"Years of Love have been forgotten
In the hatred of a minute." E. A. Poe
Nydia stood confidently, her hands on her hips and her chin held high, as she pulled the shield over her face. A warrior preparing to do battle, all she needed was her foe.
The door to the Emergency room burst open. A gurney being pushed by the EMTs came careening into the room. A nurse took hold of one of the rails as she directed the gurney stop in front of Nydia. A nurse took over compressing the ambubag delivering oxygen to the man lying on the stretcher.
The room around Nydia disappeared. No longer was it a room full of
people running around, instruments and carts. For her the pale blue walls and tiles vanished into nothing. Nydia focused solely on the patient in front of her.
"What's the story?" She asked the EMT closest to her as Nydia moved over to the patient to begin her initial assessment.
The female EMT called out, "MVA victim, male, was unrestrained in the vehicle. He was trapped and had to be cut out with the Jaws of Life. We found him unconscious and unresponsive on scene. He appears to have a compound fracture of the lower left extremity. There are diminished breath sounds on the right with a possible tension pneumothorax. Blood pressure is low at 70 over 40, his pulse is150 beats per minute."
Nydia looked up. "Thanks, Kate, we'll take it from here."
The ER team grabbed hold of the backboard and lifted him onto the table, being careful of the braces holding his neck and head immobile. A trauma nurse stood out of the way as she recorded the events taking place.
Nydia stepped forward eager to go headlong into the fray. "Okay, people let's get going," Nydia called out. As one, the team moved into action, hanging IV bags, hooking up the equipment, doing everything required. One of the nurses was running in catheters to allow the team to measure urine outputs and check for kidney damage. Blood was drawn to measure blood gases, cross and type match.
Nydia tuned out the din of the room and used her stethoscope to listen to his breathing. What she heard didn't please her. She could see his breathing was rapid and shallow and the sounds from his lungs were diminished. His muscles were straining to take in what air the nurse could give. "All right, we have respiratory distress. What's his blood pressure and O2 levels?" She asked the room
"His oxygen level is eighty-two percent," a nurse said.
"Blood pressure is 65 over 30," another nurse said.
The hemothorax was obvious to Nydia; his chest cavity was most likely filling with blood, forcing the lung to collapse. However, before she could do anything she needed to secure his airway. Nydia stepped up to the man's head, which was immobilized by the C-spine collar. She needed him to be able to get as much oxygen in his system as possible, and fast. Nydia reached out her hand for the intubation tools. She carefully placed the scope into his mouth and down his throat. She made sure not to pull on his neck. The last thing she needed was to cause further damage to it. Once in she introduced the tube and set in place.
Now that he was intubated and oxygen was attached, she gracefully moved to his chest. She made sure not to run into any of the people rushing about the room, even though her focus was on her patient alone. She knew her team would do most of the preliminary things without instruction.
"Blood pressure is 78 over 40.
O2 is at 85% and climbing." Trudy, the chief nurse on the team, called out.
"Make sure you draw blood gases, Trudy."
"Already on their way to the lab," Trudy said.
Nydia held out her hand, waiting for her the chest kit to be presented. Her assisting nurse placed a scalpel in one of her gloved hands.
She watched one of the nurses wash down the man's chest with disinfectant as she stood back.
Nydia stepped forward and made an incision in the side of his torso, noting that his ribs moved freely under her hand. His ribs are broken, could be the source of the hemothorax
, she thought.
Nydia reached into the incision. Once open, she spread it with her fingers to make it bigger. She reached out with her other hand and Steven gave her the chest tube and rib spreader without her asking. She made a space for the tube and began trying to get it in. Nydia felt the resistance of the chest cavity as she used her forceps to push it through. With a pop, it entered the chest cavity. Blood poured from the end onto the floor and Nydia's shoes.
"Damn it! Trudy, get a unit of O positive hung and push it through. Then lets hurry and get him cross matched." Nydia was not happy with the amount of blood coming out. She could taste the metallic smell in the back of her throat.
