The Fellowship

"Hey, careful where you go tapping," the raven-haired woman raised her arms in caution. "These are the arms of a surgeon. Can’t afford any injuries, you know."

Both broke into gentle laughter as the nurse shook her head in disbelief of the easy nature the surgeon was allowing her to see. It was only a few months ago on their first meeting, that the nurse was ready to throttle her for her rude and arrogant nature. Rosie made a mental note to thank Danni for not letting her do that. The "Amazon" label that the tall nurse had given her that first day now seemed so inappropriate.

"Seriously, Rosie, it’s good to have you back." Looking around quickly, Garrett asked, "Have you seen Danni? I need to get my duffel bag from her."

As if on cue, the loud shrill tones of the Trauma Team pager went off.

"Trauma Team Page, Trauma Team Page" the crackling sound of the voice being emitted sounded of urgency. "Multiple vehicle accident, three possibly four victims transporting via helicopters with an eight minute ETA. This is a Level One Trauma Team Page."

"Guess you’ll find her in the trauma room, Doc."

Garrett nodded her head, "But I won’t need that duffel bag now. Looks like I’m not going to get any sleep tonight."

In unison the pair turned and headed toward the trauma rooms in the back hallway. The calm, cool demeanor of the professionals that they were was now replacing the laughter they had shared only a few minutes ago. Reaching the hallway, they quickly donned the lead aprons and trauma gowns, each mentally preparing themselves for the worse case scenario before the patient’s arrival. Garrett watched from the hall as Rosie strode off into the second trauma room, the first trauma room being already manned by the petite blonde nurse.

Scanning over the rooms, Garrett allowed her gaze to settle on Danni. The young nurse, sensing the attention, turned to look at the surgeon. The brief visual exchange between the two roommates as they acknowledged each other, brought the slightest hint of a smile under their protective masks. It was as if they had spoken volumes of words of encouragement as the green eyes locked on to blue.

The scurry of activity in the hallway increased as the other members of the Trauma Team arrived. Quickly, Garrett sized up the available resources and began plotting a course of action. It was hectic enough when one severely traumatized patient arrived, but now she had the possibility of three or four arriving within minutes of each other. Her chief resident for the night was Kreger, whom she knew to be capable in the trauma setting. He was eager to learn and had demonstrated that to her time and again.

"Rob," the surgeon called out. "You take the first one, use room # 2."

Kreger nodded in approval as he moved into the second trauma room where he positioned himself opposite Rosie. He waited patiently for the first trauma to arrive.

The Trauma Fellow thought about her next move in this game of chess. Her team tonight was not as deep as she would have liked it to be. The experience of the members was not of a surgical nature, and she pondered over the choice of team leader for the next patient. The surgeon thought of Dr. Rene Chabot up in the delivery suite, resigning herself to call upon the impending father-to-be as a very last resort. She viewed members of her team again. The sight of a lone red-haired bespectacled figure came into her view. ‘There’s my answer!’ she thought. The young E.R. attending physician would be able to handle any life threatening emergency until one of the surgeons could break away from their own patient.

The tall surgeon moved in a path to intersect that of the E.R. Attending physician. She acknowledging her colleague with a slight nod of her head, "Dr. Potter, would you be so kind as to be team leader for patient #3?"

The physician pushed her glasses up as she grabbed one of the lead aprons that hung outside of the trauma rooms, "Don’t mind if I do." She accepted the surgeon’s offer as she completed her preparations for the job of team leader in the end room.

Everyone snapped into attention as the loud speaker overhead blared out, "Trauma’s in the department, Trauma’s in the department."

"Alright, people, let’s do our jobs." The commanding voice of the Trauma Fellow was heard throughout the hallway.

The first patient-laden stretcher accompanied by the helicopter crew turned the corner and was met by Garrett who motioned them into the trauma room where Dr. Rob Kreger waited. Advancing speedily into the room, the Flight Medic gave a brief report of the patient’s obvious injuries and vital signs. The blood splattered and twisted body belted onto the backboard was swiftly lifted from the stretcher and placed carefully onto the gurney. Each member of the team with his or her own tasks at hand began their work. Garrett watched approvingly from the foot of the bed at the skills that the team leader was demonstrating, her smile shielded by the mask. Dr. Kreger was proving himself in her eyes. His quick assessment of the patient’s airway, breathing, and circulation began to reveal the critical nature of the injuries that the patient had sustained.

