THE SHOOTER HAD HERDED THE five of them into the waiting room. The front desk was littered with glass. There were pamphlets scattered all over the place and smears of blood on the carpet. Furniture had been piled against the front door as a barricade—a coffee table, a file cabinet, a couch. The television overhead was playing The Chew.
Joy had left her purse and her phone in the recovery room when she ran away from the shooter. His name was George. She had heard him say it, on the telephone. He looked like any of the male protesters who had been standing outside yelling at her as she ran into the clinic. She didn’t listen to a single word they said. But she remembered a man holding a baby doll upside down by the foot, with a knife sticking out of its belly.
To be here today, she had switched shifts at the bar and said she was going to Arkansas to visit her family. If anyone else were going to be a casualty of a pro-life shooter, he’d pick the woman who’d just had an abortion. Was this the karmic price she had to pay? A life for a life?
Would anyone even miss her?
“Hey.” Dr. Ward’s voice floated toward her. “You all right?”
She nodded. “Are you?”
“I’ll live. Maybe.” He grinned faintly at his own joke. “It’s Joy, right? It’s gonna be okay.”
She didn’t know how he could say that with such authority, but she appreciated it, the same way she appreciated his kindness during the procedure.
If she died today, she’d be a footnote in a newspaper.
She wouldn’t finish her associate’s degree.
She wouldn’t know what it was like to fall in love.
She wouldn’t have a chance to be the kind of parent she never had.
A hysterical laugh bubbled in her throat. She was a hostage, at the mercy of a lunatic with a gun. The soles of her feet were literally soaked with the blood of others. She had stepped over a dead woman to get where she was sitting, and she might very well watch more people die before her eyes. She might even be one of them.
But at least she wasn’t pregnant.
—
TO SAY THIS WASN’T GOOD was an understatement.
Izzy knelt down in front of Bex. She had managed to get the woman out of her blouse and could see the exit wound of the bullet. It had gone through the right breast and out just above her right shoulder blade. But even with Janine pressing gauze onto the wound, Bex’s bleeding hadn’t slowed.
“We’re going to take good care of you, Miz Bex,” Izzy said, smiling down at her.
The woman’s breathing was labored. “I’m … I …”
“Don’t try to talk,” Dr. Ward said. “We’ll patch you up like new. I can’t risk sullying my reputation as a physician.”
That, at least, brought a smile to the woman’s face. Izzy squeezed her hand.
“Can I … ?” Janine looked up at her. The girl’s hands were covered with Bex’s blood, and quivering with the effort she was making to stanch the flow.
“No,” Izzy said tightly. “You can’t.”
The phone rang again, and they all turned to stare at it. Last time, Izzy had been the one who answered it. The shooter had directed her to do it by jerking the gun in her face.
“Don’t touch it,” he barked.
The phone rang twelve more times; Izzy counted.
Bex’s breathing was tighter, soupy. “Hard,” she said. “To … catch … my …”
Izzy reached for Bex’s wrist, counting heartbeats for her pulse, and doing the math: 240 beats per minute; Bex was tachycardic.
“She probably has a tension pneumothorax,” Dr. Ward said. “We have to get the air out of her chest cavity so she can breathe freely.” He twisted, trying to haul himself upright on his good foot, but he lost his balance and crashed onto his bad leg.
Izzy took the bulk of his weight. “The last thing we need right now is for you to play hero.”
“What we need is a trauma doctor,” he said, meeting her gaze. “And it looks like that’s going to be you.”
Izzy shook her head. “I’m not a doctor.”
“That’s just a bunch of letters after your name. You know what you’re doing, I bet.”
Izzy had seen needle decompressions done before in a hospital setting, when they had sterile conditions and all the proper equipment. She also knew that Bex was not long for this world without some kind of immediate medical intervention. As air entered her pleural space from the wound, the pressure would increase and collapse the lung, which in turn would compress the heart and shift the mediastinum. That meant her heart wouldn’t pump effectively and the vena cava—the big vessel that returned all the blood to the heart—wouldn’t do its job.
Bex started wheezing, fighting for air. Her body shook with the effort. Izzy grabbed Janine’s hand and pressed it down harder on the gunshot wound. Then she stood, summoning all her courage. “This woman needs medical attention,” she told the shooter.
He stared at her.
“Do you want her to die?”
What a stupid question. Of course he did. He wanted them all to die. It was why he’d come in with a gun.
“I can treat her. But I need to get instruments in the procedure room.”
“You think I’m an idiot? I’m not going to let you go off by yourself.”
“Then come with me,” Izzy said, desperate.
“And leave them alone?” He gestured around the waiting room. “I don’t think so. Sit back down.”
“No,” Izzy said flatly.
He raised his eyebrows. “What did you say?”
“No.” She began to walk toward the shooter. The gun was pointed at her belly, and her legs were like noodles, but she managed to take one step and then another until the barrel of the pistol was six inches away from her. “I will not sit down. Not until you let me get supplies so I can save that woman’s life.”
He stared at her for a moment that lasted days. Then he suddenly grabbed Joy and kissed the pistol to her head. “I’m counting to ten. If you do anything stupid, or if you don’t come back, this woman dies.”
A small, wounded whimper escaped Joy. Behind her, Bex was outright gasping for air. “One,” the shooter said.
Two. Three.
Izzy spun on her heel and raced down the hall to the procedure room. Four. She scrambled through drawers, flinging open cabinets, blindly grabbing whatever she could lay hands on as if this were a macabre supermarket sweep. Five. She lifted the hem of her scrubs top and dragged her booty off the counter and into the makeshift basket. Six. Seven.
She scrambled back to the waiting room, dumping her treasures all over the floor.
The shooter let go of Joy, who fell, trembling, onto the couch and drew her knees up to her chest.
“Pick those supplies up,” Izzy said to Janine. She pulled off the johnny she had draped over Bex. The woman’s eyes were wide and terrified; they fixed on Izzy as if she were the only mooring in a storm. “Bex,” she said firmly. “I know you can’t breathe. I’m going to fix that. I just need you to try to stay calm.”
Janine settled an armful of items beside Izzy: gauze and tubing and a number 15 stab blade, a Kelly clamp and a tenaculum, a curette.
Izzy was a pro at fixing problems with little but ingenuity. When the stove broke, you made a campfire and boiled eggs by holding them up to the steam coming out of a kettle. When there was no milk for cereal, water worked. When you wore through the sole of your shoe, you made an insole out of cardboard. If growing up poor teaches you anything, it’s how to problem-solve.
She picked up a 22-gauge needle. She had seen needle decompressions done before, but with bigger needles. This one was delicate, meant to inject lidocaine. It wasn’t long enough or stiff enough to provide a release for the air building up inside Bex’s chest cavity.
“Not gonna work,” Dr. Ward corroborated. “You’re going to have to put in a chest tube.”