With the tube in, Nydia took a step back, checking for any improvement in her patient's condition. Her eyes focused on the rise and fall of the patient's chest with the flow of the ventilator. The movement was much smoother than it had been before she began her work on him.
Stepping forward, she placed the stethoscope over his lungs. She was happy to hear smooth breathing. "Okay people, now for the rest of it."
Her patient was suffering from internal bleeding. From where and how much, she couldn't tell. She needed to determine if he was stable enough to make it up to surgery. There, they could find the source of the bleeding and repair it.
"What's his blood pressure and O2 now?" she asked, eager for the answer. Nydia watched as Steve checked the pressure with the cuff while Trudy checked the oxygen levels.
"Pressure seems to be holding at 90 over 60. His O2 is at 95%," Trudy said.
"Okay, someone call surgery and make sure they're ready. They should have an Ortho to handle this leg," Nydia moved on to the next phase of her examination.
Going around the patient, she proceeded to check all his pulse points. Nydia started on his leg where the fracture was sticking out. She noted right away that the pulse in his foot was almost nonexistent. His lower leg and foot had a bluish tint to them. Pressing on the toenail, Nydia noted that the nail took several moments to regain color indicating poor blood flow. If something wasn't done soon her patient ran the risk of losing his leg.
Nydia began examining the wound itself, noting the amount of blood pushing out of it.
"What is his BP?"
"Still at 90 over 60." Trudy told her as she watched the recording nurse make the notation in the man's chart.
"It should be better than that now. What's his heart rate?"
"160 and thready."
"Shit. Okay, he's going into shock,
" Nydia said. S
he noticed the color and cool, clammy feel of his skin. "We need to get this leg taken care of. We don't have time to wait for upstairs. Sponges."
Steven handed her a series of sponges and she packed the wound. She hoped it would slow down the flow and stem the blood loss. She noticed that the flow had, in fact, decreased after a few minutes and a lot of sponges. It no longer seeped out at the rate it had been. "All right. Is his BP looking stable now?"
"It's holding steady at 100 over 60."
"And his heart rate?"
"All right, let's move him out. The faster we let Ortho fix this leg, the better his chance of keeping it."
Each member of her team grabbed a piece of equipment. They began moving him out as one cohesive unit pushing the gurney through the crowded halls.
As Nydia and her team wheeled the patient into surgery and passed him off to the surgical team, she felt a great sense of satisfaction. Nydia knew that he would walk again when all this was over because of her actions. With his pulse back she had great confidence in the Orthopedics team. She pushed the loose strands of blonde hair out of her face and walked away.
Nydia sat at the nurse's station desk with her feet on one of the chairs and a chart in her lap. It had taken her a half hour to get cleaned up from the mess of the last patient. Now she sat with her hair still damp from the shower.
She made notes on the chart concerning the patient. The station was U-shaped with a high counter under which ran a large desk space. Next to Nydia, was a stack of charts she would need to finish before the end of her shift. She supposed she could do the work in her office. However, Nydia preferred being in the middle of all the activity.
As she thought about the notations she needed to make, she twirled the pen in her fingers. Without warning her feet were pushed off the chair. Getting ready to give a piece of her mind to whoever had dared do it, she saw Trudy.
"How many times do I have to tell you not to put your damn feet on my chair?" Trudy asked with a small grin on her face.
"Well, if you didn't keep it so neat I wouldn't have anyplace to put my feet," Nydia retorted. She stood up and tried to intimidate the woman with her un-imposing five foot, four inch stature and a stern look.
Trudy laughed at Nydia's attempt. "Don't bother with that look. It may work on the others but your just wasting it here, and it's not my fault you keep your desk looking like a bomb went off in your office. It's still no reason to abuse mine."
Nydia stepped back and smiled at the nurse, holding Trudy's chair out for her. "Here. Never let it be said, I kept you from your work."
"Yeah, well the same for you. Here's a new patient for you,
" Trudy said,
handing a new chart over.
