A few days earlier...

The ER was one of the most challenging places Clare could have chosen to work.  She stepped through the automatic sliding doors into the sultry night for a break during what had turned out to be a crazy and busy night.  A slight breeze brought the salty smell of the Gulf as it blew across her skin.  It had been so hectic, she hadn't been able to take a break all night. This well-overdue one was at the tail end of her shift, when there was a lull in the action.  Glancing at her watch, she saw it wouldn't be long before the next crew arrived.

Clare looked down at her scrubs relieved the hospital provided and laundered them for the ER staff.  A couple of traffic accidents with minor injuries, a broken hip, and an upper GI bleed had her hopping for most of the night. The patient with the GI bleed had vomited the contents of their stomach, splattering her with coffee-ground-appearing emesis. As a result, her scrub pants were a mess, and she would need to change them when she got back.

She pressed the icy, dripping can of Diet Coke against the back of her neck.   Oh, that felt so good.  Her face softened as her lips turned upward at the corners.  She had always dreamed of working as a nurse and getting a job in Florida was an unexpected plus.  Panama City Beach had white, sugary beaches with turquoise blue waters so clear you could see the sandy bottom of the Gulf along the shoreline.  Summertime could be intense due to the heat, but the winter was nonexistent as compared to the ones she remembered, growing up in the Upper Peninsula of Michigan.

Her good mood shifted as her thoughts veered off to her life in Michigan and her family.  Her father and mother had operated a resort offering fishing and hunting excursions to the tourists. Rory Thibodeaux was the quintessential outdoorsman and served as the resort's guide.  Able to track, hunt, fish, and shoot - the man loved the life he'd made for his family in the rugged North.  Her mother, Maureen, was a warm-hearted lady with a spine of steel.  Well-liked by the resort guests, she handled all aspects of the business from dealing with reservations, boat and equipment rentals, and the occasional visits from the local wildlife which included black bears.

Clare and her twin brother, Noah, grew adept at the skills learned from their survivalist father.  They loved to ski, snowshoe, hunt, fish, and trap.  The siblings were inseparable in their youth.  Clare cleared her throat trying to get rid of the restrictive lump which suddenly appeared.

Her break was over, and it was time to get to work.  She re-entered through the sliding doors of the ER and headed towards the nurses' station.

"Clare!  We've got a bleeder!"

At the sound of her name, she spun around towards two paramedics, trying to hold pressure to their patient's multiple wounds, as the gurney they pushed barreled down the corridor towards her.  When she looked down at the patient, she found she couldn't readily identify the victim's gender due to the gross amount of blood and the tissue damage to their face, neck and upper torso. She directed the paramedics to Trauma Room 4.

A nurse and two CNA's joined her, washing their hands before donning gloves and gathering needed supplies.  One person began cutting away the blood-stained, ripped clothing while another continued to apply pressure to the bleeding wounds.  The other nurse, Jenni, hooked the patient to the monitors.

"BP's falling.  Do we have some packed cells coming from the blood bank yet?"

"They just arrived," Clare stated as she grabbed IV tubing with a blood filter from the cart as the ER doctor entered the room. 

Jenni updated the doctor on the patient's status as he gloved up.  "We have multiple wounds from an unknown cause on a male approximately 30 years of age, unresponsive with BP of 64/40 and pulse rate of 140.  PRBC's are hanging,"

The monitor went off with a high-pitched sound. "He's crashing!"  Someone sounded the warning as the nursing staff scrambled in preparation to resuscitate the patient, if necessary.

Dr. Demerest grabbed an endotracheal tube which he would use to open an airway to the patient's lungs.  The tube would be placed into the mouth and down the throat of the man on the gurney.  The doctor assessed the patient's airway with a lighted scope before beginning the intubation, but the severe damage to the victim's neck made the procedure impossible.

"I need to place a trach."  The ER doc palpated the man's throat for the exact location to place the curved plastic tube.  Clare pulled the medical supplies and equipment needed from the cabinet and put them on the tray near Jenni.

"Scalpel." Dr. Demerest held out his hand to receive the sharp instrument.   Jenni placed it into his gloved palm.  He made a quick incision and slipped the tube into the opening allowing oxygen to reach the patient's lungs. Jenni stepped in to finish securing the trach tube ties and quickly cleaned around it.  The patient's oxygen level increased with the airway established, but his heart rate continued to climb as his blood pressure dropped dangerously low. 

