Luka stripped off his gloves. "Ok. Let's get her up to the OR." He followed the residents as they took the woman to the elevators, then stopped and looked around. The worst of it seemed to be over. She was the last critical patient. The other trauma room was empty. There were a few minors yet, but they could probably wait a bit longer, or he could leave them to the residents. He'd check on Jane and sign off on her patient, then maybe grab Sam and get the lunch he'd planned to get an hour before.

Jane was doing well. They change in her had been remarkable. She was a completely different person from the shy, awkward non-entity he'd taken under his wing two short weeks earlier. She was confident now; eager to learn and quick to master every new skill. A neglected flower blossoming beneath his care. Luka smiled to himself. Maybe he could get Carter to pay off on that bet. A thousand pounds if he could turn the flower girl into a duchess. But no, he knew what Carter's response would be. "Ah, a thousand pounds of what?" And, knowing, Carter, it would probably be a thousand pounds of something he didn't want, delivered to his apartment at 3 a.m.. In any case, Jane wasn't quite a duchess yet. Maybe a countess, but not a duchess. She still had a ways to go.

Still half lost in thought, Luka pushed open the door to exam 4 – and froze.

Blood. There was blood everywhere. Puddles of it on the floor, splatters of it across Jane's white coat and on her gloved hands. Summer's tee shirt had been pushed up around her armpits, leaving her chest bare, but it too was soaked with blood. Jane was doing CPR as tears coursed down her face, making faint pinkish trails through the blood smeared on her cheeks.

"Jane!"

"She needed a chest tube…" sobs choked her and kept her from saying more.

Luka turned and quickly looked back out into the hall. "Chuny! Four units of O-neg, stat! And another pair of hands!" Then back to Jane and their patient. "How long has she been down?"

"I … I'm not sure … 5 minutes?"

"Why didn't you call for help?"

"I did. I called for help. Nobody came."

Luka's heart skipped a beat and, for just an instant, he froze again. Then a breath, and he made himself focus. He grabbed an IV kit to start a line; it had to be ready when Chuny got back with the blood. But even as he worked, beneath Jane's frantic sobs, he also heard his own voice in his memory, 'I kept calling for help … nobody came.' God … Jasna had been just about the same size as Summer … and he had been just about Jane's age. He knew too well what it was like to be alone and inexperienced, with a life … literally … in your hands. What is was like to panic and forget the obvious; the alarm button on the wall.

The door flew open and Chuny was there. "This is the last of the O-neg, just 3 units."

"It will have to do. Chuny, take over for Jane." Jane let her hands fall and she started to sink down onto the stool, exhausted. No, he had to keep her busy, keep her focused … let her feel that she was doing something, making a difference for her patient. Though, in his own gut, he knew that nothing they were going to do would make a difference. "Jane, hang the blood."

"What?"

"Come on, Jane. You've done it before. She needs blood now."

Jane's hands were trembling as she picked up the first unit of blood. It slipped from her hands. She looked at him for a moment; he forced himself to give her an encouraging smile. Picking up the bag she slowly hung it from the stand.

Luka had the ET tube in and the monitor leads attached before Jane had finished hanging the blood. Asystole.

Oxygen, blood, saline, FFP, another chest tube, a dozen shocks. Luka did everything he could, but he knew they were just going through the motions. Summer was so small; it took no time at all for a child that size to bleed out. He could crack her chest, but that too would be just going through the motions.

Finally he shook his head and said quietly. "Ok, that's enough. Time of death, 15:25."

Jane stared at him, kept squeezing the bag. "No, Dr. Kovač. You have to keep trying … maybe more blood? There has to be something…."

"It won't help, Jane." He gently but firmly took her hands from the bag-mask and unhooked from the tubing. "Chuny, do you know if her mother's here yet?"

"I don't know. I'll go find out." She left, and Jane sank back down onto the stool.

"I killed her," she whispered. Then, with an edge of hysteria to her words, "I killed her!"

"No, Jane," Luka was about to say, when Jane suddenly jumped up from the stool and was clinging to him, her arms around his waist, sobbing into his shirt. "I killed her … I did …" Firmly, Luka took Jane's hands and unwrapped her arms from around him. Holding her by the shoulders he gave her a little shake.

"Come on, Jane, that's enough. Pull yourself together." Jane pulled free and crumpled back onto the stool; covered her face with her hands and sobbed.

Just then the door opened again. Luka turned, expecting to see Chuny, but it was Susan. For a moment she just stood there, frozen, just as Luka had been 20 minutes earlier. He knew she was taking in the blood, the hysterical medical student … and the dead child on the bed.

"What the hell happened here?" Susan finally asked slowly.