"What is it?" Nydia asked as she took the chart. She ran her free hand through her shoulder length blonde hair.
"It's a chart. A metal binder. It holds paper usually pertaining to medical information."
"Ha, ha, very funny. I mean why is the patient here?" She asked.
"She is a thirty-two year old female brought in by the police. She was hit in the head and was unconscious for approximately five minutes. The vitals are on the chart, except for one."
"Which is?" she asked as she leaned on the counter to hear what the nurse had to add.
"I don't think your husband would appreciate that observation."
"Nope, that was entirely for your benefit. I didn't want you to drool on the chart when you see her." Trudy laughed at Nydia's expense.
"You're a riot today," Nydia said, as she turned and headed to exam room three.
Nydia had her head down reading the chart as she walked into the room. Suddenly, she heard a deep, pleasant voice.
"So will I live, Doc?"
Nydia looked up into the deepest, blue eyes she had ever seen. They contrasted attractively with the straight, dark chestnut hair and olive skin. The look, combined with the statuesque features, took Nydia's breath away for a moment. Not even the hospital gown she wore could detract from her appearance. Nydia didn't realize she was staring until the woman on the exam table spoke.
"Doc, you ok? Or, does this mean I'm terminal and you're afraid to tell me?" the patient asked with a smug grin on her face.
Shaking herself out of her daze, Nydia stepped up to the table. "No, you're not terminal. At least not that I can tell. Yet. Yet, being the operative word. Let me have a look at you and we'll decide then, okay?" s
he asked as she gave the woman a wink. Did I just flirt with her? I can't believe that. Trudy would have a field day with it if she found out.
"Sure, anything you say. I just want to get out of here."
"Well, let's wait until I look you over first, before I let you go." Nydia looked down at the chart, "Ms. Powers."
"Jo. You get to call me by my first name," she said as she gave Nydia a wink of her own.
Nydia felt a warmth come over her at the idea that this woman might find her attractive. She smiled back at Jo as she took her wrist in hand to check Jo's pulse.
Next, Nydia placed the ends of the stethoscope in her ears. "I'm going to listen to your lungs. If you could just take a deep breath when I ask."
"Sure thing Doc. Anything for you." Her patient commented, with a wry grin and a mischievous twinkle in her eye.
Nydia couldn't help herself as she gave Jo a smile of her own. Nydia placed her hand on Jo's shoulder as she positioned the stethoscope on her back. Under her hand, she felt the firm muscles along Jo's broad shoulder.
As Nydia came around the front to place her instrument on Jo's chest, Nydia leaned in and listened.
Nydia realized Jo's eyes were looking at her chest and grinned.
"Is there something I can help you with?" Nydia asked as she pulled away.
A blush rose on Jo's face. "Uh, I was just wondering what the N. in N. Gilman stood for."
Nydia was surprised. Somehow I don't think she's the type to blush easily. Nope seems too much of a flirt for that
The doctor smiled at Jo.
"Well, nice to meet you, Nydia."
Nydia looked back down at the name on the chart "You too, Jocasta." Nydia let the words roll seductively off her tongue.
Jo blushed again. "My mother was a big fan of Greek tragedies."
"I love a good tragedy myself. ' Electra' is my all-time favorite."
At that comment, Jo let out a short laugh.
Nydia looked at her hoping for an explanation.
"Private joke, sorry."
Nydia re-checked the chart as she tried to pull herself back into her professional persona.
Nydia looked at the large bump on her head near the hairline. She felt around the area and noted the bruising around it. The blonde doctor pulled out her penlight and began checking Jo's eyes. "Are you feeling any numbness or weakness on your left side?"
"No, not at all." Jo responded as she lifted up her arm and made a fist.
Nydia couldn't help but admire the flex of muscle it caused. She knew she would never act on the flirting that was going on. Jo was a patient. It felt nice to engage in some harmless flirting. She found Jo attractive but, since Jo was a patient, end of story.
"How long were you unconscious?" She asked as she took her blood pressure.
