She’d only seen it done once. Ugh. At least she didn’t look it. Move past it. Enzo gestured to the defibrillator and she followed his gaze.
“Not yet. He’s already banged up enough. Let’s give him one more chance to convert. Honestly, it’s not electrical, it’s the pressure in his chest. I doubt cardioversion would do any good for him unless his heart stops entirely.”
She rose on her knees and shouted toward the back of the medic, “Bring epi if you have it! Enzo, start the cuff again. I want the pressure before and after each draw.” With a fresh alcohol prep she swabbed the area where she’d just gone in, readying the chest for another puncture.
Long, torturous seconds passed and the other medic arrived. As soon as the pressure was displayed, she pushed through with the second needle.
Enzo watched another rush of bright red fill the tube. It looked thinner and more translucent than it had before. “It’s part serum, or he’s filling with more serum than blood now.”
“Good. The pressure might stop his heart still, but maybe it’s not an aortic dissection. Buys us some time.”
If it was only a small cut in the aorta rather than a hole through it, they had a chance of getting him stabilized and to the hospital before he crashed.
He concentrated on what he was hearing—the monitor couldn’t tell him how loud the heartbeats sounded so the stethoscope was still needed. It was easier to look at the monitor—or even the dark, eggplant-like bruise on the man’s chest—than at her worried face. He could tell from her complexion that she was normally a warm tan, but today she looked pale and fragile. Not a great look for a trauma surgeon. Even a trauma resident.
With the second round of pressure relief, the speed of the man’s heart slowly decreased and the rhythm began to convert to something closer to normal. First, a few normal beats amid the pre-ventricular contractions. Then louder. Then steadier.
“It’s working.” He pressed the button on the cuff again and then leaned back to place the stethoscope in her ears, holding the chest piece over the heart again. He let her listen as she was the one performing the procedure.
After a few seconds she nodded. “I don’t want to go again, I might hit the heart. The less fluid that’s in there, the closer the pericardium is to the heart, the less balloonish padding to protect it.” And they didn’t have the luxury of imaging equipment here to see how thick that fluid balloon was.
“Agreed.” Enzo checked the cuff again. “One hundred and forty-three over eighty-one.” The tension that had held him stiff and hard in the preceding moments left in one rushing wave, so swift his shoulders slouched forward briefly.
Without thinking, his nearest hand landed on the back of her neck to lightly squeeze as he directed her gaze to the cuff. Her skin felt hot beneath the ponytail she wore, and his palm prickled where it touched her.
“Blood circulating again,” she whispered, her breathless smile hitting him square in the chest. Shared relief. Before he could think it through, he pulled her into his arms for a hug. She sagged against him, her hands fisting in the back of his scrubs.
Apples. Her hair smelled faintly of apples, and something earthier. Clean. Sweet.
The comfort was fleeting as within seconds she’d stiffened. Her hands released the material of his shirt, reminding him it wasn’t the time to be hugging this stranger with the soft womanly curves, or smelling her fruity hair.
He let go and put a little distance between them. What was worse, looking overly familiar or overly emotional?
Color had returned to her face and was focused on her cheeks now. He’d definitely crossed some line.
Right. “Get a line in him, and we’ll ride with you.” He redirected his thoughts to the paramedics, who really didn’t need to be told what to do except that they’d come to a scene with two surgeons running things.
Kimberlyn left the cuff in place but went about gathering the contents of her bag as if the contact had never happened. He reached for his cell again.
Ootaka answered on the first ring. “Dr. Ootaka, there was an accident a few blocks from the hospital. Assisting with a cardiac tamponade. Thought you might want a heads-up to meet the ambulance.”
The conversation was brief. A neck brace and helmet removal later, they lifted the man onto a backboard, then the stretcher, and trotted for the ambulance.
“He’s on call today?” She climbed into the ambulance after the stretcher had been rolled in.
Enzo nodded, keeping his hands off her even though his natural instinct was to help her into the ambulance. “He’s going to meet us.” He stashed his phone and jerked his head in the direction of the hospital. “I’m running. Keep our patient alive. It’s only a little way to the hospital.”
Some physical exertion would help. So would avoiding any enclosed spaces with her. Good for all concerned. Or good for him, which was the important bit. And she wouldn’t have to worry that he was about to hug her again. What the devil had that been about? He was happy about the patient, but still—weird.
Probably some kind of natural instinct in the wake of all that fear and hope warring on her face roused his protective instincts. Unfortunately.
He closed the doors, banged once to let them know it was safe to drive and then took off at a run for a nearby alley. Three blocks by vehicle, one on foot.
After her showing up on the scene, even if Ootaka would’ve been put off by the emotion, he still would’ve been impressed by the woman’s knowledge. Which was okay, so long as Ootaka remained most impressed with him. Enzo hadn’t fought his way through school and years of residency to lose it at the eleventh hour to a little scared Southern nobody…
If his luck held, Ootaka would meet him at the ambulance bay and he’d have a couple of minutes to speak with him before the ambulance—and his shiny new competition—caught up.
ENZO MET DR. TAKEO OOTAKA at the ambulance bay doors. Normally, sprinting a block would do very little to his heart rate. Not today. Today he was winded by the time he jogged through the automatic doors. Winded and annoyed. Off his game.
The older Japanese surgeon stood waiting, leaving Enzo no time to work out his problem. He barely had time for a good breath. Ootaka stared past Enzo to the empty ambulance bay, a look that demanded answers.
During the past four years, and especially the past year when he’d largely been Ootaka’s primary assistant, he’d become used to anticipating Ootaka’s questions from his expression alone. So he answered, “I ran ahead. It was faster on foot and I wanted a better chance to brief you.”
And it’s hot, he wanted to say. Hot and muggy, which no doubt contributed to his elevated pulse and respirations.
He took another deep, cleansing breath and launched in, giving the pertinent details even as he heard the sirens drawing closer to the building. “Massive bruising, likely fractured sternum, probably some ribs, too, but structure mostly intact.”
From where the ambulance bay was located, he could see the vehicle turning into the parking lot. If he wanted to ask, it was now or never.
“I expect that there will be a need for surgery.” He waited only long enough for the usually taciturn surgeon to nod, and added, “I’d really like to stay with the patient and assist you.”
Underhanded? No. Smart.
She’d been the one ahead of the curve with the diagnosis and field aspirations. While he wouldn’t ever claim the spot of underdog, or let himself be relegated there, winners made their own fate. Preemptive maneuvers. Offense, not simply defense.