The emergency department of the hospital was bristling with activity following an explosion at one of Madrid's trendy clubs. There had been a lot of people packed into the club and many had died. Those who hadn't were sent to the various hospitals. The SAMUR were busy transporting patients of various degrees of injury to the hospitals.
Eva and her partner brought in yet another victim, a young woman whose arm looked like it was severely dislocated and injury to her leg. They met a few of the doctors gathered at the entrance waiting for the new patients. Doctors Javier Satamayor and Maca Fernandez ushered the newest patient past the doors into the trauma area.
As they began their initial examinations, Esther Garcia, the nursing department head, moved in coordination with the doctors, setting up intravenous solutions as per order and getting vital statistics from the patient. From an outsider's perspective, it might look like an intricate dance; each person knowing what the other's moves would be and allowing for changes in steps and orders as they followed.
After the radiology department sent the results of the x-rays of both shoulder and leg and establishing the extent of the leg wound and determining the patient's stability, Javier ordered a temporary pain blocker so that they could reset the dislocated shoulder. Once it was determined that the patient could go onto surgery to have the leg set, Maca and Javier relinquished the patient to Dr. Cruz Candera.
The rest of the night seemed to go in fits and starts with patients coming through. A myriad of doctors and nurses intertwined to save the lives of some and work to mend others. In addition to the incoming patients from the club, the emergency department also handled less than its usual number of patients, as they'd had to close down the department to incoming emergencies, so the remainder of incoming patients were walk-ins or delivered by families.
One such patient was a child who'd been brought in through the night by a distraught parent. When Maca, the head of pediatrics, was able to discern what the mother was saying, she had the young boy rushed through. Esther guided the mother through to sit with the child as Maca examined him. The young boy had leukemia and was no longer responding to his therapy. Maca's observations and subsequent test revealed that the child was very anemic. Maca's heart went out to the mother. It always hurt when she knew she couldn't save a terminally ill child, but her efforts were then motivated to keep him as comfortable as possible. She would have to talk with the pediatric oncology consultant later but she had some ideas of options open for pain control and assistance for the mother.
During a brief break later on, Maca ventured into the cafeteria looking for Esther, finding her sitting at a table, grabbing a bite to eat, and reading through a magazine. Esther had been distracted and thus hadn't noticed her coming closer, a fact that Maca used to her advantage.
"Hey," Maca said as she draped her arms around her partner and bit down on the sandwich that Esther had in her propped up hand. "Mmm. That's good."
She earned a playful swat and a smile from Esther. "Go get your own. It's in the fridge."
"Spoilsport. Where's the fun in that?" She bit off another piece before heading to the refrigerator to pull out her own lunch and then grabbed the coffee pot, pouring herself a decent amount, before heading back to the table with Esther.
"What are you reading that's got you so absorbed?"
"A nursing journal." At Maca's slightly amused grin, she continued. "It's interesting."
"Good to know."
"How are you?" Esther asked, knowing her partner's attachment to the children she worked on. Her thoughts briefly turned to Jaime, a young boy that had come through the department the previous year complaining of headaches and unexpectedly died of an aneurysm. And the emotional fallout that Maca dealt with – or rather hadn't dealt with until it was nearly too late.
"Okay, I think. I was talking with the pediatric oncology consultant. She gave me some ideas to work with. Some I'd already come up with, but I wanted further confirmation. First things first is to keep the boy comfortable. I'll talk with his mother in a while to discuss the options. I'm admitting him to the pediatric unit for further testing, especially as his immune system is pretty weak, and to bring is iron levels up to something near normal."
"How's the mother handling this?" Esther asked. Though she'd initially been involved with the case, she'd had to delegate the responsibility to one of the other nurses. Her presence had been required elsewhere with the major traumas that were admitted.
"As well as can be expected. It has to be very difficult to know your child is terminally ill and you can't do anything stop it. That most of what you do is to provide comfort measures. I don't know how I would..." Maca left the sentence unfinished. Esther's hand landed upon hers in a gesture of support. Maca's head was down as she nodded. "I'm going to go talk with her shortly." She glanced up at Esther's face. Bright brown eyes shone back at her. "Will you come with me?"