Luka sighed, spoke quietly and matter-of-factly. "She started to crash. Jane realized she needed a chest tube; she didn't have a pediatric kit. The tube was the wrong size." He sighed again. "It was my fault, Susan. I left Jane alone with a potentially unstable patient. I hadn't finished assessing her … the girl looked stable, but I must have missed something."

Susan shook her head. "All the same, Jane should have known better than to try and do an advanced procedure like that without supervision. If the patient was crashing, she should have gotten help. There will definitely have to be an inquiry."

"I know," Luka said. His voice was surprisingly husky.

Jane took her hands from her face, looked up at him for a moment, then at Susan. "It doesn't matter," she whispered. "I don't care. Throw me out of the program … throw me in jail. I don't care. I can't do this!" Standing up again she brushed past Luka and, before he could react, pushed past Susan and ran from the room.

Luka moved to go after her but Susan said quietly, "Let her go, Luka. She'll be ok."

"Yeah." Of course she would be. Almost every medical student went through something like this; losing a patient through carelessness or over-confidence. He'd lived through it as a med student, and so would she.

There was nothing more to say. Luka wet a cloth and began to clean the blood from Summer's face. "Let me know when her mother gets here. She's supposed to be driving in from Elgin."

"A nurse can do that, Luka," Susan said gently.

"The nurses are busy." He didn't look at her; focused on Summer's face.

Susan stood in the doorway a moment longer, seemed to be about to say something, then turned and left.

The tubes and IV's would have to stay in place for the coroner, but he could clean her up a little; make her look nice for her mother. You're never helpless Jane. There's always something you can do. Sometimes it's just a matter of finding that something. He couldn't save her. He couldn't ease Jane's guilt, or his own, but he could clean away the blood, maybe make this a bit less traumatic for Summer's mother.

Summer's shirt had been cut down the front during the resuscitation efforts. Luka gently removed the tattered fabric. It was covered with blood, better for the mother to not see it. He folded it to put it away, and Bob the Builder smiled up at him.

xxxxxxxxxxxxxxxxxxxxxxxxxxx

He had broken the news to Mrs. Clearlake as gently and clearly as he could. Not the whole truth (though, no doubt, it would come out soon enough), but no lies either. "Summer had some very severe injuries to her chest. We did everything possible, working on her for a long time. But her injuries were too serious; she'd lost too much blood. Summer died. I'm very sorry." Then he had taken her to see her daughter's body.

As soon as Chuny had taken her upstairs to wait for her husband to get out of surgery, Luka went to the desk. "Jerry, have you seen Jane?"

"I think she's at lunch. She went out with her coat on around half an hour ago."

Luka sighed. He grabbed the staff/student phone book from the shelf by the phone. Figler. 555-3872. He started to dial, then suddenly noticed the address. It was just a couple of blocks away. Some conversations were better done in person. "I'm going to lunch," he told Jerry, hanging up the phone and heading to the lounge for his own coat.

It had started to snow again. Luka stepped out into the ambulance bay and turned up his collar. The wind was sharp and cold. Walking rapidly, he started towards the sidewalk, and then suddenly saw a slender figure sitting on the curb. Her arms were wrapped around herself for warmth. The large white snowflakes in her hair and on her coat contrasted sharply with the vivid streaks of blood still on her face.

"Jane," he said gently. "Let's go back inside. Jane didn't answer, just shook her head. "Come on, it's freezing out here. You need to get cleaned up, and there are still patients to see."

"I can't …"

Luka sat down beside her. "I know it's upsetting to lose a patient. It's something you have to learn to deal with."

"I didn't lose a patient, Luka. I killed a patient. There's a difference."

"What exactly happened?"

"I told you. She started having trouble breathing. I knew she needed a chest tube. I'd done one before … I thought I could do it. I thought I did everything right, but the tube wouldn't go in. I … I kept pushing on it. It finally went in, but then she was bleeding … so much blood … it wouldn't stop … I didn't know what to do …" Jane wiped at the fresh tears. "What did I do wrong?"

"A 32 french tube is too large for a patient that small. You needed a pediatric-sized tube. And when you forced it into her chest, there wasn't much room for error … it probably struck her heart … we'll know for sure after the autopsy."

Jane was silent, shivering. Instinctively Luka took her hands in his own. She wasn't wearing gloves, her hands were freezing. "You made a mistake, Jane. Everyone makes mistakes. It's part of learning. What's important is that you did what you thought was best for your patient. You were doing the best you could to help her, right?"

A slow nod from Jane, then she bit her lip and shook her head. "Yes … no! I was …. I wanted to help her, but it was more than that. I wanted to impress you. I could have gone for help, but I guess I wanted to show you what I could do … show you that I can be a good ER doctor. But I was wrong … I can't be."