“Bree?” Emma’s dark eyes, filled with fear, stared up at her from the gurney, her voice a muffled whisper through her oxygen mask. “It hurts. It...it hurts so much.”
“I know, sweetie. Hang in there,” she said, shoving down the fear that had filled her throat the second she’d awakened from the knock on her head to see Emma trapped and unconscious. She swallowed hard. Was there something, anything, Bree could have done to prevent the accident?
She lifted a shaking hand to wipe away the blood trickling into her eye again. Please, please let them be okay.
The medics, as breathless as Bree, started in with their rapid-fire report to everyone in the room. “Twenty-nine-year-old, thirty-seven weeks pregnant. Vehicle struck by a truck, passenger side, pushing vehicle into oncoming traffic. Extensive damage to multiple vehicles. Forty-five-minute extraction, GCS fifteen, last heart rate one thirty-five, BP eighty over fifty.”
Bree blinked fiercely as she listened. Remembered. The impact had nearly flipped Bree’s car as it skidded into a sedan coming the opposite direction. The horrific shriek of tearing, crumpling metal. Her own door caving in, knocking her head against the window as the air bag exploded into her face, briefly blinding her as she heard Emma’s screams just before Bree blacked out for a moment. Awakening to turn, stunned and disoriented. Seeing Emma’s body terrifyingly still and bleeding.
“Were you the driver of the car, Dr. Donovan?” Kurz asked, looking at her more closely than she wished he would.
“Yes.” She should have known he’d figure that out, but her own minor injuries weren’t an issue at the moment, and she was more than capable of helping the team. “But I’m fine.”
Kurz gave her a nod. “Let’s get the patient moved over.”
Hearing the senior critical care doc’s calm, commanding voice helped her focus as she watched four pairs of hands lift the board Emma was strapped to, sliding her onto the trauma bed. Bree took her place at Emma’s right as the team cut away her clothes.
“That’s about the only top that fits me now,” Emma gasped through her oxygen mask.
“I’m sorry, but we have to,” she soothed, swallowing hard. As though her blouse mattered one iota under the circumstances. She stroked Emma’s hair then reached to squeeze her hand. Could she hope it was a good sign Emma had even thought about it? “I’ll get you another just as pretty, I promise.”
In mere seconds, the team had Emma set up with blood-pressure cuff, IV, and cardiac leads to the monitor as the surgical resident examined every inch of her, and Bree was so thankful again that they weren’t in that smashed car anymore, or the ambulance, as good as the EMTs had been, but finally here, getting Emma the help she needed.
“Tell us where you’re hurting,” Kurz said as the X-ray tech got ready to shoot films.
“My chest, my stomach.” Emma moaned. “My arm and leg. My baby—oh, please make sure my baby—”
“I promise everyone’s going to take good care of the baby, Emma,” Bree managed to say. Question was, would it be too late? “Let’s get a monitor on him, check how he’s doing.”
A nurse got the monitor on Emma’s belly. The infant’s heartbeat showed up strong and steady, and relief made Bree’s knees so wobbly, she gripped the side of the bed to hold herself up. Whether he was ready or not, baby had to come into the world soon, in case he or Emma took a turn for the worse.
It took every ounce of restraint Bree could muster to just stand there and watch the team work instead of assisting in some way. But right now, she had to remember her training as an ER physician who was used to trauma just like this and let the team do their job. Pretend the woman on this bed wasn’t her close friend. Wasn’t the sister of the man she’d been in love with not so long ago, no matter how unsuited they’d proved to be for one another.
Thinking of him and how devastated he’d be by this accident ratcheted her adrenaline even higher. Had her chest tightening at the thought that he might blame Bree, and maybe she deserved it. “Anyone know if Dr. Sean Latham is in the hospital? This is his sister. He needs to be notified right away.”
Kurz’s attention swung to her in surprise before he barked more orders.
Bree closed her eyes, thinking of Sean hearing the overhead paging him to Trauma Two. He’d be so unprepared for what he was about to walk into. Sean got frustrated with Emma sometimes, but he adored his little sister.
Bree glanced at Emma’s monitor and her stomach lurched. “Heart rate’s one-sixty.”
“Blood pressure’s dropping, too,” a nurse said.
Kurz had his stethoscope and fingers on Emma’s poor, bruised chest. “Hemothorax. Hold on X-ray. We need the chest tube tray—you got this?” he asked the surgical resident.
Bree didn’t like the shaky affirmative of the resident’s answer, and anxiety rose in her own chest as she prayed the resident had the confidence and experience to get the tube inserted into Emma’s lung fast. Steadily stroking Emma’s hair, she couldn’t say for sure if she was trying to calm Emma or herself.
Kurz continued barking orders, sending techs and nurses scurrying. “I want Anesthesia down here now, and why the hell isn’t OB here yet? And get the NICU team.”
“Bree, what’s happening? NICU team?” Emma’s eyes were wide and scared, and Bree took her hand and squeezed it gently.
“Got to get you fixed up and deliver the baby. You’re going to meet your little guy today. Can you believe it?” Somehow, she managed to keep her tone light. “You still going to go with the name you told me you’d decided on?”
“What? I’m not ready! I—”
“We’re going to help you be ready. It’s going to be okay.”
“I... Bree,” Emma whispered, her words slurring. “I feel...funny. It’s... Is it getting dark? Where...?”
Just like that, Bree saw her eyes close, her head go limp and her skin turn as white as pure, pearly beach sand.
“Emma!” Oh, no. Please, no. “Emma, stay with me!” Her shouts were punctuated by the cardiac monitor alarm, heart rate forty, thirty, fifteen, then asystole. Flat line. The sight of that neon line felt like a sharp knife blade slicing right through Bree’s heart as the screech of the monitor filled her ears. Air didn’t seem to be getting to her lungs. Watching hands pumping on Emma’s chest, hearing Kurz’s voice demanding Epi and oxygen, felt utterly surreal.
“What the...?”
Bree whirled. Sean. Standing there in the doorway, staring at his sister in shock.
“Pulmonary injury. Right hemothorax.” It was hard to choke out the words, and the next were even harder. “Coded twenty seconds ago.”
“About to place a chest tube,” Kurz said as he worked. “We’re going to OR Three. When we can get her there.”
Before one more second ticked by, Sean moved into action. He shouldered the surgery resident aside to get the tube placed as quickly and efficiently as possible. Immediately the blood began to flow, releasing the pressure on her lungs and heart.
Bree watched him secure the tube to the chest wall when the startling beep of the cardiac monitor cut through the fog in her brain. Emma’s heart’s back! She’s back! But each beat was so far apart. Slow. Too slow. She must have some other serious injury. Needed more blood circulating. Needed for her heart to pump harder. Needed it for both her and her baby.
Bree knew what had to be done and drew on reserved strength to get