"Let's get him to OR.  Is the surgeon here?" Dr. Demerest asked as he finished giving orders to transfer the patient to the OR.

"Yes, Dr. Demerest, he's scrubbing now," Clare called out.   The trauma team moved in sync with each other, understanding the pre-assigned role each would play, after the countless hours of working together.  Hesitation could spell disaster, and the team's orchestrated tasks were automatic and precise.  Clare assisted the rest of the team as they rapidly wheeled the gurney with IV's, monitors and oxygen from the trauma room to the OR.

After the staff returned to the ER, Clare cleaned the room to prepare it for the next emergency.  She picked up the patient's clothing, securing the items in a plastic bag.  The man's wallet dropped from the pants pocket and onto the floor.   She stooped to retrieve it and automatically checked for ID. 

She gasped when she saw the driver's license. Josh Brewer!  No, it couldn't be!  The wallet fell from her hands as Clare collapsed onto a chair placing her head in her hands.  Josh was her brother's friend from high school in Michigan.  She hadn't realized he was in Florida.  Please, please keep him safe...

"Clare.  Are you OK?" Jenni stood in the doorway. 

She looked up at her friend and co-worker with a weak smile. "I know the patient we just took to the OR."

"Are you kidding me? How do you know him? " Jenni placed her hand on Clare's shoulder and squeezed it. 

"Josh grew up with us in Michigan.  He and my brother were best friends.  I 'm shaking.  I can't believe this is happening.  Oh, my God..."

"Oh honey, why don't you head home.  Amanda's here, and I know she'll punch in early.  Do you need someone to drive you home?"

"Thanks, but I 'll be OK.  I'd rather stay here until Josh is out of surgery," Clare stood and moved to the counter so she could start replenishing supplies.  Jenni nodded, understanding her need to keep busy, and left the trauma room.  

When Clare finished restocking the supply cabinet, she headed out to the nurses' station.  She saw Dr. Demerest sitting at the desk as he placed the phone receiver back into its cradle.

"Dr. Demerest, have you heard how the patient we sent to the OR is doing?"

"It isn't looking very promising.  Jenni told me you know him."

"He's a family friend."  Her vision blurred with unshed tears.

"I'm sorry, Clare.  Go on home.  The day shift's here now.  We'll call you if there is any change.  Get some rest.  You can't do anything for your friend at this point."

"Did anyone contact his parents?" She hadn't seen the Brewers in years.  She didn't even know if they still lived in Red Maple, her hometown.

"They've been called and said they would be flying down as soon as they got a flight."  She nodded and gave Dr. Demerest her thanks.  Feeling weary now that the adrenaline had left her system, Clare barely had enough energy to insert her ID into the time clock. 

Jenni, after finishing the change of shift report to the other nurses, stood next to her waiting to clock out.  She gave her grieving friend a quick hug.  They'd became friends when Clare started working at the hospital. "I'll call you tomorrow," Jenni promised. 

Too choked up to say anything, Clare raised her hand in a quick wave and headed for the parking lot.  She didn't want anyone to see her cry. What happened to Josh would have devastated her brother, but Noah was gone.  Her parents, too.  Clare shook her head to rid it of the memories she'd worked so hard to bury in her psyche.  She relied on the numbness and the crisp chill of anger to keep the other immobilizing emotions in check.  

Home.  She needed to get back to her apartment, so she could sleep.

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Clare stepped out of her shower, toweled off, and wrapped her favorite robe around her.  She'd hoped the hot shower would relax her.  Only time would tell. Tonight had been terrible.  Just when my life was beginning to make sense, Josh ends up in my ER fighting for his life.  No, I understand life isn't fair, but why, why, why is mine so full of tragedy?

Her nerves were ragged.  Maybe some chamomile tea might be soothing.  She put the teapot on the stove and readied a tea bag and a cup.  As the water heated, she walked to the balcony and opened the sliding glass doors. 

Seagulls floated on the warm gulf breezes.  Their cries sounded mournful this morning. Or is it just me?  The rhythmic lapping of the surf was hypnotic and soothing in contrast to her neighbors who scurried from their apartments to their cars, carrying travel mugs of java, briefcases, children and diaper bags.  Life continued without apology. 

While Clare stood watching the rest of the world begin their day, she heard the teapot whistle.  Closing the sliders, she headed to the kitchen. Maybe the tea would help her fall asleep.  Thoroughly exhausted, she climbed into bed where she spent the night, tossing and turning as she mumbled unintelligibly, lost in her dreams.