Radclyffe - Passion's Bright Fury Read online

  "We'll get releases for anything that we air. We can block their faces electronically if we need to," Jude pointed out reasonably. She'd had practice fielding these kinds of objections before.

  "And what about the ones who can't give consent-the comatose, or the moribund, or the children?"

  Jude was about to give another stock answer, but something in Sinclair's voice made her stop. There was an edge of anger, of protectiveness, that intrigued her. She sat forward, meeting Sinclair's admittedly intimidating gaze head on. "What if I guarantee that every precaution will be taken to protect individual privacy? I'll be there myself the entire time the cameras are rolling. I'll talk to the families personally if I have to. No one will be filmed without consent."

  "Your presence is going to interfere with Deb Stein's training. She's going to be more worried about looking good for you than about learning to make decisions and exercise good judgment."

  "I thought the trauma fellows took call with a senior attending who supervised them," Jude stated.

  "They do," Sax agreed. "Deb Stein will be on duty with me most of the time."

  "And you're concerned that…what? That she's going to pay more attention to me than to you?" Jude's voice rose in a way that suggested she was trying not to laugh.

  Sax was forced to grin again. The dynamic director was proving hard to resist. "She'll be distracted at least."

  Jude regarded her intently, aware that this confrontation could spell success or failure for a project that she had invested all her energy and considerable resources into for six months. She could do it without Sinclair's cooperation if she had to. She had a signed contract from the hospital, and it would stand up in court if it came to that. But if she went that route, going over Sinclair's head to get the job done, it would make the work hellishly difficult. And she didn't want this woman as an enemy - for a lot of reasons, not the least of which was that she found the surgeon's obvious lack of concern for diplomacy refreshing. "What is it that really bothers you about all of this?" she asked quietly.

  "There are some things people don't need to know, maybe don't even want to know," Sax said, surprising herself. I don't even know this woman and she has me admitting things I wouldn't say to a single living soul before now. "What happens in that unit-not always-but often enough, in those few seconds when life hangs in the balance are not things to be exposed for the sake of curiosity. These patients aren't just naked and defenseless-they're helpless. And sometimes what we do in there is not pretty."

  "This is human drama, Dr. Sinclair. This is real life. Don't you think that the public can appreciate that and understand how special it is?"

  The public's right to know-the relentless pursuit of the story in the name of truth-is often just a convenient excuse for invasion, Sax thought, but didn't say. She shrugged instead and answered flatly, "I don't know. I'm not a sociologist-I'm a surgeon."

  "Yes," Jude agreed, thinking that Sinclair was much more than that. "And it's your trauma unit. But can we agree to give it a try?"

  "Do I have a choice?"

  "I'm sorry," Jude said, to her surprise, meaning it. "No."

  *****

  Personal Project Log - Castle

  July 1 - 7:50 a.m.

  Sinclair stood up at seven a.m. on the dot and every person in the room grew quiet. There were a dozen people present - six senior staff, two first year trauma fellows, two general surgery residents, and two medical students. I was the only outsider-the only non-physician. She walked to the front of the room, leaned against the edge of the conference table and crossed her arms over her chest. She looked relaxed in just a scrub shirt and pants - like she didn't have a care in the world. She never said a word until every eye was on her. I felt like I should jump up and salute. I thought a couple of the younger residents might. God, she looked tough.

  I expected a speech. She didn't give one.

  She laid out the ground rules instead. [Note: Title First Episode Rules of Engagement]. Twenty-four hours on, forty-eight hours off. Rounds in the trauma unit at eight a.m. and no one goes home until they're over. Which by my calculations turns out to be somewhere in the range of thirty hours straight without much sleep. I lost track of what she was saying after that, because I was trying to imagine that kind of schedule. I'm used to working hard, sometimes days at a time when a story is breaking. But I'll be the first to admit I don't function at my peak the whole time. And I'm not cutting into people.

