remain where they fall. Black tags—those expected to die within ten minutes or less are given palliative care to reduce suffering, but are likely to die of their injuries.” Her voice became more clinical as she continued. He understood. It was vital to separate emotions from actions at times like these. She sucked in a breath and continued. “Immediate evacuation for the red tags—medevac if possible. Do you think they’ll come? The helicopters?” She turned in her seat to face him.
“Absolutely. They’re probably en route already. Keep going,” he said, encouraged to hear her voice becoming calmer the more she reminded herself how much she did know.
“Ah, delayed or yellow tags can have delayed evacuation—that is, they can’t go until everyone who has critical injuries has been transported.”
“And the green tags?”
“Last in line, but need constant checking in case their condition changes and they require retriaging.” She sat back with a triumphant smile, which immediately dropped from her face as the accident scene came into view.
Santi’s low whistle reflected what she felt. Impressive was the wrong word to describe what they saw. Overwhelming was coming close.
The fog that had enshrouded the causeway was clearing to reveal something more akin to a horror scene. Passengers and drivers were staggering out of vehicles. A fuel truck was jackknifed across three lanes of traffic, flames reaching higher with each passing moment. A couple of fire trucks and a rescue team were already on-site, doing their best to clear people as far away from the fuel truck as possible, columns of black smoke scalding the sky above them. The scream and roar of their equipment releasing trapped passengers from their vehicles was all but drowning out the cries for help.
Santi pulled their ambulance onto the edge of the causeway at the direction of a stressed-looking sheriff.
“Where do you want us?”
“Check with the Fire Rescue Squad. They were here first and know their way around an MCI better than anyone.”
Santi and Saoirse each shouldered medical run bags, putting as many supplies as they could on their wheeled gurney, and ran into the depths of the scene.
“Over here! We need someone on the red tags until the medevac arrives!” A paramedic from the fire crew directed them to a huge red sheet where four people were laid out and another was on approach. “Can you start here? Compound tib-fib, arterial bleed. I’m afraid you’ll have to do the rest.” And he ran off into the choking fug of smoke and flames.
Santi dropped to his knees next to the unconscious patient, signaling to Saoirse to do the same on the other side. She pulled out her flashlight and checked the man’s pupils for dilation. Her wrist flicked first to one eye, then the next.
“Responsive.”
“Good,” Santi muttered, his gloved fingers seeking and immediately stemming the arterial bleed in the man’s leg.
The compound fracture was so crudely exposed to the elements Saoirse nearly retched at the sight.
“Check airways, circulation.” Santi’s voice was steady. Reassuring. Exactly what she needed.
This was precisely what her paramedic training had prepared her for. The car racing. Moving to Miami in the first place without knowing a soul. A complete reinvention in order to handle every painful curveball life threw at her.
She looked into Santi’s eyes and felt fortified by the understanding they held, as if his strength was flowing directly into her. They would get through this. Together.
“We can do this one of two ways.” He reached across to his run bag and grabbed a clamp for the arterial bleed. “Can you get a drip going on this guy with some morphine in the bag?” Her hands flew into automatic pilot, working quickly, efficiently as she focused on what he was saying. “We can work through the patients together, like the A-team we are, or you can peel off on your own and call me if you need a hand.”
Saoirse looked up for a millisecond to gather her thoughts. Her eyes didn’t even have a chance to reach the heavens before the decision was made for her. “Sir! Stay where you are!” Seconds became nanoseconds as she swiftly checked she’d secured the saline drip for Santi’s patient. “You good here?” She received a curt nod and was up and guiding a man with a massive head wound to the large tarp for severe traumas, all the while taking in just how bad the situation unfolding around them was.
Time took on an otherworldly quality.
Head wounds were downgraded; blood flow always made them look worse than they were. A perforated lung was stabilized as best she could before a helicopter crew whisked the teenaged girl away. On Santi’s count, they stabilized then shifted a screaming middle-aged woman who’d seen her daughter being loaded onto the helicopter, the screams increasing as the extent of her pelvic injuries became clearer.
Saoirse saw herself as if from above, a whirling blur of activity matching medical supplies to patients. Neck braces. Splints. Sterile bandages. Change after change of gloves. Her stethoscope pressing to chest after chest. The sudden realization her own knees were bleeding after kneeling in glass while giving lifesaving compressions to a little boy. Heartbeat. None. Clear!
She watched as her fingers unwrapped hydrocolloidal dressing for a twenty-something woman who’d just been pulled out of a burning vehicle, inserting a saline drip, doing her best to stop the woman from going into shock as she cooled then dressed her burns, all the time murmuring soothing confirmations that she would get to a hospital. She would survive this.
A shift in the wind abruptly changed the tenor of the entire operation.
Flames, licking at the sky above them, abruptly veered toward the triage section, bringing the thick black smoke along with it and all but threatening to devour everything in its path. Sight, sound and especially smell were overwhelmed with the terrifying change of events.
She froze completely—the heat of the fire seemed to be sucking the very oxygen out of the air around her. Out of her peripheral vision Saoirse saw firefighters unleash streams of foam into the inferno, to little effect. Instinct took over. The need to survive and to help her patient took precedence.
She threw herself over her patient in an arc, only just managing to slip a space blanket between them, ironically staving off the hypothermia the burned woman might be prone to.
As she heard and felt the elements around them being fought with the incredible bravery of the fire crews, Saoirse was rocked by a revelation, then another and another. Each hit of understanding striking her in all-encompassing body blows.
With the kind of clarity one has after a weather front thunders down abruptly then shifts and clears, she saw her life for what it was. A massive move forward.
Her need to change her life had come not from heartbreak, as she’d thought, but from a deeper place. Something that had craved change. Her very essence had fought to become the woman she was now. And for the first time in her life she liked what she thought she had come to embody.
A brave, slightly lippy, kind soul. She dared to open her eyes, urgently needing to see Santi. He had helped her reach this place, to gain the newfound confidence she couldn’t have ever imagined having just nine short months ago.
Still hunched over her patient, she squinted against the soot and smoke of the accident scene. The winds had shifted again and the firefighters were mastering the blaze now. But her eyes still sought and at long last gained purchase on the only visual salve she needed... Santiago Valentino.
* * *
Santi’s eyes met Saoirse’s and the interchange of relief and untethered emotion was all but palpable. He ached to pull her into his arms, wipe the soot from her face, take her away from all of this and assure her she would always be safe as long as he lived. But there was more work to do.
He’d just begun securing a patient to a backboard when the flames threatened and he needed to act as swiftly as possible. This was one of those moments