Trauma Plan (12 page)

“Here.” Jack handed Riley his stethoscope. “I’ll bag. You listen.”

Her stomach sank. “Okay.”

Jack’s huge hand compressed the bag effortlessly, and Riley pressed the stethoscope to their patient’s chest, confirming equal exchange of air in all lung fields—initial proof that the tube was properly placed. “Sounds good,” she said, meeting his gaze.
And I’m sorry.

“Medics are here!” Bandy reported from the end of the porch.

“Good. We’ll leave the IV to them.” Jack gave the bag another squeeze. “Glad we got the tube in, though. She’s quitting on us now.”

No, please don’t die.
Riley slid her gloved fingers quickly under the patient’s jaw. “Pulse is there, but it’s faster now, a little thready.” She looked down at the girl’s too-pale face. “She’s so young. All made up to look older, but I don’t think she’s more than a teenager. How could she end up—?” She heard Jack’s smothered curse. The hostility in his eyes chilled her.

“Runaway,” he growled, a muscle on his jaw bunching. “Put to work by any one of a dozen ruthless pimps who make it their business to ‘rescue’ these poor kids. I see it way too often. Most of the girls are barely fifteen years old, maybe thousands of miles from home. And scared. They’ll come here if they’re sick or hurt, knowing they don’t have to provide documentation the way they do at the hospital. I try to—”

A police officer stepped close. “I’m going to move aside for the medics, but any chance you could check for some ID on this girl?”

Riley nodded. “There wasn’t a purse, but I’ll check her pockets.”

“Careful,” Jack warned quickly. “Could be needles.”

Needles?
Riley swallowed, trying not to imagine what her parents would think of this situation. She warily patted the pockets of the girl’s raincoat. “Nothing here. Let me check her pants.”

She undid the coat’s remaining buttons, swept the thin fabric aside.

Riley gasped. “She’s pregnant—and there’s a lot of blood down here.”

“Medics coming through!”

In mere moments the paramedics surrounded the patient, taking over with the Ambu bag and obtaining a report from Jack. The clinic’s once-homey parlor was a sea of uniforms as police mingled with fire rescue, boots thumping across the hardwood floor and radios squawking. Within four minutes “Jane Doe” had two IVs, automatic blood pressure and pulse oximetry equipment, as well as a cardiac monitor. She was scooped up with cervical spine precautions and high-flow oxygen continuous.

Riley winced at the sight of her lying on the stretcher. A discarded, broken doll, glittery raincoat snipped into tatters.
Little Tinker Bell . . .

The ambulance pulled away from the clinic parking lot with lights and siren, blasting its horn when a gathering crowd of onlookers was slow to yield the right of way.

Father, go with . . . her.

Riley stood alone in the quiet vacuum of the waiting room, wishing she knew the girl’s name so she could add it to her prayer. She wondered if what Jack had said was true, that Jane was a runaway turned prostitute. Or if the girl had instead been a victim of a brutal assault by a stranger. Riley trembled, her teeth beginning to chatter.

“Here, take these,” Jack said, arriving beside her with a set of scrubs. “You can change in the hall bathroom. Bandy will find you a plastic sack for those clothes.” He pointed at her suit. “Don’t think you want to go out of here like that.”

Riley noticed for the first time that her linen jacket, shirt, and the knees of her slacks were stained with blood. She shivered again, remembering the clotting puddle under the girl’s narrow hips. Had she been kicked in the abdomen? She must have been scared to death. Riley’s stomach lurched. She pressed the back of her hand to her mouth and breathed slowly through her nose to dispel the haunting scent of the dank hospital garage, the memory of merciless hands around her throat.
No, don’t start remembering . . .

“Thanks,” she said finally, reaching for the scrubs. “Are you going to the hospital?”

“No.” Jack studied her face for a few seconds, concern in his expression. “I called and spoke with the ER doc, reported what I know. We’ll have patients to see here in a few minutes if they aren’t frightened off by the police cars. If we get clearance, Bandy will set it up so that we can guide patients in through the back door and not disturb the detectives.” He frowned. “Two investigations in a week.”

