Career Girl in the Country / The Doctor's Reason to Stay (25 page)

“No, you’re not,” Rafe said patiently. “I’ve got a child trapped in there who could die, and you’re not going to let that happen to her, are you? If you let me go in, it’s
not
your responsibility—if you do, it is. Simple choice, in my opinion, Chief.” He held up the phone. “You know my brother Jess? He’s going in with me.”

“You’re as persuasive as your aunt was,” Brassard said, stepping back.

“I’ll take that as a compliment.” Rafe rushed round the man to get to Edie’s side.

“Or a curse,” Brassard muttered. “Here’s the deal. If we cut through the metal, it’s going to take a while, and it may undo what we’ve done to stabilize the van.
Also, because the kid’s head is positioned so that cutting around her is going to be a risk, that’s pretty much the last thing we want to do. That, plus the fact that she’s coming to, and I’m not sure she’s going to hold still for what we’d have to do. One of my men tried getting her out, but she was lodged in there tight. There’s not much room to do anything.” “Did he see bleeding?”

“Some. Not excessive. He couldn’t tell where it was coming from, and he was afraid to start probing and risk more complications.”

Tamponade
, where blood flow was stopped by a constriction created by an outside force. It was the first thing that came to Rafe’s mind, and something he couldn’t shake off as he prepared to go in. A tamponade could be a lifesaver but, if dislodged, could be a killer. Somehow, in such a serious situation, with a lack of blood.

“Look, Corbett, you’re aware how dangerous this is. And I don’t like the fact that you’re not experienced in field rescue. But we may not have too much time left for this kid if we don’t get something done fast, and if we need a field amputation—”

“Last option,” Rafe interrupted.

“Or first, depending on what happens. Which is why I’d rather put a doctor in there on that than one of my firefighters. We’re going to keep trying to get at her from out here, but in the worst-case scenario, we have an emergency … you’re going to have to take her arm and get her the hell out of there fast. No time to argue with us. You’ll just have to do it. Understood?”

Rafe nodded.

“Good. I’ll give you your shot at this, but if you
can’t make it work, we’re going to have to take that van apart piece by piece so it doesn’t fall down on that car below here. Those people trapped down there are at risk, too. Meaning five minutes in and you amputate if you don’t have another solution. So you’ve got your timeline. Five minutes, then we’re pulling everybody out. And at that point, if the kid is still stuck, I’m putting one of my medics in to take her arm if you haven’t already done it. So it’s going to be your rescue, Doc. And also your choice.” He tossed his helmet over to Rafe.

Five minutes. He was already feeling sweat drip down his back. Five minutes wasn’t a lot of time to wait, but those five minutes could be precious to that child trapped in there. Especially as more than five minutes had already ticked off the clock since he’d been here, and at least thirty minutes beyond that. “I’m going in,” he said to Edie.

“And I’m right behind you,” she replied, then thrust out her hand to stop him from arguing with her. “You’re not stopping me, Rafe. If April wakes up …”

Edie was good at what she did. Brilliant, actually. But putting her into this kind of situation? “You’ll do what I tell you,” he warned her. “Your job … your only job … will be to keep her calm, and if she’s not conscious, I want you out of there. Do you understand? You can’t get in the way because I may have to …” He paused, swallowed hard. “May have to amputate her arm. You understand that, don’t you?”

“I understand,” she said. “And I’ll do whatever you tell me to.”

“Then let’s do it.” He held his phone back to his ear. “I’m going in. I’ll keep this line open, but if something
happens …” He didn’t finish the sentence, didn’t even wait to hear his brother’s response. Instead, he got down on his belly and wormed his way through the broken-out windshield.

“What can you see?” Edie asked, wedged in tight against Rafe’s back.

“First thing I can see is that there’s no way in hell I’m going to fit in here. Second thing I can see is that her arm is pinned in tight, and it’s basically caught up in the mechanism of the seat that was in front of her. I don’t see any blood so I want to get a blood-pressure reading, but I can’t move.” The forces of his own private hell were beginning to close in around him already. He was basically on the interior roof of the car, lying on his side, wedged in between two dislodged seats where there was barely enough room for his large frame to fit. Maneuvering in this tight space was nearly impossible. Catching his breath in the tightness closing in on his chest was nearly impossible as well. “Can you take a BP reading? I think we’re going to have to trade places so you can do it, as there’s no maneuvering room in here for a man my size.”