"I don't know. The last thing I remember was standing and talking to Reilly."
"Do you remember getting hit?"
"No, I just remember waking up with everyone standing over me with the EMT's starting to work on me," Jo said. "But I sort of refused when they tried putting me in one of those neck contraptions and a backboard."
"Okay, well you have a nice concussion. It's not unusual for there to be a little amnesia with that. Don't worry about it. But, I would like to admit you for observation. At least overnight then we can get some x-rays to be safe," Nydia said as she made notes in the patient's chart.
"Sorry, Doc, I don't do hospitals. I'll sign whatever you need, but I have to go home."
"Jo, I don't think you realize the danger you're in. If you suddenly develop other complications you need to be in the hospital so we can deal with them. I would feel better if you were here for me to keep an eye on." Nydia told her.
"As appealing as that sounds," she said with a wink.
"I really can't stay. Just give it up, Nydia. You won't win this argument."
Nydia liked the way Jo said her name so she was willing to ignore her using it. "Is there at least someone at home that can keep an eye on you?" She was a little concerned about the sense of disappointment she knew she would feel if the answer was yes.
"Yes, I'll be under good care. I live with my mother and sister."
Nydia felt a sense of relief. "Okay, then at least let me get the x-ray and I will give you some instructions for you to take with you. You will have to sign out 'Against Medical Advice'. If you feel nauseous, dizzy, or have trouble with numbness or weakness, please come right back."
"Sure thing, Nydia. No worries."
"Well, then let's get an orderly to get you to Radiology and then you can come meet me back here. If everything checks out I'll give you everything you need to get out of here. I assume the police have already taken any information they need from you."
"Yeah, they know where to find me. No problem there."
Nydia left Jo to wait for the orderly.
Jo returned from Radiology and sat in the exam room. She had already changed out of her hospital gown and ditched her wheelchair along the way and was waiting for Nydia to return.
She could see Nydia sitting at the nurse's desk as someone handed her a large manila envelope. Nydia removed what looked to Jo to be her x-rays. Nydia was so involved in what she was doing she didn't hear Jo approach her.
"So Doc Nydia, am I ready to go?" Jo asked.
Jo noticed Nydia shiver as she spoke to her. A smile came across her face. So nice to see I can affect her like that.
Nydia turned to find Jo standing there wearing a suit with a bright gold police detective shield attached to her waist. Nydia's face paled. A coldness came out in the look she pointed at Jo.
"Doctor Gilman. Thank you."
Jo was shocked at the sudden tension she felt coming off the beautiful doctor. It confused her. "I'm sorry, Dr Gilman. Have I done something to upset you? I thought we were getting along well." She seemed receptive to the flirting. I didn't think I had offended her. The Doc gave as good as she got.
"No, everything is fine. Thank you."
Deciding to go ahead with the question on her mind, Jo asked, "Well, I was wondering if you would like to join me for a cup of coffee or dinner sometime. I mean if that's all right with you. You don't have to or anything." Jo stumbled to get the words out there, feeling unsure of herself. Something she wasn't used to.
"Thank you, but no." Nydia said. She turned back to the desk and grabbed the papers she needed. She pointed to a line on the page. "Please sign this here and here," she said pointing to another line. "These are the instructions you'll need. If you have any questions, I'm sure Nurse Swenson would be happy to help you." With that curt comment, Nydia grabbed a chart off the desk and left.
Jo stood alone watching Nydia's retreating form. Jo's shoulders slumped. Finally, she simply walked away.
As she watched Jo walk out the doors, Nydia returned to the desk.
"What the hell was that all about, Nydia?" Trudy asked as she sat putting together the last of Jo's chart.
"You know I don't get along with cops, Trudy. I damn well am not going out with one. Besides, it would be unethical to socialize with a patient. You know that,
" she snapped. She grabbed another chart and went to check on her latest patient before her friend had a chance to respond.
Jo sat in the cruiser with her partner Reilly.