Riley glanced down at the littered floor. “They’re taking her to Alamo Grace?”

“Yes. It’s closest and they’re equipped to handle high-risk obstetric cases. From the look of her, I’d say she could be seven or eight months along. Certainly viable if the trauma didn’t—” Jack’s fists clenched, the earlier anger back. “Beating a pregnant girl! The cowardly, low-life son of a—” He bit off the words.

Riley shifted the scrubs in her arms. “So . . . I change in the bathroom?”

“Second door on the right.”

“Thanks. I think I’ll go on to the ER. See how she’s doing.”

“Yeah, well . . .” Jack dragged his fingers across his jaw, met her gaze. “Don’t take this the wrong way, but that’s probably a good idea. I’m afraid our Jane Doe is going to need a chaplain much more than a doctor.”

Heart cramping, Riley turned away and walked toward the inner hallway.

“Riley?”

She paused.

“This isn’t our normal day. But all things considered, will you be back? To work?”

“I . . .” Riley was quiet for a moment, hearing the distant, clattering sound of Bandy in the kitchen making another pot of coffee for the investigating officers. She glanced at her jacket sleeve, stiff with blood, before meeting Jack’s gaze. “I’ll be back to return the scrubs. I’ll let you know then.”

* * *

Thank heaven . . .

Vesta followed the fire truck with her binoculars—a limited glimpse, but long enough to see that it was heading back to the station. The truck’s short turnaround time and the fact that she hadn’t smelled smoke on the trek around her secluded yard meant fire wasn’t an issue this time. The crew had no doubt been dispatched as first responders . . . for that poor girl.
Oh, dear Lord.

Vesta set the binoculars on the windowsill and fought a chill. Attempted murder half a block away. According to the action committee. She glanced at the screen of her laptop, the urgent mass mailing from Andrea Nichols still open:

Bluffs neighbors:

I feel it my duty to inform you that today a teenage girl was beaten and left near death at the free clinic. It’s entirely possible that this victim suffered her critical injuries on that property, as did the vagrant who was burned only a few days ago. I’m sure none of you need to be reminded how close the property is to our homes. Our safety is at risk. As are the tender psyches of our children. Dr. Jack Travis treated this girl on the clinic porch in full view of impressionable Bluffs youngsters! Yet another example of his reckless insensitivity. I urge you to be present at the upcoming special city council meeting, which will convene to hear arguments in favor of closing the clinic. I will be sending out reminders. Remember, too, that tickets are still available for Fashion Fiesta, the spring style show featuring clothing and accessories from Bunny Merrit’s darling new dress shop. A portion of the proceeds will benefit local charities. A worthy cause, dear neighbors.

Vesta closed the laptop, groaning at the obvious, sad irony.

She settled into the rose plaid chair near the window, reached for her tea, and then glimpsed a colorful flurry of feathers in the redbud tree. She snatched up her binoculars and adjusted the focus. She hoped it was a painted bunting—vivid scarlet beneath, blue head, brilliant yellow-green on top, black wing bars, red-circled eyes. In her opinion, the most beautiful of Texas birds. Vesta needed that joy right now, because . . .

No. Don’t remember.

She shoved the ugly images down, refusing to let them bring suffocating panic again. She shifted the glasses, switched her focus to another graceful tree branch, and scanned its lush, round foliage, still needing the bunting’s jewel-bright and elusive joy. And a merciful distraction from the frightening truth: today’s incident wasn’t Jack Travis’s first brush with murderous violence.

* * *

Riley parked the car and headed to one of the hospital’s side doors, the same entrance she’d used the day she made a fool of herself shrieking at the grackles . . . and at Jack Travis. That had been only two days ago, but it seemed so much longer. Especially after all that had happened today. She glanced toward the emergency department’s ambulance bay and saw the advanced-life-support rig parked close, metal scoop stretcher leaning against its open back doors. A medic she recognized from the clinic sprayed it with a bottle of disinfectant, scrubbing away the blood. Two SAPD patrol cars were parked nearby, officers still hoping to ID the young victim, no doubt. And waiting to see if her assailant could be charged with murder.

