smiled.
Doctor Novak studied the monitor, as if in disbelief.
David FitzHarris arrived with a man of around six foot four, fit, with wavy blond hair and pale eyes, and four gold bars on white epaulettes. Judging by the way the room fell silent, he was superior in rank.
Hands behind his back, he surveyed the scene. ‘What is the situation?’
‘Gunshot to both knees,’ Novak stated. ‘Close range.’
Anya kept an eye on the vital signs. ‘He’s stable for the moment, but . . .’
‘Captain Burghoff,’ FitzHarris interrupted, ‘this is Doctor Crichton, and Mr Hegarty, who were invaluable this morning.’
‘Ah, yes.’ He bowed his head. ‘We are grateful for your assistance, then and now. How long before the patient needs specialised hospital treatment?’ Captain Burghoff checked the clock on the wall and immediately moved to the X-ray images on the screen, hands still firmly at his back.
Anya studied them again, from behind his shoulder. There was no need to explain what they showed. The femurs were damaged far beyond pinning or plating, even by the most experienced surgeons with every facility available. She knew they had only bought a short amount of time. The tourniquets could not remain on for hours without compromising circulation to the good tissue in the legs. Loosening them could result in the release of deadly amounts of potassium, the same thing that killed crush victims if they were lifted out too quickly.
Doctor Novak had begun to scrub. ‘If I operate, he should be stable until Bora Bora.’
That was five days away, Anya thought.
‘Do you have an anaesthetic protocol?’ Martin asked, as if reading Anya’s mind.
Karen answered. ‘Propafol. It’s attached to the portable ventilator under the bed. Number two on the picture.’
All equipment had been photographed and placed on the walls. It meant that, if necessary, non-trained personnel could assist. It also removed language barriers in emergencies. In medicine, pictures were universal.
Martin scanned the laminated document. ‘I’ve used this type of ventilator before, transporting ICU patients. The protocol’s pretty straightforward, but . . .’
Captain Berghoff nodded. ‘If we turn back to Hawaii at full speed, we are at least sixteen hours from range for a medical evacuation. Either way, we are headed into severe storms.’ He paused, and surveyed the blood on the floor and on Karen’s clothes. ‘I suggest you do what you can.’
There was little choice if emergency care was so far away. Anya made her mind up. ‘I’ll intubate and monitor the anaesthetic.’
‘What about patient consent?’ Rachel’s voice sounded half an octave higher. ‘He’s had morphine.’
‘He was not rational with the pain,’ Doctor Novak snapped. ‘He will have time to discuss more surgeries once he is at hospital. Now, we save his life.’
‘I give you all the authority and indemnity to do whatever procedures are necessary,’ the captain announced.
The issue had not occurred to Anya. International waters were a medico-legal minefield if anything went wrong with the surgery.
‘Thank you,’ she said. ‘Doctor Novak is right. There’s no other option. We’re going to have to do a bilateral amputation.’
Martin and Karen had already begun to roll the patient onto his back. He had gone quiet after the last dose of morphine.
Reluctantly, she moved to the head of the bed and placed the rubber mask on Carlos’s face. Martin prepared the anaesthetic agent. Anya would intubate once Carlos was fully asleep.
Suddenly, his body tensed and the fear returned to his eyes. She removed the mask and bent down to reassure him.
‘Kill her . . . Stop . . . him.’
7
At the bar on the pool deck, Anya ordered a lemon, lime and bitters and thought about Carlos’s words. The shooting could have had something to do with what he knew about Lilly Chan. Then again, he could have just heard about her death and been hallucinating with the
Doctor Novak studied the monitor, as if in disbelief.
David FitzHarris arrived with a man of around six foot four, fit, with wavy blond hair and pale eyes, and four gold bars on white epaulettes. Judging by the way the room fell silent, he was superior in rank.
Hands behind his back, he surveyed the scene. ‘What is the situation?’
‘Gunshot to both knees,’ Novak stated. ‘Close range.’
Anya kept an eye on the vital signs. ‘He’s stable for the moment, but . . .’
‘Captain Burghoff,’ FitzHarris interrupted, ‘this is Doctor Crichton, and Mr Hegarty, who were invaluable this morning.’
‘Ah, yes.’ He bowed his head. ‘We are grateful for your assistance, then and now. How long before the patient needs specialised hospital treatment?’ Captain Burghoff checked the clock on the wall and immediately moved to the X-ray images on the screen, hands still firmly at his back.
Anya studied them again, from behind his shoulder. There was no need to explain what they showed. The femurs were damaged far beyond pinning or plating, even by the most experienced surgeons with every facility available. She knew they had only bought a short amount of time. The tourniquets could not remain on for hours without compromising circulation to the good tissue in the legs. Loosening them could result in the release of deadly amounts of potassium, the same thing that killed crush victims if they were lifted out too quickly.
Doctor Novak had begun to scrub. ‘If I operate, he should be stable until Bora Bora.’
That was five days away, Anya thought.
‘Do you have an anaesthetic protocol?’ Martin asked, as if reading Anya’s mind.
Karen answered. ‘Propafol. It’s attached to the portable ventilator under the bed. Number two on the picture.’
All equipment had been photographed and placed on the walls. It meant that, if necessary, non-trained personnel could assist. It also removed language barriers in emergencies. In medicine, pictures were universal.
Martin scanned the laminated document. ‘I’ve used this type of ventilator before, transporting ICU patients. The protocol’s pretty straightforward, but . . .’
Captain Berghoff nodded. ‘If we turn back to Hawaii at full speed, we are at least sixteen hours from range for a medical evacuation. Either way, we are headed into severe storms.’ He paused, and surveyed the blood on the floor and on Karen’s clothes. ‘I suggest you do what you can.’
There was little choice if emergency care was so far away. Anya made her mind up. ‘I’ll intubate and monitor the anaesthetic.’
‘What about patient consent?’ Rachel’s voice sounded half an octave higher. ‘He’s had morphine.’
‘He was not rational with the pain,’ Doctor Novak snapped. ‘He will have time to discuss more surgeries once he is at hospital. Now, we save his life.’
‘I give you all the authority and indemnity to do whatever procedures are necessary,’ the captain announced.
The issue had not occurred to Anya. International waters were a medico-legal minefield if anything went wrong with the surgery.
‘Thank you,’ she said. ‘Doctor Novak is right. There’s no other option. We’re going to have to do a bilateral amputation.’
Martin and Karen had already begun to roll the patient onto his back. He had gone quiet after the last dose of morphine.
Reluctantly, she moved to the head of the bed and placed the rubber mask on Carlos’s face. Martin prepared the anaesthetic agent. Anya would intubate once Carlos was fully asleep.
Suddenly, his body tensed and the fear returned to his eyes. She removed the mask and bent down to reassure him.
‘Kill her . . . Stop . . . him.’
7
At the bar on the pool deck, Anya ordered a lemon, lime and bitters and thought about Carlos’s words. The shooting could have had something to do with what he knew about Lilly Chan. Then again, he could have just heard about her death and been hallucinating with the
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