"So, are you okay?" Reilly asked.
Jo sat looking out the passenger window. It was not an unheard of thing for her to get shot down by a woman, just rare. She was confused and the one thing she hated most was being put off balance. That was what the doctor had done to her. Jo felt like she had somehow lost her best friend. It's so bizarre.
"You all right, Powers?" Reilly asked again, "What did the doctor say?"
Letting out a sigh, she turned to look at her partner. "Nothing important. I just need to go rest. Once we get to the station, I'll finish out my shift at the desk. I'd rather be working on cases than sitting at my desk, but it's better than the alternative. Though I love my family the prospect of sitting at home doing nothing is not appealing."
"I don't know, Jo. I mean I understand you live and breathe this stuff but maybe you should take the rest of the day off. You took a pretty hard hit in the head."
"Nah, I'm okay. Nothing a couple of aspirin won't fix." She turned to look at her partner giving him a brief smile.
Jo could tell Duncan Reilly didn't look convinced. She knew he had seen the size of the bat that hit her.
"Still I think you should take the rest of the shift off. What did that cute doctor I saw you talking to say?"
Jo was more than a little disturbed by the question. She turned away and looked out the window again. "Oh, she just said to take it easy for a while. I can do that sitting in the station. I have some reports to finish up about the incident anyway."
Reilly gave her a curious look at Jo's reaction at the mention of the doctor. Normally, Jo would have made some comment about the woman by now. "Don't try to hide it, Jo. I know you too well. So did you get a date out of her?" He kidded.
"Nah," she said, trying to downplay the emotions she was feeling. "Not my type. Nice women don't appeal to me."
"I never met anyone not your type."
"Yeah, well now you know. Besides, this one was an ice princess." Jo wasn't sure what made her lie and didn't want to. "I don't go in for that kind."
Reilly seemed to have gotten the hint that the subject was closed.
The two rode the rest of the way to the station in silence.
Trudy waited for Nydia to finish with her patient before grabbing her by the elbow. She steered her into one of the empty treatment room and closed the door behind them. She turned on her friend, "What the hell was that all about earlier?"
"What are you talking about?" Nydia asked as she nervously pushed back a lock of blonde hair behind her ear.
"You know what I'm talking about, Nydia. You and that cop.
What happened?" Trudy demanded, putting her hands on her hips.
"I told you before Trudy. I don't go out with patients and especially not police officers." Nydia flung the chart down onto the exam table next to them as she started to lose her patience.
"That fact that she was and I repeat was a patient isn't the issue. It's that you're letting your family dictate your life."
"My family has nothing to do with this!" Was the terse response.
"That's right. They don't. I can't believe you would let them do that to you. It's been over ten years since you've had a real conversation with any of them. Yet, they still have influence over you."
"No they don't. I just choose not to associate with some people. Now if you'll excuse me, I have patients to see," Nydia said, as she pushed past her friend and rushed out the door.
If the subject of Nydia's family no longer bothered her, Trudy wondered, why she was so upset. She knew part of the story behind the issue, but not the whole thing. Trudy knew that Nydia's mother had died when she was a teenager and that her father raised her along with her brothers. She could only imagine what that could have done to make Nydia so afraid of personal relationships. As far as Trudy knew, she was one of her only friends. It saddened her to no end that Nydia had nobody in her life. But Nydia fought her every time she tried to intervene. Not knowing what more she could do, Trudy went back to her desk and to her paperwork. She did give one final thought regarding the officer, "I can feel she would be a perfect friend for Nydia."
Nydia stood in the Doctor's Lounge and took out a new lab coat out of her locker. The one she had on suddenly felt dirty to her. She put it on and slammed the door to her locker in frustration. She knew that despite what she told Trudy she did let her old feelings have free reign over her. She didn't know how to let it stop. Nydia had spent too many years building up her defenses. Nothing or no one had the power to get to her. At times,
it made for a lonely existence. She was willing to live with it given the alternative, especially when it came to people like Officer Jocasta Powers.