“Tess Noble, twenty-five-year-old female, gunshot wound to the abdomen. Coded in the ambulance on the way to the hospital but was resuscitated. She’s been unconscious for approximately fifteen minutes. We started an IV and packed the wound which seems to have stopped the bleeding, but she’s lost a lot of blood. She’s going to need a transfusion ASAP,” the paramedic tells me as the woman is wheeled into the ER.
“Put her in Trauma Two,” I order, as nurses help me put on a gown and pair of gloves.
“Pulse is thready and blood pressure is low,” Dr. Jake Winter, my junior resident, informs me as the patient gets hooked up to our machines and a rhythmic beep starts sounding in the room.
“Page surgery stat and let them know we’ve got a high priority case coming up to them. Let’s get her stabilized and up to those guys, there’s not much more we’re going to be able to do for her down here,” I order.
Noble.
I know that last name.
The team busies themselves around the patient, following the trauma response instructions I’ve given them. I walk around one of the nurses and go to the patient’s head, looking down at her face.
I try never to look at patients, using only their names to humanize them. It’s easier that way. Easier to keep my distance from the pain of losing them.
But my stomach clenches when I look down. Even with her face half-obscured by the oxygen mask, I recognize her. She was in the ER weeks ago, responding as the next of kin to an assault on another patient of mine, her mother.
Seeing her unconscious and fighting for her life on my table is surreal. I lose all objectivity as I feel an inexplicable connection develop, linking us together.
I won’t let her die. I can’t.
All of a sudden a strident beeping noise explodes around us and all heads turn towards the monitors.
“She’s flatlining,” Jake yells.
My pulse pounds loudly in my ears as my body reacts to the burst of adrenaline. “Start compressions. Now,” I direct.
Jake threads his hands together and starts pumping Tess’s chest. Her whole body thrashes as he presses hard enough to crack her ribs. My eyes remain trained on the monitor, not seeing any changes.
“Charge two milligrams of epinephrine.”
“Yes, Doctor.”
Loud noises sound through the walls, coming from the hallway, but I ignore them and focus on her vitals.
Still no change. My own pulse starts racing.
“Alright, prep for the defibrillator. Keep performing CPR in the meantime.”
Jake continues chest compressions as one of the nurses readies the AED. She puts the pads on Tess’s chest, but her head snaps to the side when the sounds of the commotion in the hallway get louder in the background.
“Are the pads in place?” I ask, grabbing the paddles from her.
“Yes, Doctor.”
“Charge to two-fifty.”
“Charged.”
“Everybody clear,” I order.
I look down at Tess, at the white of her face and the red drying her blonde hair in clumps. Knowing what she looks like when she’s not at death’s door but alive, as a breathing, feeling human being triggers me. I’ve only had that happen one other time and I’ve worked hard to forget those memories.
Tess is going to live. She has to.
One by one, all seven nurses and doctors in the trauma room remove their hands and step away from her until everyone is clear.
“Shocking,” I announce.
There’s a loud electrical thump and Tess’s body jerks once. I stare at her vitals, looking for any sign of change in activity. Something pinches in my belly when her heart rate stays in flatline.
“Come on, Tess,” I shout, desperation making my voice unrecognizable. “Come on, stay with me.” Louder, to the rest of the room, I say, “Charge to three hundred.”
“Charged.”
“Everybody clear?”
“Clear!”
“Shocking.”
Tess jerks again and silence descends on the room as we all stare at the monitor. It feels like it stretches on for hours as I hold my breath, as we all do, hoping and hoping to see signs of a pulse.
And then there’s a beep.
One single beep, threadbare and timid.
The most beautiful sound I’ve ever heard.
I feel emotion crawl up my throat and I’m not sure why. Maybe it’s because I saw the way she cared about her mother, maybe it’s because she’s only a year younger than me, but the relieved breath that expels from my lips feels like it releases twenty tonnes of pressure off my chest.
That one beep morphs into a steady beat as her vitals level out. It’s not strong, but it’s there.
“We’ve got a pulse,” I announce. I witness the relief I also feel etch itself on the faces of every single other person in that room. “Let’s stabilize and monitor her closely.”
I lean in close to her ear and whisper so only she can hear me. “You’re a fighter, Tess. You’re going to get through this.”
A thrashing noise comes from outside, this time much louder than previously. The sound of distressed voices follows, clamoring unintelligibly for something. It seems like the situation is escalating.
“What the hell is going on out there?” I demand, my mind clear now that the code is out of the way.
A nurse exits to assess the situation and comes back minutes later with an upset expression on his face. “It’s the victim’s husband, Doctor,” he tells me. “Pardon my French but he’s losing his shit out there and demanding to see her. The furniture’s bearing the brunt of his anger.”
I can only imagine the agony of waiting for news about your loved one, not knowing whether they’re going to make it or not, not knowing whether to hope or grieve and caught in that unbearable moment of suspension between both.
“Is the surgical team ready for us?” I ask.
“Yes, Doctor. Dr. Whiteshaw is ready to operate.”
“Finish prepping the patient and I’ll go talk to the husband. Winter, you’ve got this?”
“Sure do, Doc.”
Snapping my gloves off and removing the surgical gown, I dispose of both in the bin before taking a deep centering breath and walking out into the private waiting area.
The first thing my gaze catches on are the two chairs and side table strewn in the middle of the hall, completely at odds with the usual clinical cleanliness of the hospital. Then my eyes lift to the large, intimidating man who’s furiously pacing at the other end of the hallway. He’s wearing all black but he’s covered in blood. I can smell it even from over here. How he can stand to be drenched in his wife’s blood is beyond me. He rakes anguished hands through his hair, pausing only to accost hospital staff as they come through the area.
Half a dozen equally terrifying men and women surround him, not quite flanking him but clearly ready to intervene if necessary.