"I need a chest x-ray now," Rob commanded. His eyes glanced over to the trauma fellow at the foot of the gurney. Garrett subtly nodded. In the brief moment that the two surgeons locked eyes, Dr. Kreger had her approval of his actions and an exchange of confidence occurred. She had inspired him from that first day in the O.R. and now he felt as though he had taken another step up on the ladder that brought him closer to being her equal.

It was obvious to all in the trauma room that the woman was seriously injured. Her breathing was labored, and the large discolored area along the middle of her chest stretching from right shoulder to left abdomen was a sign of significant seatbelt injury, specifically that of a restrained passenger. The chest x-ray would be a guide to the appropriate treatment.

Rob Kreger decided to utilize the precious time that he needed to see the

X-ray. "Let’s set up for bilateral chest tubes, type and cross for six units of blood. Alert CT Scan that we will need to scan the head, and chest- abdomen-pelvis."

Garrett watched the electronic screen as the patient’s chest X-ray appeared. Her eyes turning a steely blue color as she studied it. Her voice came out tense, "Looks like she has a lot of broken ribs and bilateral pneumothorax." She peered at the X-ray again letting her fingers measure out something on the screen display. "The aortic knob looks pretty wide."

"That’s what I was afraid of," the team leader shook his head. "What’s her pressure?"

Rosie looked up at the monitor to her right. "Eighty over fifty and the heart rate is 126."

Rob’s eyes snapped up to the heart monitor, "Damn, look at those irregular complexes." His eyes quickly fell back onto the chest wall that he was inserting the tube in. "Call the O.R. and tell them to have a room ready for a ruptured aorta." Kreger hurried to finish placing the tube into the left chest and secure it from falling out. Blood now escaped from the chest via the tube as it drained into the holding container. "Damn!" He bit off the word, "No time for the other side to be placed. Call the O.R., we’re coming now."

As if on cue, the overhead speaker squawked again, "Trauma’s in the Department. Trauma’s in the Department."

Garrett turned to face the hallway leading from the door to the trauma rooms. Her eyes could barely see the patient through all of the bulky dressing wrapped around his head soaked through with blood. The only thing that she was sure of was that the patient was being assisted in his respirations by the medic that was bagging him. She motioned for the crew to follow her into Trauma Room #1.

Danni looked at the stretcher with the seemingly lifeless body on it. She noted the small chalky white hand that stuck out from under the cover that the flight crew had used to control his body temperature during the flight. Her heart sank as it always did when confronted with the ravages of trauma on a young person. Her thoughts drifted briefly to her own younger brother and she said her well-rehearsed prayer for his safekeeping. She quickly drew the soft cloth of the trauma gown sleeve across the side of her face, catching the single tear that lingered at the corner of her eye.

He had always been such a vivacious child, getting into trouble at the drop of a hat. It wasn’t that he was bad or ill mannered, trouble just seemed to follow him around. Matt was with her visiting with their grandfather at his cabin. She would have been ten that year and he had just turned five. Being the older sister, she always felt responsible for him, especially when he got injured. That was the first time she could remember having to tell her parents of Matt’s misfortune. He had fallen out of a tree trying to get an egg out of a bird’s nest. His grip had let go as he stretched out for it, thus resulting in a broken arm. After a while it became standard policy that Danni possessed in her hands a letter of parental consent for emergency care, just in case Matt had to be rushed to the hospital. She thought about how it felt to be in charge of her sibling, watching out over him like a mother hen. Perhaps that is when she first felt the urge to start collecting and helping lost, injured or wayward animals. It made her feel important, at least for a little while.

