Cold Grave (8 page)

She wiped the cheek on her shoulder. ‘That was Lilly’s favourite movie when we were little. She wanted the bird lady to come and live with us. That way, she thought we could have the birds as pets but they’d still be free.’

Anya pulled a clean tissue from her pocket and passed it across. Jasmine flicked a strand of hair from her face. It had the same apple scent Anya had noticed on Lilly.

‘How could this happen? I don’t understand.’

Anya wished she had the answers. If Jasmine wanted to keep talking, she would listen. As inadequate as that felt, it was the most anyone could do.

‘That’s something the people in charge are trying to work out.’ She paused and sat forward. ‘Is it possible Lilly met someone on board?’

Jasmine shook her head. ‘No way, she would have told me.’

There was another moment’s silence.

‘Mother will be back soon.’ The violin was returned to its case.

Anya handed the book back and stood. ‘Thank you for playing. It was beautiful.’

Jasmine clutched the bow to her chest. ‘I’m glad you were with Lilly when . . .’ The fragile voice faltered. ‘She’d like you.’

In a way Anya was glad she had been there. Lilly Chan sounded like a remarkable young woman. Anya half-smiled and glanced around at all the spines on the shelves.

‘May I ask one thing? Did Lilly choose anything from here to read?’

Jasmine nodded. ‘Typical Lilly. She couldn’t believe her luck finding a copy:
Romeo and Juliet
. She loved the romance and cried when the lovers died.’

6

That afternoon, the kids’ club pager bleeped. Anya rang and was asked to head straight to the medical centre. There was an emergency. The Irish counsellor was quick to reassure her that Ben was fine but that’s all she knew. Anya hurried and once inside the main doors, followed the screaming. It sent the hairs on the back of her neck to attention. It had to be Martin. She pushed open the treatment room door.

Doctor Novak glared in her direction. ‘Out!’

‘I called her.’ Karen managed above the wailing of a dark-haired man. ‘We need all the help we can get.’

Anya felt relief flood through her. Martin was OK.

A younger woman with a copper-coloured ponytail and green-rimmed glasses held a large surgical pad in its half-open pack for Karen. With blood-stained gloves, the senior nurse reached over and collected it, maintaining sterility.

‘We’re going to need a lot more,’ she instructed. ‘Rachel, there’s another box on the top shelf.’ She gestured with her head toward the glass-door cabinet.

In contrast to the junior nurse’s crisp, white uniform and skirt, Karen’s was saturated with blood across her belly and hips.

The man writhed, face down on the treatment bed. Tourniquets were tied just below his dark blue trousers, which had been cut at mid-thigh level. Karen placed the pads on top of the ones already there, compressing the backs of the knees. The man screamed at the contact.

‘Can you do anaesthetic?’ the doctor snapped.

Anya was taken aback. She had only ever assisted in anaesthetics as a medical student. ‘What happened?’

The patient screamed again.

Rachel handed her some gloves and a plastic apron, which she slipped on.

‘Carlos is a crew member. From Colombia.’ Karen flicked her head to remove hair from the middle of her forehead. ‘Shot in the backs of both knees.’

Anya’s eyes widened. Shot? On a cruise? That explained the severe pain. Kneecapping was one of the cruellest acts; more painful than being shot in the chest and it generally caused long-term damage.

Doctor Novak repositioned the overhead light before collecting packets from a cupboard. Each parcel had a strip of black tape on the outside, proof it had been sterilised in an autoclave.

Karen had said Doctor Novak was a military surgeon. Anya’s heart picked up pace.

‘You’re not thinking of . . .’ She didn’t want to alarm anyone else in the room, especially the patient. ‘Dissecting?’

The whites of Karen’s eyes flared. ‘We can’t. We have to stabilise him until we can get a medical team for an airlift.’ She looked to Anya for support. ‘There’s a helipad on the top deck.’

‘You’re not talking of amputation?’ Rachel said, sounding shocked. ‘We can’t do that.’

Dark red blood leached through the pads in Karen’s hands. The patient panted faster.

Anya hated to think how much pain he must be in.

Another officer knocked and entered the room, perspiring. He caught sight of the blood and colour drained from his face. He half-turned away from the patient and swallowed hard.

‘I’ve spoken to the captain. We won’t be in helicopter range for at least eighteen hours, and we’re sailing into bad weather.’

That meant there was no guarantee a helicopter could land even if they were in range.

Doctor Novak spoke first. ‘He will not survive unless we amputate. Better to live with no legs than die.’

Carlos began to flail again. As he turned his head, his dark, desperate eyes met Anya’s. He grabbed her wrist with all his strength.

‘
Please
. Help!’

Twisting, she tried to loosen his grip and bent down to his face. ‘We’re doing everything we can.’ He released her wrist and Anya placed a hand on his forehead.

‘Help . . .’ He murmured something else.

Anya tried to understand as Karen and Novak kept up a rapid dialogue of instructions.

‘Her,’ he whispered again.

Anya bent down to better hear among the chaos.

‘Stop him.’

‘It’s all right,’ Anya answered, ‘we’ll look after you.’

‘Is he refusing treatment?’ Rachel pulled the stethoscope plugs from her ears after checking Carlos’s blood pressure again.

‘There will be plenty of time for naming the shooter once we are finished.’ Novak was matter-of-fact.

‘He’s frightened, and doesn’t understand what’s going on,’ Anya said. ‘If you can stem the blood loss and get a stable BP, that could buy enough time to get him to a major treatment centre.’

