Mile High
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Ophelia Bell
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1: Chapter 1
CALLIE
āTwo GSWs incoming!ā
The charge nurseās announcement rises over the wail of the alarm signaling the arrival of an ambulance. A spike of adrenaline blasts through me. Iām not usually assigned to the pit, but when I am, some ghoulish part of my soul gets a thrill out of the true emergencies. Not just one, but two trauma patients are headed our way.
I tail Dr. Blanchard, UCLAās trauma attending on duty, hyperfocused and ready to anticipate whatever she or the patients need when they arrive.
The doors sweep open, and a pair of gurneys rush in, one after the other, flanked by the paramedics who reel off a concise detailing of the victimsā ages, vitals, and injuries. Two men with gunshot wounds, one a lower abdominal wound, through and through, the other a chest wound with no exit.
All I see is blood-soaked gauze as my mind cycles through all the potential implications of both injuries.
Dr. B is on the abdominal, trotting toward the room they wheel the patient into. Behind her trails a half-naked gangbanger wearing nothing but purple silk boxers. His hands are covered in blood, a distraught look on his face. More blood is spattered across his tattooed torso. The sight is almost too surreal for me to catch Dr. Bās gift to me.
āNumber two is a potential spinal injury, Nicolo. Youāre welcome!ā She lobs the comment at me just before disappearing into the room with her patient while I jump into action on mine.
āSir, are you injured?ā I overhear a nurse ask the tattooed companion who stands staring through the glass into the room Iām in. I just barely make out his response before a nurse closes the door. āIām fine, just go help them. Donāt you dare let that man die. Maddoxāll never survive if his brother dies.ā
The crack in his voice sends a twinge of pain through me, poking an old wound of my own. I do my best to ignore it as I jump into gear. I have no intention of letting anyone die, but I canāt fool myself. I saw the carnage as it blurred by and brace myself for the worst before I get a better look.
How the man is still breathing with a gunshot to the chest is nothing short of lucky, but a cardio attending needs to assess him, not a second-year neurosurgery resident like me. I order the nurses to page cardio and focus on the patient. The paramedics said there was no exit wound, so if the bullet managed to miraculously miss his heart, thereās a strong chance it hit a lung, then possibly his spine, and lodged there. I should page neuro too, but I am neuro for the moment. He doesnāt have a head injury, and if itās his spine, itās well within my level of training to handle. Iāll order a CT-scan and go from there once weāre sure his other wounds arenāt life-threatening.
My heart leaps into my throat when he opens steel-gray eyes that lock onto me over the plastic oxygen mask covering his mouth and nose. How the hell is he still conscious through all this? He didnāt just take a bullet; from the look of his shirtless, blood-covered chest, the man must have been tortured too. His face is a battered, bruised mess, both eyes swollen and bloodshot, and his entire well-muscled torso from shoulders to waist is covered in what appear to be electrical burns.
In between the burns are numerous darkening bruises with a uniform pattern that looks like he took a beating from someone with lead fistsābrass knuckles, Iām guessing, just based on the company he keeps. Not even his numerous tattoos can obscure how grave the damage is.
āMaddoxā¦ā the man wheezes from behind the oxygen mask. He reaches out and grips my wrist, squeezing hard enough to hurt.
I cover his hand with mine and smile, determined to comfort rather than alarm him. āIs that your brother? Heās in good hands, I promise. So are you, but I need you to try to relax. Can you do that for me?ā
The rigid cervical collar locked around his neck prevents his attempt at a nod, so he just slow blinks, his grip easing. āYou do your thing, Doc. Iām not going anywhere. Especially since I canāt feel my legs.ā The words are strained, and I think I catch a bitter half-smile behind the mask. But his lips have a bluish tint, and he begins struggling to breathe.
Cardio arrives at that moment, and I step aside. I move to his feet, which are bare and dirty, and test his reflexes there. The lack of reaction confirms Dr. Bās statement, and the patientās, but we still need more tests. Tests that will evidently have to wait, since he goes into cardiac arrest and is rushed to surgery a moment later.
