Carter headed towards the desk to take another chart just as Haleh signed off the radio. "We'll be ready. County base out."
"What's coming in?" Carter asked.
"Two GSWs, one in full arrest. ETA less than two."
Carter sighed. This was not shaping up to be a good evening. He'd started out with a double MVA with two fatalities, and now this. And he was barely two hours into the shift! Must be the full moon. It didn't help that he was in a bad mood anyway. He'd barely seen Abby for weeks, and now she was suddenly being clingy and paranoid; an attitude that, somehow, made him feel annoyed and irritated rather than loving and protective.
"Ok. Make sure both trauma rooms are ready; and that there's 2 units of O-neg for each, and page Lewis and Weaver. I'll be outside."
He headed out into the chilly ambulance bay. Probably a gang shooting he thought. Just so neither of them were innocent bystanders. Carter was surprised by the thought. He must be getting hard ... been at this too long. He didn't care if gang members shot each other, just so they didn't hit anyone else. A vacation. Maybe it was time for a vacation.
Sirens and flashing lights. Back doors of the ambulance opened, and Carter rushed to help the paramedics lift down the gurney. Doris was squeezing an ambu-bag, and a cop was doing chest compressions.
Doris began rattling off the bullet. "Adult male. Two GSWs to the chest. At the scene was minimally responsive to pain, in respiratory arrest. Was initially in v-tach, lost the pulse about 30 seconds out. Pressure's 60 palp. Intubated at the scene and started a line ..."
Doris's voice seemed more strained than usual, but Carter wasn't really hearing her anymore. He was looking at the man on the gurney. Tall, his feet hung off the end. His shirt sleeves were blue, but the front of his shirt was a deep red. And the face behind the ambu-bag was utterly white except for some blood around his mouth and his black eyebrows and lashes, and blue-green eyes beneath half-closed lids. Utterly white and painfully familiar.
He looked up at Doris, and she looked away uneasily. "Why didn't you say something?" he demanded, fear and shock making his own voice harsher than it should have been.
"I didn't know how to tell you." A pause. "Second victim's behind us."
Carter pulled himself together. He had a job to do. "Ok. Let's get him inside. Trauma 2."
Carter turned, just as Susan stepped out into the bay. She too registered the identity of the man on the gurney, and breathed softly "Oh, Jesus...."
Inside they met Kerry, also enroute to the bay. "We've got this one, Kerry," Carter said. "Second victim should be rolling in now."
"I've got it," Kerry agreed, then her eyes widened in momentary shock as she looked at the patient, then at Carter again.
Carter's head was spinning. Luka had just left! Not half an hour ago. He must have been mugged on his way from the el, he thought. Or maybe stopped to intervene in an fight, or help someone who was being mugged ... which might explain the second victim. So like Luka, he thought, to risk his own life to help another. But was that courage, or just a feeling that his own life wasn't worth much? These days, Carter was more apt to believe the second explanation.
In the trauma room, everything shifted into the sense of barely controlled chaos that typified a trauma. Everyone knew their job and did it smoothly, but with 6 different jobs being done all at once, a less knowledgeable outsider might believe that it was chaos. Cutting away clothing, hanging blood, doing CPR, getting monitor leads, taking vitals -- not that Luka had any at the moment.
Carter touched the paddles to Luka's chest and looked at the monitor to see what they registered.
"He's in fib," said Haleh.
One shock. Still fib. "Come on, Luka," Carter whispered. "You are not going to die on our fucking doorstep, do you hear me?"
A second turn with the paddles, and Haleh's voice came, relieved. "Sinus tach." Not ideal, but better than what he'd had before.
"He's not going to stay that way," Susan said, "unless we can get his pressure up. He's lost most of his volume. Squeeze in that blood, and we'll need a lot more blood. All the o-neg we've got, and type and cross for type specific now!"
"There's another victim," Yosh reminded her. "He'll need blood too."
Carter looked through the window to the other trauma room. He could see Kerry and Pratt working on someone, but couldn't tell what was happening.
He looked back at Luka. Two small holes in his chest. How could someone lose so much blood from two such very small holes?
"He's B-positive," said Haleh. "He's mentioned that several times."
"Ok. Get 6 units of B-positive down here," said Susan.
"Thoracotomy?" suggested Gallant.. "If we can find where he's bleeding ..."
"Not unless I have to." Carter knew well that survival rates after thoracotomy were very low. Far better to stablize him here, if they could, and let the surgeons open him up in the more controlled setting of the OR. And the idea of opening Luka's chest made him shudder a little.
Gallant had been listening to Luka's lungs. "Well, he needs a chest tube anyway. Absent breath sounds on the left."
"Fine. Do it."
For a moment there was a lull, as Gallant put in the chest tube, they squeezed in the blood and continued to quietly assess him, fear and nerves masquerading as calm professionalism. Carter looked up at Doris, who was still hovering by, anxiously. "What the hell happened?"
"I'm not sure. He was lying outside his apartment door. The shooter was lying a few feet away with a self-inflicted gunshot wound. We heard the shots as we were pulling up, but it was a few minutes before we could go in. The cops weren't sure at first if the gunman was still shooting, or there might be a second one. They wouldn't let us in until they'd secured the scene."
'Well ..' thought Carter ironically. 'At least he wasn't going to die on his own doorstep.'
Luka's vitals were starting to stabilize as his blood volume increased and the chest tube relieved some of the pressure in his chest. "BP's up to 80 systolic," said Yosh quietly. "Pulse down to 110." Better. Blood was still flowing steadily out the chest tube, he was still bleeding into his chest, but he was starting to make faint choking sounds around the ET tube, trying to breathe.
Just then the adjoining door opened and Kerry came in. "How's he doing?"
"We're starting to get him stabilized. . Two GSWs, one to the lower chest, one looked like it nicked the aorta. Just missed his heart. He's lost a hell of a lot of blood, but the damage should be operable once we get him upstairs."
"Good." She said the one brief word calmly, but the relief in her eyes was clear.
"How's your patient?" Susan asked, and Kerry shook her head.
"DOA. We gave it a shot but he left most of his brains at the scene. Never had a chance."
Carter found it hard to feel particularly sorry about that.
Haleh said quietly, "Dr. Carter." Carter looked at Luka. His eyelids were fluttering a little. He was looking at them.