So what is this book about, anyway?

Here's a little taste of Vampire's Touch.


I reconsidered my stance on the supernatural when my pager went off at two a.m. Its incessant chimes confirmed ESP as a prerequisite for the job of emergency department secretary. I was certain that a conspiracy existed between that woman and the dying patients of St. Louis, because both parties always knew when I had barely reached my call room, ready for a quick nap, making it the ideal time to summon me back to work. The cool orange glow of the screen said “Trauma Alert, 2 inbound, ETA 4 minutes.” As much as my body hated me for working twenty-four hour shifts, I had to admit that I liked my job. There were no distractions here, no room for self-pity, nothing else to think about but keeping the patient alive.

Another five seconds and the trauma residents would get the same page, and I made my way outside of their call room to wait. They had exactly twenty seconds after the page to get their butts out of the beds and head for the elevator. Pulling lazy residents from the bunks and dumping their asses on the floor was a favorite pastime of mine, and it didn’t take long for word to spread to the new arrivals. “Hardass” was probably the nicest adjective they used, though “psychotic bitch” had to be my favorite.

“Comfortable enough in the call room for you, Dr. Jacobs?” I said as I watched him trying to pull on his scrub shirt as he walked out the door. His fellow resident joined him with an accusatory glance, as if somehow the removal of his shirt had caused the two trauma patients to be injured, or at least transported to our hospital instead of somewhere else.

“It won’t happen again, Dr. Winsome,” Dr. Jacobs said, but at that point, I just didn’t give a damn if he was sorry or not. Sorry never changed anything.

“You’re lazy, Jacobs, and just because you’re new to the team doesn’t get you a pass. You’re probably also stupid, since I’m sure Dr. Carson informed you of the rules about not tempting fate.” By that point, we were in the elevator and headed for the Emergency Department’s trauma bays, a.k.a. Hell. “Try to follow her instructions more closely when we get upstairs and see if you can learn something. Anything.”

Jacobs opened his mouth to protest, then closed it. Carson knew better than to even have gotten that far. At twenty-seven, she was the youngest in the trauma surgery program, and the brightest. She wisely said nothing, gave nothing away, but did her job with skill and speed. Teaching her had been easy, effortless really, and even though she had another year to go, I would have trusted her with my life if it came to that. Though I hoped it never did. I’d already paid my dues as a trauma patient, and I had to say that I preferred the role of physician.

As the elevator doors opened into the short corridor that only staff would see, I smiled at the words I stenciled onto the doorframe when I first became an attending here four years ago. “All hope abandon ye who enter here. Hope has nothing to do with it.” Dante was just missing that last part.

I stopped just before the archway and leveled my gaze at the new resident. “I’ll say this only once and entirely for your benefit, Jacobs. In here, you and I may not be God, but we had better convince the patient that we are the next best thing when they’re lying on their gurney and waiting to find out if they are going to die. Everyone should have something to believe in during those hours when their fate is decided. It might as well be us, so for God’s sake, at least act like you know what you’re doing.”

Three nurses greeted us. Well, they didn’t so much greet as scowl and hold open our trauma gowns. Close enough. At least Jacobs could manage to gown and glove correctly, and we all had our masks in place as the first chopper whirred overhead.
Miss Castle, our grey-haired charge nurse, yelled out the stats on the two patients. We never called her “Wilomena”, only “Miss Castle” if we wanted to go on living. You didn’t mess with this woman. She spent two days in jail after beating the hell out of the last person to use her first name. As far as I was concerned, “Miss” was her first name.

Miss Castle began the litany: “Patient A: African American male, late thirties, driver of a pickup truck versus eighteen-wheeler. Blunt trauma to head, chest, abdomen, pelvis. Unresponsive to pain. Left chest decompressed en route. Presumed pelvis fracture, stabilized in the field. Intubated. Two large-bore IV’s started, with two liters of fluid in. Open fracture of left femur. Orthopedics and neurology have been notified and will be here in ten minutes. Blood pressure eighty over fifty, heart rate one hundred thirty. Patient B, white female, late twenties, same accident, ejected from vehicle, with penetrating trauma to the left upper abdomen, apparently with a screwdriver still in place.”

“Screwdrivers” got another tick mark on the white board, bringing the total to three, still clearly outpaced by knives at fifteen, but pulling ahead of fence posts at two. Bullets weren’t even listed, as they no longer qualified as interesting enough to record. There was a separate list for items removed from bodily orifices, which was even more entertaining.

Miss Castle gave me the evil eye as I set down the marker and put my gloves back on, but she continued with her litany. “CPR in process as patient has no pulse.”
The elevator that led to the roof gave the “ding” that had haunted me for the first year of my tenure here. Now it was familiar, welcoming. It focused me on the task at hand, much like I always thought Pavlov’s dogs were focused on their food after hearing their version of the bell. At least I didn’t salivate on the job.