Iām standing in a daze when Dr. Yao, the neuro attending and my supervisor, pops his head in a moment later. āNicolo, what are you doing? Get your ass up to surgery, youāre scrubbing in on this one.ā
āBut I need to get his history, and cardioā¦ā I stutter, waving abstractly toward the door, then it hits me that this isnāt just a cardio case. āHis spine. There was no exit wound and he couldnāt feel his legs.ā
āBingo. Come on, Iāll have one of the other residents get his history.ā
The shrewd, middle-aged doctor who oversees the neurosurgery department has never played favorites, which also means itās been a challenge to get noticed. Thereās no way in hell Iām missing this chance now that heās offered it to me. It will be my first time scrubbing in, so thereās no chance of actually performing the surgery as a second-year, but for some reason my teeth ache with the need to at least observe this surgery. My wrist still tingles from the force of the patientās grip, and I canāt help the flutter in my chest when I step into the OR, scrubbed and ready to go. Even though Iāll only be observing, itās still one of the most profound moments of my entire life so far.
I take a deep breath, wanting to take in every detail. All I get is a lungful of surgical mask, but my senses are heightened. The cardio surgeon already has the patientās chest open and is repairing a perforated lung, relaying a subdued play-by-play as he works. An orthopedic surgeon and Dr. Yao stand at the ready. I tamp down the nervous energy in my belly as I wait and watch.
The surgery turns out to be straightforward and relatively quick. They marvel that the bullet missed his heart, but still donāt look optimistic when they turn him over to us. Theyāve already taken an x-ray and determined that the bullet is indeed lodged against his eighth thoracic vertebrae. If this surgery doesnāt go well, he could wind up paraplegic.
We carefully position him face-down, the enormous C-arm imaging machine curving around and above the surgical field so we can have an x-ray visual of the procedure while itās underway. His back is covered in a yellow surgical incise drape surrounded by another blue surgical drape. Through the transparent material is clearly visible a hyper-realistic tattoo of a black and white koi fish swimming through water.
āImpressive ink,ā Dr. Yao comments. āShame we have to cut into it.ā
Of all the tattoos I caught glimpses of on his body so far, none were as striking as the tattoo that must cover a good portion of his back. When Dr. Yao makes the first incision down the center of the spine, I canāt help but wince at the slice that cuts straight through the side of the fish.
I lean in as Dr. Yao begins talking through the steps of the procedure. He glances at the x-ray image every few seconds as he deftly maneuvers his instruments into the incision to extract the slug of metal lodged there.
Out of the blue, he says, āDid you know that koi fish are symbolic? Black and white ones like this signify transformation. Rebirth.ā
I nod in interest. Iāve watched Dr. Yao from the gallery, and he seemed like a fun surgeon to assist since heās always spouting off random trivia in between teaching surgical technique. He goes on about what different colors of koi tattoos symbolize while I look on, soaking up every nuance of his movements.
The entire procedure seems deceptively simple as itās happening. My fingers can feel the weight of the instruments even though Iām not holding them myself, and when Dr. Yao surprises me with a question about the next step, rather than more tattoo trivia, Iām ready with the answer without even thinking. The corners of his eyes crinkle and he nods. āGood job, Nicolo. When orthoās finished, see to the patientās superficial wounds and stay with him in recovery to make sure heās stable.ā
Iām positive he can sense my wide grin behind my mask, but I only nod once to maintain the illusion of professionalism. āIād be honored, sir.ā
Once the bullet is out, I exhale, then step back and observe as ortho slips in to insert a pair of small screws, which are all thatās required to hold the fractured vertebra together. Then I watch with bated breath as they stitch the wound. I finally breathe easily once more when itās done and the tattoo looks as well as it can with a line of stitches down the center of it. Heāll have a scar, but with an artist talented enough to create a work of art like this, he can surely get a touch-up thatāll make it look as good as new once the cut is fully healed.
The surgery a success, I float on an adrenaline-fueled cloud as I scrub out, then meet the patient in recovery. I finally have a chance to review his chart, and I learn his name is Julian Santos Jr. On the way there, I checked in on the other patient, his brother, Maddox Santos, who is zonked out on painkillers but otherwise doing fine, and Iām happy to have good news to tell Julian when he wakes up. Maddoxās wound was only a flesh wound, the bullet passing clean through the muscles over one hip.
Julian is breathing on his own, which is a good sign. His chest is covered with a gauze bandage and wrapped to immobilize several broken ribs, but there is still an impressive amount of ink visible on his torso. Iām more and more intrigued as I clean and treat each of the dozensāhundredsāof small wounds. Most are bruises and minor contusions, but in some places the skin is broken enough to need bandages, and there are several serious burns as well.
