Sam was pulling to the side of the road, leaning his body and bike as far right as he could without tipping over. As this happened, the Civic spun in a complete circle before it skirted across the left lane, then shot off the road entirely and crashed into the trees. Branches snapped fiercely and more glass exploded as if a bomb had gone off inside the car, followed by a whoosh when the Civic’s air bag deployed.
Julie applied her brakes hard. Her bike teetered without going over. Sam accelerated, trying to avoid a direct hit with the pickup as it veered into their lane. Julie was overcome with a terrible knowing. The pickup was traveling too fast and Sam was not going fast enough. The front left fender of the pickup collided hard with the rear tire of Sam’s motorcycle. The pickup slipped into a harder skid as the rear wheel of Sam’s bike lifted off the road.
The bike’s front wheel spun across the pavement like a runaway gyroscope before it lost traction entirely. The bike went airborne, with Sam riding it the whole way. How high was he when he finally let go-five feet? Maybe more. His body was still moving forward. It looked like both he and the bike were flying.
Sam flipped over in the air and landed hard on his back as the bike’s rear wheel struck him in the chest. The bike bounced off him, then the pavement, with a loud metallic crunch. It flipped again, and again, until momentum carried the crumpled heap of metal off into the trees where it came to a stop, front wheel still spinning.
Julie threw her body weight hard right and skidded to a full stop, letting her bike fall away as she tumbled to the ground. She had slowed down enough for a soft landing.
Sam had not slowed at all. He skidded helplessly down the road on his back. Ten feet… fifteen… twenty…
Julie thought she heard him screaming, only to realize it was her own terrified voice. She pushed to her feet and ran toward Sam. Her body lurched awkwardly from side to side as she fought to regain her balance. Blood roared in her ears. A blaring horn was stuck on one long wailing note. From the corner of her eye, she could see the metal carcass of Sam’s motorcycle caught in a tangle of weeds.
Sam lay spread-eagled on his back in the middle of the road, his head and shoulders extended over the yellow dividing line. An approaching car shuddered to a stop just before it would have crushed Sam beneath its wheels. A trail of blood followed Sam’s path down the road, ending at his body.
Julie registered that Sam’s leg was bent at an awkward angle. His right wrist looked misshapen, obviously fractured. But she saw Sam’s head loll from side to side, and her heart leapt.
Thank God, he’s alive. He’s alive!
She ran toward him, screaming at full volume, “Somebody call nine-one-one!”
CHAPTER 8
Julie had done what she could. All that remained was to wait for help to arrive and keep up the ABCCs-airway, breathing, circulation, cervical spine immobilization. Sam lay motionless in the middle of the road, his hazel eyes open wide in a vacant stare focused on the sky and nothing else. Julie observed the rapid rise and fall of his chest and heard the distressed wheezing sounds of his breathing.
She had checked his pulses, both carotid and radial. Those were present, fast and weak. Naturally she worried about shock. The jugular venous pressure was elevated, and just by looking at Sam’s neck, she could see the vein on the right side was engorged. She checked the left and it looked the same. If Sam were in hemorrhagic shock, which was her assumption, those veins should be flat as a pancake. Low blood pressure caused the body to shunt blood to the heart and brain to preserve life.
Why would the jugular veins be distended? she wondered.
“Sweetheart, it’s going to be all right,” she said in a shaky voice. “You were in an accident. Don’t try to move. Help is on the way.”
And it was.
The man driving the pickup had called 911 and retrieved the first-aid kit Julie kept in the satchel on her motorcycle. He let Julie know the driver of the Civic escaped serious injury, but they were sending two ambulances as a precaution. To Julie, it seemed a common occurrence for reckless drivers to escape the mayhem they caused unscathed. Julie pushed the thought from her mind. What mattered now was comforting Sam the best she could. She wanted to hold Sam’s hand, but his riding gloves had shredded from the long skid down the asphalt. The skin of his palms was nearly sheared off. His fingers had yet to move.
Instead, Julie knelt beside the man she could hardly wait to marry, the man who made her heart swell with his kindness, and tried to comfort him as best she could. The helmet had safeguarded his head and face, but blood escaped from a grisly four-inch gash that had opened on Sam’s chin. His beard, flecked with debris, looked red.
The panic that had gripped Julie in those first terrifying moments gave way to a gut-wrenching awareness. This was happening. This was real. This had happened.
A circle of bystanders had formed around Julie and Sam, watching the gruesome scene with grave expressions. The spectators were visibly shaken. Some were crying. Some looked away as Sam emerged from the initial shock enough to feel the first pangs of real pain. He groaned and his mouth contorted into an agonized grimace.
“Sam, can you hear me? Can you say anything? Baby, please, say something if you can.”
Sam’s lips trembled. “It hurts,” he wheezed. “Oh God, this hurts. This hurts so much.”
Tears streamed down Julie’s face. “I’m sorry. Help is on the way. Wiggle your fingers if you can. Just a little wiggle.”
Nothing.
Off in the distance, Julie heard the first wail of sirens on fast approach. She saw the flashing lights, and soon the first responders were on the scene. She counted three police cars, two fire trucks, and two ambulances.
Julie stood, waving frantically. She got the attention of the lead ambulance driver, who made a hard stop not more than ten feet away. Two paramedics, dressed in blue uniforms with EMT badges sewn into the pockets of their shirts, latex gloves already donned, burst from the vehicle and raced to Sam’s side.
“I’m Dr. Julie Devereux,” Julie said in a breathless voice. “I work in critical care at White Memorial Hospital.” Julie got the names of the two EMTs. Bill was a thin man in his midtwenties with shaggy brown hair and deep-set eyes. Ashley, in her late thirties, was athletically built, with broad shoulders, strong legs, and muscular arms.
“Did you see the accident?” Bill asked.
Julie nodded. “Yes, we were riding together. The victim is my fiancé, Sam Talbot.” Julie had to look away until she steadied herself.
“His airway is clear,” she said, trying to find some authority in her voice. Julie did not hear any crackling, grating sounds of crepitus, indicating air had not penetrated the soft tissue. “No crepitus, but I’m fairly certain he has a flail chest on the left ribs seven, eight, and nine. Both carotid and radial pulses are present, but weak. I don’t think there’s bleeding in the abdomen, but I’m worried about hemorrhagic shock. I’m also concerned his jugular veins are distended. I checked for a pneumothorax, but he has good breath sounds.”
Bill and Ashley crouched next to Sam.
“Is his airway still clear?” Bill asked.
Ashley checked. “Yeah, he’s got a good airway. He’s breathing on his own.”
A firefighter wearing a brown turnout coat and pants with sewn-in yellow bands approached.
“Need any help?”
“Yeah, we need the backboard and a cot, please,” Ashley said. “Bill, can you take a look at his lower extremities? I need to get his helmet off to make sure he has a really good airway. Dr. Devereux, are you in a position to assist?”
Julie did not respond. Her focus had been entirely on Sam, who moaned and made a low gurgling sound.
“Dr. Devereux, can you assist?” Ashley asked again.