Randy, the medic who was bagging our male patient, pushed the gurney into Trauma Room A, reciting the same summary we’d just heard. One of the newer ER docs here at Barnes Hospital, Dr. Ryan, followed Randy in as we all descended on the helpless man, moving him over to our gurney to begin our assessment.

“Nice to see you again, Megan,” Ryan said pleasantly as he felt for a pulse in the man’s neck.

“Yeah, you too,” I said, listening to the patient’s chest. Small talk was not uncommon to lighten the mood, but I was getting the impression that Ryan was actually happy to see me. That was disturbing. I focused on the sounds of the air moving in each half of the battered man’s chest, before handing out the orders.
“X-ray the cervical spine, chest, abdomen, pelvis, left femur. Call CT for a stat head scan. Carson, walk Jacobs through placement of chest tubes. Get the usual blood work started, someone get the ultrasound machine in here, and call respiratory for a ventilator.”

Ryan was busy with the neurological assessment by the time I was done with the initial round of orders. He added a few of his own before we stepped back to let our residents do their appraisal and treatment.

“Want to go out a week from next Saturday? Dinner and a movie, maybe?” Ryan asked me casually. Sure, if I were going to be academic about it, I’d have to say he was handsome. Sandy blonde hair, blue eyes, nice smile, athletic build, and he had a teeth/tattoo ratio greater than one. He wasn’t even married.

“I don’t fuck co-workers,” I said flatly, hoping that would be the end of it.

He had the audacity to smile at that. Most of the time those four simple words put an end to the inquiries into my personal life from the people I worked with. Word must not have gotten around to Ryan yet.

“You heard there was an opening down at St. Anthony’s, right? Well, it’s been filled. So I won’t be your co-worker in six more days.”

The ortho team showed up on the heels of neurosurgery, all jockeying for a space at the bedside. The chest tube was in, oxygen levels were good, and everything I needed to do was pending or in the hands of the other teams for the moment. Once all our ducks were in a row we’d haul the guy off to surgery and get down to the real business of fixing the broken bits.

Ryan reminded me that I hated persistent men. Once I thought of getting business cards made up that said, “Dr. Megan Winsome. Don’t call me, I’ll call you if I ever find you interesting,” but the guy at the Office Depot refused to print them. I still don’t understand why.

“I’m flattered that you’d change jobs for me, Dr. Ryan, and don’t take this the wrong way, but fuck off,” I said, as I evaluated patient’s belly with the ultrasound. “There’s blood in the peritoneal cavity.” I was happy that orthopedics and neurosurgery were going to take care of three of the guy’s problems, because his chest and abdomen were going to make for quite an extensive surgery, assuming he survived the next hour down here.

Ryan didn’t look entirely unhappy like I thought he would as he said, “Okay, I understand, sure. You want to talk about something other than our work on a date, I get it. I do have other interests though, and I promise not to talk about medicine if you don’t want to.”

“You’re taking it the wrong way.” I let that sink in for a second as I imagined the gears turning in the man’s head. Now that seemed to have had the desired effect. He wouldn’t ask again, which was just as well, as I hadn’t dated since my husband died four years ago. I simply wasn’t interested in getting attached to anyone in that way ever again.

I left the case in Carson and Ryan’s capable hands as the screwdriver victim rolled through the archway and into Trauma B. You never truly know how bad an injury is going to be from the description given by the medics. Was it an eyeglass screwdriver, or a normal caliber but very short-shafted screwdriver? There was no substitute for seeing it with your own eyes.

“Holy shit.”

“My thoughts exactly,” said Tim, the paramedic who was forcing air into the woman’s lungs with the bag valve mask.

While “screwdriver” was still an appropriate description, they had neglected to mention that it looked like it had come from the toolbox of the Jolly Green Giant.
Paramedics were a well trained bunch of people, and they knew not to pull out foreign objects in the field if it could be avoided, since the continued presence of the screwdriver was likely all that kept this woman from bleeding to death internally long before now. It was too close to her aorta for comfort.
I grabbed the ultrasound machine from the other trauma room. In the back of my mind, I thought her abdominal organs didn’t look quite right, but what I really cared about was blood in her abdomen. There was none. With the ultrasound probe, I followed the shaft of the screwdriver up, through her diaphragm, and into her chest. At least I knew why she was dying.

“God, someone get me a thoracotomy tray. That thing has to have lacerated her heart.” If she survived once the screwdriver was removed it was a bonus, but at least I wasn’t going to make her any worse.