  She got my attention with the very last thing she said-the only direct order I can remember her giving. She said, "Some will die in the field, and there's nothing you can do about it. Those you let go. But if they come into my trauma unit warm and with a pulse, you'd better not lose them."

  *****

  Jude caught up to Deborah Stein just outside the conference room. "Deb," she called, pulling even with her as they started down the stairwell.

  "Hey, Jude," the blond, two-time basketball Olympian answered with her trademark effervescent grin and sparkling blue eyes. "Good to see you again."

  "What happens now?" Jude asked, hurrying along beside her. They exited on the first floor and double-timed down an intersecting corridor off the main hallway. Doesn't anybody walk at a normal pace around here?

  "You heard the Chief. Rounds in the trauma intensive care unit in five, and then we wait for a trauma call. I'm assigned to the admitting unit this month, so I don't have any floor responsibilities."

  "Gotcha," Jude affirmed, mentally reviewing what she remembered from the all too brief synopsis the surgical department had provided her. She had a feeling, however, that Sinclair didn't adhere to any script. "So once the patients are transferred from the trauma intensive care unit to a regular floor bed, you don't have any responsibility for them?"

  "Well, I'll be involved in that aspect of things during the weeks I'm not taking trauma call. It's an either-or kinda deal because you can't really do both at once." Deb held open the heavy gray windowless door with the red rectangular sign announcing the TICU - Trauma Intensive Care Unit. "Grab a cover gown. I'll get you some scrubs later so you don't have to worry about your street clothes getting ruined, and you won't have to keep covering them up every time we go in and out of the units."

  "Thanks," Jude replied absently, standing just inside the door and scanning the length of the brightly lit rectangular room. A u-shaped counter area just inside the entrance to her right was empty save for a few swivel chairs left askew in the middle of the space, a plethora of charts scattered over the countertops, and a misshapen box of fossilized donuts. What captured her attention were the ten beds lined up along the opposite wall, separated from each other by a few feet of space and featureless curtains on ceiling tracks that were all pushed back to expose the occupants to anyone who happened to be looking.

  Almost every spartan, steel-railed adjustable bed contained a genderless, nearly naked form dwarfed by the dispassionate machines of modern medicine. Free-standing ventilators the size of dishwashers flanked every bed, delivering a predetermined volume of gas ten to fifteen times a minute through the hard plastic breathing tubes jutting from the vicinity of every patient's mouth. Arms were strapped akimbo to extremity immobilizers or tied by soft cotton restraints to the bed rails. Tubes of all sizes ran from every orifice, delivering salvation in the form of antibiotics and liquid nutrition or removing the waste of injury and decay. Monitors occupied every available space, metering out lifetimes in monotonous beeps and flashings pinpoints of light.

  The trauma intensive care unit, one of the triumphs of medical technology, was a cold and impersonal place. Jude shivered.

  "You okay?" Deb Stein asked, noticing Jude's reaction.

  "What? Oh…yes, I'm fine. Sorry," Jude replied, dragging her gaze away from the silent tableau. She searched the room, trying to shake the eerie sensation of having stepped into a nightmare, and finally found something to occupy her attention. Sinclair stood at the center of a group of figures wearing white coats or rumpled scrub suits who w
ere crowded around the bottom of the first bed. Her foot was up on the seat of a wheeled chair, one arm propped on her raised knee. She held a long sheet of paper in her hand as she leaned forward, her face sharply focused on the figure in the bed as she listened to what a young man next to her was saying.

  "Let's go, then," Deb whispered urgently. "Sinclair's already started."

  "Will I be able to film in here?" Jude interjected, because she wanted this on tape. Sinclair, with every eye upon her and every expression expectant, looked like a commander surveying a battlefield.

  "Probably," Deb said as they approached the people clustered around Sinclair. "We'll figure it out later-after rounds."

