One Summer in Santa Fe - By Molly Evans Page 0,38
TEN
PIPER returned to work on Monday morning exhausted. She’d spend Saturday and most of Sunday with her sister in Phoenix, returning to Santa Fe late Sunday evening. They’d fought, they’d yelled, they’d cried, they’d made up. She’d let go. Elizabeth was on her own, standing tall beside a man she professed to love, who seemed to adore her, as well. That was more than Piper had in her own life, something she’d put off in order to see Elizabeth cared for. A small thorn of jealousy stuck in her side for the trip back to Santa Fe.
Although she knew that Elizabeth was diving head-first into dangerous waters, Piper finally realized that she had to let her, couldn’t stop her anyway. She wasn’t Elizabeth’s mother or guardian anymore, and as Taylor had said, Elizabeth was of age to make her own decisions, good or bad. She was the one who had to live with the consequences, not Piper. Sighing, Piper had resigned herself to being there to pick up the pieces when Elizabeth’s world came crashing down around her. Maybe after the restaurant venture failed, she’d go back to culinary school the way she was supposed to have done in the first place.
Thirty seconds into Piper’s shift, a cardiac arrest, a car crash victim and a woman in late labor all arrived in a car, an ambulance and a taxi.
“I’ll take the crash,” Taylor said, steering away from the pregnant woman. “Piper, you’re with me.”
Relieved, she followed Taylor into the trauma room where she forgot everything else except the patient and her work, and the symmetry with which she and Taylor moved together. She removed the ambulance crew’s monitoring equipment and hooked the patient up to the room’s equipment.
Though her hands trembled slightly with the unexpected intensity of the situation, this anxiety was familiar and something she could deal with. Much better than personal trauma any day.
Taylor listened to the man’s lungs, then immediately palpated the man’s throat. “He’s got a deviated trach.”
“Chest tube set-up?” Piper spun around without waiting for Taylor to answer and extracted a large procedure tray from the cupboard, opening it as she turned back.
Taylor whipped off his lab coat and thrust goggles over his face at the same time. As soon as Piper opened the sterile gloves, he shoved his hands into them. “Betadine,” he said, and held out a wad of gauze.
“Yes, Doctor.” Piper squeezed the skin prep solution onto the gauze, then cast a glance at the monitor. “BP and oxygen saturation are okay, but his heart rate is creeping up.”
Arturo, the respiratory therapist, stood at the head of the bed, pumping oxygen into the man’s lungs. “He’s getting a little harder to ventilate, too. Not good, man, not good.” He shook his head as if he knew something was going to happen.
Sweat broke out between Piper’s shoulder blades. A deviated trach indicated tension pneumothorax. If not corrected immediately, it could lead to further life-threatening problems. As she looked at Taylor, her pulse evened out and her breathing no longer seemed tight. Though he moved quickly, every move had purpose and was extremely efficient. He exuded confidence and absolute certainty in what he was doing. Just watching him calmed Piper. Taylor knew what he was doing, and he was going to save this patient’s life. There was no doubt in her mind.
“Once we get the pressure off his heart, that should improve.” Taylor finished scrubbing the skin on the outside of the patient’s left ribs and tossed the gauze away. Keeping his eyes on the chest, he palpated the ribs with his left hand and held out his right to Piper. “Blade first, then the tube with stylette.”
Piper placed the items into his hands and watched as Taylor nicked the skin with the scalpel blade, then placed the tip of the chest tube in the small opening. With his strong right forearm, he forced the tube through the patient’s ribs and into the pleural sac over the lungs. Piper held her breath as she watched Taylor’s focused motions, knowing this was a painful procedure for the unconscious patient, but a lifesaving one.
As soon as the tube reached its destination, Piper’s breath burst from her lungs. She connected the external end to the chest tube set-up filled with sterile water. “Bubbles. We have bubbles, Doctor.” Piper gave a small smile. The procedure was a success.
“Good.” Taylor nodded and wiped his forearm on his forehead. “Always makes me sweat getting those tubes in.”
“A little sweat saves