Undone (4 page)

Instead of going back into the doctors’ lounge to finish her charts, Sara walked past the nurses’ station, through the double doors, into the overfilled waiting room and finally found herself outside. There were a couple of respiratory therapists by the exit smoking cigarettes, so Sara kept walking toward the back of the building. Guilt about Faith Mitchell still hung heavy on her shoulders, and she looked up Delia Wallace’s number in her cell phone before she forgot to follow up. The service took her message about Faith, and Sara felt slightly better as she ended the call.

She had run into Delia Wallace a couple of months ago, when the woman had come in to see one of her wealthy patients who had been airlifted to Grady after a bad car accident. Delia and Sara had been the only women in the top five percent of their graduating class at Emory University Medical School. At the time, it was an unwritten rule that there were two options for female doctors: gynecology or pediatrics. Delia had chosen the first, Sara the latter. They would both turn forty next year. Delia seemed to have everything. Sara felt like she had nothing.

Most doctors — Sara included — were arrogant to one degree or another, but Delia had always been an avid self-promoter. While they drank their coffees in the doctors’ lounge, Delia quickly offered the highlights of her life: a thriving practice with two offices, a stockbroker husband and three overachieving kids. She’d shown Sara pictures of them all, this perfect family of hers who looked as if they had walked out of a Ralph Lauren advertisement.

Sara hadn’t told Delia about her own life after medical school, that she had gone back to Grant County, her home, to tend to children in rural areas. She didn’t tell Delia about Jeffrey or why she moved back to Atlanta or why she was working at Grady when she could open her own practice and have some semblance of a normal life. Sara had just shrugged, saying, “I ended up back here,” and Delia had looked at her with both disappointment and vindication, both emotions conjured by the fact that Sara had been ahead of Delia their entire time at Emory.

Sara tucked her hands into her pockets, pulling her thin coat closed to fight the chill. She felt the letter against the back of her hand as she walked past the loading dock. She had volunteered to cover an extra shift that morning, working straight through for nearly sixteen hours so that she could have all of tomorrow off. Exhaustion hit her just as the night air did, and she stood with her hands fisted in her pockets, relishing the relatively clean air in her lungs. She caught the scent of rain under the smell of car exhaust and whatever was coming off the Dumpster. Maybe she would sleep tonight. She always slept better when it rained.

She looked down at the cars on the interstate. Rush hour was at its tail end — men and women going home to their families, their lives. Sara was standing at what was called the Grady Curve, an arc in the highway that traffic reporters used as a landmark when reporting trouble on the downtown connector. All the taillights were bright red tonight as a tow truck pulled a stalled SUV from the left-hand shoulder. Police cruisers blocked the scene, blue lights spinning, casting their eerie light into the darkness. They reminded her of the night Jeffrey had died — the police swarming, the state taking over, the scene combed through by dozens of men in their white suits and booties.

“Sara?”

She turned around. Mary stood with the door open, waving her back into the building. “Hurry!”

Sara jogged toward the door, Mary calling out stats as she got closer. “Single car MVA with pedestrian on foot. Krakauer took the driver and passenger, possible MI on the driver. You’ve got the woman who was hit by the car. Open frac on right arm and leg, L-O-C at the scene. Possible sexual assault and torture. Bystander happened to be an EMT. He did what he could, but it’s bad.”

Sara was sure she’d misunderstood. “She was raped and hit by a car?”

Mary didn’t explain. Her hand was like a vise on Sara’s arm as they jogged down the hallway. The door was open to the emergency triage room. Sara saw the gurney, three medics surrounding the patient. Everyone in the room was a man, including Will Trent, who was leaning over the woman, trying to question her.

“Can you tell me your name?” he asked.

Sara stopped short at the foot of the bed, Mary’s hand still on her arm. The patient was lying curled on her side in a fetal position. Surgical tape held her tightly to the frame of the stretcher, pneumatic splints binding her right arm and leg. She was awake, her teeth chattering, murmuring unintelligibly. A folded jacket was under her head, a cervical collar keeping her neck in line. The side of her face was caked in dirt and blood; electrical tape hung from her cheek, sticking to her dark hair. Her mouth was open, lips cut and bleeding. The sheet they had covered her with was pulled down and the side of her breast gaped open in a wound so deep that bright yellow fat was showing.