  Jude had no choice but to agree, because she could see that she couldn't interrupt what was underway, and besides, she wanted to watch this. No one seemed to object, or even particularly notice that she was there. Nurses moved efficiently between the beds, going about the business of administering meds, adjusting fluid pumps, and drawing blood. XRay techs threaded there way through the residents and staff who were blocking the aisles, sliding rectangular film plates under the patients, then shouting clear with complete disregard for what was happening nearby. At the sound of the technician's warning, everyone shuffled behind the nearest person wearing a lead apron to shield themselves as much as possible from the radiation, waited for the tech to shoot the XRay, and then moved back to their places with barely an interruption in their rhythm.

  A deep commanding voice caught her attention.

  "How high is his intracranial pressure?" Sax asked the fair-haired young man standing just in front of Jude.

  "38."

  "Up 10 in the last two hours?" the trauma chief queried, a faint edge to her voice.

  "Yes."

  "And what does that indicate to you, Dr. Kinney?"

  Jude craned her neck to see Sinclair, whose blue eyes were fixed, laser like, on the young man's face. He was a first year surgery resident according to the ID badge clipped to his pocket. His voice was taut with strain as he replied.

  "It means that something is causing the pressure to rise inside his skull."

  "Such as?" The edge had progressed to razor sharp now.

  Jude thought she could hear him swallow.

  "Uh…cerebral edema, subdural hematoma, uh…epidural bleed."

  Sinclair set her foot down from the chair she had been leaning on and straightened, her fierce gaze still on the younger physician. She seemed taller than Jude remembered, but she knew that they were very nearly the same height. It had grown very quiet, although activity still teemed around them.

  "Are any of those conditions surgical emergencies?"

  The resident blanched. "The subdural and the epidural bleeding."

  "Then why don't I see the neurosurgeons here looking at him?"

  "We called...they said they'd be by," he offered tentatively. He glanced right and left as if looking for assistance, but his fellow residents studiously avoided his gaze. He was on his own.

  "And if he herniates his brainstem while we're waiting? Who will be responsible for that, Dr. Kinney?" Sinclair turned her head a fraction and met Deborah Stein's eyes. "Call neurosurg. Tell them I want them here now. Contact radiology and let them know we need an emergency head CT on this guy. Check the chart and find out who signs the consents for his procedures, but don't call the family until we know for certain he's going to the OR."

  "Right," Deb answered briskly and moved off toward the nurse's station on the far side of the room.

  "Okay, who's next?" Sinclair asked, already stepping to the next bed. Someone pushed the wheeled chair over to her. She absently propped one leg up on it and leaned forward to study the patient in bed two while a different resident began to give report.

  Chapter Three

  Personal Project Log - Castle

  July 1-10:45a.m.

  My first morning of rounds just ended. I'm exhausted and no one even asked me any questions. All I had to do was move from bed to bed and watch the process. I didn't understand everything that was said, especially when they began reeling off blood gas values and talking about Glasgow coma scores [Note: get Deb to explain this rating scale for head injury on film, preferably with a patient in the background. Get Sinclair's okay to film in TICU. Get DP to check lighting in there with film compatibility]. What I did understand loud and clear is that trauma rounds is where the real business of the day gets done. It's the only time during the day that the whole team is together, and it's the time when Sinclair fine-tunes the treatment plan for every patient in the Trauma ICU. Each patient's status is summarized for her by the resident covering that person, and whatever needs to be done - consults, studies, medication adjustments etc - are discussed and ordered. Sinclair signs off on all decisions. Now the doctors assigned to the less sick critical patients on the regular patient floors will go see to them, and those doctors responsible for incoming trauma emergencies - Sinclair and Stein today - will go down to the Trauma Admitting area. And I…

  "Ms. Castle?"

  Jude jumped, startled, and clicked off her recorder. She smiled at Sinclair, who was leaning with one shoulder against the wall just outside the TICU, watching her. "Sorry. I didn't know you were there. Do you need me for something?"

  "I want to show you the admitting area. I'm on my way down there now."

  "Great," Jude replied, slipping the small device into her trouser pocket as they walked. "Thanks for letting me tag along on rounds this morning."

