Chapter 3
Code Red
Dr. Miles Thornbridge graduated Oklahoma State University School of Medicine just three years before the night that changed everything. On that night, he was deeply enmeshed in OSU’s Emergency Medicine Residency Program as the Resident ER physician in the ultra-small Darkwell Memorial Medical Center. Thornbridge had hoped for a more cosmopolitan placement—Houston or Dallas would have been nice—but his poor academic performance had made such choices unavailable, at least for the moment. Too many of his more academically excellent classmates and graduates from more prestigious schools such as the University of Texas, Harvard, and just about every other North American medical school had wanted and had landed those spots, so he was stuck in Darkwell dealing mostly with farming-related accidents, a periodic honky-tonk bar fight injury, and a variety of other mundane, nonemergency procedures that did little to satisfy his passion for trauma medicine. Suffice it to say that the report of someone being beaten or run over and left for dead in need of medical attention was a welcomed change of pace for Thornbridge’s mostly untested trauma medicine skills. He was excited that someone had almost died, and looked forward to the credit he would get after he saved the poor unfortunate soul’s life.
The facility was abuzz with the news of the Code Red patient in transit to the ER—it was the first injury-related Code Red the hospital had seen in months, as opposed to the several cardiac and stoke patients transferred from the local nursing homes—and the entire ER staff, including Thornbridge and several nurses from the main hospital, was prepping for the worse-case scenario. Other staff members were hoping and praying that their normal routine—changing a bedpan of one of the elderly hypochondriacs or responding to the couple of overnight patients experiencing problems with the television remote control—would not be altered. Thornbridge fantasized in a rather macabre sort of way about the most heinous incident, one that was so dire that in the event the patient died no one would be surprised, and he would be free to practice his craft without the fear of a medical malpractice lawsuit. Risk-free medicine, that’s what it meant to a first-year ER resident: an opportunity to practice on a cadaver-to-be with all the benefits of a pumping cardiovascular system, preferably one already brain dead. Thornbridge loved the feeling that came with saving lives—at least he thought he would when the moment arrived, a prospect that had eluded him thus far—but he was also thrilled with the prospect of being up to his armpits in warm intestines and hemoglobin.
As Thornbridge entered the well-lit trauma area, he barked, “Where’s this so-called Code Red?” toward a senior nurse old enough to be his mother, who was standing on the other side of the nurses’ station reviewing a case report.
“The ambulance is en route,” Marge Blakely, RN, curtly replied.
I hate these smart ass know-it-alls, she thought, as she turned her attention away from the wet-behind-the-ears rookie doctor and reviewed the scant notes called in by the paramedic just a few moments before. You’ll be gone in a year and we’ll be left to clean up your messes.
Marge was the nursing supervisor as well as the most experienced trauma nurse at the hospital, so regardless of the condition of her personally assigned patients, she was brought down to the ER when a serious case came in—the total number of times for which she had been called in the last year she could count on one hand. After thirty years at the Center, Marge had grown accustomed to the chaos the occasional emergency brought with it. The facility experienced so few that even the experienced community surgeons and physicians were often at a loss as to the proper thing to do for any given emergency. Indeed, Thornbridge was the first dedicated ER physician, resident or not, to work at the hospital in more than five years, yet Marge still considered him to be more trouble than not—too inexperienced to do much good and cocky enough to do a lot of harm. He had much to learn, in her mind, especially in a smaller community like Darkwell. And lesson one was to know who the true boss of the facility was: Marge.
“What do we know so far?” Thornbridge asked as he snatched the report from her. His arrogant, condescending attitude miffed her greatly; regrettably, she could not, at the moment at least, do anything about it. He was the doctor, not her.
He adjusted his moderate-strength, wire-framed glasses and focused on the notes before him. At least he looked the part, Marge considered. He was of average height, 5’8”, had a slight cowlick in his closely-cropped blond locks, and was of slight build due to a holistic, vegetarian diet and a limited exercise routine of twenty minutes of running three days per week. He clashed starkly with the local yokels’ preferred redneck attire and attitude.
How in the world did you end up in my world? Marge kept her thoughts to herself, only the smirk on her face communicating them to several LPNs standing nearby.
“Has Dr. Baker been called yet?” Thornbridge asked, knowing that he was merely a resident who required the supervision of an experienced physician.
“He’s on the way,” she replied.
“Good,” he said while hoping that the patient went critical in a hurry so he could go it alone.
Just then a siren blared through the double-wide glass ER doors and everyone inside rushed to the entrance to greet their new patient. Moments later the reinforced doors burst open as the paramedics slammed the gurney into them, their spring-loaded hinges giving way as they slammed into the walls on each side of the entrance.
Thornbridge went to work, rushing to the side of the rolling gurney, shoving the ER technician out of the way as he did. He pried open a swollen eyelid and flashed his pen light in the pupil to verify what he already knew—the patient was unconscious after experiencing severe head trauma. In the midst of his initial assessment the patient went into cardiac arrest. He slipped his pen light into the pocket of his surgical scrub shirt and pounded on the patient’s chest for what seemed to Marge to be an eternity—it was actually no more than a couple of minutes—before the patient had at least marginally stabilized. Before Thornbridge had a chance to assess the severity of the man’s other injuries and give him yet another chance to die, he knew he had to act. Time was of the essence.
He was critical, just as Thornbridge had hoped for, yet he felt a twinge of regret that he’d brought bad karma into the ER.
“Get a CT scan now and prep him for surgery!” he yelled with slight panic in his voice, as his cockiness gave way to the gravity of the situation. “We’ve got to relieve the pressure on his brain before we lose him for good.”
Panicked or not, Marge sensed that Thornbridge might actually know what he was doing, so she complied, still hoping that Dr. Baker would arrive so she would not be forced to admit yet again that four years of medical school and a few months of residency trumped her thirty years of nursing experience.