It was there, in the first emergency room that her brother was in, that she had made her mind up to be a nurse. Not just any old nurse, but the best and most skilled one that she could be. She always thought that she owed her brother a thank you for introducing her to the profession she loved and had brought so much joy to her. In fact, Danni made a mental note to thank him the next time she talked to him, but who would know when that would be. They were older now and with lives of their own. Twenty years had flown by and now they were both adults and living in separate cities. It wasn’t just the years that had them growing apart, but rather Danni’s choice of life at the cabin, out of the reach of all the materialistic goals that her mother tried setting for her, that had lost most of the ties of their teen years. She found the simple life with her Grandfather during the summer months to be so much more enjoyable than the loneliness of the city and her family for that matter. Her mother was always trying to push her daughters into meeting only the most promising young men from well-to-do families, thinking that only money could buy them happiness. She wanted a life of success for her daughters and in her mind that meant running a house and raising a family. Danni’s parents had always gauged their children’s success by the status that they lavished with on the social circuit. Unfortunately, she was never one to rise to the occasion of parties and dating with her classmates. She left that to her younger sister, Breanna, whom was seen as more favorable and brilliant in their eyes with her many interested suitors all vying to wear her on their arms. The bond of sisters was still between them, but each had always listened to their own hearts. Now, they all had grown and gone there separate ways. Matt was with his friends now, all working in law firms, Breanna with her boyfriend Marc who eventually became her husband, fathering her first child on their wedding night and Danni, mostly by herself, always wanting something that would make her feel whole.

Her mother never approved of her choice in careers, saying that it was beneath someone of her upbringing to be a servant to sick people. Her mother never understood her or her needs: to be giving and compassionate to a total stranger. That would always be a bone of contention between them. Her mother viewed this job as one without rewards or a decent income. Thinking that she needed more time to come into her own with men, her mother agreed to let her go to Nursing School but only if it were at a college that was attractive to the right elements, namely males of good breeding and money. Secretly, she feared that her mother still prayed that it would lead to her rightful position in society, by landing her a well-established physician to marry. Danni could never see herself as the arm piece of anyone, nor would she flourish being treated as someone’s lesser half.

The blonde nurse was brought back from her thoughts by the voice of the woman across from her, commanding the placement of the patient. Once the stretcher was in position beside the gurney, the Trauma Fellow disconnected the bag from the tube that was securing the patient’s airway. "Okay, on my count," her eyes sweeping the length of the patient for any possible problems with the move. "One, two, three!" The size of the patient was evident by the ease of the move as he was lifted on the long board over to the trauma room gurney. The mechanical act of breathing was again resumed for the patient by the respiratory therapist positioned at the head of the bed.

Extending her arm, Garrett arched her body overtop of the now patientless stretcher as she adjusted the earpieces of her stethoscope listening for lung sounds to assure her that the breathing tube was in the proper place. She moved the sensitive device from one side of his chest to the other.

"I want a chest X-ray now," the surgeon bellowed out as she rose to her full height. Stepping back slightly to allow the flight crew to depart with their equipment, she caught the harried pace of Dr. Kreger and his patient being moved briskly through the hallway to the elevators. Their eyes met for a second. The silent exchange was acknowledged by the slightest of nods on each of their parts and each one’s attention quickly returning to their own patient at hand.

Garrett moved closer to her patient as she reached over to the neck area to check for a carotid pulse. She glanced over to the tracing on the heart monitor, assuring herself that the weak pulse she felt under her fingertips was indeed the patient’s and not her own. "Let’s get blood hung on the rapid infuser." The surgeon’s gaze riveted to the medic at the end of the bed, "What the hell happened?"

The exasperated medic snapped back, "He was a rear seat passenger, that was partially ejected through the windshield of the SUV. It was a head-on with a tractor trailer, that’s what stopped him, doc." The medic grew pale as he gulped and continued. "We had to get his head out of the truck’s grille."

An eyebrow arched high under the dark hair of the tall surgeon. "Karen, get me…"

Her words were cut off; "I have neurosurgery called already."

"Then get me a…"

"Scanner’s ready and waiting, doc." The charge nurse motioned to the CT Tech standing patiently in the hallway outside of the trauma room.

"Chest X-ray is out," the technologist informed.

Garrett stepped back, "finish up on that blood work. X-ray, get me a lateral C-spine and abdomen." She turned and walked into the hallway and then over to the electronic viewer. She carefully studied the chest x-ray that was displayed on the screen. ‘The tube is in a good location, no apparent fractures or pneumothorax,’ she pondered. She sidestepped and looked back into the trauma room.

"Dr. Trivoli," the experienced CT Tech tried to get her attention.

"HMMMM," she muttered as she turned her head toward the voice, while her eyes remained observant of the activity around the patient.

"Head, chest and abdomen scans?" She asked staring up at the doctor’s face, full of concern.

Nodding her head in agreement, "Yes, but that may change after we see the head."

"Okay, doc, whenever you’re ready."

