SPIRIT OF CHRISTMAS by Michelle Creek (missy@ipax.com.au) DISCLAIMER: The characters of ER are the property of Michael Crichton, Warner Bros. Constant Productions and Amblin Television and the actors who so marvellously portray them. Any comments and/or constructive criticism will be gratefully received at the above e-mail address. PART 8/? "Damn." Carter swore to himself. Carter gently eased Kerry to the floor, her small body quickly becoming a dead weight in his arms. Meredith had heard him swear and turned just in time to see Carter lowering Kerry to the floor. "Meredith, get a gurney. Ask Randi to call for another surgical consult and pull Dr. Weaver's medical records for blood type, stat." Not needing to be told twice, she left to get the gurney. As she passed Conni and Chuny, she directed them to the lifts to help Carter. "What happened Carter?" Conni asked, finding Carter kneeling beside Kerry, stethoscope to her chest. "GSW" Carter responded, flicking the scope back around his neck. Meredith returned with a gurney and in syncopation, they moved Kerry from the floor. "Trauma One is free and clear." Meredith informed him. They pushed the trolley quickly towards Trauma One, passing Mark along the way. Catching sight of the occupant of the gurney, he was worried about what had caused Kerry to collapse. He had heard about Kerry's grand mal seizure during the chemical spill earlier in the year and seeing her unconscious sent chills down his spine. "What happened Carter?" Mark asked as he followed the group into Trauma One. "Dr. Weaver's got a GSW to her upper left leg. She must have been shot earlier." Carter said as all the staff used complete blood precautions of gloves, glasses and protective covering. "Didn't anybody notice?" "I don't think she even noticed. If she did, she chose to ignore it." Carter responded. "Get a mask on her." "I didn't. She cracked Jerry and you wouldn't have even known she had been shot." Chuny responded as she pulled down the oxygen mask and slipped it over Kerry's nose and mouth. Randi popped her head in the door. "I've paged Benton. Weaver's type is O neg." "Thanks Randi." Mark said. Meredith connected the pulse ox. monitor and Conni began cutting away the leg of Kerry's trousers. The black material was sodden with blood, making it difficult to cut. "BPs 70 over 50." Chuny reported. " Pulse 140. Pulse ox is down to 86." Meredith interjected. "Two units of saline wide open." Carter ordered. As Conni continued to cut away the trousers from the wound, blood spurted out with each heartbeat. "We've got an arterial bleed here." she warned. "Two units of O neg. on the rapid infuser. Set up a dopamine drip." Mark instructed. "CBC, Chem-7, coag panel, H&H & ABG." "Call radiology. We need a left upper extremity film." - 0 0 0 - Dr. Goldberg surveyed the admit board, gaining an immediate sense of the extent of injuries sustained. However, it did not tell him how many were staff at County General. He had been going through the files Mark Greene had provided him with, allowing him an overview of the running of County's ER Department, when he had been informed of the shooting. It had dragged him away from the administrative work he loved, the files he had been reading were extensive, giving a full and rounded view of all aspects of the ER. Being down here at the grass level of the ER was not something he enjoyed. He had shot through the ranks, doing his journal articles and research reports, attaining acclaim to enable him to make his way up the medical administration ladder. "Doctor, why aren't you treating these patients?" he asked of Randi as she made further calls to arrange for further surgical, orthopaedic and paediatric consults. "These calls should be made by the clerk." "I am the Acting Unit Services Co-ordinator." Randi informed him shortly, with a certain amount of disdain in her voice. She already had no respect of this new Chief who failed to notice that she was the same person with whom he had spoken twice that day. "It would help if you wore more appropriate attire than scrubs." "I agree. The colour just doesn't do anything for my complexion." she replied sarcastically. "Where's Dr. Greene?" He asked, not sure how to handle the sarcasm and with the current state of affairs, he did not need to think about it. "Trauma One." Randi responded as she finished the call, going across to the board to insert Dr. Weaver's name in Trauma One. It was then it dawned on her that Dr. Goldberg didn't know Dr. Weaver was the patient in Trauma One. - 0 0 0 - Benton rushed in Trauma One, putting on the protective clothing as he absorbed the fact that all the other staff was implementing this precaution. "You paged me?" He had just arrived at the surgical floor when his pager went off, demanding his return to the ER. It was bedlam with patients having to be triaged in order of their injuries for surgery. Although, they had the equipment and room for surgery with ten operating rooms, they did not have all available staff in the department as yet. "Yeah. GSW to the left upper leg." Mark informed him. Benton examined the injury. "We're putting in two units of O neg and two of saline. I've ordered an x-ray." "It looks like its hit the lateral femoral artery but there is pre-existing muscle and tissue damage to the leg. Can we roll her." It was the first time Benton took time to actually look at the patient and he was shocked to find it was Kerry "Kerry?" He looked across at Mark, silently questioning what had happened. "There hasn't been any more shooting. She must have worked on Jerry with her leg like this." Rolling Kerry, Benton check for an exit wound and found none. They gently eased her back onto her back. "I'll book the OR but we're overloaded until more staff arrives" Benton packed the open wound with gauze. "Order another two units of blood. I would say it will be at least at hour before we can get her up." "Pulse ox is 92, she's coming around." "Kerry." Mark said gently. Kerry opened her eyes slowly. She frowned as she recognised the room and the faces peering down at her. Automatically, she closed her eyes again, hoping that the scene would not be the same when she reopened them. "Kerry." Mark gently stroked the side of her face. Reluctantly she opened her eyes. "Mark." Her voice was muffled by the