Chapter 1 — Cut Her Dress

“Cut her dress.

Now.

If we wait another minute, she’s going to die.”

The trauma shears moved from the hem of the dark gray dress up to the collar while the monitor sounded one frantic alarm after another.

“Blood pressure sixty over forty,” Nurse Brenda called out.

“Oxygen saturation seventy-eight.”

I did not answer.

For nearly thirty years I have gone in and out of these rooms, and I have learned not to waste words when someone is fading in front of me.

The woman on the stretcher had a swollen face, bluish lips, and could barely draw in any air at all.

She was drowning on dry land, in a room full of air, and I had perhaps ninety seconds to find out why before her heart gave out for good.

And then I pulled the fabric back from her chest, and I saw the thing that made me forget every protocol I know for two full seconds.

Just beneath her left collarbone, stuck to her skin, was a small rectangular medication patch.

I do not, as a rule, freeze.

Freezing is a luxury a trauma physician cannot afford.

But I froze, for those two seconds, because I recognized the woman on the table, and I recognized what should not, under any circumstances, have been on her skin — and in the space between those two facts, I understood, before I had consciously formed the thought, that the emergency in front of me was not an accident, and that the person who had caused it was someone I had trusted with my life for forty years.

I need to explain what those two seconds cost me, because they were the strangest two seconds of my professional life.

A trauma physician’s entire training is designed to prevent precisely the paralysis that seized me.