By Lacy

The meager contents of my stomach empty out on to the wet concrete. I am peripherally aware of Sam behind me, with his hand on my back. I am also aware of the morbid observers watching me with unconcealed curiosity.

"No," I gasp. My heart and faith shatter into infinite pieces. "Please, God, no."

Turning back to the scene I wonder why the paramedics are now swarming around the trunk of the car. One kneels down with his magic box of goodies and shuffles through it for something.

"We’ve got a pulse!" a paramedic shouts. "Get the gurney and a backboard."

A small seed of hope blossoms inside of my chest and Sam hazards a vague smile, his eyes reflecting my own unshed tears. My legs suddenly decide to work without informing the rest of my body. I close the distance between the tapeline and the car, but don’t reach my goal because a rough pair of hands reaches out to grab me. A large uniformed bulk blocks my path, but my eyes remain fixed to the car.

I struggle to free myself, but the bulk is unrelenting and unmoving.

"Let go of me!" I scream, and somewhere in the back of my mind I’m surprised by the desperate sound of my own voice.

"Josh!" Sam yells from behind. I hear him but choose to ignore rather than respond.

"Donna!" I scream again.

I can’t…I can’t see her. The nameless, pitiless bulk in my way blocks me from seeing beyond the crowd of officers and medics.

And then, two medics reach down to pry her from the space not meant for any normal sized human being to occupy.

She must be curled into a fetal position, because they have trouble unfolding her body from the trunk. When they liberate her, it is head first -- a rebirth from a tin can womb. Her limbs are limp and dangling when they pull her free, careful to support her spinal column. She was crammed so tightly inside the trunk of my car, I’m surprised the bastard didn’t need a shoehorn to get her in.

"Oh, God," I hear myself whimpering. Sam’s hand on my chin forces my head around.

"Look at me," he orders. "Look at me, Josh!"

But I can’t. I can’t take my eyes from her limp and, now I notice, bloody body. Taking my eyes from her now would be wrong. It would mean avoiding my punishment. It would make me a coward.

They lay her gently on the backboard and set to assessing her immediately apparent injuries. One medic places a stethoscope against her chest, while the other places a heavy brace on her neck. I can see her now, laid out before me like a sacrificial lamb, and I cannot tell that she is still alive.

Her beautiful blonde hair is matted with blood, and I have to wonder if Proctor didn’t shoot her in the head after all. I wonder if there is nothing left of my Donna except for the involuntary responses like respiratory or cardiac activity. I think that would be the ultimate cruelty.

Her skin has a blue-ish tint and her clothes are soaking wet. She was trapped in the trunk for God knows how long, wet, bleeding and in 40 degree weather. Even from this distance, I recognize the signs of hypothermia.

"Donna," I plead, "open your eyes." She doesn’t respond, and I am not surprised. "Don’t be stubborn, Donna," I say in my best bossy tone. "Open your eyes."

"She can’t hear you, Josh," Sam says, grabbing a hold of my arm.

"Don’t say that! She can hear me," I insist, breaking our connection. "She can always hear me."

"She’s borderline. Decreased breath sounds, bilaterally. We need to get her in the rig." The paramedics look at each before lifting the backboard onto the rolling gurney. One of her arms dangles loosely from the conveyance before a medic places it across her abdomen.

The gurney unfolds with a loud snap and the paramedics wheel her away. "I'm going with her," I say, as if there were any doubt. "Sam?"

"I know the play," he answers. "Go."

"You'll call Leo?"

"And CJ," he replies. "I'll meet you there when I'm finished here."

It's impossible to explain how a person can feel such a depth of conflicting emotion. Donna is alive, but for how long? Somewhere, inside of her wounded head, she is standing at the razor's edge of a precipice, staring into a yawning and welcoming abyss. Somewhere inside of herself, she must decide whether to hang on, or to just let go.

My hope -- my life -- balances upon the choice she will make.

I am a ghost inside of the ambulance. So focused on the Donna, the EMT barely notices my presence. I am afraid to touch her for fear of getting in his way. He continues to shout procedures to the medic in the driver’s seat, as he inserts two large-bore IVs -- one in each arm. He places an oxygen mask on her face and covers her with a woolen blanket.

Her face is…damaged. Her right eye is swollen shut and the left side of her head is covered in dried blood. The delicate skin of her cheeks is so pale that I can see a network of blue veins beneath it.

The EMT unexpectedly turns to me, and I realize he’s known I was there all along.

"Medical history?" he barks.

"She was diagnosed with an ulcer a few months ago," I reply quickly.

"Did she go into shock?"

"She fainted," I say. At the time, I’d worried that she was losing all the blood inside of her, but now I know there is more. So much more.

"Beginning fluid resuscitation protocol," he announces to his partner. "Hanging a liter of LR. Wide open." He inserts a needle attached to a bag of clear fluid into her arm, before hanging it above her.

"Is she going to live?"

He yanks a clipboard from a peg above his head and scribbles in the answers to his questions, and treatment administered. He pulls back the blanket to place his stethoscope over her heart once more and then over her ribs, and then he probes her abdomen with his fingers. "Apparent injuries are the scalp lacerations, which bleed excessively," he says, clinically. "Her belly is slightly distended, we’ll need to do an ultrasound to be sure that she doesn’t have an intraabdominal bleed. She’s lost a lot of blood, and the hypothermia is skewing her vital signs. Plus, she isn’t regaining consciousness."

