even other departments send down whoever is free to assist. We need to go.”
She stopped everything, maybe even breathing, for long enough that he had to look at her and found her eyes too wide again. And focused on him.
This was a mistake. She wasn’t up for this.
Her eyes were rich chocolate, and the innocence he saw sucked him in. He protected others from danger, should he be protecting patients from her? Or her from rushing into the deep end before he knew she could swim?
Whatever she was thinking passed, and it really had only been a couple of seconds before she started moving again, tugging her shirt in place and thrusting her hand into his locker to grab her stethoscope, a pen and her phone from her bag.
“I’m ready.”
Another lie. But then again, it was the same lie he told himself every morning at the start of shift, when the double doors that cordoned off Emergency from the rest of the hospital felt like gates to a bloody battlefield where he was going to drag off bodies.
No. She wasn’t ready. But he didn’t have time to coddle her.
As soon as they hit the hallway, he sped up to run down the three turns it took to reach Emergency, with her following close behind.
Another thing he had no time for: dropping her off with Backeljauw to find a new sitter. That would have to come later.
No sooner had he reached the monitoring station than he had to step aside for a stretcher and team to roll past. The man on the stretcher had dark red compresses and bandages held to his abdomen. Conley headed the team, but, seeing him, nodded, which he took as a request to follow.
“Sabetta.” He said her name, leaving her to figure out what she was supposed to do, and hurried off with the team.
Abdominal bleeding. A mass event. His mind could supply only one cause. Was this it, what his gut had been warning him about?
“Was it a shooting?” he asked Conley when he caught up, prompting her to begin her report there, since she was obviously wanting to hand the patient off. Pediatric emergencies were a little different from this kind of trauma.
A look flashed across her bonnie freckled face, confusion and then sympathy, but she shook her head. “Subway derailed. Yours is in triage.”
She knew. His brother had obviously been sharing, and Lyons didn’t have the mental currency left to be angry about it.
Derailment. That could still be a man-made incident, but it wasn’t a gun. It couldn’t follow into the department and begin attacking personnel, unless it had been orchestrated and was the first step in a larger plan.
He turned, nearly trampling his unfortunate shadow, and had to grab her shoulders to stop them both making more of a mess of this. She grabbed his forearms in return, back to the wild-eyed stare as he took a breath and put her to the side to step around.
He pushed the tingle spreading from the center of his palms and hot on his arms from his head and jogged to meet the next stretcher coming out of triage.
Tingles didn’t matter. The delicate, fragile-feeling slender shoulders on his new colleague didn’t matter either. His too-young new colleague.
She kept up this time.
“What have we got?” he asked the nurses and paramedics rolling with his new patient.
“He was standing, and when it jumped track, he flew. Person from behind him hit him right after.”
Crushing damage.
“Name?” Sabetta asked, reaching for the chart as they ran alongside the stretcher.
“Samuel Riggs.”
“Mr. Riggs?” she called in his ear but got no response. “How long has he been unconscious?”
“Since it happened, probably. Uneven pupils, he’s breathing too fast. Tachycardic,” one of the paramedics filled in as they wheeled into the treatment bay.
“Get his shirt off.” Lyons gloved and reached for his stethoscope.
She beat him to it, listening to the patient’s heart while the others in the team fell in, taking the steps he didn’t even need to order at this point. Get an IV started. Hook up the telemetry to monitor vitals.
A good sign, not freezing up as he’d half expected.
“Get a blood workup,” he ordered, joining her in listening to the man’s heart and lungs.
She’d grown a bit paler than she’d been, but that wasn’t unusual for first-timers.
“Thoughts?” That would tell him more than blanching.
“His pulse is far too rapid,” she answered, backing up the paramedic’s report. “And he’s heavily bruised. There’s also a substantial lump on his head that I can see. If his pupils are unreactive, he needs a CT.”
This was easier, working with a critical patient to take his focus.
Lyons listened again. Everyone breathed faster when tachycardic. The heart didn’t pump blood and circulate oxygen efficiently, which caused the body’s natural remedies to kick in, even if they couldn’t help. He breathed faster naturally because his heart beat faster, it just didn’t help.
“What’s his pressure?”
One of his nurses took it manually while another worked on the telemetry and read off numbers far too low for his liking. She’d gotten the obvious things, and this wasn’t a teaching hospital, but it was his hospital, and he needed to know his peers could handle themselves.
“What do you want to check?” He knew what he wanted to check, but he’d give her one shot since all the techs should be descending on the room any minute.
“Rapid heart and low blood pressure, along with all this bruising from the impact. I’d want to check for internal bleeding.” She shook her head as she said it, as if she knew the answer was wrong, but stuck with it. “The head trauma is separate.”
Right about the head trauma, wrong about the internal bleeding—which, while probably present, wasn’t the most immediate danger to life.
“Look at his oxygen levels.” He indicated with a nod.
A number in the high eighties; he could tell by her expression that she recognized it wasn’t good.
“What tests?” he asked, giving her another shot.
“Typing for possible transfusion, a CBC, maybe troponin levels?”
Sticking with bleeding, but with a twist?
“Testing for heart attack?”
Wrong.
“All heart damage causes the same enzymes to release.”
He waited for her to listen to the patient’s chest one more time, still not leading.
She placed the bell to the man’s chest and listened, but not to his lungs. Just his heart. It was the obvious symptom, the flashy thing demanding attention. When she commented again, it was on the speed, and shouldn’t they slow it down? She’d somehow managed to miss that distinctive crackling sound his lungs made upon inspiration.
She’d said she normally worked Urgent Care facilities, not places that saw much active emergency. She wasn’t ready for this, so out of her depth it was almost laughable. When he spoke to Backeljauw, he’d suggest she be shifted to the non-emergency cases.
“I want a CT, head and chest. Image and circulation.” He directed his team. “And a blood panel. At least one lung has been damaged. I want a D-dimer.”
“For clotting?” she asked.
“Go back to the station and wait.” He grabbed his comm to suggest to Imaging that they hurry the hell up, but as she stood,