Who the hell is this guy?
“WHERE IS MY WIFE?” he roars at a passing nurse, livid with fury. “They wouldn’t let me in the ambulance with her. She’s been here for twenty minutes and no one will tell me where the fuck she is or how she’s doing.” Two of the men grab his arms, holding him back from destroying the reception desk. “Take me to her before I start tearing this hospital apart and find her myself.”
The nurse freezes in fear, cowed by his formidable presence, but she’s already lost his interest.
The man’s gaze snaps over to me when he notices me standing in the hall. He takes one look at my scrubs and the way I stare back at him and charges towards me. Having him descend on me with single-minded purpose is akin to standing in front of an angry bull and waving a large red flag, but I don’t let him scare me.
The irritation that’s locked my spine since I saw him yelling at the staff and causing a scene evaporates in an instant when he gets closer and I gaze into the open pools of despair that are his eyes. There’s an immense amount of pain contained in his tormented stare, pain he doesn’t bother to conceal away. It radiates off him.
I clear my throat. “Are you Tess Noble’s husb–”
“Is she dead?”
My heart leaps into my throat at his swift interruption. The question is clinical in wording but delivered with such visceral, raw emotion it punches me in the gut. The air is tense around him, thickened by his misery.
His gaze pings wildly between my eyes, desperately searching them for an answer I haven’t given him yet. His shoulders are tense, like he’s bracing himself to receive the worst news of his life. It tells me everything I need to know about him; this is a man who wouldn’t survive the death of his wife.
“No.”
His face crumples, his expression fracturing like fine china.
A broken moan slips past his lips and then his entire body sags forward in relief. His shoulders slump and his head bows as the anger abruptly drains out of him, leaving behind only a gut-wrenching combination of fierce sorrow and frail hope. He runs a shaky hand over his face, obscuring his eyes from me as he takes in a deep, haltering breath and composes himself.
“Are you her husband?” I ask gently.
He nods, working to control his emotions.
“Da Silva,” he finally says, face still in his hand. “Her name is Tess da Silva. She’s my wife.”
His voice cracks on the word ‘wife’.
I already know she is, but he says it with the vehemence of someone who used the word “soulmate”, as more a designation of exactly what she means to him than a legal classification of their partnership.
The last name registers only secondarily, as does the realization of who I’m dealing with. There’s only one man with that last name in this town and he’s not someone to be crossed.
But it doesn’t matter to me if he’s a random man off the street, the King of England or the Pope himself, the standard of care Tess is receiving is the same regardless of who he is.
“Is she going to die?” he asks, voice brittle like blown glass.
From the little I know of the Underworld, those men are meant to be nigh invincible. Watching a man like him showing such distraught emotion, clearly brought to his knees by what’s happened to his wife is shocking.
It doesn’t take a genius to guess that may be why she has a bullet in her abdomen and is currently fighting for her life. She must have been targeted to get to him.
It’s working.
“Not if we have anything to do with it.” His eyes finally lift back to mine. He looks at me like he can see me for the first time. “The most talented doctors in the country work at this hospital. She’s in the best care possible. I’m Doctor Cavanaugh. Cassie,” I add, pausing for a moment before deciding to tell him, “I met your wife a few weeks ago, very briefly, when her mother was admitted.” Awareness seeps into his gaze. “I liked her. She seemed strong. A fighter.”
The ghost of a smile touches his lips, the first sign of an expression other than devastation.
“She is.”
“Then there’s a very good chance she’s going to make it.” Steel makes its way into my tone before I continue. “But we can’t focus, let alone do our jobs properly, if you’re out here destroying our waiting room. Your wife is going into surgery as we speak so it’ll be a few hours before you get any updates. I suggest you head to our guest area, take a shower and clean up. Make yourself presentable so that when your wife comes out of the operating theater you don’t scare her.”
One of the men behind him gives me a warning glare as another’s eyes widen in shock at the way I order their boss around. I don’t give a shit who he is out there, but in here he’ll follow my rules.
“I’m not leaving her,” he growls.
I tip my chin up at him. “Do you want the first thing she sees when she wakes up to be you covered in her blood?”
He looks disbelievingly down at his body, having seemingly forgotten the state of his appearance. The black of his clothes might hide most of the blood, but it’s also everywhere on his arms and up to his neck, contrasting obscenely with the elaborate tattoos on his skin.
One of the men, an older guy with a paunchy stomach, places a strong hand on his shoulder.
“Jefe, I’ll stay.”
“We all will,” another adds, stepping up to him.
“We’ll look after her,” a third assures, and I wonder if Tess knows she has an army of people waiting for her to come back.
He nods slowly, throat working thickly. “Gracias,” he says to his entourage, before looking back at me.
“I’ll let you know the second there’s news,” I tell him before he can even ask, then add, “Just so you know, your wife will likely need a transfusion due to the massive blood loss.”
“Take it from me,” he says, immediately extending his forearms at me like I’m going to extract it from his veins right here.
“What’s your blood type?”
“B.”
Pity crosses my face but I’m quick to mask it away. “I’m sorry. She’s type A negative, so you’re not a match. Don’t worry, we’ll look at what we have available and call other hospitals to find what we need.”
“Joder,” he curses, rubbing another over his face.
“Go,” I order, pointing in the direction of the guest showers.
“You’ll have me notified the second there’s news?”
“Yes.”
“Alright,” he says, and I watch as he walks off with one of his men, saying to him, “Tráeme un cambio de ropa.”
When I turn back around, I find the others still looking at me.
“What?”
“Do you know who that is?” one of the younger guards asks.
“I deduced it about two minutes into the conversation.”
The paunchier older man chuckles softly. “Then you’re one brave woman. You’ll get along well with our Tess when she wakes up.”