Edie drew in a sharp breath, heard Rafe do the same. “Sure, I can do that,” she said, already backing away so Rafe could scoot himself out and let her go in first.

“April,” Edie said, on her way out. “Can you hear me?”

The child murmured a faint “Uh-huh.”

“We’re here to get you out, so don’t be afraid.” As she brushed by Rafe, she whispered, “Talk to her. Reassure her. The words don’t matter as much as the fact that she’s not alone here.”

“How is it in there?” Rick called from outside.

“Tight,” Edie yelled. “Her arm seems caught almost all the way to her shoulder, but it’s hard to tell, and she’s trapped at a difficult angle. Rafe’s too large for the space.” She glanced back in, aimed her flashlight into the interior dark space and saw Rafe talking to the child as he slid himself out.

“Well, once you get back in there, maybe you could.” Rick held out the blood-pressure cuff she needed, as well as an old teddy bear. “It used to be Christopher’s.”

“I think she’ll be glad to have it,” Edie said, dropping back to her knees, waiting for Rafe to make his exit.

“I’ll be right back, April,” Rafe reassured the child in a voice so tender it nearly broke Edie’s heart. Somehow she had to make Rafe understand what an amazing father he’d make for Molly. She could see it so clearly. She thought Molly probably could, too. Rafe was the only one denying it, and she didn’t know why. It bothered her, though, because where there could be so much happiness, Rafe was bound to a path that seemed like such a waste.

“Four minutes,” Brassard stepped in and warned.

Rafe nodded, but didn’t acknowledge him in any other way. “She’s brave,” he said to Edie, “but we’re going to have to get her out of there pretty soon because I don’t know what else is going on with her, and she’s been pinned too long. Have you ever taken a blood pressure in somebody’s leg before?”

Fear, icy cold and blinding, hit her. “No, but I can do it. Um … Rafe? Since
you
can’t get in there, you won’t
expect me to … to amputate, will you? If that’s what it comes down to, I won’t have to be the one …?”

“It’s not going to get to that,” Rafe said. “I promise, Edie. We’re going to find another way to get her out of there.”

Reassuring words that didn’t reassure her as much as she would have liked because her hands started to tremble and she couldn’t stop them. “Rafe, I … I’ll do what I have to do. But I’m not sure …”

He reached out and took both her hands into his. “That’s the last possible alternative, Edie. To save that child’s life, if that’s what it comes down to, I know you
can
do what you have to do. And I’ll be right there with you. But we’re going to look at other alternatives first. I’m not going to take that little girl’s arm without exhausting every other possibility. I promise you.” Ever so gently, he brushed a strand of hair back from her face. “I’ll be with you, Edie, no matter what happens.”

His voice was so calm, so reassuring she wanted to believe him. Something in Rafe inspired her to be more than she was, to see capabilities in herself more than she had. “I know you will,” she whispered, fighting hard to keep the trembling out of her voice. “But I’m not sure if I can.”

“My aunt trusted you with the ominous task of turning me into the father she thought I could be, and that speaks volumes. Actually, it shouts volumes.”

“You know about that?”

“Of course I know about that.” He tilted her face up to his. “I trust you to help me, Edie, not because my aunt trusted you but because I trust you. You can do this … we can do this. But I won’t force you to go back in there with me if you don’t want to.”

“When you get back in there, you’ve got three minutes,” Brassard reminded them.

This time Edie paid no attention to the fire chief. “I’m going in
with
you, Rafe,” she whispered, her voice still shaky. This was nothing she’d ever prepared herself to do, but Rafe gave her confidence. And that confidence grew as she felt Rafe right behind her on her way in. “Hi, April. My name is Edie, and I’ve come to help get you out of here. I know you’re scared, so I brought you a little friend to hold on to while Dr. Rafe and I take care of you.” April took hold of the bedraggled teddy with a fierceness that told Edie she was a tough little girl. “So, what I need to know first is where you hurt the most. Can you tell me?”

April nodded. “My arm. It’s stuck. And there’s something in my tummy, on the side.”

