“He is nonresponsive, and he stopped breathing en route!”
There were two people on the gurney, the patient and the young man
straddling him, doing CPR.
“Take it to bed 5!” the doc yelled. We gathered around, and the
patient was lifted on a count of three and moved from the gurney to the
other bed. The ER staff took their positions, hooking up monitors and
putting in IVs.
I was on the patient’s left-hand side next to Jackie with my tools in
hand. I leaned over Jackie’s shoulder.
“Car accident,” I whispered at Jackie. “Was he on the outside of
One of the ambulance crew overheard my whispering and answered.
“Yes, he was actually,” the EMT replied.
“Ouch! That explains all the blood,” I muttered to myself.
The patient had blood all over him; there wasn’t a clean spot to be
seen on his clothing, yet we had not found exactly where it was all
coming from. There were a few minor cuts on his face and arms, but they
didn’t look nearly bad enough for the amount of blood that was on his
The EMT had added, “We had to restart his heart twice on the ride
“God, he looks too young to end up like this.” I gave the patient a
quick look from head to toe.
Jackie had gotten the first IV in place, and I proceeded to tape it down
for her while she drew off a syringe of blood for me, but when I touched
the patient, it felt like a mild hum of electricity was coming off of
him. I paused, concentrating on the sensation I was getting. I could
feel it even through my latex gloves. I abruptly jerked back as I looked
up and glance around at the others. I was looking for some confirmation
that they had picked up on this as well, but no one seemed to notice as
they all busily moved around him, cutting off his clothing and hooking
up all the equipment.
I moved back a step as I got a tingling sensation down my back. The
patient’s eyes fluttered open, and he seemed to look directly at me,
not at Jackie, who was right against him, but at me. That hum I was
getting off him seemed to hit me directly in the gut, making me gasp as
it arced across me like static electricity against my skin.
The syringe that I had given to Jackie was suddenly in front of my face
as she turned to elbow me. She must have been holding it up for a few
“Sara! You okay?” she asked with a “take this” look.
“Yes…umm, yes! I’m good, sorry…,” I stammered, still looking
at the patient. “Thanks,” I said taking the syringe and pulling my
attention back to the job at hand. “Hey, Doc, what tests do you
want?” I asked as I separated the blood out into its appropriate
tubes. A purple top tube for hematology, a green and red for possible
chemistries, and a little blue top for coagulants or what most know as
clotting factors. It’s what we call a rainbow, and every trauma has it
drawn just in case.
“Full trauma panel and blood type stat,” he replied without even
looking up. I was happy for that; I didn’t need him noticing how out
of beat I was. I turned and made a mad dash back for the lab. I paused
at the curtains to yell back, “I’ll put the orders in.”
Those of us on the evening and night shift often order labs when ER is
in the middle of a mess.
As I came rushing back into the lab, Nicky instantly prodded me for
information. “Well, what’s the down low? A drunk fall and bump his
head?” Nicky asked.
I went to putting in the orders that the doctor had requested as I
talked. “Car accident, I think it was a pedestrian versus car, and the
car may have won.” I was at the computer typing in the requested
Nicky was putting the samples of blood into the centrifuge, and then she
took off with the little purple-top tube to hematology to start the CBC
(complete blood count). As the machine took its sample and rocked it
through the system, I grabbed a glass slide to make a blood smear to
look at so I could do my visual comparison to the information that the
machine would be giving to me. The machine was red flagging all over the
place; it didn’t seem to like the sample.
Nicky furrowed her brow. “Was this sample drawn from an existing IV
port that the ambulance crew had put in?” Nicky asked with a concerned
look. That happened sometimes; we’d get a sample that was contaminated
with saline, and our equipment would go all haywire.
“No, there was no IV in when they brought him in. Jackie and I put it
in ourselves. It’s not watered down, the sample is fresh,” I
replied, as confused as she was about how the machine was reacting to
“Well, Sara, something is up with it,” Nicky said, pointing out all
the red flags.
“He has lost a lot of blood. He looked like the car dragged him, not
just hit him. Maybe that’s the problem.” I shrugged, searching for a
viable explanation and at the same time thinking about the odd sensation
I had picked up on.
“Well, he has a hemoglobin count of 4.2. That very well may be the
problem,” Nicky pointed out.
“Wow, 4.2,” I replied, astonished. A normal count was about 12 to
16. Anything below 6, a person is considered at death’s door, and an
infusion of blood is needed immediately.
“That’s not good, Sara. I’m not sure how he is still alive being
this low,” Nicky said, shaking her head.
“They had to restart his heart twice on the way in,” I added,
staring at the readout, trying to make sense of it.
“Damn, he must be a determined one.” Nicky smiled.
“Yes, would you believe me if I told you that he opened his eyes and
seemed to look right at me? It kind of…” I didn’t finish that
statement as I shivered at the remembered sensation of that hum that I
I pulled out the glass slide that I had made and put it under the
microscope to take a look and…“Wow.” I seemed to be saying that a
lot tonight. “Hey, Nicky, come look at this.” I slid back from the
“What is it?” Nicky looked at the slide through the scope. “This
can’t be right.”
“I know, so that is a lot of nucleated red blood cell, isn’t it? Or
am I seeing things?” I asked.
“That’s what it is,” Nicky confirmed in confusion. “This isn’t
funny, Sara. This can’t be from a human.” Nicky turned to give me a
disgruntled look. Nicky was assuming that I was playing a joke on her.
“I’m not pulling your leg. This is what we pulled out of the IV
start,” I swore, with just as much confusion as Nicky was expressing.
How could this be? I stood right there. I knew this blood came from a
“I have only seen this type of red cell in birds,” Nicky said,
turning back to the slide to look again.
“And reptiles,” I added. “I will have to go redraw him before I
can release any of the tests. Tell me, how are his chemistries
looking?” I sighed as I got the distinct feeling this was about to
become a very, very long night.
“Well, they are…How old did you say you thought he was?” Nicky
“I didn’t, but he can’t be much over twenty-five. He’s very nice
on the eyes, for a man hit by a car and covered in blood.” I chuckled.
“I’m going straight to hell for that observation, aren’t I?”
Nicky just smiled at me, shaking her head. “Maybe.”
“What do the chemistries look like?” I asked Nicky once more.
“Well, like a ninety-year-old dialysis patient. But his cardiac’s
look perfect,” she replied, handing me the readouts. I stood thinking
way too hard as I glanced over the numbers. Nothing was adding up right,
Nicky now had this twisted look on her face. “You did say they had to
restart his heart twice on the way here. That should have put quite a
bit of stress on his heart, so why aren’t his cardiacs elevated?”
Nicky was just as thrown as I was over this.
“Something is not right with all of this,” I confessed aloud.
“Either our equipment is going haywire or…” I paused for a long
moment. “The IV tubing. I’m going to go over and redraw. I’ll be
back, start the type please,” I called out as I turned and darted back
toward the ER. I was on a mission. Something wasn’t right, and I knew
it wasn’t my machines. They couldn’t all be going haywire at the
same time. Even my luck wasn’t this bad, and I did calibrations the
day before, so I knew beyond a doubt that my equipment wasn’t the
Excerpted from "The First Born" by Helena K Workman. Copyright © 2015 by Helena K Workman. Excerpted by permission. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher. Excerpts are provided solely for the personal use of visitors to this web site.