Chapter 5 - Blood and Collateral
The Emergency Department at Toledo Memorial was a scene straight out of a wartime field hospital.
Because the central electronic health records were blacked out, clipboards with carbon-copy paper hung from every doorframe. Runners in blue scrubs jogged between the laboratory and the nursing stations carrying handwritten phlebotomy results.
In Trauma Bay 4, Paula Hayes was lying on a gurney, propped up at a forty-five-degree angle.
She looked terrifyingly small. The immaculate hair was matted with sweat; the gold earrings and diamond tennis bracelet lay forgotten in a clear plastic patient-belongings bag beneath her bed. A nasal cannula hissed oxygen into her nostrils, and an IV drip hung above her arm, ticking out saline and nitroglycerin.
Beside her bed stood Erin, her mascara smeared across her pale cheeks, and my father, his hands shoved deep into the pockets of his winter coat, looking utterly broken.
Matthew Parker was standing at the foot of the bed, studying an analog electrocardiogram strip that had just printed out from a portable machine.
"Matthew, please!" Paula gasped, her voice reedy and thin, her skin an alarming shade of grayish-yellow. "Tell them... tell them who you are! Get me a private room! Get me that specialist from Cleveland! I can't breathe in here with all these... these common people shouting!"
"Paula, be quiet!" Matthew hissed, his surgical mask hanging around his neck, his eyes fierce. "You have a seventy-percent occlusion in your left anterior descending artery! You are having an acute anterior wall myocardial infarction! If we move you right now, you could throw an arrhythmia and die before we hit the elevator!"
"Then fix it!" Erin cried, clutching Matthew’s arm. "You're a cardiologist! Why aren't you fixing it?!"
"Because our digital imaging fluoroscopy in Cath Lab 2 is locked by the ransomware!" Matthew shouted back, his voice cracking from exhaustion and sheer frustration. "The only unit that has manual analog override capability is Cath Lab 6, and that suite is reserved under executive disaster protocols for multiple-trauma stabilization! I don't have the legal authority to override that reservation! Only one person can do that!"
"Who?!" Paula wheezed, tears of raw terror spilling over her gray cheeks. "Call them! Pay them whatever they want! Use my credit card!"
"She doesn't want your credit card, Paula," a voice said from the doorway.
The curtain was pulled back.
I walked into the bay.
I was still wearing my tailored dress, but over it, I wore the white lab coat of a Fellow of the American College of Healthcare Executives. On my lapel gleamed the gold executive pin of Great Lakes Regional Health.
Paula stared at me through the oxygen mask, her eyes widening in disbelief and humiliation.
"Natalie..." Erin sobbed, taking a step toward me, but stopping, unsure if she was even allowed to approach the woman she had spent a lifetime looking down upon.
My father took a shuddering breath and stepped back, hanging his head in shame.
I walked straight to Matthew, ignoring the family dynamics entirely. "Show me the strip."
Matthew handed me the EKG paper without a word.
I studied the rhythmic spikes and valleys. I wasn't an MD, but twenty-five years in hospital administration, combined with a doctoral curriculum that required extensive clinical systems oversight, meant I could read an anterior STEMI within three seconds.
"ST elevation in leads V1 through V4," I said crisply. "Reciprocal depression in III and aVF. Matthew, she needs an emergency percutaneous coronary intervention within forty-five minutes, or she’s losing forty percent of her left ventricular wall."
"Cath Lab 6 is locked under your executive order for the trauma overflow," Matthew said, his voice dropping into formal deference. "I need your direct authorization to bump the reserve status."
I looked down at the woman on the bed.
Paula looked up at me.
For the first time in my forty-five years of life, my mother was looking up at me not with disappointment, not with critical disdain, not with the smug superiority of someone holding a fifty-dollar gas bill, but with pure, naked terror.
She knew that her life, her heartbeat, her very survival hung on the word of the daughter she had treated like a household servant.
"Natalie..." Paula whispered through the plastic mask, her fingers clawing weakly at the rough hospital sheet. "Natalie... please. I’m sorry. I’m so sorry."
The words were choked with bile and shame, but they were real. For the first time, they were real.
I leaned down until my face was six inches from hers.
"Mom," I whispered, my voice steady, cool, and entirely without malice. "I’m not saving you because you apologized. I’m saving you because every patient who enters this hospital is my responsibility. Even the ones who don't think I’m worth a dime."
I straightened up and looked at Matthew.
"Dr. Parker, prep Cath Lab 6. You have twenty-five minutes. Take surgical nursing team Beta. Bump the trauma reserve to the ambulatory surgical center on the third floor. I’ll sign the executive override on the chart myself."
"Yes, Dr. Brooks," Matthew said, immediately turning to the nurses. "Move her! We’re going to Lab 6! Move, move, move!"
The gurney was unlocked, its wheels rattling against the linoleum as the medical team surged out of the bay.
Erin stood frozen by the wall, watching the gurney disappear down the corridor. Then she turned to me, her body trembling with uncontrolled sobs.
She dropped to her knees right there in the empty trauma bay, her designer dress pooling on the dirty floor.
"Natalie... please forgive me," Erin wept, grabbing the hem of my lab coat. "Please. I didn't know. I was so stupid. Mom made everything about me, and I just... I let her make you invisible. I’m so sorry. Please don't let her die."
I looked down at my sister. The anger that had lived in my chest for decades—the resentment over stolen trust funds, forgotten birthdays, and condescending snickers at holiday dinners—did not flare up.
It simply dissolved, replaced by a deep, profound pity.
I reached down, took Erin by her trembling hands, and pulled her up to her feet.
"Get up, Erin," I said gently, wiping a tear from her cheek with my thumb. "You're a Parker now, and you're my sister. We don't kneel on hospital floors. Go upstairs to the surgical waiting room. Matthew is the best interventionalist in this state. He’s going to save her."
Erin threw her arms around my neck, sobbing into my shoulder with a desperate, childlike grief. I held her for five long seconds, feeling the ice between two sisters crack and fall away under the weight of mortality.
Then I checked my watch.
It was 10:45 a.m.
I had seventy-five minutes before Donald Vance attempted to steal my life’s work.
May you like
I patted Erin’s back, stepped out of the trauma bay, and headed for the executive elevator.
***