Edie rolled a little to her left, wedged herself back against another of the seats that had broken loose, and aimed her flashlight at April. That was when she saw it … something wedged into the child’s side, just above her waist. Maybe part of the metal bracing broken off one of the seats?

“Two more minutes,” someone outside shouted.

“Rafe,” Edie said calmly, trying not to alarm the child, “April has a tummyache. I think I can see the cause of it.”

“Where?”

“Left side, just above her waist. Metal bar of some sort, I think. Wedged in, can’t tell how deep.” She waited for his response, waited for him to tell her what to do, but what she heard instead was an utterance of profanity under his breath. So she continued to talk to April. “Can you wiggle your fingers, April? Just
your fingers, nothing else.” Edie shifted the position of her flashlight so she could watch April’s reaction, and what she saw for a moment was a child putting forth every effort she had—frowning, biting down on her lip, squeezing shut her eyes to concentrate.

“A little,” April finally said, with great effort. “My thumb a little, and I think my first two fingers. My others feel … yucky.”

“How yucky?” Edie asked instinctively.

“Like they’re not there.”

Edie cringed inwardly, and Rafe gave her a supportive squeeze on her shoulder. “Are they sticky?” he asked April.

“Some.”

“And cold?” he continued.

“Yes. And they hurt all the way up my arm.”

“Pain is a good sign,” Rafe murmured into Edie’s ear, then continued, “When we get her loose, we’ve got to stabilize the metal bar in her side before we move her out. Just make sure we don’t bump it or dislodge it somehow.”

Those words sent cold chills up Edie’s spine, almost as much as Chief Brassard’s one-minute warning did. “Let me get her BP before we do anything else, and maybe you can figure out how to take care of her arm in the meantime.” She wedged herself in a little closer to the girl. “April, I’ve got to check your blood pressure. It’s going to pinch a little, but it only lasts a few seconds. The reason we do this is so we know how well your heart is sending the blood flowing to all the places in your body it needs to go.”

“So you can fix me up when I get my arm out?”

Edie felt a knot catch in her throat. That was what
she wanted, what she was praying for, but the two things she’d never do were offer false hope or lie. Which was why she chose her words carefully. “So we can give you the best care when we get you out of here. OK?” The knot almost choked her as she spoke, but she was going to hold on to hope … because of Rafe. He would do everything possible to help this child, and to assure the best outcome. She believed that with all her heart.

“OK,” April agreed. “But I’m getting sleepy. I want to go home.”

Sleepy meant shock. With her limited medical training, Edie knew that, and it worried her. “Soon, sweetheart. We’ll get you home as soon as we can. In the meantime, just try and hold as still as you can, and be very quiet, because I’ve got to listen through these.” She held up the stethoscope, then impulsively placed them in April’s ears and placed the bell on her own heart. “Can you hear it beating?”

“Yes,” the girl said, almost mesmerized.

“That’s what I’m going to be listening for in you, only in a different place. I’ll bet you didn’t know that there are places all over our bodies where we can either feel your heartbeat or listen to it.”

“Will you show me?” April asked, almost timidly.

“When we get you out of here, and after the doctors at the hospital have had a look at you, I will definitely show you. So.” She held a shushing finger to her lips then twisted slightly to look back at Rafe, who handed her the blood-pressure cuff.

“You’re doing a good job,” he whispered, as she took it from him.

She hoped so, hoped that wasn’t just Rafe trying to
be encouraging. “How do I do this? I know how to take a reading in the arm, but not in the leg.”

“There’s not much difference. It’s all about the positioning. What you need to do first is bend the knee of her right leg, and try keeping her foot flat, without twisting her abdomen. Actually, let me move over a little so I can work with her foot.”

He scooted back, brushing against her, and even in his slightest touch she felt his strength rush through her. Edie hoped her shiver was imperceptible to him, even though to her it was massive, shaking her down to her very essence. “So I strap on the cuff next?” she asked.

“Make sure the bottom is about an inch above April’s ankle then put the stethoscope on the dorsalis pedis artery. Find that by placing your finger halfway between the inner ankle bone and the Achilles tendon. Let me know when you’re there.”

Knowing such a little thing may have seemed simple to Rafe, but to Edie his knowledge was awe-inspiring. “I feel it,” she said, when she’d finally located the pulse.