“Ma’am?” Will asked. “Are you aware of your condition?”

“Move away,” Sara ordered, pushing him back harder than she intended. He flailed, momentarily losing his balance. Sara did not care. She had seen the small digital recorder he had in his hand and did not like what he was doing.

Sara put on a pair of gloves as she knelt down, telling the woman, “I’m Dr. Linton. You’re at Grady Hospital. We’re going to take care of you.”

“Help… help… help…” the woman chanted, her body shivering so hard the metal gurney rattled. Her eyes stared blankly ahead, unfocused. She was painfully thin, her skin flaky and dry. “Help…”

Sara stroked back her hair as gently as she could. “We’ve got a lot of people here and we’re all going to help you. You just hang on for me, okay? You’re safe now.” Sara stood, lightly resting her hand on the woman’s shoulder to let her know she was not alone. Two more nurses were in the room, awaiting orders. “Somebody give me the rundown.”

She had directed her request toward the uniformed emergency medical techs, but the man across from her started talking, delivering in rapid staccato the woman’s vitals and the triage performed en route. He was dressed in street clothes that were covered in blood. Probably the bystander who had given aid at the scene. “Penetrating wound between eleventh and twelfth ribs. Open fractures right arm and leg. Blunt force trauma to the head. She was unconscious when we arrived, but she gained consciousness when I started working on her. We couldn’t get her flat on her back,” he explained, his voice filling with panic. “She kept screaming. We had to get her in the bus, so we just strapped her down. I don’t know what’s wrong with… I don’t know what—”

He gulped back a sob. His anguish was contagious. The air felt charged with adrenaline; understandably so, considering the state of the victim. Sara felt a moment of panic herself, unable to take in the damage inflicted on the body, the multiple wounds, the obvious signs of torture. More than one person in the room had tears in their eyes.

Sara made her voice as calm as possible, trying to bring the hysteria down to a manageable level. She dismissed the EMTs and the bystander by saying, “Thank you, gentlemen. You did everything you could just to get her here. Let’s clear the room now so that we have space to keep helping her.” She told Mary, “Start an IV and prep a central line just in case.” She told another nurse, “Get portable X-ray in here, call CT and get the surgical on-call.” And said to another, “Blood gas, tox screen, CMP, CBC, and a coag panel.”

Carefully, Sara pressed the stethoscope to the woman’s back, trying not to concentrate on the burn marks and crisscrossed slices in the flesh. She listened to the woman’s lungs, feeling the sharp outline of ribs against her fingers. Breath sounds were equal, but not as strong as Sara would’ve liked, probably because of the massive amount of morphine they had given her in the ambulance. Panic often blurred the line between helping and hindering.

Sara knelt down again. The woman’s eyes were still open, her teeth still chattering. Sara told her, “If you have any trouble breathing, let me know, and I’ll help you immediately. All right? Can you do that?” There was no response, but Sara kept talking to her anyway, announcing every step of the way what she was doing and why. “I’m checking your airway to make sure you can keep breathing,” she said, gently pressing into the jaw. The woman’s teeth were reddish pink, indicating blood in her mouth, but Sara guessed that was from biting her tongue. Deep scratches marked her face, as if someone had clawed her. Sara thought she might have to intubate her, paralyze her, but this might be the last opportunity the woman had to speak.

That was why Will Trent would not leave. He had been asking the victim about her condition in order to set up the framework for a dying declaration. The victim would have to know she was dying before her last words could be admitted in court as anything other than hearsay. Even now, Trent kept his back to the wall, listening to every word being spoken in the room, bearing witness in case he was needed to testify.

Sara asked, “Ma’am? Can you tell me your name?” Sara paused as the woman’s mouth moved, but no words came out. “Just a first name, all right? Let’s start with something easy.”

“Ah… ah…”

“Anne?”

“Nah… nah…”

“Anna?”

The woman closed her eyes, gave a slight nod. Her breath had turned more shallow from the effort.

Sara tried, “How about a last name?”

The woman did not respond.