If they ever catch him. . . . They don’t always catch them.

Riley shivered and entered the door’s security code. In moments she’d covered the stretch of corridors leading to the ER to find Kate outside the trauma room. Her expression was grim, and she did a double take when she saw Riley.

“Scrubs?”

“I was at the clinic when . . .” Riley glanced toward the trauma room’s closed double doors, heard the telltale
whoosh-sigh
of a ventilator, monitor beeps, and a chorus of staff voices, some reporting numbers, others barking curt orders. “I went there for a tour. Ended up helping with the resuscitation. I changed my clothes afterward because—” Riley stopped short, noticing the deepening distress in the charge nurse’s expression. “Are you okay?”

“Fine,” Kate said quickly, dragging her fingers through her short hair. “Completely.” She forced a smile that did nothing to dispel the troubled look in her eyes. “Skipped lunch. I’ll grab some coffee after we finish in there—rough case. But we’ve got it under control.”

“What have you found?”

Kate’s lips pinched together. “Still unresponsive, Glasgow scale maybe 5 at best. Neck’s not fractured. So we reintubated her, put her on the vent. Doctor says he found an area on her scalp that’s ‘mushy as a ripe melon.’ Depressed skull fracture, he thinks. And probably an extensive brain injury. The neurosurgeon’s champing at the bit, but things are doubly complicated because—” Kate winced—“there’s a live baby despite the belly trauma. And it’s stressed with all that bleeding. The perinatologist wants that baby out, stat. So the plan is—” She stopped as the trauma doors slammed open behind them.

“Let’s roll, guys. Coming through!” an ER tech shouted.

Riley stepped aside and Kate moved to help as the gurney, squeaking and clattering, burst from the room. A respiratory therapist squeezed the Ambu bag, and IVs swung above pole-mounted pumps—one infusing dark blood. Riley watched as a flurry of scrubs followed, a faded rainbow of colors representing ER, OR, OB, neurosurgery, and neonatal ICU. All focused on the nameless patient, no more than a child, deathly pale, deeply unconscious . . . and barely clinging to life.

She turned as Kate reappeared beside her. “Emergency cesarean?”

“Yes. And then she goes immediately into the hands of neurosurgery.”

And God.
“Did the police make an identification?”

“Still Jane Doe so far. They said they’d get fingerprints, DNA. The TV news will broadcast a general description, and the police are going door to door in neighborhoods adjacent to the clinic.”

The Bluffs residents will love that.
“Jack thinks she’s a runaway.”

“Mmm.” Kate cleared her throat, then tugged at her wispy hairline, face paling enough to make her freckles stand out.

“Whoa there.” Riley touched her arm. “You don’t look so good. Let’s go to the lounge and sit down for a few minutes. Find you something to eat.”

“No.” Kate’s hand fluttered across her stomach. “Couldn’t eat anything. Not now. And I should check on the rest of the staff.”

“Kate, I want to do something to help you. Let me.”

“You can’t. Really. I’m fine.”

“Well . . .” Riley hesitated, telling herself not to push her stoic friend. “I’ll bring you some coffee—with enough cream and sugar to qualify as Southern pudding.” She smiled gently. “Now don’t you argue with Rah-lee, hear?”

“I hear,” Kate said, trying to smile.

Riley squeezed her friend’s hand, then turned toward the hallway. She hadn’t taken more than a few steps when Kate called her name.

“Maybe you
can
do something.”

“Anything—name it.”

“Pray they find that girl’s family. She’s just a kid. And no matter how badly she’s screwed up her life, no matter
what
she’s done . . .” Kate shivered. “That little baby shouldn’t be handed over to strangers . . . tossed away like table scraps. He should have a chance to know his family.”

Tossed away?
Riley had no idea where that had come from but knew she should tread carefully. She wanted to fold Kate into a hug, but her friend would resist just as stubbornly as she was fighting to hold back the tears shimmering in her eyes. Riley nodded. “I’ll go to the chapel—right after I bring that coffee.”