"Just give us enough time for those X-rays and we’ll be right over," the surgeon glanced over at the technologist who was walking back to her scanner. ‘It’s nice to have experienced people to work with,’ she thought as her eyes moved between the two nurses in her room.

The sound of the loud speaker again was heard, "Trauma’s in the Department, Trauma’s in the Department."

Within seconds of the announcement, a stretcher was whisked around the corner and toward the beckoning motion of the E.R. Physician in front of the third trauma room. Jamie Potter, red hair flaring out from around the mask/shield combination that she wore, stood there waiting for them to transverse the distance to her. The young doctor’s attention stayed solely on the patient lying on the stretcher. Her assessment began with that initial moment. The experiences that she had gained in the few short years of being an attending in the metropolitan city hospital setting were evident. Her attention was on the patient as she absorbed the exchange of information from the medic. The cries of pain not only attested to the anguish of the patient’s torment, but also assured her that his airway was patent. With the blanket removed from the lower extremities, Dr. Potter could see the evidence of trauma to the man’s legs. The odd angularity of his right ankle caused her to wince at the sight of it.

"Call Ortho down," she commanded as she readied the team for the careful transfer of the injured patient. "Okay, nice and gentle now. One, two, three."

The patient was settled on the gurney, as a string of curses rolled off of his lips that would make a sailor blush. The anger and the intensity of his pain were fully realized by the facial expressions that he displayed to convey his emotions. His hands reached out as if to soothe and steady his aching limb, only to find them restrained by the belts that secured him to the long board he was lying on. Breathing hard and ragged in an effort to control his pain, the patient’s right hand grasped the gloved hand of the nurse as she released the board; his terror-filled eyes shifting to lock onto hers.

"Give me something for the fucking pain, will you! You’ve got drugs here."

His gaze seemed to burn a hole through the insecure nurse as she attempted to remove her hand from his grasp. Lori looked over to Jamie, her eyes silently pleading for help.

The physician leaned into the patient’s line of sight to get his attention. "Sir, we know that you are in pain, just give us a minute to find out what all hurts. I need to know where you hurt first before I can give you something to take the edge off that pain." Her left hand slowly traveled down the man’s arm until her gentle touch conveyed her sincerity as she held on to his hand. "Now let us do our jobs. Okay?" She asked.

With that the man’s grip weakened, allowing the slender hand to withdraw. The tall blonde nurse gently rubbed her hand trying to forget the memory of the vice-like grip that had held on to it.

The tension and strain of the situation was evident on the faces of the Flight Crew, as they made their way back down the hallway to finish their report. The short, thin medic walked over to the Trauma Fellow who was now studying the X-rays displayed on the viewer.

"Dr. Trivoli," he started as she looked over at him. "We thought you might like to know that the forth victim was DOA." He unzipped one of the cargo pockets on his nomex flight suit, fishing out a Polaroid, he offered it to her.

Garrett accepted the picture for closer observation. Her keen azure eyes scanned the images; quickly noting the victim pinned behind the steering wheel. The classic signs of upper body and extremity engorgement and the distinct purple discoloration of the skin along with the animated fully thrusted tongue and bulging eyes screamed only one thing in her mind. "Hmmm," she nodded. "Looks like traumatic asphyxiation, wouldn’t you say?" Her eyes raised to his in question as she handed the Polaroid back to him.

"Yeah, I’ve read about it but never saw it before," his tone was sober. "Maybe, I hoped that I never would," his voice trailing off to a whisper.

The surgeon reached out and touched his shoulder; "None of us should ever have to." Her voice was reassuring, "Thank you for sharing that with me." She looked directly into his eyes saying, "If you need to talk about it…."

Closing his eyes, he simply nodded and slowly moved away from her, letting her hand slowly slide off of him. "Thanks, doc," he whispered.

"Dr. Trivoli, we’re ready to go," Danni informed her as the entourage of medical personnel slowly rounded the corner of the trauma room into the hallway escorting the gurney.

"Yeah, I’m with you." The tall woman pulled herself away from her thoughts that the Polaroid had brought to her mind and once again assumed her role as Trauma Fellow. "Let’s see what’s going on in that head." She turned and popped her head into the nearly vacant trauma room, "Karen, when Neuro..."

"When Neuorsurgery shows, I’ll send them into the scanner," the older nurse cut her off. "Now, go do your job, I’ll take care of mine," she said teasingly, and winked at the surgeon.

