“We don’t know our neighbors around here yet. We just moved in from Kansas.” The man’s voice grew tighter and higher. “Tell me what to do!”
“Do you have any cooking extracts? Any vanilla?” If there was enough, vanilla extract could save the child’s eyesight due to the high percentage of alcohol. It could even save his life.
He heard the man put the phone down and ask his wife, heard her frantic reply and a small clatter of bottles, and then suddenly remembered who else lived near Old Well. Yes!
Chapman came back on the line. “We’ve got half of a little bottle of vanilla, Doctor. Is that enough? Will that help?”
“Give it to him, but you’ll need more.”
“He’s not showing any symptoms yet. He isn’t acting sick.”
“The symptoms won’t show up for twelve to twenty-four hours.” And then it would be too late. “Mr. Chapman, do you know Emmet and Ruby Taylor? They live out in the hills near you at the edge of Mark Twain National Forest, about two miles from the cemetery by the church at Old Well.” He should know. Ruby Taylor had almost died of lead poisoning from her still a few months ago. The still had been destroyed since then, but Lukas knew Ruby. “Take your son over to their place. Tell them I sent you, and ask for a bottle of their best. They’ll have liquor somewhere.” He prayed that the Taylors were there. They usually were, with their teenage boys and dairy farm, pigs and chickens and rusted-out tireless cars sitting in the front yard.
“You want me to get my little boy drunk?” Chapman asked, a hint of indignation in his voice, as if it had suddenly dawned on him what Lukas was saying.
“I want you to get enough grain alcohol down him to counteract the effects of the antifreeze,” Lukas said. “About three tablespoons of Ruby’s stuff ought to do it, but you don’t want to overdose him, especially since we don’t know how much he’s ingested. Mix some orange juice or something with it so he’ll drink it. Maybe some sugar will kill the taste. Then get him here as fast as you can.”
“Won’t the alcohol interfere with the antidote?”
“In this case, the alcohol is the antidote. Mr. Chapman, the effects can kill him if you don’t treat.” He didn’t want to be cruel, but the man needed to be aware of the serious risks. The sound of a siren echoed through the doors, then the reflection of ambulance lights bounced against the bay entrance. “Are you okay with that?”
“Yeah, Doctor. We’ll get him there.”
“Good. I’ll see you then.”
Lukas hung up and got up to walk out to the ambulance bay just as the EMT threw open the back doors of the van. He stepped over to the foot of the first cot that was pulled out.
The patient was a female in a nonrebreather mask, fully immobilized on a long spine backboard with head blocks. She had a large bore IV in her right arm, and blood splattered her clothing. Blood also concentrated in a dark, thick stain that had seeped through a bandage over her right lower leg, where her jeans had been cut free, and a Harris long traction splint held firm.
“Is this the worst?” Lukas asked.
“Sure is. She looks pretty bad.” The EMT gestured to the other patient, who was still inside the van. “That’s her husband in there.”
Lukas didn’t like the looks of the patient’s right foot—almost white from lack of circulation. She moaned, but her eyes remained closed.
The paramedic stepped out of the back of the van. Connie was a muscular, seasoned professional with short boy-cut blond hair and a chronically serious expression. “Hi, Dr. Bower. This is Alma Collins, forty-five years old. First responders had to free her from between the car and the concrete balustrade of the courthouse.” Her voice remained monotone, a habit she practiced when she worked with patients to keep from alarming them. “She was unconscious on scene, but she’s been coming around since we’ve been en route, and she’s in a lot of pain. She has an obvious open tib-fib fracture, badly mangled leg, no pulse on the foot. Vitals initially on scene, heart rate 115, BP 90 over 60, respiratory rate rapid, with slight improvement following a liter bag of normal saline wide open. She’s received 700 cc’s so far. A lot of bleeding on scene from right lower extremity, but we managed to control it some after we placed the splint.”
“What about the other patient?” Lukas gestured toward the cot still in the van.
“That’s Arthur Collins, the husband,” Connie said. “He has a deep scalp laceration, and it looks like he may have a dislocated or broken right shoulder. He lost a lot of blood from the scalp, but it’s been controlled by direct pressure.”
Lukas reached forward to check Alma more thoroughly while he continued to talk to Connie. “What else is coming?”
“Two more are on their way in the BLS ambulance, and one’s coming in by private car.”
Lukas placed his hands over the sides of Alma’s hips and gave a gentle but firm squeeze. There was no reaction of pain. Good. He would get a film on it, but if she didn’t have a pelvic fracture, it would be a lot easier for her. As Connie continued with the report, Lukas helped her rush the patient through the doors and into the first trauma room, leaving the EMT and E.R. tech to handle Alma’s injured husband.
“Judy, get a chopper on standby,” he called over his shoulder as he and Connie transferred Alma to the exam bed. “And let Lab know we’ve got stat blood work for them.” He turned to Lauren, who had come in behind them. “Start another IV, and draw blood for a stat trauma panel.”
Alma’s pupils reacted briskly, and her breathing, though a little fast, was even. Her eyes remained open after he checked them. She moaned again, and Lukas bent toward her. “Mrs. Collins, I’m Dr. Bower, the E.R. physician here.” Because Connie’s businesslike manner could sometimes make a patient feel cut off from human support, he injected even more tenderness than usual into his own voice. “Can you hear me?”
Physical pain etched itself in the lines of the woman’s face. Her eyes filled with tears. “Yes…Hurts bad…Can you help me?”
“Yes. I’m sorry, but I need to do a quick check and ask you some questions. Do you have any drug allergies?”
She attempted to shake her head.
“Please don’t move your head or neck until we know how badly you’re hurt. Just tell me yes or no.”
“No.” Her voice shook with the effort to control her reactions.
“Good. I know your right leg hurts. Do you have pain anywhere else?”
“My head.” Her chin quivered. “I think I hit my head.”
“Were you knocked out?”
“I think so. Arthur?” She stretched out the fingers of her right hand as if to free herself, but she was constricted by the backboard. “Where’s Arthur? Is he okay?”
“I haven’t checked him, but he seems to be doing okay. Do you hurt anywhere else?”
“I can’t tell.” She grimaced. “My leg hurts so bad. Please!”
Lukas turned to find Lauren securing the second IV tube with tape. “Get me a pressure, and if that’s okay, give Mrs. Collins 2 milligrams of morphine, slow IV push. And add 12.5 milligrams of Phenergan. I don’t want to risk the morphine nauseating her.” He looked at the open tib-fib fracture just below the knee, then moved down to look at Alma’s right foot. He still didn’t like what he saw. It was cool to the touch, white, and when he checked for a pulse on top of the foot, he found none. The capillary refill was very sluggish. He had to get this woman to a vascular surgeon fast if he wanted to save her leg.
Lord, guide me. Touch her through me. Give her the comfort I can’t.
He stepped to the hallway and called, “Judy, launch that