The Wolf She Sever Knew

The road was dark, quiet, like the world was taking a breath as Elara Grey walked alone after her shift at the biker bar she worked at. The Crimson Fire was the biggest, rowdiest biker bar around, and everybody knew it. It sat back in the greenest part of town on a lonely highway, just far enough away from town to be considered out of county. They sported several pool tables, darts, a stage, and 3 bars it was the largest around that is probably why it was the rowdiest of its kind. Bikers from all over would stop just to say they survived it. They even had a T-shirt that said it. Elara worked there while she was going to college, but her college plans didn't work out so well; she flunked out after the 2nd year. She only received her AA degree in psychology. She often felt lost and alone out here on these quiet nights. With only the company of the owls and lightning bugs to keep her company. She was lost in her thoughts of all her failures when she heard a twig snap behind her. She turned her head quickly toward the sound and stopped dead in her tracks. She wasn't paying attention to anything but that crack that was deeper in the woods as she thought to herself; it was probably just a deer. When she turned around, a car was headed right for her. She didn't have time to move out of the way, for the driver was all over the road. Obviously drunk, the driver hit her; she smashed into the windshield and over the roof, head over feet, landed on the pavement, crushing her arm in the process, and her head hit the pavement so hard it bounced twice. That sobered up the driver fast. Dwayne, an orderly at the hospital, thankfully. For her sake. Jumped out of his car and ran to her side, his phone already dialing the ambulance driver's personal cell. He saw that she was unresponsive; he began CPR at 3:03 am. He left the line open as they continued to instruct him. He was celebrating his niece's graduation, had one too many, and should not have driven. He was kicking himself in the ass as he reached for her pulse at 3:20 am and yelled, "Mike, she has no pulse! Do I keep going?" "Yes!" Dwayne continued CPR until his arms felt like they were going to fall off. When he heard a crack, he screamed, "Oh s**t, I'm so sorry." The paramedics heard Dwayne over the open phone line and knew what had happened. "Dwayne, don't stop until we get there. Do you hear me? Try to go for as long as you can; we will be there in 5 minutes." Dwayne didn't stop; he kept going: one, two, three, breathe, one, two, three, breathe; he kept chanting to the beat of staying alive in his head. Stupid song, he thought, as he kept going over and over again; the five minutes felt like an eternity. When the paramedics arrived, they rushed out of the ambulance, medical kits in hand, as the siren was blaring and lights filled the area for about a mile in each direction. Dwayne stopped, turned to the left, and puked. Right there, no warning, just puked, and then he backed away, shaking. "Oh dear God, please help her, don't let her die!" He sat on the side of the road with his knees pulled up to his chest, rocking back and forth, trying to calm his nerves down. But the only thing that would help is if...Beep… Beep. Beep. Beep... Beep. Beep. The sound of the heart monitor started, and he knew she had a fighting chance. "Oh, thank God." He moaned out loud. Mike looked over at Dwayne, "What the hell happened, Dwayne?" as his partner brought the stretcher over to load her into the back of the ambulance. Dwayne sighed and said, "I f*****g hit her, man. I was drinking, and I guess I had a bit too much and didn't see her until it was way too late." "Oh f*****g hell, Dwayne, you're f****d, you know that, right?" Dwayne was white as a sheet. He didn't care about himself right then; all he cared about was that she lived. "Please get her there as quickly as you can," he started for his car as they loaded her in the back. "And Mike...Please don't let her die," he practically begged as he opened his car. The windshield was cracked and spider-webbed across the left side, but he could still see out the window enough to follow them to the hospital. ~~In the Ambulance~~ Mike radioed ahead and said, "We have a 30-year-old female driver's license in her bag states, Elara Grey, Caucasian, Female, approximately 185 pounds; patient was non-responsive on the scene, hit by a drunk driver who performed CPR, and was able to revive on scene. Pulse is thready but continuous; multiple lacerations, crushed arm with obvious deformity, suspected rib fractures, possible head trauma, abdomen distended, possible internal bleeding. We are out by 20 mins. Please advise." "Copy that, Medic 1. Received report for 30-year-old female, Elara Grey. Confirming 20-minute ETA. Hospital St. Francis Memorial Hospital is notified, and the trauma team, surgery, and blood bank will be standing by for your arrival" "Secure the airway and initiate high-flow oxygen. Monitor for potential airway compromise due to head trauma. Establish large-bore IV access en route and initiate a fluid bolus to support the thready pulse, keeping permissive hypotension in mind for the distended abdomen. Manage hemorrhage and reassess neurological status frequently. Keep the patient