oxygen mask. "How are you feeling?" "I'm fine." Mark had to smile. This was Kerry's standard answer whenever he queried whether she needed a break, never one to admit that she had had enough. "Kerry, you've been shot in your left leg. Can you move your toes for me?" Benton asked. She slowly moved her toes. "Is there an exit?" "No. We've booked you in to have it removed and control the bleeding. It's hit the lateral femoral artery." Kerry absorbed this information, then suddenly remembered her niece. "Oh my gosh. Jess!" She struggled to sit up. "Don't worry about Jess. Jeanie has been looking after her." Mark pushed Kerry gently back, finding little resistance. He hoped Jeanie was looking out for Kerry's niece because in all the ruckus, he had completely forgotten about her. "On a scale of one to ten, how would you rate your pain?" "Three" Benton and Mark exchanged glances. They wondered why they had even bothered to ask the question because they weren't going to rely on the answer. "Okay Kerry, you just rest now." "Carter, give her 15 migs of morphine IV infusion." "15 migs" "Yes, Carter, fifteen migs." Benton confirmed his support of Mark's decision. He had seen Kerry Weaver work with an arterial bleed. There was no possibility that her understanding of pain was on the usual scale that they tested most patients with. They would also use it as an adjunct to the anaesthesia for surgery. "Dr. Greene" Mark looked up at Dr. Goldberg as he walked through the swinging doors to Trauma One. He waited for him to continue, sure that Dr. Goldberg would not be at a loss for words after what Kerry had told him about her experiences. "What's the current situation?" "Four critical GSWs are currently in surgery and there are another four still waiting to go." Mark moved from Kerry's side, removing his protective clothing and gloves, tossing them in the bin beside the door. "Dr. Anspaugh has called all surgical staff that he can contact to come in." Mark nodded in acknowledgement. "How many of our own staff went down?" "Four with GSWs. Two attendings, one nurse and a clerk." He didn't think it dawned on Dr. Goldberg how much the loss of these staff, even for a short period of time, was going to impact on the ER. "That many?" "I think we got off lightly considering the kid was carrying two guns. If he had been a crack shot, it would have been a lot worse." "Yes. You're quite right. Now, administration wants me to give a press release, I need some details of the full extent of the injuries." Dr. Goldberg looked expectantly at Mark as they arrived at the central work station. "Dr. Greene, we've got a code in Exam 5." Lily ran up to Mark at the desk. "Randi, can you give Dr. Goldberg a rundown of the injuries from the shooting including majors and minors." Dr. Goldberg didn't seem to pleased to be left with Randi giving him the information but he knew there was little choice in the matter. "Yep." Randi replied going to the closest computer to download the information they had thus far. "What is it?" Mark raced down the hallway with Lily keeping pace at his side. "Heart attack. Woman suffering lacs from the glass. As Jeanie was treating her cuts, she started complaining of chest pains. As we got her on the monitor, she went into v-tach." - 0 0 0 - David Morganstern walked determinedly through the crowd of television crews, newspaper reporters and inquisitive general public. The area outside the hospital had been cordoned of by police, allowing only hospital staff and genuine relatives to enter. He flashed his old id. tag which he had initially forgotten to return and upon locating it, had decided to keep it as a momento of his days at County, never imagining that he would need to use it again. Once he had heard the newsflash of the shooting in the ER, David has rushed down to help in whatever way he could. Having been involved in the earthquake drama at another hospital in his early days as an attending, he was well aware that it was at this time that practical assistance would be of some use to the department, especially if the injuries to staff that had been reported was true. "Randi, where's Dr. Weaver?" David Morganstern asked as he reached the central work station. Surprised to see Dr. Morganstern, she automatically replied "Trauma One" As he went down to Trauma One, he found Carter and Benton looking at the x-rays that had just been obtained on Kerry, just outside the trauma rooms. Benton had been allocated to serve as the consultant for all surgical patients. "Peter. Where's Kerry?" "Dr. Morganstern. What are you doing here?" Peter was surprised to see his mentor back in the hospital. "I heard about the shooting on the news and came down to offer some assistance, if you need it. I was going to ask Kerry what I could do to help. I was told she was in Trauma One." Dr. Morganstern looked into the Trauma Room for Kerry but could only see the nurses in the room. "She is. Dr. Morganstern, Dr. Weaver is the patient." Peter continued as he saw the worry etch David's face. "She's got a GSW to the left femoral artery. We're waiting for the OR to take her. Have a look at the x-ray." - 0 0 0 - "Let's call it. Time of death 1.34 a.m." Mark said. The trauma of the shooting had caused the woman to suffer a myocardial infarction. This was not uncommon to occur as a result of a shooting such as had taken place that evening. Signing the chart, Mark left the room with Jeanie leaving Lily and Amara to complete the death kit on the patient. "Jeanie, I don't know if you have heard but Kerry was also shot." "But....." Jeanie was stunned. She had seen Kerry take Jerry into Trauma One after the shooting. "I know. She didn't say anything about it." Mark commented dryly. "She collapsed from blood loss but she's okay. The bullet hit the lateral femoral artery and is still lodged in her leg. Benton's arranged for her to be operated on but it's going to take time. Where's her niece?" "Jess? I'd forgotten all about her." Jeanie thought for a moment. "It's okay. Kerry put her to sleep earlier in the resident's room." Together they went to check up on the little girl, gently easing the door open, not wanting to wake her. Both were shocked to find that the bed was vacant. Turning on the light, they could find no sign of Jess. "Where is she?" Mark asked. END PART 8/?