Chapter 3 - Triage and Tremors
The inside of the ambulance was a whirlwind of fluorescent glare, tearing plastic, and shouted medical jargon.
“Starting two large-bore IVs! Hang two units of O-negative blood right now!” the paramedic above me yelled. He was a broad-shouldered man named Dawson, his face drawn with the intense, focused fury of someone fighting the clock.
The needle bit into the vein of my left forearm. The cold rush of synthetic fluids and packed red cells hit my circulatory system, making my teeth chatter uncontrollably.
“Rebecca, stay with me,” Dawson commanded, pressing two fingers firmly against the carotid artery in my neck. “Look at my eyes. Keep your eyes on my badge. Don’t you dare close them.”
“My boy...” My tongue felt thick, coated with the metallic taste of severe internal hemorrhage. “Please... don’t let him die.”
“We’re not letting anyone die tonight,” Dawson said, his voice fierce, though his eyes darted toward the fetal monitor screen. The digital readout showed the baby’s heart rate bouncing erratically: 95... 88... 92... 80.
A normal fetal heart rate was between 110 and 160. My baby was suffocating in the dark, starved of oxygen as the placenta tore away from the uterine wall.
The ambulance rocketed through city intersections at eighty miles per hour, its siren screaming a relentless warning to the night. Through the tinted rear windows, I could see two State Police cruisers flanking our rear quarter-panels like attack dogs, clearing cross-traffic with their air horns.
Back at the house, the scene was rapidly deteriorating into chaos for Carter Vance.
As the ambulance sped away, Carter tried to step off the porch to follow in his BMW, but a massive state trooper in a high-peaked campaign hat stepped smoothly into his path, placing a leather-gloved palm flat against Carter’s chest.
“You’re staying right here, sir,” the trooper said.
“Get your hands off me!” Carter snarled, though his voice lacked the vicious bite it had possessed ten minutes earlier. “I am her husband and her medical proxy! I have the legal right to be at that hospital! You are committing unlawful detention!”
Eleanor appeared in the doorway, clutching a silk wrap around her trembling shoulders, her makeup smeared with sweat and shock. “Do you know who my brother-in-law is? Marcus Vance! He is the senior prosecutor for this entire district! If you don’t let my son pass, Marcus will have your badges by midnight!”
Special Agent Miller, still standing on the porch steps, pulled a secure satellite phone from his overcoat pocket. He didn’t look at Eleanor. He simply dialed a four-digit extension and put the phone to his ear.
“Marcus?” Miller said into the receiver.
Eleanor stopped mid-breath. Carter’s mouth fell open.
“Marcus,” Miller repeated calmly. “I’m standing on the front porch of 442 Elmwood Drive. Your nephew Carter has just committed felony aggravated assault resulting in severe bodily injury to a pregnant woman. His mother, Eleanor, appears to be an accessory before and after the fact. Carter has repeatedly invoked your name to obstruct law enforcement.”
A pause hung in the cold night air. Through the phone’s high-output earpiece, even Carter could hear the muffled, frantic voice of Marcus Vance—the man they treated like a demigod—stammering in sheer terror.
“Miller? Please, listen to me—” Marcus’s voice crackled through the speaker. “I didn’t know! Carter told me he married a girl from a farm up north! He said she had nobody! He never told me her maiden name was Hayes! I swear to God, Miller, I had nothing to do with this!”
“You’re on thin ice, Marcus,” Miller said, his tone devoid of warmth. “Arthur Hayes is currently aboard a private Gulfstream at thirty thousand feet, descending through ten thousand over the city right now. He personally called the Attorney General seven minutes ago. If that girl or that child does not survive the night, Arthur will not bother with the civil courts. He will dismantle your office brick by brick, and the Department of Justice will audit every single case you’ve touched in the last twelve years. Do you understand where you stand?”
“I... I understand,” Marcus choked out, sounding like a broken man. “What do you need me to do?”
“Tell your nephew to sit on his front steps, shut his mouth, and wait for the criminal investigation division to arrive,” Miller said.
Miller tapped the screen to put the call on speaker and held it toward Carter’s face.
“Carter!” Marcus’s voice boomed from the device, cracking with hysterical rage. “You idiot! You absolute, suicidal idiot! Do you have any idea who Arthur Hayes is?! He doesn’t own a farm! He owns Hayes Heavy Industries, Hayes Aerospace, and three-quarters of the energy infrastructure in the Midwest! He is the chief benefactor of the federal judiciary! Sit down on the damn porch and don’t say another word until I get there, or I will prosecute you myself!”
The line went dead.
Carter’s phone slipped from his hand, tumbling down the three wooden steps and landing face down in the manicured lawn. His knees seemed to lose their structural integrity; he sagged against the white porch railing, staring into the dark street where neighbors were now peering out from behind drawn blinds.
“Carter...” Eleanor whimpered, reaching for his sleeve. “What is he talking about? Her father... her father drives an old Ford truck...”
“Shut up, Mother,” Carter whispered, his eyes hollow, staring at the flashing red lights reflected in the wet asphalt. “Just... shut up.”
At St. Jude’s Regional Medical Center, the ambulance bay doors were already thrown wide open.
A trauma team of twelve doctors and nurses in sterile surgical scrubs stood waiting on the ramp under the blazing halogen floodlights. At their head was Dr. Alistair Vance—no relation to Carter, but rather the Chief of Pediatric Surgery and the most renowned neonatal trauma specialist on the Eastern seaboard.
The ambulance screeched to a halt, the rear doors flying open before the chassis had even settled on its springs.
“Twenty-four-year-old female, twenty-eight weeks gestation, grade three placental abruption secondary to blunt force trauma!” Dawson yelled, shoving the gurney out onto the ramp.
“We’re bypassing trauma bay one,” Dr. Vance announced, jogging alongside my gurney as we entered the automatic sliding doors. “Operating Room Four is prepped for an emergency crash C-section. Get the general anesthesia team scrubbed. We need the neonatal intensive care transport isolette running at thirty-seven degrees Celsius right now!”
The fluorescent light fixtures in the hospital ceiling blurred into a continuous white ribbon above my face. Nurses were ripping open surgical packs, the smell of iodine and betadine washing over me.
“Rebecca,” Dr. Vance said, leaning down close to my ear, his blue eyes calm behind his clear protective visor. “My name is Dr. Vance. Your father called me directly from his plane ten minutes ago. I promised him I would take care of you and your son. You are going to sleep now. When you wake up, we will have done everything humanly possible.”
“Save him,” I whispered, tears cutting clean channels through the dried blood and sweat on my cheeks. “Please... just save my baby.”
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The anesthesiologist pressed a clear plastic mask over my nose and mouth. The sweet, chemical scent of sevoflurane filled my lungs.
The frantic shouting of the surgical team, the high-pitched alarms of the vital monitors, and the searing agony in my abdomen began to fade into a deep, rhythmic hum—like the sound of an airplane engine cruising through the dark clouds far above the earth.
