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to his abdomen. “Stomach. My chest.”
They rolled the gurney into the trauma room, and an instant later they’d moved Tommy, still strapped to the backboard with his head immobilized, to a hospital bed.
“Just hang on a little bit longer while we run some tests and take a few pictures,” Ethan told the youngster kindly. “Can you do that for me, sport?”
Tommy’s lower lip trembled. “I’ll…I’ll try.”
Ethan stroked a wayward lock of hair out of Tommy’s eyes. “Fair enough.”
Ivy had been afraid Ethan didn’t have a compassionate cell in his body, but his simple, kindly actions blasted away her lingering doubts. He might be gruff, but he cared about his patients.
What in the world was he doing in Danton? Even if he wanted an extended vacation, she would have guessed a more exotic, touristy place would have been his choice.
“If you don’t need me anymore, Doc,” Ben said to Ethan, “I gotta go back. They were using the Jaws of Life to extricate the driver of the van when we left, and because they aren’t back yet…”
“Marybeth?”
Ben looked surprised. “Do you know her?”
“Only what Nancy told us before you arrived. And if Nancy says we can manage on our own, then we’ll see you later.”
The nurse looked surprised, but pleased he’d consulted her. “We’ll be OK. See you later, Ben.”
“Thanks for your help,” Ethan seconded, before he addressed Nancy. “Start another IV, large bore needle with lactated Ringer’s.”
An instant later he patted the boy’s hand and began examining his abdomen and chest. Suddenly he cocked his head and frowned, as if he’d heard something he didn’t like.
Ivy listened, too, and recognized the distinctive wail of babies—the same noise she’d blocked out earlier.
“Still here, Dr. Harris?” Ethan mentioned idly.
Caught in the act! But it had been worth it, because she’d seen enough to rest easier in the abilities of her temporary partner. “I’m leaving now,” she promised, doing just that.
Yet as she examined the twins, ordered a few precautionary X-rays and lab tests, as well as a bottle of formula for each, she found herself impatient to return.
Funny thing how Ethan’s training and previous experience as a general pediatrician seemed to surface from out of nowhere as he examined his young patient. Apparently it was true that some things, like riding a bike, just weren’t forgotten, because from the moment Ethan saw the bruises on Tommy’s torso, the abdominal rigidity, cool clammy skin and shocky vital signs, he knew what to do. Grateful that he wasn’t in over his head as much as he’d feared, he relaxed a bit and mentally ran through the diagnostic protocol.
“I want cervical and lumbar spine X-rays, as well as chest and abdominal films,” he told Nancy, guessing that the two people lingering in the background were the lab and X-ray techs. “A CBC, basic chemistries, liver enzymes, renal function, amylase, type and cross-match for two units, coag studies, and a urinalysis. Stat. Any chance we can get a CT scan?”
Nancy shook her head. “Sorry. We’ve been trying to raise money for a scanner, but haven’t yet.”
The scan would have ruled out intra-abdominal or peritoneal bleeding, but if one wasn’t available then he’d have to depend on other tests to make his diagnosis. For the first time since he’d left St. Louis he realized how fortunate he’d been to have every resource available.
He stepped aside to allow the techs to work, remaining nearby to watch Tommy’s monitors, guess at his weight and double-check his mental calculations for the amount of fluid replacement.
By the time Ivy rematerialized he’d run a nasogastric tube and ruled out a stomach injury, gotten a baseline hemoglobin level from the lab, studied the films and decided the spine immobilization could be discontinued—although he’d feel better if a radiologist had given his seal of approval.
“Reinforcements have arrived,” she said cheerfully. “What can I do?”
“Find a surgeon in the next thirty minutes.”
“I wish. What’s the problem? Internal bleeding?”
Ethan pulled her aside. “I think his spleen’s ruptured. I don’t have a second hemoglobin level yet, but he has all the signs, especially abdominal pain and tenderness, pain in his left shoulder, and being shocky. The question is, do you want to observe him here and then Medevac him out when we know for certain, or move him close to an O.R. now, before he needs one?”
“Do you really have to ask?” Her tone was wry.
“I’d vote to move him out now, but this is my first day on the job,” he reminded her. “I’m still learning your protocol.”
“The only protocol I have is that I make a point never to gamble with my patients’ lives. I’d rather give them an unnecessary helicopter ride than hold them here until it’s too late.” She met his gaze. “Do you have a problem with that?”
“Not at all,” he admitted. “I’d hoped you’d agree with me.”
“Then I’ll make the arrangements.”
“As an FYI,” Ethan mentioned before Ivy got too far, “Ben said they were using the Jaws of Life to free this Marybeth person, so she might need to catch a chopper ride, too.”
“I’ll notify the air dispatch.”
After making the flight arrangements, Ivy ran into Jed outside the trauma room. The same age as Walt, Jed was looking as haggard as Ivy felt.
“Busy day for you, too?” she commiserated.
He smiled. “I haven’t worked this hard in years. How Walt did it all by himself is a mystery. Not to mention downright miraculous.”
Ivy chuckled. “I have to agree.”
The ambulance bay doors whooshed open and the E.M.T. crew wheeled in another victim. At the same time the main doors at the other end of the department flew open, and a crowd of frantic adults rushed through.
“Have fun with that group,” Jed murmured, before he sprinted toward the incoming gurney and disappeared inside the trauma room where Ethan and Tommy already were.
Immediately Ivy was surrounded by parents asking after their children. After trying unsuccessfully to get a word in edgewise, she gave an unladylike whistle.
Complete and utter silence followed.
“Who belongs with Suzy and/or Emma?”
A young couple and a single woman raised their hands.
“Tommy?”
“He’s our son,” another couple said.
Ivy smiled. “Dr. Ethan is with him right now, but I’ll let him know you’re here. The rest of you—” she glanced at the other parents “—come with me.”
She led her group to a nearby treatment room, where she paused in the hall. “Both Suzy and Emma are fine,” she told them. “They have some bruises and bumps, and will be sore for a couple of days, but nothing that a few hot baths and plenty of rest won’t cure.”
“Are you sure?” The woman who’d identified herself as Emma’s mother asked.
“Absolutely. But if they complain about anything new in the next couple of days, be sure you bring them in. In the meantime they can have acetaminophen to ease their aches and pains.”
“Thanks, Dr. Ivy.” Suzy’s father pumped her hand. “We appreciate this.”
“Can we take our girls home now?” Emma’s