explain how the equipment worked, how the blades shredded the corn and blew it into the silo, how sometimes a piece got fouled up and needed an extra push with the next stalk in line. From the look on the woman’s face, he could tell his explanation was as incomprehensible to her as her medical jargon was to him. Another thing he could see on her face was the real question, the one she would not ask.
How could you let a child work around such dangerous equipment?
Caleb couldn’t even answer that for himself. It was the way things had always been done on the farm. From the time they learned to walk, kids helped out. The tiniest ones fed chickens and ducks, weeded the garden, picked tomatoes and beans. When a boy got older, he helped with plow and harrow, the hay baler, sheaves, fetching and carrying from the milk house, anything that needed doing. It was the Amish way. And the Amish way was to never question tradition.
He tried to check on his nephew, but there was little of Jonah to see amid the tangle of tubes and wires and the guy squeezing the big plastic bulb into the boy’s nose and mouth. The chopper veered again, and the landscape quickly changed. Philadelphia was a bristling maze of steel and concrete giants arranged along the wide river and other waterways. The city had its own kind of strange beauty, made up of crazy angles and busy roads. Atop one of the buildings, a series of markings seemed to pull the chopper from the sky like a magnet.
“They’re going to do a hot unload,” the nurse explained. “They’ll get him out even before the chopper stops. You just wait until it stops, and the pilot will tell you when it’s safe to get out.”
“Got it.” Caleb was startled when he looked down and saw that his hat was still clutched in his bloody hand.
His other hand lay on the blanket covering Jonah’s bony bare foot. Please, Jonah, he said without speaking. Don’t die on me.
The Amish never prayed aloud except at meeting. They were a people of long, meditative silences that made folks think they were slow-witted. Caleb begged, with wordless contemplation, for mercy for his nephew.
He’s only a little boy. He sings to the ducks when he feeds them in the morning. He sleeps with his dog at the foot of his bed. Every time he smiles, the sun comes out. His laughter reminds me that life is beautiful. I can’t lose him. I can’t. Not my Jonah-boy.
Caleb was praying for the first time in years. But for him, prayer had always been like shouting down a well. Your own words were echoed back at you. Only the truly faithful believed someone was actually there on the other end, listening.
In Philly, traumas were plentiful and Reese had attended her share. Gunshot wounds, stabbings, and automobile wrecks accounted for most of them. But every once in a while, something new and unexpected came through the heavy doors of the trauma bay—a guy crushed in a logrolling contest. A window washer who had fallen from a scaffold. A skydiver whose chute hadn’t opened properly in midair and who had hit the ground at seventy-five miles per hour.
The dramatic, over-the-top traumas had a peculiar effect on the team. Everyone felt the sting of the razor’s edge, reminding them that anyone could be a hair’s breadth from death. The sole purpose of the team was to reel the victim back from tragedy.
According to the advance reports coming from the life flight crew, this boy, too, balanced on the edge. On the one hand, he was young and strong and in a good general health. But on the other, he had suffered a devastating injury and had lost a lot of blood. If the shock didn’t kill him, sepsis or secondary injuries could.
“They’re bringing him down now,” the lead trauma nurse reported.
“Get ready, people,” Jack added. The trauma chief worked the team like a drill sergeant, preparing the high-tech bay with painstaking attention to detail—airway, IV, monitoring equipment, essential personnel, lab and radiology backup. With everything in readiness, the area resembled the inside of a strange, futuristic cathedral, the bed in the center like an altar where victims were brought forth to appease a pantheon of wrathful gods.
The last moments were silent, team members’ minds weighted by the tension of expectation while their bodies were physically weighted by the heavy purple X-ray vests. Everyone was alone with their thoughts—the team leader, primary physician, airway team, nurses and patient care techs, radiology tech, CT, pharmacy, recorder, support staff, chaplain. Reese imagined that some were praying. She herself clung to her mantra: do right.
The team members stood poised in their designated positions. Reese felt a surge of adrenaline course through her, starting in her chest and spreading like a drug through her neck and shoulders, arms and legs. She understood the physiology of the human body, but no textbook could adequately describe certain things—the heady rush of anticipation, for one thing.
Stone-cold fear, for another.
During this rotation, she was learning that in a trauma situation, there was almost no time to think. Though her head was crammed with facts and procedures, she shut down everything except that which would help the patient. In a trauma, she didn’t feel hunger or fatigue or even the need for the bathroom. She got so focused that she didn’t even feel emotion, which worried her.
Mel said it was a good thing. When a patient was coded, the doctor needed cold algorithms, not empathy. He’d told her to consider a residency in trauma, but she had dismissed the suggestion. That wasn’t where she was headed.
But in moments like this, she caught herself reconsidering.
“Keep an eye on Jack,” Mel murmured in her ear. “Watch and learn. He is the maestro.”
Reese nodded. There were a few more moments of breath-held anticipation, tingling with the awareness that everything was about to change. Then the wire mesh doors exploded open with a loud thud, and the patient arrived.
“Coming through,” someone said, walking backward and pulling the gurney along a hallway marked with a red line on the floor and the words All Trauma. “Clear a path.” More paramedics ran with the stretcher between them, preparing for the transition into the trauma bay. Reese craned her neck but couldn’t see the boy amid the cluster of personnel and equipment—just an oversize C-collar and two vacuum-splints painted with fresh blood.
Behind the stretcher was a man so large he dwarfed everyone else. His shirt and hands were covered in blood. Beneath a dramatic wave of golden blond hair, his expression was a mask of agonized worry—a guy facing every parent’s worst nightmare.
The stretcher was angled into the middle of the trauma bay and the team went to work.
“How’s he holding up?” Jack asked, positioning himself at the foot of the bed.
“Not so hot.” Irene, the life flight nurse, stepped back from the rig, consulted dual tablets, and gave a swift MIVT report—mechanism, injuries, vitals, treatment. She stated that the boy had been given blood agents to lower the risk of hemorrhage. Monitors beeped and screeched off-key as the patient was transferred to the X-ray table. In the corner, a server’s lights flashed green and gold.
Reese tried to make out his features with the clear mask cupped over his nose and mouth. Deep lacerations slashed one cheek, as though he’d been clawed by a huge bear. His eyes were blue, darting from side to side.
“Dear God,” she whispered. “He’s conscious.”
“Been that way since it happened,” Irene said. “You’re an amazing guy, Jonah. You’re doing great.”
“I’m Dr. Tillis,” Jack said, looking straight down into the kid’s face. “We’re going to take good care of you.”
The boy’s lips moved inside the mask, fogging the plastic. He wasn’t crying. Reese suspected that shock had pushed him well past that point.
“Right,” said Jack. “Let’s have a look at that arm.”
The