'He took that okay,' she said to herself. 'All things considered.'
The door to the lounge opened, and Dubois poked his head in. 'Coast clear?'
'Yup. And I'm heading down to the chute.'
Dubois pushed the door wide and strode in, his crocs making no sound on the linoleum. 'I don't know how you do it. You're the only one who doesn't need smelling salts after dealing with him.'
'He's no problem, really.'
Dubois made a chuffing noise. 'Don't get me wrong. I respect the shit out of him, I truly do. But I don't want him pissed.'
She put her hand on her colleague's shoulder. 'Pressure wears on people. You lost it last week, remember?'
'Yeah, you're right.' Dubois smiled. 'And at least he doesn't throw things anymore.'
Chapter Seven
The T. Wibble Jones Emergency Department of the St. Francis Medical Center was state-of-the-art, thanks to a generous donation from its namesake. Open for just a year and a half now, the fifty-thousand-square-foot complex was built in two halves, each with sixteen treatment bays. Emergency patients were admitted alternately to the A or the B track, and they stayed with whatever team they were assigned until they were released, admitted, or sent to the morgue.
Running down the center of the facility was what the medical staff called 'the chute.' The chute was strictly for trauma admits, and there were two kinds of them: 'rollers' who came by ambulance, or 'roofers' who were flown into the landing pad eleven stories up. The roofers tended to be more hard-core and were helicoptered in from about a hundred-and-fifty mile radius around Caldwell. For those patients, there was a dedicated elevator that dumped out right into the chute, one big enough to fit two gurneys and ten medical personnel at one time.
The trauma facility had six open patient bays, each with X-ray and ultrasound equipment, oxygen feeds, medical supplies, and plenty of space to move around. The operational hub, or control tower, was smack in the middle, a conclave of computers and personnel that was, tragically, always hopping. At any given hour there were at least one admitting physician, four residents, and six nurses staffing the area, with typically two to three patients in-house.
Caldwell was not as big as Manhattan, not by a long shot, but it had a lot of gang violence, drug-related shootings, and car accidents. Plus, with nearly three million residents, you saw an endless variation of human miscalculation: nail gun goes off into someone's stomach because a guy tried to fix the fly of his jeans with it; arrow gets shot through a cranium because somebody wanted to prove he had great aim, and was wrong; husband figures it would be a great idea to repair his stove and gets two-fortied because he didn't unplug the thing first.
Jane lived in the chute and owned it. As chief of the Trauma Division, she was administratively responsible for everything that went down in those six bays, but she was also trained as both an ED attending and a trauma surgeon, so she was hands-on. On a day-to-day basis, she made calls about who needed to go up one floor to the ORs, and a lot of times scrubbed in to do the needle-and-thread stuff.
While she waited for her incoming gunshot, she reviewed the charts of the two patients currently being treated and looked over the shoulders of the residents and nurses as they worked. Every member of the trauma team was handpicked by Jane, and when recruiting, she didn't go for the Ivy Leaguer types necessarily although she was Harvard-trained herself. What she looked for were the qualities of a good soldier, or, as she liked to call it, the No Shit, Sherlock mental set: smarts, stamina, and separation. Especially the separation. You had to be able to stay tight in a crisis if you were going to W-Z the chute.
But that didn't mean that compassion wasn't mission-critical in everything they did.
Generally, most trauma patients didn't need hand-holding or reassurance. They tended to be drugged up or shocked out because they were leaking blood like a sieve or had a body part in a freezer pack or had seventy-five percent of their dermis burned off. What the patients needed were crash carts with well-trained, levelheaded people on the business ends of the paddles.
Their families and loved ones, however, needed kindness and sympathy always, and reassurance when that was possible. Lives were destroyed or resurrected every day in the chute, and it wasn't just the folks on the gurneys who stopped breathing or started again. The waiting rooms were full of the others who were affected: husbands, wives, parents, children.
Jane knew what it was like to lose someone who was a part of you, and as she went about her clinical work she was very aware of the human side of all the medicine and the technology. She made sure her people were on the same page she was: To work in the chute, you had to be able to do both sides of the job, you needed the battlefield mentality
A nurse came up to her. 'Dr. Goldberg just called in sick.'
'That flu?'
'Yes, but he got Dr. Harris to cover.'
The nurse smiled. 'He said his wife was thrilled to see him when she was actually awake. Sarah is cooking him chicken soup and in full fuss mode.'
'Good. He needs some time off. Shame he won't enjoy it.'
'Yeah. He mentioned she was going to make him watch all the date movies they've missed in the last six months on DVD.'
Jane laughed. 'That'll make him sicker. Oh, listen, I want to do grand rounds on the Robinson case. There was nothing else we could have done for him, but I think we need to go over the death anyway.'
'I had a feeling you'd want to do that. I set it up for the day after you get home from your trip.'
Jane gave the nurse's hand a little squeeze. 'You are a star.'
'Nah, I just know our boss, is all.' The nurse smiled. 'You never let them go without checking and rechecking in case something could have been done differently.'
That was certainly right. Jane remembered every single patient who had died in the chute, whether she had been their admitting physician or not, and she had the deceased cataloged in her mind. At night, when she couldn't sleep, the names and faces would run through her head like an old fashioned microfiche until she thought she would go mad from the roll call.
It was the ultimate motivator, her list of the dead, and she was damned if this incoming gunshot was going on it.
Jane went over to a computer and called up the low-down on the patient. This was going to be a battle. They were looking at a stab wound as well as a bullet in his chest cavity, and given where he'd been found, she was willing to bet he was either a drug dealer doing business in the wrong territory or a big buyer who'd gotten the shaft. Either way, it was unlikely he had health insurance, not that it mattered. St. Francis accepted all patients, regardless of their ability to pay.
Three minutes later, the double doors swung open and the crisis came in at slingshot speed: that Mr. Michael Klosnik was strapped to a gurney, a giant Caucasian with a lot of tattoos, a set of leathers, and a goatee. The paramedic at his head was bagging him, while another one held the equipment down and pulled.
'Bay four,' Jane told the EMTs. 'Where are we?'
The guy bagging said, 'Two large-bore IVs in with lactated ringers. BP is sixty over forty and falling. Heart rate is in the one-forties. Respiration is forty. Orally intubated. V-fibbed on the way over. Shocked him at two hundred joules. Sinus tachycardia in the one-forties.'
In bay four, the medics stopped the gurney and braked it while the chute's staff coalesced. One nurse took a
