Andrew Peterson - First to Kill

“Upstairs in ICU. Hey, where’re you going?”

“I don’t have time for you, Henning.”

“You can’t go up there.”

“Watch me.” He approached a nurse who was running toward the ER doors.

“Where’s ICU?” Nathan asked.

“Third floor.” The nurse pushed through the dual swinging doors. Nathan had a brief look inside. Doctors. Nurses. Blood.

“Damn it, McBride. Wait.”

“You coming, Special Agent Henning?”

The fed stepped into the elevator. “You’ve got a lot of nerve barging in here like this.”

“Save your resentment for someone who gives a shit.”

“I should arrest your sorry ass.”

Nathan squared with him. “You’re welcome to try.”

At the third floor, the elevator chimed and the doors opened to a horrific scene. Directly ahead the nurse’s station was abandoned. Several dozen gurneys containing the wounded lined the perimeter of the room. The floor was tracked and smudged with blood. What was normally a quiet place had been transformed into battlefield triage unit. Physicians, paramedics, and nurses were hovering over the injured, and from the look of things, many of them critically. It was plainly evident there weren’t enough doctors and nurses to deal with the situation. The moans of pain sounded forlorn and eerie. A uniformed officer stationed just inside the room looked ashen, his expression grim. He stepped toward Nathan and Henning, but when the FBI man flashed his badge, the officer turned away.

On the far side of the room, a doctor leaning over a wounded woman looked over his shoulder and yelled, “I need help over here.”

No one came. Clearly, no one was free.

Nathan sprinted over. “What do you need?” He looked at the woman’s arm where a twelve-inch gash had laid it open, exposing muscle and tendons. The skin surrounding the wound was charred and blistered. Blood was pooling on the sheets of the gurney.

“Who are you?” In his mid-fifties and balding, the doctor wore protective goggles over rimless eyeglasses. Nathan towered over him by a good twelve inches.

“I’ve got field-medic training, tell me what you need.”

“Throw on some gloves. Behind you on the counter. Nurse’s station.”

Nathan ran over and grabbed a pair of light-green latex gloves from the box and pulled them on.

“When I pull the bicep aside, I need you to clamp the brachial artery as close to the tear as you can. The tear’s just above the radial and ulnar branch. I’m pinching it closed right now with my fingers.” The doctor looked at the mobile table containing instruments. “Shit, use the hemostats, they’re all I got. You’ll need to sponge the blood first. Ready?”

“Yes,” Nathan said.

With his free hand, the doctor reached into the woman’s arm just above the elbow, grabbed a handful of muscle, and pulled it aside. “Sponge,” he said.

Aware of Henning’s presence behind him, Nathan pressed the sponges into the opening, and watched the blood soak into them. He knew he had mere seconds to get the artery clamped before more blood would overflow the sponges and fill the cavity. “I see it,” he said, opening the hemostats. He inserted the tool into the wound and applied the needle-like pliers just above the tear in the artery.

“Not too tight,” the doctor said. “One click.”

“One click,” Nathan repeated. He pinched the hemostats to its first locking setting.

The doctor released the artery from his thumb-and-forefinger grip. “Good job.”

Nathan removed the sponges without being told and set them on the table.

The doctor let the muscle slide back into place, which overlaid the pinching end of the hemostats. He removed the tourniquet. “That artery will have to be repaired where it’s clamped. Crushing it with hemostats makes it susceptible to clotting at the crush point, but it’s the lesser of two evils. It’s better to damage the artery and repair it later, than to lose the arm.”

“How long can you leave it that way?” Nathan asked.

“Not very long. Ischemic time for muscle is two hours max. We have to add the tourniquet time to the clamp time so she’ll need a vascular surgeon within ninety minutes at the outset. Problem is, she’s tied up downstairs in the ER. We need to repeat this procedure for the other end of the tear to prevent back bleeding from collateral artery pressure. You ready?”

“Yes.”

“Okay, I’m going to pull the bicep aside again. Use another pair of hemostats on the other side of the tear. Clamp it as close to the tear as you can. Get ready with a sponge again. Here we go.”

Nathan had no trouble clamping the lower end of the tear. The bleeding was much less severe, but as the doctor had known, the lower end of the tear had been oozing blood from back pressure.

“Okay. I need you to wrap up this wound with gauze fairly tight, but not too tight. Don’t worry about the hemostats. Just leave them where they are and work around them. Shave the area around her head wound, clean it up, and lay gauze over it, not taped. Try to keep her hair out of the cut. Keep an eye on her IV. She’ll need another bag of saline in a few minutes. Can you stick around until more of our people arrive?”

“You got it. No problem.”

“I appreciate your help.” The doctor looked Nathan’s face over. “Looks like you’ve had some trauma yourself. Do you know how to hook up an intracranial pressure monitor?”

“I’m afraid not.”

“Don’t worry about it. Just do what you can.” As the doctor moved to the next gurney, Nathan wrapped her arm.

“That’s Special Agent Ashley Banks,” Henning said.

“Find me a bag of saline.”

The man didn’t move.

“Henning!”

“Yeah, okay, I’ll be right back.”

For the next twenty minutes, Nathan went through a dozen pairs of gloves assisting other doctors, nurses, and EMTs. He and Henning spent most of their time acting as a couriers, bringing monitoring machines, medical instruments, and bandages to the doctors and nurses who called for them. He kept looking for Holly, but she wasn’t here. She must be undergoing emergency surgery. That had to be it. They were operating on her, right now, at this very moment. He wasn’t willing to distract anyone by asking. Now wasn’t the time, and no one up here would know her status anyway. Stay busy, he told himself, stay focused.

As each minute passed, more of the hospital’s staff arrived. By the time he felt some sense of sanity had returned to the room, the ICU had close to fifty doctors and nurses attending the wounded. Nathan respected the dedicated people working here. Although he’d only been helping for a short time, he felt drained, as though hours had passed, not minutes. Most of the victims were burned to one degree or another, some severely, and the smell of charred flesh permeated the room. Nathan was no stranger to the sight of blood, he’d seen plenty, but Henning was another matter. All things considered, the man had managed to hold himself together pretty well.

Senator Stone McBride was on the phone in his office when he heard a knock. He covered the mouthpiece. “Come in.”

His secretary handed him a note. Leaf Watson holding on line two. SUPER-URGENT . He nodded and she left the room, closing the door behind her.

Stone continued with his call. “Look, Scott, I can’t promise a yea vote yet. I haven’t read the entire bill. As long as the bacon’s not raw, I don’t see a major problem. Give me another day or two. What’re the latest poll numbers? Well, that’s something. Listen, I’ve got to go. Two days, max… Okay, let’s do lunch soon…. Take care.” Lobbyists, he thought. He punched line two. “Hello, Leaf.”

“Turn on your television.”