Fertility: A Novel (21 page)

Sarah nodded.

“How old are you?”

Again, he pulled down the mask.

“Thirty-two.”

It was like a dance in which the EMT led and Sarah willingly followed. As the other rescuers continued their digging, he’d ask a question and pull down the mask. She’d answer and then he’d firmly replace it over her nose and mouth.

“Very good, Sarah. Do you have any medical problems that we should know about?”

“I have no problems,” she said. The irony was not lost on the EMT.

“Great. You’re doing great, Sarah. Just a few more questions. Do you have any allergies to medications or latex?”

“No allergies. Please. My baby. You’ve got to get me out. Call Dr. Scholl, Jared Scholl.” She suddenly was gripped by fear when she realized the baby had stopped kicking. “Oh God, the baby’s not moving.”

Tommy didn’t miss a beat. “Oh, babies get quiet. You know that, Sarah. It’s probably taking a snooze now,” he said, hoping to God he was telling the truth.

“Yes, yes. I forgot.”

Tommy persisted with his questions. “Do you have any pain?”

“My leg. At first it hurt so much. Now I can’t feel it.”

“Can you tell me which leg?”

She closed her eyes and tried to visualize her legs, moving the toes in her left boot. “The right leg.”

“Okay, that’s great Sarah, you’re doing great.”

“Are you on any medications?” Tommy asked.

“Prenatal vitamins.”

Just then the rescue workers dug out Sarah’s left arm.

“Can you move that arm for me, Sarah?”

Sarah moved it across the mound of debris.

“Great, Sarah. Any pain when you move your arm?”

“No, no pain.”

“I need to get a blood pressure reading on you, but it means I’m going to have to cut the sleeve of your coat.”

“All that matters is the baby. You’ve got to save the baby. Please.”

Tommy called out, “Get me a blanket.” In no time, his partner, Ed, was at his side with the blanket so Tommy could wrap her arm once the clothing was cut off. The last thing his patient needed was frostbite.

Using the same scissors Caroline had used to cut the face mask, the EMT sliced through the sleeve of the wool coat, then the jacket of the pantsuit and finally the turtleneck, exposing Sarah’s bare arm. He wrapped the cuff around it and covered it with the blanket. The machine read out 90/45 with a rapid heart rate. The pulse ox machine showed a blood oxygen saturation level of ninety-four percent with two liters of oxygen. Under ordinary circumstances that would be fine, but he knew in pregnancy, vital signs were not always reliable. To make things even sketchier, pregnant trauma victims didn’t necessarily present with the usual signs of shock from blood loss. Who knew what was going on under that mound of wreckage? She could be bleeding out. He’d better get her started on an IV with Ringer’s to maintain maternal and fetal perfusion. As he worked to get the IV started he kept Sarah engaged in conversation.

“Sarah, can you tell me how your blood pressure usually runs?”

“It runs low.”

“Okay, that’s great. You’re doing great. And the guys here are digging you out to beat the band. So, you have no medical conditions that the docs should know about?”

Sarah shook her head.

“You mean to tell me you’re healthy as a horse, Sarah?”

“Well,” she hesitated, “until now.”

Tommy couldn’t have asked for a better response. The patient was lucid, that was for sure. “You’ll be out of here in no time. In just a few minutes we’ll have all this crap — pardon my French — off of you. In the meantime I’m going to save the nurses at the ER a little work by starting you on an IV right here in the field. Hold on. It will pinch just a little.”

As he wiped her arm with alcohol he kept up his end of the conversation. “So Sarah, you having a boy or a girl?”

“I don’t know. I wanted it to be a surprise.” She started crying again.

“Don’t worry, Sarah, you’re going to have your surprise before you know it.”

“Really? You think it will be born soon?”

“Could be,” said Tommy as he found a good vein for the IV. Ed worked with him to get the IV taped in place. After the Ringer’s was running well Tommy wrapped Sarah’s arm with the blanket.

“Sarah, do you have an emergency contact you’d like us to get in touch with?”

“My parents. My mother’s my labor coach.” Sarah started rattling off their phone numbers.

