“The shrapnel moved,” Sarah said, leaning over him, her face close to his.
“It didn’t just migrate, Mike. It sliced something. You’re bleeding internally.
We have to move.”
It was the first time she had used his first name. It was the last thing he heard before the darkness took him. The world came back in flashes of chaotic noise and blinding light.
Lieutenant Colonel Sterling was moving. He was staring up at the acoustic ceiling tiles racing by. Someone was shouting.
“BP is tanking! Seventy over forty. We’re losing the radial pulse.
Fluids wide open. Squeeze the bags!”
“Where the hell is the surgeon?”
Sterling tried to turn his head, but his body felt like it was made of lead. He recognized the voice shouting orders.
It was Sarah. They burst through a set of double doors into a trauma bay. The air was colder here.
He was lifted, rough hands grabbing the sheet under him, and transferred onto a hard trauma table. “Trauma team to Bay One,” the PA system announced overhead. A young resident in a white coat rushed over, looking at the monitors.
“What do we have? I thought this was a hip consult.”
“Retroperitoneal bleed,” Sarah’s voice cut through the noise. She was at the head of the bed, managing the airway.
“Patient is post-op combat injury. Twenty years. Shrapnel migration.
He’s hypovolemic. He needs blood, not saline. O-neg.
Two units. Stat.”
The resident hesitated, looking at Sarah. “Nurse, we need a CT scan to confirm before we—”
“Look at his belly!” Sarah shouted, grabbing the resident’s hand and forcing it onto Sterling’s distended abdomen.
“He’s rigid as a board. If you send him to CT, he dies in the elevator. This is a blowout.
You need to clamp the aorta or get him to the OR now.”
“I can’t open him up down here without an attending,” the resident panicked. “Dr. Halloway is still scrubbing out.”
“Then get another attending!” Sarah yelled.
Sterling’s eyes fluttered. He felt cold. So incredibly cold.
It felt just like Garmsir. Just like the ditch where he had bled for three hours waiting for the bird. This is it, he thought.
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