  "Were you recording then, too?"

  "No," Jude said evenly. "I usually record notes to myself-impressions, reactions, reminders. Things I might use for voiceovers later on the film. If I want to tape you or anyone else, I'll ask."

  Sinclair didn't say anything for a moment, then asked, "How did you come to pick Deb Stein to focus your project on?"

  They passed the Emergency Room waiting area, already crowded with walk-ins, mostly mothers with children and middle-aged people with minor injuries. Those individuals with potentially serious medical conditions usually arrived by ambulance and were delivered directly to treatment rooms. Jude looked ahead down the hallway and saw yet another set of windowless doors with a keypad preventing entry except via a combination. "We met three years ago at the Olympics. I was doing a piece on female athletes, and we started talking about her plans after the games were over. When I began working on this, I thought of her."

  "And she agreed?" Sax asked, pushing in the code on the door lock. "It's the same as the phone extension - two four two zero."

  "Yes," Jude replied, following her in. "She did. Why?"

  Sax shrugged. "That's what I'm wondering-why?"

  "You'll have to ask her. I'd like to talk to you, though-on tape-about your own training. Background information, personal experiences, that kind of thing."

  Sax stopped walking and faced her. "Everything you need is on my CV. My secretary can get that for you. You should have her number."

  There was a note of finality in her voice that left no room for discussion. Jude kept her surprise, and her curiosity, to herself. She'd pushed enough for the first day. "All right, thanks."

  "This," Sax said, leading her through a small alcove containing scrub sinks and cupboards with surgical hats and gowns into another unadorned room that appeared to be a hybrid operating theatre and treatment area, "is the trauma admitting area. Every trauma patient is brought in here, stabilized, and triaged."

  There were three operating tables lined up in the center of the space, each of which could be enclosed by curtains for privacy if necessary. Above each narrow, stainless steel table hung large, circular silver lights containing brilliant halogen bulbs capable of lighting the area adequately for surgery. Jude stared at the silver domes and flushed with a sudden wave of heat and dizziness. Her vision narrowed and spots danced across the darkening landscape. Reflexively she reached out a hand to steady herself and was dimly aware of an arm encircling her waist.

  "Ms. Castle," a quiet calm voice
asked, "are you all right?"

  Jude forced herself to take a deep breath, reminding herself that this would pass quickly if she just kept breathing. Her legs were unsteady and she held on hard to the warm solid body next to hers. "Yes," she whispered faintly. "Just…I'm sorry…just a minute."

  Sax stood perfectly still, letting the other woman lean on her, holding her so close it might have been an embrace. A fine sheen of perspiration filmed Jude's forehead, and she was very pale. "Let's get you lying down," Sax said softly. She could feel her tremble.

  "No," Jude responded quickly, pressing one hand to Sax's shoulder, straightening up with effort. "I'll be fine. I'm okay, really."

  Sax studied her, still not releasing her hold on her as she rested two fingers on the pulse in Jude's wrist. Fast but strong. "I agree. You will be, but you still need to sit down."

  "I'm sorry," Jude said, laughing self-consciously as she allowed Sax to walk her to a chair in front of a long counter that edged the rear wall. Her vision had cleared and she was acutely aware of the fact that Saxon Sinclair still had an arm around her waist. She was also aware of the hard length of Sinclair's body against her side and the soft swell of the surgeon's breast against her own. Her legs trembled again and it wasn't from dizziness. She stepped away quickly and settled into the chair. "Thanks."

  One of the nurses asked Sax if she needed anything, but she shook her head no. She pulled another chair over close to Jude's and asked, "What happened?"

  Embarrassed, Jude blushed. "Nothing. I got a little light-headed. Guess I should have had breakfast."

  "That happens," Sax acknowledged with a nod, but she didn't really think that it was hypoglycemia. That usually gave some warning - a racing pulse, tremors, the gradual onset of faintness. Jude Castle had been perfectly fine until she walked into trauma admitting. "Has this occurred before?"