“Whoa, whoa, whoa. Hold your horses, Sarah. My memory’s not the best. If we rely on my memory, likely as not I’ll come up with a number from Timbuktu. Just a sec.” He reached for his radio to call dispatch with the numbers. Just then an ambulance flew by with its siren screaming, shepherding another victim to the hospital. When it passed he called his dispatcher, put his ear close to Sarah and parroted what she said as she recited the home and work numbers of Eva and Joseph Abadhi.

Just as she finished, she felt a shiver go through her body; a moment later she felt another and then another. Suddenly, she couldn’t stop shivering. Tommy was worried about hypothermia given the air temperature and the temperature of all the debris that buried her.

“Okay, Sarah. Are you getting cold?’

“Oh, I’m so cold. I can’t stop shaking.”

“Okay if I take your temperature, Sarah?

“Why am I shaking?” she asked as she nodded her ascent, teeth chattering like cartoon characters she had watched as a child.

“Well, let’s see what the thermometer says and then I’ll be in a better position to give you an answer.” Tommy reached into his bag for the digital thermometer and then put it into her left ear. In seconds it beeped. Tommy looked at the reading: 94.9 F/35 C. Shit. Now he had to worry about hypothermia on top of everything else. He hoped they got this woman out of her death trap soon. Tommy gave a knowing look to Ed.

“Okay, Sarah, your temp has dropped a bit because it’s a freezing cold day and your body is just trying to warm itself by shivering. That’s all the shaking means. It’s completely normal, a natural response to the cold. That’s all it is.” Ed radioed ahead to the ER to be ready with warming blankets.

Tommy was right about getting Sarah dug out quickly. Eighteen minutes after the German shepherd discovered her, the rescuers had removed most of the debris from her body. It was then that they saw why she couldn’t move her leg. A steel construction stud from the condo project — ten feet long, six inches wide, and nearly two inches thick — was planted across the blood-tinged shearling boot covering her right shin. Her lower leg was lying at an unnatural angle, apparently fractured at the calf by the steel stud. A firefighter with a hydraulic demolition shear was there in moments and started cutting through the steel. As he worked, the others stood back, waiting for the moment when the last remnant of their victim’s entombment would be cut away.

CHAPTER TWENTY-TWO

As rescue efforts were ramping up just blocks away, Jeff Gotbaum was finishing a successful surgery on a seventeen-year-old girl who had been injured in a car crash on the FDR Drive. Changing out of his scrubs, he congratulated himself on acing the femur repair. Just as he was tying his shoes his cell went off, alerting him to an incoming trauma. He had been looking forward to grabbing something from the cafeteria after the four-hour procedure. Instead, he pulled a protein bar out of his locker and headed to the ER.

Coming through the doors, he immediately knew something big had happened. The place was hopping. Then he heard the harpist playing, a new initiative aimed at calming patients during their time of distress. It gave him the willies and he guessed he wasn’t alone. He made a beeline for the nurses’ station.

“I’m Dr. Gotbaum, orthopedics,” he said, identifying himself to an attractive ER nurse he had never seen before. He glanced down at her left hand and noticed her ring finger was bare. “You have a patient in need of my finely honed skills and expertise?”

To his disappointment, the pretty nurse’s response was all business. “Trauma room 2. A thirty-two-year-old primigravida, full term, open, multifragmentary fracture of the lower right leg.”

“Thanks very much.” Jeff made a mental note of the nurse’s name — Cheryl Aiello — and walked quickly to the trauma room, where emergency surgery could be done if need be. Perhaps they were thinking of delivering the fetus immediately. That would make his job easier.

Trauma 2 was abuzz. He recognized the OB, Dr. Catherine Hanna, but he didn’t know the other attending. Probably a neonatologist for the fetus. The ER docs were working to stabilize the patient. From the looks of the monitors, things were okay on that front. She was already getting a unit of whole blood. He motioned to Dr. Hanna to meet him outside so he could get brought up to speed. The OB joined him in the corridor.

“Hey, Catherine. So what have we got here?”

“The woman was hit with falling debris from the crane accident over on Lexington. They had to dig her out. I guess she was buried alive.”

“You’re kidding. There was another crane accident? Wasn’t there one a couple of months ago?”

“Hey, Jeff, one more crane falls from the sky and I’m getting out of the city. What good are lower crime rates and cleaner streets when cranes keep toppling from construction sites?”

“I know, it’s nuts. But tell me about our patient.”

