she set off running with them toward the scene.
“We’re from PMC,” Linda called to a man with a lot of gold braid on his uniform cap who Tristan figured was the incident commander. He held two radios and was waving emergency crews in various directions.
“Over there,” he directed.
Tristan looked where he pointed. A cluster of emergency personnel knelt on the highway inside a loose ring of state police. Two news vans were angled on the shoulder of the road and a handful of reporters with television cameras strained against a temporary barricade of yellow crime scene tape, trying to get footage. The patient, assuming she was in there somewhere, was not visible.
“Jesus,” Tristan muttered under her breath.
Juan cleared the way by announcing who they were, and the crowd parted enough to let them through. When she finally cleared the protective ring of cops and the assorted curious, Tristan saw a woman in her early thirties, unconscious, bleeding profusely from obvious facial injuries. Judging from the victim’s position, Tristan surmised she’d been ejected from a vehicle—probably the overturned Lexus SUV covered with flame retardant foam that was now resting on the median.
Her right leg was angulated, a portion of the femur protruding through a long rent in her once-white slacks. With trauma to both her head and lower extremities—bracket injuries—there was a good chance she had internal injuries as well. She already had IVs running in both arms.
Tristan dropped to her knees by the patient’s head and placed her stethoscope quickly on both sides of the patient’s chest, listening for breath sounds. She heard no air movement on the right. “Pneumothorax on the right.”
While Juan positioned the backboard next to the victim, Linda opened the emergency equipment box and pulled out a thin trocar with an attached flexible polyethylene tube connected to a syringe. She pushed aside the remnants of the patient’s bloodstained blouse, quickly swabbed a spot below her breast with antiseptic, and pushed the three inch needle between her ribs. Then she slid the tubing in after it and used the syringe to evacuate the air from the patient’s chest. As Tristan listened, breath sounds returned. It was a temporary measure, but it would do for now.
“Better,” Tristan said.
Despite the improvement in airflow, the patient’s breathing was labored. Fractured ribs. Tristan gently palpated her jaw. The mandible shifted beneath her fingers with a grating sensation. Fractured as well, and probably her mid-face too, if the amount of blood streaming from her nose was any indication. With this much hemorrhage and mobile facial fractures, her airway was very unstable.
“She needs to be intubated.”
When Tristan glanced up, Juan already had a laryngoscope out and handed it to her. Using the portable suction, he cleared some of the blood out of the patient’s mouth while Tristan inserted the scope’s flat metal blade with a light at the end into the back of her throat. Moving the tongue aside and carefully lifting up on the jaw so as not to move the victim’s head, Tristan squinted into the oral cavity, hoping to find some landmarks. Unfortunately, with the continued bleeding and massive swelling, she couldn’t see a thing. Still searching for anatomical landmarks, she held out her free hand for the endotracheal tube and made a blind pass in the direction of the trachea—or at least where she hoped the trachea was. She really needed to get this tube in, because the last thing she wanted to do was an emergency trach in the field. Too much risk to the patient, especially one with an unstable neck. Tristan eased the tube in a little more. God, she hated blind intubations. Please, baby, come on.
Juan pressed his fingers to the patient’s throat, and as Tristan continued to push, he nodded and said, “Feels like it’s going through the cords.”
Tristan persisted until only a few inches of the tube protruded from the patient’s mouth. Then she took the ambu bag that Linda had connected to the oxygen tank and carefully hooked it to the end of the endotracheal tube. She squeezed the inflatable bag while Linda listened to the patient’s chest.
“You got it,” Linda announced with satisfaction. “Good breath sounds on both sides.”
“All right then,” Tristan said. “Let’s get her on the backboard and go.”
Tristan stabilized the head, Juan placed a cervical collar, and then on Linda’s count, they rolled the patient, slid the backboard underneath her, and strapped her down. While Linda secured the IVs, O2, and other tubes, Juan splinted her leg. Within minutes, they were ready to go. As they worked, Tristan could hear shouted questions from the reporters.
“Is that Marsha Eisman?”
“How badly is she injured?”
“Does the governor know?”
“Is she going to die?”
Tristan ignored everyone. She’d have to face the reporters soon enough, but it wasn’t going to be out here. She had far more important things to do than worry about the hospital’s PR.
Jett checked her gauges in preparation for takeoff while she waited for the medcrew to return with the patient. She hated this part—the waiting. She wanted to be out there in the field, doing something. But her job was to get her crew out and back again as quickly and as safely as possible. She could and had assisted in retrieving the wounded. But that had been under different circumstances.
“Chief, you shouldn’t be out here! Get back to the chopper.”
The major had to scream in Jett’s face to be heard above the rattle of small arms fire and the explosion of mortar rounds that came with such rapidity the air reverberated with the continuous roar.