Carlos had one intravenous cannula and a bag of saline dripping through it.

Doctor Novak may have been good at amputating legs in a war zone, but they owed it to Carlos to try to save both legs. Another pair of experienced hands would help. She asked the officer to page Martin Hegarty, a trained intensive care nurse. He exited the room in record time.

‘What pain relief has he had?’

‘Total twenty milligrams morphine,’ Karen said. ‘Didn’t touch him.’

‘We need to act now.’ Novak seemed intent on operating.

Anya had to think quickly. ‘Do you have X-ray facilities?’

‘Already done,’ Novak announced. ‘There, on the screen.’

Anya examined the computerised images. Her heart sank. The first showed a shattered base of the right femur, where the thigh became the top of the knee. The left hadn’t fared much better. Carlos needed both vascular and orthopaedic surgeons on hand to have the best chance of keeping either leg.

Rachel checked the blood pressure. ‘It’s dropping, eighty over sixty. Pulse rate’s one-forty.’

He had lost a lot of blood. ‘Do you have any O negative?’

The nurses shook their heads.

‘We can put out a call for blood donors and do a transfusion, but it’s not a simple process,’ Karen explained.

‘That will take too much time,’ Doctor Novak replied. ‘BP is already compromising the kidneys.’

‘What if we give more analgesia? He should stop moving around, then we can push fluids.’ Anya turned to Rachel. ‘Can you take over from Karen?’

The younger nurse obliged.

Karen quickly changed her gloves and checked the cannula site. ‘It’s tissued.’

Anya could see the swelling in Carlos’s forearm. The fluid was no longer going into his circulation.

Karen put a tourniquet on his other arm and tapped a vein in the back of his hand. Carlos was still flailing about and it was like trying to hit a moving target. Karen’s hands began to shake.

Martin bowled in and quickly assessed the scene. ‘If you like, I’ll have a go at that.’ He sidled beside Karen and she seemed relieved to hand over the task.

Anya was impressed at how calm Martin appeared, despite the chaos in the room. Karen locked the elbow straight and held it firmly to minimise Carlos’s movement.

‘Eureka.’ Martin secured the access point. ‘Just like riding a bike. Good thing I kept the old registration up.’

Karen breathed a sigh of relief as she reconnected the saline and it flowed, unimpeded. ‘I owe you two dinner.’

Doctor Novak seemed to ignore everyone in the room, including his patient. He had already set up a surgical tray with scalpels, clamps and suture equipment. ‘Give another ten milligrams morphine, two milligrams at a time,’ he ordered.

Carlos drifted into unconsciousness. Anya placed prongs in his nostrils and turned on the oxygen supply attached to the wall. A rubber cap placed on his left index finger connected to a monitor on the wall and registered his pulse rate and oxygen saturation. The monitor beeped . . . 118 . . . 112 . . . 108 . . . Anya rechecked the blood pressure. ‘One hundred over eighty.’

‘The bleeding’s slowing,’ Rachel declared.

‘Don’t know what all the fuss was about.’ Martin smiled.

Doctor Novak studied the monitor, as if in disbelief.

David FitzHarris arrived with a man of around six foot four, fit, with wavy blond hair and pale eyes, and four gold bars on white epaulettes. Judging by the way the room fell silent, he was superior in rank.

Hands behind his back, he surveyed the scene. ‘What is the situation?’

‘Gunshot to both knees,’ Novak stated. ‘Close range.’

Anya kept an eye on the vital signs. ‘He’s stable for the moment, but . . .’

‘Captain Burghoff,’ FitzHarris interrupted, ‘this is Doctor Crichton, and Mr Hegarty, who were invaluable this morning.’

‘Ah, yes.’ He bowed his head. ‘We are grateful for your assistance, then and now. How long before the patient needs specialised hospital treatment?’ Captain Burghoff checked the clock on the wall and immediately moved to the X-ray images on the screen, hands still firmly at his back.

Anya studied them again, from behind his shoulder. There was no need to explain what they showed. The femurs were damaged far beyond pinning or plating, even by the most experienced surgeons with every facility available. She knew they had only bought a short amount of time. The tourniquets could not remain on for hours without compromising circulation to the good tissue in the legs. Loosening them could result in the release of deadly amounts of potassium, the same thing that killed crush victims if they were lifted out too quickly.

Doctor Novak had begun to scrub. ‘If I operate, he should be stable until Bora Bora.’

That was five days away, Anya thought.

‘Do you have an anaesthetic protocol?’ Martin asked, as if reading Anya’s mind.

Karen answered. ‘Propafol. It’s attached to the portable ventilator under the bed. Number two on the picture.’

All equipment had been photographed and placed on the walls. It meant that, if necessary, non-trained personnel could assist. It also removed language barriers in emergencies. In medicine, pictures were universal.

Martin scanned the laminated document. ‘I’ve used this type of ventilator before, transporting ICU patients. The protocol’s pretty straightforward, but . . .’

Captain Berghoff nodded. ‘If we turn back to Hawaii at full speed, we are at least sixteen hours from range for a medical evacuation. Either way, we are headed into severe storms.’ He paused, and surveyed the blood on the floor and on Karen’s clothes. ‘I suggest you do what you can.’

There was little choice if emergency care was so far away. Anya made her mind up. ‘I’ll intubate and monitor the anaesthetic.’

‘What about patient consent?’ Rachel’s voice sounded half an octave higher. ‘He’s had morphine.’