A snowflake landed on her nose. It was chilly, crystallized, and mean.
Another snowflake.
And another. And another. And another.
Read on for a free sample of Santuary: A post-apocalyptic thriller.
Chapter 1
“You look tired,” Janelle said, smelling the coffee in the center divider.
“I am,” Deeta answered.
“What’s going on?”
“Patient in the unit, septic.”
“Ooooh, tell me.” Janelle was intrigued; she loved going over complex patients with Deeta. Even though she wasn’t in the medical field, when the doctor went over difficult cases, it was as good as a documentary.
“A guy came in, older guy, with a hot abdomen. Surgery was consulted but he didn’t show up for more than twenty-four hours. He needed surgery but the “CT didn’t show a definitive source of the ailment” was his excuse. Now, he’s getting sicker: fevers, positive blood cultures, LFT’s and renal function getting worse. So we repeat the CT. We can’t use contrast now with his renal failure, and that one doesn’t show an abscess or stranding, so he holds off surgery again. So last night, he tanks and I put him on norepinephrine, he’s got an anaerobe growing in his blood on top of the gram negative that was already there. I was up all night stabilizing this guy and talking to the surgeon and anesthesia.”
“He’s going to surgery?” Janelle asked.
“Yeah, surgeon said he’d take him this morning.”
“That’s good.”
Deeta took a sip of coffee as she drove through the winter landscape. It was a bright day and not too cold. Janelle was glad she wouldn’t be getting off the plane in Florida in a lot of heavy clothes, hot and uncomfortable. Traffic was starting to pick up and she watched the cars around her, wondering when she would be able to upgrade her car for a newer one. After a while, she grew bored looking out the window and turned on the radio.
“So, did you hear about this bank executive,” the voice on the radio said, “This CEO of a large bank goes missing. There’s this huge search for him.”
“Looking for a girlfriend,” the cohost says.
“Right, skipped out of town with some young hottie and gonna mail the wife divorce papers. They track this guy down to a Manhattan apartment, which is some sort of sex club. He’s been there for like, three weeks. I guess you pay a fee and can stay there as long as you want. The DA is looking into bringing charges, but everyone there pays a fee and goes in, but it’s voluntary for everyone there, so it’s not really prostitution.”
“Is it a monthly charge or like a buffet, one price and all you can eat,” both hosts laugh.
“It doesn’t say, but it sounds like the buffet. But get this, there’s a mother of four that was there for six weeks.”
“So the women have to pay too. Do they at least get a discount?”
“Yeah, by the pound,” the host laughs. “Let’s see, you’re one twenty-five, that’s five bucks. Two fifty, twenty grand.” Both laugh. “Yeah, so they got like four missing persons cases solved with this one bust. People had…uh… been in there from 3 days to six weeks. Can you believe that?”
“How’d they get busted, did the pizza delivery guy report strange smells?” The cohost asked.
“Oh, that’s just nasty. Yeah, who’s doing the laundry in that place, Augh?”
“Can I change this?” Janelle asked.
“Please,” Deeta answered.
“What you listening to?” Janelle picked up the doctor’s phone and plugged it into the auxiliary jack. Distorted guitar blasted out of the speakers. It sounded somewhat familiar to her. When she heard the lyrics, she remembered. “It’s just one of those days when you don’t wanna wake up, everything is fucked, everybody sucks.”
“Agh, how can you listen to this early in the morning?”
“I wasn’t, you turned it on,” Deeta answered. “I was listening to it last night. Remember, you were gonna meet me at the gym?”
“I wish I did. I’m sorry; the interview ran late. Shoulda worked out. It was a waste of time.”
Deeta patted her leg.
The second verse started, and Janelle found herself singing along, “First one to complain leaves with a blood stain!”
“Can I change?” She asked.
“You turned it on!”
Janelle scrolled through her selections. “Don’t you listen to anything new?”
“Sorry, Beyoncé just doesn’t cut it for me when I’m working out.”
“The Goo Goo Dolls?” Janelle questioned.
“Yeah,” Deeta said, “play that.”
“Which one?”
“Any, they’re all good.”
Janelle listened to the sweet guitar and mandolin, and listened to the first verse of the song Iris. “White people can be so romantic,” she mused. Deeta rolled her eyes.
The traffic became heavier as more people poured onto the highway. “Did you hear that?” Janelle asked.
“No, what?” Deeta answered, as a series of loud pops sounded off behind them.
“That!” Janelle turned around. “That sounds like a gun.”
The doctor looked in her rearview mirror, “Yeah, it is.”
The volume of the music dropped, and as the phone rang over the speakers, Deeta answered.
“Dr. Nakshband? This is the answering service. I have a Doctor Slagle on the line from the ICU. Can I put him through?”
“Yes, please,” Deeta said. Janelle squirmed in anticipation.
“Doctor Nakshband, Dr. Slagle would like to speak with you.”
“Okay, put him on,” Deeta said. “God, what now?” She thought, as she heard Slagle come to the phone.
“This patient is unstable. How am I supposed to take him to the OR?” He shouted.
“Pardon?” She said somewhat confused and taken aback.
“This patient is septic. He’s too unstable,” he said curtly.
Taking a deep breath to calm herself, she answered,“Yes he’s septic and unstable. The abscess must be located and drained or he will continue to deteriorate,” she answered calmly.
“You need to stabilize him before I can take him!” He was shouting again.
She hoped she could keep the contempt out of her voice. “He has been on Imipenem and Vanc since he’s been in. I added metronidazole last night. I cannot expand coverage any more than that. I can’t put him on an antifungal without evidence with his kidneys and liver failing. He has Kleb growing in the blood and they called me last night with an anaerobe that turned up in his blood. That is two bugs in the bloodstream. That is evidence of a communication between the gut and the vascular system. I cannot help him with antibiotics, so you need to open him up, find the abscess and drain it.”
“Is it KPC?” He was accusatory again.
“No.”
“How do you know?” Now he was mocking her.
“The C&S is in the chart,” Dr. Nakshband answered, “it’s pan-sensitive.”
“So you’re telling me that now I have to worry about this guy bleeding on the table with an entero-vascular fistula? If I drain that abscess and there’s an artery in there, he’s gonna spew.” Slagle was getting angrier.
“It looks that way,” she said.
“I don’t need this guy dying on the table! I don’t need an inquiry!” Now he was screaming. “He’s too unstable! Anesthesia won’t do it!”
“I spoke with Heidelberg, he’ll do it,” Nakshband answered calmly.
She could tell the surgeon was furious. “Oh, I see you covered your bases, leaving me with MY balls on the table. You need to stabilize him!” Slagle ordered.