Letting a lopsided grin show, the raven-haired woman stated, "Mom, you’re the best." ‘I guess this bunch of nurses are quick learners. They seem to anticipate my thoughts before I can voice them.’ She was relieved that they had followed her way and not fought her demands. ‘I wonder if they know that they joined my team?’ She smirked at the thought of how McMurray would view this when he reviewed the tapes.

The painful screams that she heard coming from behind her made her think of Dr. Potter and the third trauma patient. She made a quick mental note to check on them as soon as she reviewed the head scan on her patient. Then using her long strides, she made off to the CT Scanner and her patient down the hall.

The air was thick with tension as the surgical team fought desperately to save the life of the woman lying on the table. The heat from the bright lights illuminating the field of operation and the anxiety of the surgeon was enough to bring a sheen of perspiration to his brow. He turned his head to the circulating nurse who hastily wiped his forehead free of the gathering sweat. His eyes never left his patient as his nimble fingers deftly worked to suture the jagged tear through the woman’s aorta. The flap of vessel was evidence to the traumatic nature of the head-on crash. It was a typical injury in an abrupt deceleration scenario. The effect on the large vessel filled with blood during the sudden impact was similar to that of a balloon filled with water. The continued kinetic energy in the forward motion had nowhere to go once the outside casing was halted, thus resulting in enough force to cause the walls to give way at their weakest points.

Kreger thought about what might be able to tip the scales into his patient’s favor. His mind trying to emulate that of his Trauma Fellow, Garrett Trivoli, he considered all of the tricks she had taught him that could possibly help in the circumstance that he now found himself. He did not want to fail his patient and let down the trust that was placed into his hands by the trauma fellow.

"Damn!" His voice was sharp; "This flap is so flimsy, it just continues to tear the more I try to repair it." He blinked several times in succession as though trying to clear his view. "It looks like the weakened area is extending up into the carotid artery as it branches off of the aorta."

What had started as only a small tear was now becoming more unmanageable as the seconds ticked on. He was losing precious time that would ultimately result in the demise of his patient.

Kerger bit at his lip nervously. His decision was being made for him and there was nothing he could do about it. Clearing his throat, he barked out, "Page Dr. Trivoli to the O.R., STAT!"

The small form lay silent on the cradle of the CT Scanner, the only sounds coming from the room were that of the rhythmic cycling of the mechanical ventilator that forced air into his lungs and the whirring of the circling X-ray tube within the gantry of the scanner itself. The saying that "a picture is worth a thousand words" came to mind as Danni watched the grim faces of the doctors. The CT Technologist shifted her position to reach for some paperwork allowing the petite nurse to maneuver herself to get a look at the images that were appearing on the monitor screen. The nurse had seen enough scans in her career that she knew something was definitely wrong. The image that she saw on the screen was nothing like what she was used to seeing. Her eyes traveled to her electronic monitoring devices as she jotted down their readings onto the patient flow sheet making sure to note the time. It was 2047.

Michelle Payo, the Neurosurgery resident on-call for the night had arrived and was watching the last few images come up on the screen. She was of medium height and her pregnancy was obvious, compared with her rather small body frame, her white lab coat hanging open around the protruding form. Shaking her short brown hair, she let out a deep sigh. "May I see," she asked as she pointed to the screen.

"Sure, doc," the CT Technologist began cueing up the first image and slowly ran through them all.

"Well, what do you think, Michelle?" The surgeon was sure that the answer would not be good.

Looking up from the screen and out to the patient, the Neurosurgeon asked, "Did you give him any paralytics?"

"No, he hasn’t had any."

"How about the initial neuro exam, any stimulus?"

"No, nothing, not even decorticate posturing." The surgeon’s voice reflected the severity of the young man’s injuries.

Pursing her lips as she gently patted her pregnant belly, the small woman sighed deeply. "I don’t know of anything that we could do. It already appears that he has sustained an anoxic injury to the brain." She shifted her weight to the other foot, "With the extent of the skull fractures, I’d have to say that the only thing to do now is see if the next of kin will consent for him to be a donor." The young woman looked up to the tall trauma fellow; "There is really no hope for this kind of injury. The respirator will keep his body alive, but the brain will have no function whatsoever. I’d be pretty certain to say that he is brain dead."

