Without his job at the hospital, Clay would be lost. The hard work, the struggles of the patients, the drama in the ER?it makes his days worth something, and gives focus to his dream of someday becoming a doctor. Clay can't afford to go away to college like the rest of his graduating senior class, but what other 17-year-old has delivered a baby or helped save a life?
Still, Clay wishes his life could be more like his best friend Joey's. Joey has it all--a great family, a good college waiting for him at the end of the summer, money, a car. Clay has to bike everywhere, and the miles are starting to wear him down.
But Joey's golden future shatters one day when he overdoses at a party. Now he's clinging to life at the hospital where Clay works, and Clay may even be implicated in Joey's injuries. Tension and emotion rise as those who love Joey gather and wait. Clay will do whatever he can to find out what happened at the party, and to help Joey recover. But to survive this ordeal Clay must draw on a strength he never knew he had.
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Delacorte Books for Young Readers
July 09, 2007
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Excerpt from Blood Brothers by S. A. Harazin
Saturday, 6 pm
I hurry down the cold hospital corridor and barge through the automatic doors of the emergency department. My sneakers squeak on the glossy white tiles I mopped this morning and catch on the hem of my blue scrubs, pulling them below my hips. I glance around, embarrassed, pull up my pants, and tighten the drawstring around the waist. These things never seem to fit me right.
I have a dull headache from the twelve-pack of beer I drank last night as I watched cars pass by on the highway. That's what passes for entertainment here in Georgia. Thankfully, I only threw up once this morning, but I haven't eaten anything all day.
I adjust my stethoscope and my name tag.
clay gardener. med tech i.
This means I do anything I'm told to do. I'm seventeen years old, the youngest employee at the hospital.
I stop at the nurses' station. Empty metal charts litter the desk. Mrs. Hunt, the nursing supervisor, is talking on the two-way radio. Five minutes ago she paged me and asked me to empty the trash in the ER.
"Can you airlift the patient to the nearest trauma center, over?" she's saying.
"Biggs, that's a negative. ETA in three to five minutes. Unit one, over and clear."
Mrs. Hunt glances my way. "Clay, help me set up for a trauma patient."
I swallow, but my mouth is still dried out from last night's beer. I hope I know what to do. "Yes, ma'am," I answer.
The other employees call her Big Mama behind her back. I don't. Well, sometimes, maybe. She hired and trained me for my job here as an orderly. I get to do what nobody else wants to do. I'm the one who mops the vomit or blood off the emergency room floor or wipes sweat from the gurneys. I work all over the hospital. Most people see my job as nothing but menial labor, but Mrs. Hunt says I'm an important part of the team, and she gives me more responsibility than a lot of the other orderlies have. She says I'll make a great doctor one day. Sometimes I imagine myself as a doctor, but then I get a big lump in the back of my throat. I don't like dreaming the impossible.
She's a big lady, and she's good with little kids and drunks. I've heard she deals with little kids and a drunk at home. She loves hearing about the cross-country bike trip my best friend, Joey, and I plan to take next year and my desire to go to college. But I have to win the lottery first to be able to pay tuition, and then actually get admitted somewhere.
In the trauma room, Mrs. Hunt flips switches and turns dials. Sounds of bubbling, swishing, and beeping fill the air.
I pull yellow plastic gowns, masks with goggles, and gloves from overhead cabinets.
Mrs. Hunt connects clear blue tubing to the oxygen. "You were late again today," she says.
This morning I rode my bike four miles to work with a hangover. I don't plan on ever doing that again.
I place a lift sheet on the gurney. Head down, I smooth out the wrinkles. I imagine the suction machine is draining all the oxygen from the room. I force in a breath. "Yes, ma'am. It won't happen again. I promise."
I glance at my watch. I get off at 7 pm. I've been here almost twelve hours, but it feels like a hundred.
Mrs. Hunt unfolds a blue pad and places it at the head of the stretcher. She doesn't smile or nod. I wonder how mad she is at me for coming in late again. I get the backboard and place it on the gurney.
I hear sirens blasting. The double doors of the ambulance entrance whoosh open and two EMTs slide a stretcher inside as they perform CPR.
"Sixteen-year-old female. Car accident. No seat belt. Went through the windshield," an EMT says. "We arrived within five minutes . . . started CPR."
"Call a code," Mrs. Hunt says. She wiggles into a yellow gown. "Thank God you got her intubated," she tells the EMTs.
