Chapter 2 - Code Triage
The interior of Julian’s truck smelled of clean leather and cedar, but within seconds, the coppery reek of hemorrhage filled the cabin.
"Keep your head back, sweetheart. Look at me. Eyes on me, Grace," Julian ordered. His voice was no longer that of the protective husband; it had snapped into the crisp, algorithmic cadence of a senior trauma specialist.
He had Grace reclined in the passenger seat, his spare emergency fleece jacket wedged beneath her pelvis to elevate her hips. With one hand on the steering wheel, weaving through the wet arterial roads of Kettering toward Miami Valley Hospital, his other hand was pressed firmly against the right side of her abdomen, feeling the rock-hard rigidity of the uterine muscle.
"She's... she isn't moving, Jules," Grace whispered. Tears were tracking through the dust and sweat on her cheeks, pooling in her ears. Her hands fluttered over his fingers. "She stopped. The second he hit me. She stopped."
"She's in shock, just like you are," Julian said, though his own knuckles were white where he gripped the leather. He reached down and hit the speed-dial on his dashboard.
The console rang once before a woman’s sharp voice filled the cab. *"Vance, where are you? The trauma board is clear."*
"Elena, I have a thirty-one-week traumatic abruption," Julian said, his voice flat, terrifyingly steady. "Direct, blunt-force abdominal blow by an adult male. Severe uterine hypertonus. Active heavy vaginal bleeding. Estimated blood loss three hundred cc's and counting. Maternal heart rate is tachycardic, roughly one-thirty. Fetal status unknown, no movements noted for ten minutes."
A sharp intake of breath hissed over the speaker. *"Who is the patient?"*
"Grace," Julian said.
A beat of stunned silence hung in the truck. *"My God. Julian... get her through the ambulance bay. I'm mobilizing OR Three right now. NICU transport team is on standby."*
"Three minutes out," Julian said, and severed the connection.
He glanced at Grace. Her skin had turned the color of skim milk, her lips a faint, bruised violet. "Grace. Stay with me. Breathe for Clara. Deep breaths, through the nose."
"Clara," she whimpered, the name they had chosen only three nights ago while sitting on their living room rug, arguing over nursery paint swatches. "He hit her, Julian. He looked right at her... and he punched her."
"I know," Julian whispered, his jaw muscle twitching violently beneath the skin. "I know he did. But you are out of that house now. You are never going back. And neither is she."
He blasted through a red light at the intersection of Main and Wyoming, the hazard lights flashing, the truck’s tires hydroplaning slightly across the wet streetcars tracks before gripping the pavement. Up ahead, the towering brick facade of Miami Valley Hospital’s emergency wing loomed against the gray Ohio twilight.
The moment the truck crested the ambulance ramp, the automatic doors hissed open. Three nurses in trauma gear and Dr. Elena Castillo, already gowned in sterile yellow paper, burst into the cold rain with a gurney.
"I have her," Julian said, jumping down before the truck had fully settled on its shocks. He scooped Grace out of the passenger seat, bypassing the stretcher’s edge to lay her down himself.
"BP is eighty-five over fifty," a nurse called out, slapping a cuff over Grace’s left arm while another tore away her blood-soaked leggings with trauma shears.
"Fetal monitor, now!" Elena barked, pressing an ultrasound wand coated in blue acoustic gel straight onto Grace’s lower belly.
The room inside Trauma One erupted into controlled violence. Monitors chimed, alarms warbled, and the harsh fluorescent lights beat down on Grace’s upturned face. She gripped Julian’s hand with a strength she didn't know she possessed, her fingernails biting through his latex gloves, drawing blood from his knuckles.
"Listen to me," Grace begged, her voice cracking. "Save her. Julian, promise me. Don't worry about me. Save Clara."
"I am saving both of you," Julian said, leaning over her, his forehead resting against hers. He refused to look away, even as the nurses established two large-bore IV lines in her forearms. "You hear me? You don't get to leave me, Grace. Neither of you."
Elena was staring at the small monitor mounted above the ultrasound cart. Her usually impassive face hardened.
"Retroplacental hematoma," Elena said quietly, for Julian’s ears alone, but Grace heard it. "The placenta is sheering off the posterior wall. At least forty percent detachment. Fetal heart rate is eighty-two. Prolonged deceleration."
"Bradycardia," Julian said, his voice dropping an octave into absolute command. "She’s suffocating. Crash section. Now."
"Roll her!" Elena shouted. "Get her to Three! Page anesthesia—stat general, we don't have time for a spinal! Move, move, move!"
The gurney slammed through the double swinging doors of the surgical suite. Grace looked back once, her eyes wide with terror, catching Julian’s face as he was forced to stop at the scrub sink line.
"Julian!" she cried out.
"I’m right here! I’m right outside the doors, Grace!" he shouted back, his voice echoing down the tile corridor. "I love you! Fight!"
Then the doors swung shut, the frosted glass cutting off her view, and a nurse pressed a plastic mask over her nose and mouth.
"Take a deep breath, honey," a soft voice said. "Breathe the sweet air."
May you like
Grace inhaled, fighting the chemical fog that clawed at her brain, her last conscious sensation being the cold bite of antiseptic wash being poured across her torn, bruised flesh, and the terrifying silence of her own womb.
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