Give it to me straight, Doc. Don’t spare my feelings.

She’s not out of the woods yet, that’s what he’s saying. She’s not getting enough oxygen to her vital organs. That’s what shock is, really. Decreased blood flow due to loss of fluid volume. Been there, done that.

"Come on, Donna," I whisper. "You’ve come this far. Don’t give up now. You can fight this." I reach out to take her hand in mine, but just as our fingers brush, the ambulance pulls into the emergency bay, and I am forced to jump from the back of the vehicle as soon as the doors open.

They unload the gurney and I am left to run behind the paramedics as they meet a doctor on the way in.

"Blunt force trauma to the head with accompanying scalp lacs. Pulse is thready and borderline bradycardic due to hypothermia, with 54 beats per minute. Decreased breath sounds. Hypotensive -- 90 over 60 — and cyanotic. History of GI bleed," the paramedic finishes as they roll the gurney into a trauma room.

"Thought you could challenge me or something?"

"Yeah, Doc."

"She got a name?" the doctor asks.

"Donna Moss," replies the paramedic, before I can make my mouth work.

The team surrounding her wastes no time transferring her from the gurney to the examination table, where the doctor takes over. He barks orders to no one in particular.

"Her clothes are soaked. Cut them off and let's get her core temp. Blankets and heat packs. Get a CBC, lytes, coag panel, PT/PTT, urinalysis, type and cross match, and get an ABG. O-neg on the rapid infuser. Book a head CT and spinal films. Set up for an abdominal ultrasound to rule out GI bleed. Okay, folks. Treat the shock first and then we’ll get to the hypothermia.

"Lacs are hemostatic."

"Small favors," the doctor mutters. "They'll start bleeding again once we warm her up. Airway is clear. Continue administering oxygen. Donna? Can you hear me, Donna? It’s time to wake up now." He opens her eyelids and flashes a penlight across her eyes. "Pupils are dilated, but responsive. Let's get her BP up."

A nurse, with an intimidating pair of large scissors, cuts her jeans and underwear away from her body, and the turtleneck quickly follows. Her running shoes are removed and tossed out of the way. A second nurse inserts a foley catheter with practiced skill, and I’m only glad Donna's not awake to feel that.

Her naked body displays a myriad of purpling bruises; some suspiciously shaped like the bottom of someone’s boot. My heart bleeds for her, as I see the physical damage done to her body. Her right side is a mass of swelling and her alabaster skin boasts a rainbow of colors, none of which are bright and cheery. A sterile drape is placed over her lower body, followed by warming blankets.

"Negative urine output," a nurse shouts.

"She had a liter of Ringer's in the field. Hang another, wide open."

"Body temp is 94.2."

"Prep an amp of epinephrine. Where’s the ultrasound?" The first nurse covers her with another woolen warming blanket.

"It’s coming."

I’m not her family -- I know this. Maybe someday if I pray hard enough, I will be. But right now, I’m not. Legally, I have no right to be here. No right to be standing in this room unnoticed by a team of people rushing to save a life. I step back into the corner and try to make myself invisible.

I have to be near her. She needs to feel me beside her, even if everything the doctor does fails and her next breath is her last. Stand or fall, I have to be here.

They move so quickly to save the life of a woman they don’t even know. Someone they probably wouldn’t look twice at if they met her on the street. But what they don’t know is that they’re saving my life, too. They don’t see me standing here, living and dying with every breath she takes.

"We need to rule out bleeding in the gastrointestinal tract and the peritoneal cavity. Get the ultrasound in here, now."

Ask and ye shall receive. As soon as he utters the command, the door swings open and an orderly dressed in scrubs pushes a large cart into the room.

"Finally. Set up for an abdominal exploratory."

The second nurse squeezes a tube of clear gel on Donna’s belly and hands the transducer to the doctor. The swoosh-swoosh of the ultrasound fills the room as the doctor positions the transducer over her stomach.

Swoosh-swoosh-swoosh. I hold my breath, my heart beating in tandem with the sound waves.

"No free intraabdominal fluids," he announces after visualizing her abdomen.

That’s good. I release my breath. That’s good, right? Sounds good.

"Stomach’s clear," he answers my silent question. "Cavity’s clear. She’s not bleeding out."

Swoosh-swoosh-swoosh. The sound continues. Swoosh-swoosh-swoosh.

"Hell," he curses. "Hold the epi." The nurses around him go suddenly the still. "Prep dopamine instead. Somebody, get Radiology on the phone and book a MRI instead of a head CT. Let’s not take any chances. Four of dopamine, IV push." He hands off the transducer to Number One.

Number Two fills a syringe according to his specifications and hands it to the doctor, who injects the fluid into the IV of her right arm.

"Get some towels. We need to roll her to left lateral, fifteen degrees." He slides his hands beneath the right side of the backboard and lifts it as though she weighs no more than a feather. The nurses slip rolled towels beneath the board to support the fifteen degree angle.

"How far along?" a nurse asks.

"Eight weeks. Give or take."

What? Wait a minute. What?

The doctor and nurses pivot in my direction. Did I say that out loud?

TBC

****