“All right, Anna. That’s fine. Just stay with me.” Sara glanced at Will Trent. He nodded his thanks. She returned to the patient, checking her pupils, pressing her fingers into the skull to check for fractures. “You’ve got some blood in your ears, Anna. You took a hard knock to your head.” Sara took a wet swab and brushed it across the woman’s face to remove some of the dried blood. “I know you’re still in there, Anna. Just hang on for me.”

With care, Sara traced her fingers down the neck and shoulder, feeling the clavicle move. She continued down gently, checking the shoulders front and back, then the vertebrae. The woman was painfully undernourished, the bones starkly outlined, her skeleton on display. There were tears in the skin, as if barbs or hooks had been imbedded under the flesh, then ripped out. Superficial cuts sliced their way up and down the body, and the long incision on the breast already smelled septic; she had been like this for days.

Mary said, “IV’s in, saline wide open.”

Sara asked Will Trent, “See the doctors’ directory by the phone?” He nodded. “Page Phil Sanderson. Tell him we need him down here immediately.”

He hesitated. “I’ll go find him.”

Mary supplied, “It’s faster to page him. Extension 392.” She taped a loop from the IV to the back of the woman’s hand, asking Sara, “You want more morphine on board?”

“Let’s figure out what’s going on with her first.” Sara tried to examine the woman’s torso, not wanting to move the body until she knew exactly what she was dealing with. There was a gaping hole in her left side between the eleventh and twelfth ribs, which would explain why the woman had screamed when they tried to straighten her out. The stretching and grinding of torn muscle and cartilage would have been excruciating.

The EMT had put a compression pack on her right leg and arm along with two pneumatic splints to keep the limbs stabilized. Sara lifted the sterile dressing on the leg, seeing bright bone. The pelvis felt unstable beneath her hands. These were recent wounds. The car must have hit Anna from the right side, folding her in two.

Sara took a pair of scissors out of her pocket and cut through the tape that kept the woman immobile on the gurney, explaining, “Anna, I’m going to roll you onto your back.” She braced the woman’s neck and shoulders while Mary took care of the pelvis and legs. “We’ll keep your legs bent, but we need to—”

“No-no-no!” the woman pleaded. “Please don’t! Please don’t!” They kept moving and her mouth opened wide, her screams sending a chill up Sara’s spine. She had never heard anything more horrific in her life. “No!” the woman yelled, her voice catching. “No! Please!
Noooo!”

She started to violently convulse. Instantly, Sara leaned over the stretcher, pinning Anna’s body to the table so she wouldn’t fall onto the floor. She could hear the woman grunt with each convulsion, as every movement brought a knife of pain to her side. “Five milligrams of Ativan,” she ordered, hoping to control the seizures. “Stay with me, Anna,” she urged the woman. “Just stay with me.”

Sara’s words did not matter. The woman had lost consciousness, either from the seizure or the pain. Long after the drug should have taken effect, the muscles still spasmed through the body, legs jerking, head shaking.

“Portable’s here,” Mary announced, motioning the X-ray technician into the room. She told Sara, “I’ll check on Sanderson and the OR.”

The X-ray technician put his hand to his chest. “Macon.”

“Sara,” she returned. “I’ll help.”

He handed her the extra lead apron, then went about preparing the machine. Sara kept her hand on Anna’s forehead, stroking back her dark hair. The woman’s muscles were still twitching when Sara and Macon managed to roll her onto her back, legs bent to help control the pain. Sara noticed that Will Trent was still in the room and told him, “You need to clear out while we do this.”

Sara helped Macon take the X-rays, both of them moving as fast as they could. She prayed that the patient would not wake up and start screaming again. She could still hear the sound of Anna’s screams, almost like an animal caught in a trap. The noise alone would set up the belief that the woman knew she was going to die. You did not scream like that unless you had given up all hope on life.

Macon helped Sara turn the woman back on her side, then went off to develop the films. Sara took off her gloves and knelt beside the gurney again. She touched her hand to Anna’s face, stroking her cheek. “I’m sorry I pushed you,” she said — not to Anna, but to Will Trent. She turned to find him standing at the foot of the bed, staring down at the woman’s legs, the soles of her feet. His jaw was clenched, but she didn’t know if that was from anger or horror or both.

He said, “We’ve both got jobs to do.”