“The incoming fire is getting worse. We need to get the wounded aboard,” Jett shouted back. She helped the major roll an injured soldier onto the stretcher, grabbed the other end, and lifted. “Another few minutes and we might not be able to get airborne.”
“If we don’t have a pilot, it won’t matter how long we take.”
Since the major didn’t actually order her to drop the stretcher, Jett just put her head down and ran for her Black Hawk. They loaded the injured and raced back for more. After that, there wasn’t time for talk.
The medevac crew finally cleared the field of injured and Jett somehow got them up and out in one piece. As soon as she’d landed at the field hospital and the wounded were offloaded, she’d gone back out again.
The hours ran together until finally she was off duty and she staggered, weak-limbed and numb, away from her aircraft for some much-needed food and rack time. She slumped down at a table in the mess tent and mechanically shoveled whatever was on the plate into her mouth, not tasting it, not caring, just knowing she needed it if she was going to wake up in a few hours and do it all again.
“Nice flying, Chief,” a dark-haired major a few years Jett’s senior said as she sat down across the table from her. She wore medical insignia in addition to her oak cluster, and Jett figured her for one of the medcrews.
“Thank you, ma’am,” Jett said, trying to put a little enthusiasm in her voice. She was so tired she could barely see her plate.
“You ought to stay with your aircraft, though. We can’t spare any of our pilots.”
Jett recognized her now from the first run of the day, which seemed like a week ago after the night she’d had. “Sorry. I didn’t recognize you, Major.”
The major smiled, and Jett tumbled into the warm blue depths of her eyes. Quickly, she looked away.
“But not sorry you put yourself in the line of fire, is that it, Chief?”
“I was only thinking of the wounded.”
“I know.” The major extended her hand across the table. “Gail Wallace.”
Jett took her hand. Her skin was smooth and warm. Warm like her eyes and her smile. Jett couldn’t remember ever seeing anyone so beautiful.
She jolted back to the present as Linda rapped one hand on the side of the helicopter. “All set, Cap.”
Jett watched the team lift the stretcher into the aircraft, and when she was sure her crew was secure, she took the helicopter up, Gail’s face still vivid in her mind. She couldn’t remember how many times she’d glanced back to see Gail behind her, tending the wounded or leaning out the door, manning a gun while Jett took off under fire. She didn’t want to think about Gail, not now, not while she was flying.
Flying had always been her escape. As soon as she was airborne, she was free—free from the memory of her father’s anger, her mother’s misery, her own helplessness. Behind the controls, she was in control.
Even in the midst of combat, she felt only exhilaration, not fear. She made choices, and no matter the outcome, she would live or die by them. No regrets. Except one.
Ignoring the familiar ache in the pit of her stomach, she gave herself over to the strong, steady hum of the rotors above her head, like the heartbeat of a lover in the dark. Even knowing it wouldn’t last, she welcomed the few moments of peace and headed toward home.
Chapter Two
Jett circled the hospital rooftop, checking her speed, her angle of approach, and the wind direction. The trauma team ringed the circle of light below, waiting to converge on the aircraft. Gently, she set her aircraft down precisely in the center of the landing pad. The doors flew open and the medcrew jumped out, guiding the stretcher out as the trauma team raced forward to meet them, heads lowered beneath the sweep of the still-turning rotors. Within a matter of seconds, Jett was alone on the rooftop, her job done. Adrenaline still surged through her bloodstream, and her hands trembled as she locked down her aircraft.
With her helmet tucked under her arm, she strode to the stairs and hurried down a level to the suite of rooms reserved for the flight crews.
She had her own small on-call room and private bathroom. The door from the hall opened into the room on one side and, opposite, another door led to the lounge area where the pilots and medcrews waited until a request came in. In addition to her bed, her room held a dresser, a small TV with only intermittent reception, a single straight-backed chair, and a tall narrow bookcase. She propped her helmet on her dresser, stripped off her flight suit, and draped it over the back of the chair. Then she went into the bathroom, ran cold water, and doused her head and face.
“Tough flight?”
Jett lifted the tail of her Army-issue green T-shirt and wiped her face, then turned to find the major standing just behind her. “Hot and dusty.”
Gail smiled. “Just routine, then.”
“Yeah.”
“How long have you been here?”
“Four months,” Jett said. “This time.”
“Regular army?”
“Yes. You?”
“Sixteen toward my twenty,” Gail said.
A career Army officer. Jett had thirteen years in herself, but she’d come up a different route. She didn’t often have casual conversations with other soldiers. She talked to her fellow pilots, but mostly about the flights or their aircraft. She’d always been a solitary person; living in close proximity with men and women with whom she couldn’t be completely honest only made her more reluctant to make connections.
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