He came in wearing only jeans, which were cut off shortly after he arrived. They likely protected his legs from damage, but I take a purely clinical peek beneath the sheet to check below the waist anyway. His muscular legs are unblemished, and I drop the sheet again quickly, face flaming though I canāt help the small smile at what appeared to be another very healthy and impressive feature that caught my eye.
Shame on you, Callie, I admonish myself. What would your mother say? I bend over and begin suturing one of the deeper cuts in the flesh beneath his collarbone, where whatever bludgeoning weapon he was hit with broke skin and dug in deep. When I hear a weak chuckle from the patient, my spine goes rigid and goosebumps cascade over my body.
āYou were not just checking out my junk, were you, Doc?ā
I keep my gaze on the wound, focusing on the stitches because theyāre through one of his more detailed tribal tattoos and Iām still at the stage where I need to be methodical about the steps. I donāt want to fuck this up, but it gives me an excuse not to look him in the eyes. āIām a doctor, Mr. Santos. I checked out everything. You were in quite the fight today, werenāt you?ā
He groans and his hands tighten into fists. The bandages I wrapped around his wrists stretch with the motion. Heād evidently been shackled too, and the bloody abrasions around both wrists were the first wounds I bandaged.
āDid they kill the bastard? Or is he at least maimed?ā
I finish the suturing and sit up straight, reaching for a fresh bandage to cover the wound. His gray eyes are intense when I meet them, and I shake my head. āI donāt know who you mean. Your brother, Maddox, is fine though. Was there someone else?ā
āDelgado. The asshole who did this to me.ā
I vaguely remember a third gurney being wheeled in after his, but I didnāt keep track of that patient. āGive me five minutes,ā I say, then stand and leave. I head to the nursesā station, where Iām most likely to get a quick answer, and a few minutes later return with the information. He gives me an expectant look when I walk into the room. āMr. Delgado has been admitted with a concussion and several broken ribs. Heāll be here overnight at least, then will be released into federal custody. Should I ask what your fight was about?ā
He eyes me thoughtfully for a moment, then shakes his head. āBetter if you stick with what youāre good at, Doc.ā
āFair enough, Mr. Santos. How are you feeling?ā
āLike I lost a fight with a goddamn steamroller. But Iād feel better if you called me J.J. Mr. Santos is my dad. He could give the steamroller a run for its money.ā
I let that comment slide, but somehow am not surprised that a man in his shape grew up with violence. Leaning down to check the wounds I just bandaged, my skin prickles, and I catch him staring at me, his gaze clearly aimed down the front of my scrubs.
āDo you have questions?ā I ask, giving him a pointed look.
He blinks and clears his throat. āSo, ah, whatās the damage here? Am I paralyzed? Is the equipment you were just admiring going to waste from here on out?ā
āYour surgery went well, actually. The bullet perforated a lung and lodged against your spine, but managed to miss your heart. You were very lucky on that count. We were able to take the bullet out and repair the damage to your vertebrae. Your spine is intact, but thereās some swelling that will likely impact movement and sensation in your lower extremities until it recedes. With therapy, you should have a full recovery.ā
āYou seem pretty damn confident of that.ā He trails off on a cough, then eyes me skeptically. A closer look at his face reveals the gray tinge to the skin that isnāt covered in mottled bruises and dried blood I havenāt had a chance to clean off yet. Heās tough, but not impervious to pain.
āI am. Iāve seen the scans. I wonāt lie to you; it was close, but you were in good hands.ā
His gaze drops to my hands and his eyebrows go up, his lips twisting into a half-smile. āWas I now?ā he rasps. āWhy donāt you make me a promise then? If youāre so confident Iāll be on my feet, let me take you out. As a thank you.ā
My cheeks heat and I drop my gaze, gathering myself before giving him a direct look, heart fluttering and core heating under his intensity. This man clearly isnāt used to being turned down, but I know better.
Deflect, deflect, deflect.
āI wasnāt the one who performed the surgery, J.J. Iām a resident, so I only observed. UCLAās neurosurgery department is one of the best in the country, and your injury was well within our capabilities to repair. That was all I meant. If you owe anyone a thank you, itās the three excellent surgeons who actually saved your life.ā
J.J. grins. āYou didnāt say no.ā
I purse my lips and give an exasperated shake of my head. āI need some fresh bandages so I can finish treating the rest of these cuts. Iāll be back soon.ā
As I walk out of the room, he calls after me hoarsely, āThat wasnāt a no either!ā