Garrett looked away. Her face took on a disgusted scowl as she sucked in on her lips. Letting out a soft snorting sound, she shook her head. "Scan his chest and abdomen. Let’s see if there is anything going on with the vital organs."

The petite blonde nurse wrinkled her nose giving her a questioning look.

"Have the social worker find out if there is any family and contact C.O.R.E." The surgeon was disappointed, "There is nothing more we can do for him, Danni," she offered, "but maybe we can help someone else."

The nurse blinked her eyes to catch the small tear that was forming, "Alright, I’ll let the social worker know. I think that I saw Alex earlier tonight." She turned to the right and reached for the wall phone.

"Dr. Trivoli, Please report to O.R. #1 STAT!" The loud speaker blared, paused, and repeated again.

Garrett’s attention was grabbed as though someone had reached out and vigorously shook her without any warning. Almost immediately her pocket came to life with the sound of the pager beeping. She looked down and studied the number that was imprinted across the display screen. She looked over to Danni, "It’s the O.R., call them and tell them I’m on my way." The tall athletic body of the surgeon was being propelled though the doorway by her long powerful legs as she spoke. She quickly made her way to the stairwell and taking the steps two at a time, she pushed herself up the two flights of stairs. The metal door at the landing slammed open as she launched herself down the hall in the direction of the O.R. entrance. Nearing the doorway she peeled off her trauma gown as she sidestepped her way past an X-ray Tech with a slow moving portable machine. Yanking the right side half of the double doors, she entered into the main desk area. She slowed only long enough to grab a blue hair bonnet and shoe covers, while dropping the lead apron to the floor. Snapping the bonnet down over her shoulder length hair with one hand, she leaned on the desk for balance. "What’s going on?" Her words were punctuated by heavy breathing. She leaned over and slid her foot inside of the covers. The older woman at the desk looked up only to see the back of the surgeon as she vaulted down the hall.

Through the window in the door, she could see the scurry of activity in the operating suite. Hastily she picked up a facemask and placing it on her face, pinched the small metal piece over the bridge of her nose. Pushing open the doors, she entered the surgical arena. The circulating nurse was holding a gown that Garrett thrust her arms through, and spun around so as to have the gown tied shut. The surgeon reached for the pair of sterile gloves that had been laid out for her use as the nurse swiftly tied the loose ends of the facemask to secure it in place.

Striding over to the operating table, the surgeon snapped her gloves into place. "What’s going on, Rob? What can I do to help?"

"She’s bleeding out." His speech was fast and frank. "For every piece of the tear that I get sewn up, another area rips more." He quickly glanced over at Garrett. "I’m losing ground here," he confided.

"Hemostats! Suture!" The instruments were promptly placed into her outstretched hand as she entered into the life or death battle allied with Dr. Kreger.

The screams of anguish heard earlier were now turning into whimpers of discomfort as the medication began to take effect. Having thoroughly examined the man and ascertaining that his only apparent injuries were indeed the multiple fracture sights of both his legs, Dr. Potter felt obligated to ease the patient’s pain. A thought brought a smile to the freckled face of the physician, ‘I wonder if I gave him that to relieve his pain or more to relieve the pain we are experiencing from listening to his screaming.’ Much to the pleasure of all concerned, the medication was doing its job. A quiet peace was once again coming to the trauma hallway and the staff that still remained with the patient in Trauma Room #3.

Jamie stepped outside of the room to look at the X-rays that had already been done. She cued the viewer and began studying the routine films that were part of the trauma protocol. Having seen nothing to alarm or concern her on the cervical spine, chest or abdomen films, she felt good about her choice in pain control for the patient. Her job was just about done, and now it would clearly be an orthopedic case. Still, with the severity of the accident and knowing the fact that one person had been killed at the scene, she thought that it would be best to at least get a CT Scan of his abdomen, just to be on the safe side. She pondered only momentarily the wrath that she might incur from the tall, gorgeous, and demanding trauma surgeon if she didn’t.

"Lori, call CT and tell them we’ll need an abdomen scan for this patient," she said leaning into the doorway of the trauma room.

"Sure thing, Dr. Potter." The insecure nurse was beginning to regain her composure. Her shyness was something that she had trouble with all of her life. She loved being a nurse, but felt at times somewhat overwhelmed by the emotional demands of her patients. Her conservatively styled blonde hair and tall shapely body made her look older, but when she smiled, the illusion was gone in an instant as the youthful appearance of braces glistened in the light.

