Love On Call

Mari finally breathed. “Turn off the saline and let me have the new ET tube.”

“Here you go. A pedi six,” Beverly said and slipped the curved plastic endotracheal tube into Mari’s outstretched hand.

Never moving her gaze from the small dime-sized opening that led down into the boy’s trachea, Mari slid the tube between his vocal cords and toward his lungs. “Hook us up?”

The ventilator began to hiss, and Mari slid out the laryngoscope and stepped back.

Abby listened to his chest with her stethoscope, nodding as she quickly moved the diaphragm over his chest. “Breath sounds are good. Pulse ox?”

“65,” Beverly said.

“Increase the rate to twenty and decrease the volume. Let’s rapid pulse him.”

The pulmonary tech adjusted the ventilator, and the machine cycled quickly in short, sharp bursts as if it was panting.

“Suction him down the tube, Mari,” Abby murmured.

Quickly, Mari complied, barely able to take her eyes off the pulse oximeter, hardly breathing herself as the numbers began to edge up. 68, 72, 75, 80, 85, 90.

“Holy Jesus,” the big burly EMT muttered. “You got him back.”

“Let’s get a chest X-ray,” Mari said, tempering her elation. A million things could go wrong, and if he’d been without cerebral perfusion for too long, she might not have saved him after all. Now only time would tell if he would recover. She had to be sure he didn’t have other injuries that could complicate his recovery, and then they would wait.

Abby said, “Draw a full panel of bloods and get him up to the intensive care unit.” Abby squeezed Mari’s shoulder. “Very nice, Ms. Mateo.”

“Thank you.”

As quickly as it had begun, it was over. Beverly drew bloods from the IV line and the two EMTs, who appeared to have no intention of leaving their charge, pushed the stretcher out into the hall. Another stretcher materialized in her cubicle, this one with a young man whose right arm was misshapen and bloodied.

“Hi, I’m Mari Mateo, a PA,” she said, and got back to work.

*

Mari had no idea how much time had passed by the time the last patient left her cubicle for an observation room upstairs. It might’ve been ten minutes, it might’ve been ten hours. All she knew was she’d never felt so exhilarated in her life. She’d splinted fractured limbs, inserted a chest tube under local anesthesia, and treated an acute case of asthma with inhalation agents and intravenous medications, avoiding a dangerous intubation. She’d evaluated more complex cases in one day than she had in a month of training, and she’d managed mostly on her own. She’d been dimly aware of the seething activity around her as she’d worked—once she’d heard the high-pitched wail of someone’s heart breaking, and a moment later Glenn’s low-pitched, melodious cadence calling for a cutdown tray. Dr. Remy popped in and out of her room, checking patient status, reviewing a treatment plan, offering suggestions.

As soon as the transport orderly took her patient, a forty-five-year-old fireman with an impending MI, to the medical intensive care unit and no one brought another patient to replace him, she sagged into the hard plastic visitor’s chair against the wall of her treatment room and stared at the litter-strewn floor. An errant glove someone had tossed toward the trash can and missed, an IV tube dangling from a metal stand, the saline slowly dripping into a clear puddle, bandage wrappers, a plastic cap from a syringe. A war zone.

“How’d you do?” Glenn asked from the doorway.

Mari glanced over at her. “Okay, I think. I didn’t lose anyone.”

“That’s a good first day, then.” Glenn grinned and checked her watch. “Of course, you’ve still got another eleven hours to go.”

“You’re kidding.”

“Nope. It’s just a little bit after 0830.”

“Oh my God.” Mari blew a strand of hair from her eyes. “Is it over? Did we win?”

Glenn’s eyes clouded. “Mostly. Two fatalities, both submersion casualties—a twenty-year-old farmhand, first day on the job, and the thirteen-year-old daughter of the farm owner.”

“Damn,” Mari whispered, sadness blunting the thrill of victory she’d experienced just moments before.

“But I hear you saved her brother—smart thinking. A gutsy call.”

Mari shrugged. “Probably more beginner’s luck.”

“I don’t believe in luck—unless it’s bad.”

At the sudden dark tone in Glenn’s voice, Mari took a hard look at her. Her skin was pale beneath her tan, her face drawn and tired. She’d had the critical patients and had probably been involved with the fatalities. “Are you all right?”

“Me? Sure. Fine.” Glenn shrugged and her usual mantle of calm control fell back into place. “Come on, I’ll show you where the locker room is. You can get clean scrubs and shower if you need to.”

Following Glenn’s pointed gaze, Mari looked down at herself and realized that a spray of blood from one of the IVs she’d started had left a crimson crescent across her chest. Another splotch of blood marred her thigh. She couldn’t see patients the rest of the day like this.

“You’re right. I need to get cleaned up.”