Triggers

“Help!” she shouted. Perhaps eight or nine people, in various states of injury, were visible outside their vehicles, some bloodied, a couple lying down on the asphalt. “This man needs help! Are any of you doctors?”

A few of the people looked at her. One man shouted, “No,” and a woman called out, “Let me know if you find one!”

Nikki inhaled deeply then let the air out; it was cold enough that she could easily see her own breath, and that of the woman pinned in the passenger seat—but there was no sign of any breath coming from the driver.

She felt herself beginning to panic. Christ, what to do? What to do? She rubbed her hands together, trying to warm them. Then she brought them to her face to blow on them, and saw them—covered with blood.

And it came to her: this man needed a crike—an emergency cricothyrotomy—right away. No, no, not right away: stat.

And—yes, yes, yes—Eric knew how to perform one, and so she knew how to do it, too.

But he—she!—needed a scalpel, or at least something really sharp.

“Oh, God!” said the pinned woman, looking now at her husband, whose blue color was becoming more pronounced. “Oh, God—he’s dying!”

Nikki undid the man’s seat belt, and, with great effort, pulled him out onto the cold wet pavement, laying him on his back. She didn’t have a razor blade or knife—not even back in her purse. But there were shards from the car’s broken mirrors, and she found one that was long, narrow, and pointed.

The top part of the man’s Adam’s apple was crushed. She moved her fingers down about an inch until she felt the bulge of the cricoid cartilage. She backed up a bit, finding the valley between it and the Adam’s apple—the cricothyroid membrane.

She knew she should sterilize the mirror fragment and the man’s skin, but there was no way—and no time!—to do that. She held the shard as firmly as she could without cutting herself, and she drew it horizontally down the man’s neck, above the membrane, but—

But she didn’t even break the skin. Knowing how to do it wasn’t the same as having the guts to do it, it seemed.

“What are you doing?” shouted the man’s wife, who could only see that Nikki was on her knees at the side of her husband; her husband’s body was mostly out of view.

It was a good question. What the hell was she doing?

What she had to do. What she—what Eric—had trained to do.

She took another deep breath, then tried the cut again, this time at least breaking the skin. But she had to go twelve millimeters deep—except she had no idea how much twelve millimeters was. Damn! It was—it was—

About half an inch.

She pushed the glass in further, making the incision. Blood welled up, thick and dark, and—

Damn! The glass broke; the sharp tip was now stuck in the wound. Nikki threw the rest of her impromptu scalpel away and it clattered against the pavement. She used her thumb and forefinger to dig out the piece of glass, tossing it aside as well. The tissues pressed together, closing the incision.

Nikki reached into her jacket pocket and pulled out a ballpoint stick pen—one with her firm’s name emblazoned across it; a good real-estate agent always had a pen handy to close the deal. She pulled out the writing tip and its attached tube of ink, and fumbled in the cold to pry off the blue end cap until, at last, she had a plastic tube open at both ends.

She was supposed to insert the tube about twenty millimeters, and, well, if twelve was half an inch, then…

She pushed the tube into the incision. And then she blew into the tube and placed her palm flat on his chest. It rose! She paused for five seconds, blew in again, waited another five seconds, exhaled once more, counted off five more Mississippis, again and—

And the man’s eyes fluttered open.

She waited to see if he was breathing well on his own—and he seemed to be; she was pleased to see puffs of condensation blowing out of the end of the tube.

Nikki rolled back on her rump, drew her knees up to her chest and hugged them, and just sat there, waiting for her own breathing to stabilize. After a minute or two, she reached up to touch her nose to see if it was still bleeding; it wasn’t—but it certainly was tender to the touch.

Off in the distance, she heard sirens; God only knew when trained medics would get here, but…

But she was a trained medic now, it seemed. And as much as she’d freaked out at the hospital, as much as she really didn’t wish to intrude on Eric’s and Jan’s lives, as much as she just wanted things to be the way they had been before this craziness began, she had just saved a person’s life.

And that was something she’d always remember.

Chapter 42

“I need to get back in action,” Seth said to Susan Dawson.

Susan spread her arms to encompass the drip bags, the vital-signs monitor, and more. “You’re still recovering, Mr. President.”

“I can lie in bed anywhere. I need to go home.”

Susan’s voice was gentle. “Sir, the White House is gone.”