Jamie was now watching, as the X-rays of the lower extremities were becoming available. Shaking her head at the multiple fractures that were very evident on the X-rays, she advised the young nurse, "It may be a while until Ortho has all of the splinting done. You may want to let them know in CT."

The nurse reached for the phone and did the doctor’s bidding. Hanging up, she informed the physician, "They’re just finishing up that second trauma now, so whenever we are ready will be all right with them."

"Good, and here comes Ortho now." She waited for the tall, lanky form to come closer to her before addressing him. "Hi! I don’t believe that I’ve met you," she held out her hand to him.

His large hand was gentle at the touch of the handshake. "I’m Dr. Armand Selep, I’m covering for your regulars tonight." His eyes held her in his gaze.

"Jamie Potter, E.R. Attending." She smiled pleasantly at him, her hand lingering in his grasp.

The young nurse looked at the two, feeling embarrassed by her intrusion on the intimate moment, she nervously coughed trying to bring them back to the realization of where they were. "Dr. Potter," Lori spoke softly. "CT Scan is waiting for the patient," she reminded her.

Surprised at her reactions to the tall dark-haired man, the physician could feel her face begin to flush. Trying as hard as she might to subdue her inner feelings, she quickly started rattling off a brief report of the patient’s mode of trauma and her findings. "Thirty year old male, unrestrained driver of a tractor trailer that was involved in a head-on crash with an SUV. Obvious deformity to the right leg and ankle, complaining of severe pain in both lower extremities." She pointed to the viewer where the X-rays of his legs were displayed. Clearing her throat, she continued. "There was a reported death in the SUV. We would like to have those legs splinted before he goes to CT Scan to check out his abdomen."

The tall doctor stood with his hand rubbing his face and the barely visible growth of beard, studying the X-rays. Blinking several times as he compared one view of the leg to the other, he began to shake his head. "Those are some pretty bad fractures." He paused and looked into the trauma room at the patient. "Seems pretty quiet for the likes of those injuries," he mused.

"Well, you should have been here when he first came in." Jamie chuckled, "We snowed him pretty good. He was disturbing the entire E.R. with his screaming."

"Yeah, I bet." Armand smiled down at the physician. "Let me get started splinting then," he said. "While he’s in the scanner, I’ll notify my attending. I’m sure he’ll want to take him to the O.R. tonight."

"All right, then." The red-haired doctor nodded in agreement. Adjusting her glasses on her face, Jamie watched as the orthopedic surgeon assembled his supplies to splint the legs.

The long, eerie-toned note was all that was heard, as the surgical team stood transfixed to the electronic monitoring devices. Garrett sniffed as she looked over to the large clock on the wall, "Time of death, 2113."

The anesthesiologist slowly turned off his monitoring devices. Suddenly the room became deafeningly loud with the silence.

She stepped back from the lifeless body on the operating table, snapping her gloves as she ripped them off of her hands and threw them into the waste bucket on the floor. She pulled at the mask on her face, ripping the ties with a strong yank of her hand. She spat into the waste bucket, using the mask to wipe her mouth and discarded it. Death always left a bad taste in her mouth, even if there was nothing she could do to prevent it.

Rob Kreger let his eyes fall into the gaping chest cavity that had been his center of attention for the last hour or so. He let his mind go over his actions and questioned the patient’s outcome. Perhaps he should have called sooner for the talented surgeon to assist him. Would that have made a difference? Had he allowed himself to become arrogant in thinking that he could do the job himself? Alone?

Slowly his hands busied themselves with the task of removing the rib spreaders that were used to gain access to the chest cavity and its contents. The draping was being removed from the face of the woman and he felt compelled to look at her features. He studied them intently, so as to burn them into his memory. This was the face of his first patient lost during an operation that he would call to mind during the rest of his career. He owed it to her and to all the patients he would treat in his lifetime. The lesson being to keep him humble, never denying to ask for help not for him but for his patient.

Long dark hair moved gently with the breeze as the tall form stood staring at the landing sight for the helicopter. The marker lights in the darkening twilight hours illuminated the helipad. Her back faced the trauma doors to the emergency area of the hospital, but she could somehow feel the presence of another human walking towards her. Sensing no danger, she remained absorbed in her thoughts.