I pick up the phone and press a button. "Code blue, emergency room." I say the words three times.
We lift the patient onto the gurney. I cut off her shirt with a pair of scissors, right down the middle. Mrs. Hunt connects the hospital heart monitor. CPR is in progress. I pull the emergency cart and defibrillator next to the patient. Dr. Murphy, Guthrie--a nurse--and a respiratory therapist appear.
"Start a large-bore IV," Dr. Murphy barks. "Give her bicarb followed by one milligram of epi. Check the ET and continue to hyperventilate. Bolus her with two hundred fifty of saline." I'm glad I'm not the one who has to remember all those orders.
The respiratory therapist listens to the girl's chest. "Breath sounds in both fields," she says.
One EMT steps out of the way and starts writing on a metal clipboard. "She was in full cardiac arrest when we arrived on the scene. Pupils already fixed and dilated," he says.
I look at the girl. A breathing tube sticks out of her mouth, held in place by tape. Her face is twilight blue, caked with dried blood.
I hope it isn't too late for you.
I can feel my heart speed up.
I hear the hiss of the oxygen, the gurgling of the suction, the beep of the heart monitor, the sounds of life clinging to this world. The one thing I can't handle is someone dying before my eyes. That's happened a couple of times. In both cases I got an urge to shut all the windows and doors in the room so the patient's soul wouldn't escape, so maybe we could still save them. There aren't any windows in this room, and the door's already shut.
The girl's jeans are ripped at one knee where her leg is partially severed. The respiratory therapist squeezes oxygen into her lungs with the ambu bag. Her chest rises and falls each time. I can smell blood and alcohol.
"Clay!" Mrs. Hunt says, preparing a syringe of medication. She's a big yellow blob calling to me from inside a tunnel. I hear a faint buzz. It's like we're inside a giant refrigerator.
"Clay! Take over compressions."
I put on a face shield and move to the side of the gurney. The other EMT steps out of the way. I position my hands in the right spot and press. This is not the plastic dummy I practiced on when I was getting certified. This is a real person. Not too hard. Press down an inch. Don't break the ribs. I count. I'm shaking, sweating, gasping. A properly trained person can do effective CPR. You don't have to be a doctor. Any CPR is better than none.
"Good femoral pulse with CPR," Guthrie says. I see her wink at me like she's saying I'm doing well.
We all have a role. Dr. Murphy calls out orders. Mrs. Hunt prepares the medication, then hands it to Guthrie, who injects it. The respiratory therapist ventilates the patient. Because no one else is here to do it, I perform compressions.
"Are her parents here?" Dr. Murphy asks Guthrie. He's sticking a needle into the girl's groin to get a blood gas. Dark blood fills the syringe. Dark blood means no oxygen. Bright red blood, good oxygen.
"On the way," Guthrie says. "I've already asked the receptionist to notify the hospital chaplain and organ procurement."
Her words slice into me like a knife. But I keep working, mostly unaware of what's going on around me. Focused. I'm doing the compressions correctly. No one yells and says I can't do anything right, or that I'm an idiot.
Dr. Murphy flashes a light into the patient's eyes. "Fixed and dilated." He shakes his head. "Stop CPR. Let's see what we have." He checks for a femoral pulse.
I stare at the girl. Her tits are blue-black. I gasp. I bet she was pretty before her head smashed into the windshield. A straight line moves slowly across the heart monitor.
"Continue CPR," Dr. Murphy says after a few seconds. "Let's keep trying."
I put the heel of my palm on her chest and start pumping.
"Repeat epi," the doctor says, and Guthrie hands Mrs. Hunt the syringe of medicine that might stimulate the heart.
Warm mist from my breathing clouds my face shield as beads of sweat collect on my forehead. I glance at the girl from the corner of my eye.
I don't want to think of you as a person. Now you're just a broken machine we're trying to fix.
"She's fibrillating," Dr. Murphy says, and I see an erratic line on the monitor. "Defib at two hundred."
Yes! There's a chance to get her back.
Mrs. Hunt places special pads on the chest. Guthrie charges the paddles to 200 and places them on the pads. "Clear," she calls out, and looks around. Everybody steps back. She presses the buttons on the paddles. The electrical shock surges through the girl. Her body springs forward as if instantly brought back to life. The doctor looks at the monitor.
"Still fibrillating," Dr. Murphy says. "Defib at three hundred."
And the same thing happens. With every passing second, her grip on life loosens.