"Yes. I have to finish something first, but that shouldn't take me long. I can delegate the rest for a while. Would twenty minutes be okay?"
"Fine. I have to get the paperwork ready for the boy and his mother anyway."
"See you soon," Esther stood up and placed a quick kiss on Maca's head before she left.
Maca found Esther at the work centre going through some charts. Esther flipped over some paperwork then signed her name and classification to the forms and looked up to find Maca waiting for her.
"Everything ready?" At Maca's nod, Esther followed Maca towards the private room where the young boy and his mother awaited. A quick knock on the door first to alert them, then Maca and Esther entered the room.
"Mrs. Rodrigues," Maca began, "I'm going to admit Paulo. He's immune system is quite compromised as the leukemia progresses. He's susceptible to infections, but we can keep him protected as much as possible. He's also anemic and we need to get his levels up a little." Maca stopped for a moment, but continued when she thought she saw a glimmer of hope from Mrs. Rodrigues. She hated to be the barer of bad news, but this instance false hope was worse to deal with in the end. And she had a feeling the woman in front of her knew this, but clung to whatever hope she could. "I'm sorry. He is unlikely to improve much. At most the medication and fluids will boost his immune system slightly for a while, so he doesn't have to expend extra energy to fight off infections as well. In combination with the medication we're giving him for pain relief, the measures are for comfort." Though Maca's voice was steady she didn't feel strong. Esther stood slightly beside her and pressed a hand lightly on Maca's back as a gesture of comfort for a few moments. Then Maca walked over to Paulo and examined a few things about him and the readouts from the equipment. "I'll give you some time before we move him upstairs. If you've got any other questions, you can ask me later. I'll be here all night."
"Doctor, thank you." Silent tears slipped down Mrs. Rodrigues's face as she turned towards Maca and held out her hand.
"You're welcome." A nod to Esther and Maca walked out the door.
Esther stayed for a few moments with Mrs. Rodrigues, talking with her, then she emerged to seek out Maca. She found her in the supply room, bent down into a crouch and a hand covering her face. Not so silent tears ran down Maca's face. Esther's heart broke for her partner as she quietly crept into the room, came up behind Maca and enveloped her into a hug.
"I love you," Esther whispered in Maca's ear. Maca shuddered briefly then stood up and turned in her partner's arms and wrapped her own around the smaller woman.
"I kept thinking back to Jaime," Maca started. "It's different, but..."
"I know." Esther brought her hands up to brush the tears that stole down Maca's face. "You want to save every child, stop them from hurting. That compassion is something I fell in love with a long time ago. Even when I wasn't sure what it was I was feeling."
They stood together for some time before they broke apart. "You ready to go out there?" Esther asked.
"Can't we just stay in here?" Maca darted in for a kiss and a smile. Despite, or perhaps in deference to the gravity of their work, they sought comfort in each other when they could.
Esther giggled a little."I think they might notice if two of the staff just disappeared on them."
"It's not like it hasn't happened before."
"I know. But you like me that way." Another kiss.
"I do. And as much as I wouldn't mind staying in here with you, I do have some work to get done before we go home. So do you. Now move it."
"Yes, ma'am," Maca smiled. A brief kiss to her partner then she headed out into the corridor feeling much calmer and relaxed than she had for most of the night shift.
The rest of the night went relatively smoother. Majority of the trauma cases had been handled, either in emergency or in surgery or they'd died as a result of their injuries. Paulo Rodrigues had been admitted to the pediatrics unit for further examination, tests and comfort measures. In the morning as their shift finished, the weary doctors transferred onto their counterparts responsibility and control of the patients for the day.
"How was the night?" Dr. Vilches asked, in his usual gruff morning voice.
"Oh, the usual," Maca said before Javier updated Vilches on something new as they went down the corridor.
Maca moved closer to Esther. "Do you think they'd notice if we just disappeared?"
"I don't think so. Come on." She grinned widely. As they were already behind their coworkers, they turned and left the work centre, and said goodbye to Theresa at the admissions desk on their way out.