The small hand reached out to touch her arm. "Gar…I mean, Dr. Trivoli,

Mom told me you were out here," Danni used her most comforting tone of voice.

"You were right the first time. I don’t much feel like a doctor right about now." She nodded absent-mindedly to herself.

"I’m sorry."

"No need to be, Danni." The surgeon turned to face her friend. "Some things just happen. We all tried the best we could." She shrugged her shoulders, "It just wasn’t meant to be."

Danni looked off into the distance, "I know that, but it’s hard knowing that you lost two from the same vehicle."

The surgeon cleared her throat, "Ah… actually it was all three that were in the same vehicle."

Danni’s head snapped around peering into the blue eyes of her roommate, "What do you mean, all three?"

"The driver of the vehicle was the one dead on the scene. The last flight crew showed me a Polaroid of him." She licked her teeth, making a dissatisfied expression, "It looked like a classic traumatic asphyxiation. He was dead before he knew what hit him."

"Oh," was all that the petite woman said, nodding her head knowingly. Her gaze fell to the ground as she stood there, pondering the results of the catastrophic accident. Her gentle nature was always thinking about the victim or the effect that the trauma would befall the survivors. She closed her eyes and prayed for strength to carry her through until morning when her shift would end.

Garrett broke the silence, "Any word yet on family?"

"No, but Alex said that she would let us know."

"She’ll notify C.O.R.E. then, when she finds out?"

The nurse nodded, "Yes, she thought that would be the best. Just in case there is no one with the authority to deal with the situation."

They stood there for several moments, each absorbed in their own thoughts. The air was turning colder and brought a shiver to the small blonde nurse. Rubbing her arms to get warm, "I’m going back in." She turned, taking several steps, then stopped abruptly, "Garrett?"

"Hmmm?"

"Would you like your duffel bag now, before we get too busy again?"

"Yeah, I guess I could use something to freshen up with right about now," her voice was teasing as she sniffed at her scrub top. "Whew!"

This action brought a smile to both of them as they headed back inside. The two roommates nudging one another with their elbows and giggling as they walked along was letting the tension of the last few hours ease on both of them. For a minute or two, they were able to act as though they still possessed the innocence of childhood.

Entering the E.R., the two were meet by an agitated charge nurse. "Oh, so there you are!" The older nurse shook her finger at the pair. "I’ve been looking all over for you two. You’re the hardest people I know of to find when there is good news."

Danni and Garrett exchanged glances with each other, shrugging their shoulders in unison, then slowly both looked down at the pagers on their clothing.

"Gee, Mom, it’s not like you couldn’t page us or something," Danni teased.

"Yeah, there for a while tonight, you were reading my thoughts like you were inside of my head. What happened?" An eyebrow raised as Garrett looked in her direction.

"Well, next time, short of setting off those darn trauma pagers again, I just might do that," she was becoming flustered.

"So what’s the good news, Mom?" The petite nurse tried to help Karen get back on track with her thoughts.

"Ah…oh! Yeah, you won the baby pool."

"Which one of us, mom?" She glanced up at Garrett, "We both guessed Nine fifteen."

"Well apparently you both won, Rene and his wife had twins; a girl at nine sixteen and a boy at nine eighteen. Surprised everyone including themselves," she chuckled. "They finally took her for a C-section. Seems you two were the closest to the actual times."

Danni looked up to the surgeon, noticing the lopsided grin on her face, "Well, how about that, roommate?" She winked. "We make a pretty good team, you and I," and her soft chuckle became infectious for all three.

The surgeon was taken by surprise at her permutation into a team player, even if that team only consisted of two. She chuckled along with them, but her laugh was more on the side of nervousness at this odd sensation, which was binding her to the small nurse.

Garrett thought about the time of delivery. "You know, it only seems fitting that those babies be born around that time."

"Why is that?" Danni had a half laugh sound to her voice.

"I pronounced the woman in the O.R. at 2113." The surgeon’s voice was somber with the reflection.

"Oh, I see." There was silence for a moment of reverent thought before the young nurse spoke. "You know, they say that when one spirit leaves this earth, another one comes to take its place." She shrugged her shoulders. "Life goes on."

"Hmm…interesting thought, Danni. Interesting in a lot of ways." Garrett wondered who would be the one to take over the place that was vacated in her life. She’d have to give this concept more thought when she had the time. Right now, she was just too tired to put forth the effort.