“She’s full term and for the moment the baby is hanging in there with a heart rate between 130 and 140. Jeff, I’m no orthopedic surgeon, but I’m thinking her lower leg may be beyond even your fine surgical powers. I’d like to get that baby out right away and then let you go at it.”

“That’s fine with me. Do we have any imaging?” Jeff inquired.

“She’s been x-rayed and scanned. No internal bleeding to major organs, which is incredibly lucky from what the EMTs told me about the scene.”

“So are you thinking of doing the section here, or do we have time to get to the OR?”

“There’s an OR ready, so I’d rather do the section there and then just hand her off to you.”

“Is the patient alert?” Jeff asked.

“Amazingly, she has her wits about her. She was headed toward hypothermia laying out in the cold under all that debris. But since she arrived in the ER, we’ve gotten her temp back up to 96.8. She’s desperate about her baby. I don’t think she has any idea what shape her leg is in.”

“Do I have time to take a look before we head upstairs?”

“What kind of time are you talking about?”

“Give me five minutes,” Jeff said. “I’d like to introduce myself to the patient and lay eyes on the trauma.”

“I’ll give you three, and then we’re outta here.”

Jeff had to make his way through a gaggle of nurses, aides and doctors to approach the patient. What he saw was a very pregnant Caucasian woman, her curly hair caked with reddish-brown dust. Her brow was cut but the rest of her face was pale and smooth. It was a face that seemed somehow familiar. Then he caught it: The woman was a dead ringer for Rick’s old girlfriend, Sarah — or her sister, if she had one. It was the patient’s wristband that was the stunner: Abadhi, Sarah. The ER doc, Jim McReynolds, snapped Jeff back to attention.

“Hey, Jeff,” McReynolds said, beckoning him to the corner of the room. “We’ve got an open, compound fracture. Pictures show both the tibia and fibula were crushed by a metal construction stud the rescue guys had to cut off her with the Jaws of Life. She was pinned for about thirty-five minutes before they got her out. Circulation was compromised. Some blood loss, so we started her on one unit. The patient is responsive.”

“Thanks, Jim. I know her — a friend of a friend. Has her husband — or the baby’s father — been called?”

“There’s no father in the picture. We asked. Her parents have been called. I guess they’re on their way.”

No father. What the hell? But he had no time to figure out how Sarah could be ready to deliver a baby. “Okay, thanks, Jim. Let me take a look,” Jeff said, trying to sound detached and professional.

Returning to Sarah, he lifted the sterile dressing that covered her right leg. As McReynolds had reported, the tibia and fibula appeared to have multiple fractures. Bones protruded through the skin in at least three places. He found a strong pulse in her left foot and a significantly weaker one in her right, which was no surprise given the magnitude of the injury. With a break caused by such a high-energy impact, it was amazing that major blood vessels hadn’t been severed.

This was exactly the type of devastating injury he’d trained for, and as a first-year attending he was already gaining a reputation as something of a miracle worker. He hated to admit defeat and, more times than not, he didn’t have to. That doggedness, that refusal to give up until he had tried every approach to the problem at hand, set him apart from other surgeons who lacked the hunger to hit it out of the park every time they scrubbed in.

After covering the injured leg with the sterile dressing, he turned to McReynolds and told him to page a vascular surgeon. He flashed back to the three of them — Jeff, Rick and Sarah — running along the river, with him struggling to keep up. Now he would have to pull out all the stops to save her leg.

His promised three minutes were up and he had yet to share his anticipated treatment plan with the patient. He wondered if she would recognize him — particularly given all that had apparently transpired since their morning runs.

“Sarah. It’s Jeff Gotbaum.”

Sarah turned toward the voice and opened her eyes to see a familiar face.

“Jeff? What are you doing here?” Sarah whispered. She thought she heard a harp. Maybe she was hallucinating. “Is it really you, Jeff? I feel like I’m in a dream.”

“Yes, indeed. You’re not dreaming. It’s really me. Jeff Gotbaum, at your service. We’re kind of in a hurry to deliver your baby, but after that I’m going to be fixing your leg.”

Jeff’s words about delivering the baby focused her attention. She started to talk, but Jeff couldn’t make out the words.

“What was that?” he asked as he put his ear closer to her face.

“You’re going to be my doctor?”

“Sure am. Lucky coincidence, eh?”