warm. Keep us updated on any changes in vitals. Control any active bleeding from lacerations. Splint and immobilize the crushed arm; check for a distal pulse. Anticipate hemorrhagic shock from suspected internal/abdominal bleeding; titrate IV fluids to maintain a minimum systolic blood pressure. Acknowledge." "Copy that, Dispatch, Medic 1 en route, ETA now 15 minutes. And out." ~~At the St. Francis Memorial Hospital Ambulance Bay~~ The ambulance pulled in, and both the paramedics jumped into action as the driver opened the door. Mike pushed the gurney through the opened doors, and the legs descended; they ran alongside the gurney through the bay doors, and Mike yelled, "Heads up, Trauma Team! This is Elara Grey, a 30-year-old female, pedestrian versus vehicle hit by an unknown driver at high speed. Patient was found non-responsive at the scene. A bystander performed bystander CPR. We achieved Return of Spontaneous Circulation on scene after roughly 3 minutes of CPR. No shocks advised. She has a distended, rigid abdomen with suspected massive internal bleeding. Crushed left arm with obvious deformity and absent radial pulse. Suspected bilateral rib fractures and closed head trauma with a hematoma on the occiput. Multiple deep lacerations packed and wrapped. Pulse is extremely thready and tachycardic at 132. Blood pressure is trending down, last clocked at 84 over 50. Respirations are shallow at 24. GCS is 6; she is withdrawing from painful stimuli but not tracking. We have her on 15 liters of high-flow oxygen via non-rebreather. Two large-bore IVs established in the right AC. We have run 500mL of normal saline, keeping fluids restricted due to the abdominal bleed. Left arm is splinted and immobilized. She is a priority for immediate incubation, a FAST ultrasound exam, and uncrossed O-negative blood. Who is taking primary?" "Copy all, EMS. Good work on the ROSC. Team, we have a 30-year-old post-arrest trauma with hemorrhagic shock and suspected head injury. Move her to our bed on three. One, two, three, push!" "Dr. Hayes, secure the airway now. GCS is 6, and she's hypotensive; let's intubate. Set up for an RSI with etomidate and rocuronium. Watch those ribs." "Nursing, clamp down on those lacerations. Skip the saline, hang two units of O-negative blood on the Rapid Infuser immediately and activate the MTP. Get a massive line or an IO" "Dr. Patel, get the ultrasound. I need a FAST exam right now; let's see where that blood is pooling. Call X-ray to the bedside for a portable chest and pelvis." "Page Ortho stat. Check for a Doppler signal in that arm as soon as the blood is running." "If the FAST exam is positive and her pressure doesn't come up with blood, we are bypassing CT and going straight upstairs to the OR for an emergency laparotomy. Let's move!" The trauma team moved, with each team having its job, trying to save her life. Only time would tell now. The doors shut behind them as the paramedics signed off on the delivery and cleaned up the gurney. ~~At the St. Francis Memorial Hospital Front area~~ Dwayne pulled in right after the ambulance, put the car in park, and cried. He didn't know if she would live or die, and he feared the worst. She was a mangled mess by the time they got there. Her hair was full of blood, her arm looked twisted at a wrong angle, and the amount of cuts on her from the road rash was a sight he never wanted to see again. He stayed there crying for what felt like forever, and when he finally got himself together, the ambulance was out of the bay, and he knew she was already being cared for. He walked slowly into the hospital as if he were already headed to prison; his head was low, shoulders were hunched over, and his eyes looked shallow and dead. He sat in the waiting room and stared at the doors and waited. Two hours in, at 5 am, the police finally arrived to ask Dwayne questions. Efficient as always, he thought, as the sheriff walked slower than molasses in winter. "Dwayne. So what happened? Tell us everything." The sheriff and his partner sat down next to Dwayne as he regaled them with the events of the night. "Well, since you admitted you were drinking and you did the right thing by helping the poor girl, we won't arrest you now, but we need you to go get a blood test for the record. We will take this up after she is out of surgery." Dwayne's blood test was so after the fact that his blood alcohol level was now under the legal limit by several points. It would be hard to get a conviction based on the blood evidence alone. If Dwayne hadn't admitted fault, they would have had a hard time convicting. But as it stood, Dwayne was going to be in trouble. How much trouble depended on the trauma team, God, and that poor lady's will to live. Again, only time would tell. ~~ Outside the St. Francis Memorial Hospital Ambulance Bay ~~ Mike and Sam took the gurney out of the hospital. Sam climbed in the back of the ambulance and started the reset procedure. As Mike loaded the gurney back into place and locked it down, he looked toward the doors where they had just left the hospital and then back to his partner, "I doubt she's going to make it, Sam. That was one damaged lady." "Yeah, man, but you never know stranger things have happened, especially around these parts."