What was worse was that besides the large spike in her abdomen and chest, the pale woman barely had a scratch on her. Her clothes had been cut off by the medics, and she looked so frail and innocent laying there. While I waited for my tray to be set up, I couldn’t help but notice that this woman was barely over twenty, and strangely beautiful and innocent laying there. The monitor sounded and I glanced up at the screen. She was in ventricular fibrillation, one step away from either smelling the sulfur or standing in front of the pearly gates. The only thing that had kept her going so far had been the one medic forcing air into her lungs and the other who’d probably broken most of her ribs trying to keep the blood flowing to her brain, or what was left of it, anyway.

“Get Ryan in here right now. Carson can handle the guy next door,” I told the nurse as I cut through skin and muscle on the left side of her chest, exposing the quivering heart deep in the cavity. Opening her chest had already deflated her lung on that side, but blood poured out of the hole I’d made. Ryan walked in and changed his gown and gloves.

“What the hell are you doing over there, Megan?” he asked, like he’d never seen this done.

“Well, I’m going to get this damn screwdriver out of her heart and you’re going to shock her when I’m done.”

I heard him fumbling with the defibrillator behind me, getting it set to therapeutically electrocute her as I put the rib spreader in, cranking it open so I could get to her twitching heart, which was desperately trying to beat but unable to get its act together. Our loveable Miss Castle already had the suture out and on an extra long needle driver. Ryan was putting the headlight with its thick grey harness over my head so I could see what I was doing in that deep cavity.

“Suture,” I called out, completely focused on what needed to be done. “Stop compressions.” The medic stopped trying to push what little blood remained around this woman’s body. She was already dead, I reminded myself. There was no way I could make her worse.

“Ryan, pull the screwdriver out slowly.” I could see where it had pierced the lower portion of the heart, but didn’t appear to exit through the opposite side. The damn thing had to be ten inches long.

A commotion in the next room and lots of shouting of orders led me to believe that the guy next door was circling the drain of death. The woman whose heart I was touching was already on top of it and therefore had priority. I sent Miss Castle and one of the medics to go help in the other room. The other medic, Ryan, and I could handle watching this woman finish dying on our own.

There were four running sutures in place in just under five seconds, and I was tying them off as fast as I could so we could get the woman’s heart restarted. “Charge to twenty and shock.” My gloves were bloodstained and empty now, waiting, but my eyes were fixed on the patch job I’d done. If it didn’t hold, she would be dead past repairing, even for me.

Ryan slid the paddles into place on either side of the heart and yelled, “Clear!”
Two things happened in quick succession. Ryan shocked her dying heart and she grabbed my left forearm and bit down, hard. How enough oxygenated blood reached her brain for her to even be conscious at that moment I didn’t know. She should have been brain damaged from being down for so long, but all I knew for sure was that she’d bitten me hard enough to draw blood, and strangely, it didn’t hurt like it should have.

I watched her as if we were lost in a dream together, moving so slowly that it felt like I was trapped in mud. Every time I tried to force the crazy bitch off me, my limbs felt too heavy to lift. She sat up, pulling me towards her as she went, and I felt the flesh on my arm tearing on her teeth as she held it up against her mouth with her right hand. Her left hand pulled the rib spreader out of her side as I observed, almost disinterested. I didn’t really care what she did, and the why of it never occurred to me as I slipped into unconsciousness.




I woke up on the floor with Dr. Jacobs standing above me, holding my wrist as bright
red blood poured down my arm. He was trying to put a pressure dressing on, and I wasn’t happy about it.

“Forget that, Jacobs, just put a blood pressure cuff on and pump it all the way up,” I said, feeling like I was being pulled out of a nightmare. It seemed like time snapped back into place, letting me move again. Not only could I move, but I could think normally, which was going to help a lot since I wasn’t in a hurry to bleed to death.

The blood was spurting out of my arm in time to my heartbeat, but not really far enough for the size of the laceration there. Strange. It was like I didn’t have enough blood pressure to push it out any harder. As I thought about it, the dizziness got worse. At least Jacobs could do something right; the cuff was being inflated on my upper arm and the bleeding slowed.

“Somebody give me a hemostat and call vascular. Now!” I yelled at no one in particular, since I was having trouble even seeing who else was in the room at the time while I was busy watching myself bleed to death. Jacobs gained another point in my book when he slapped the requested instrument into my right hand and I poked around for the side of the vessel closest to the edge of the gash. As I snapped the hemostat down all the way so it locked in place and closed off the radial artery, I fell backwards and tried desperately to resist the desire to pull that clamp off. I understood why patients always complained so much when we took blood with a needle from that spot. It was laced with very sensitive nerves, and they were all screaming at my brain at the same time.

As I lay there, I glanced to my left and saw Ryan’s lifeless eyes staring back at me, the shaft of the object he so recently removed from our patient was now embedded in his brainstem, the handle protruding from between his teeth. Only two thoughts crossed my mind before I passed out again: I was happy Ryan didn’t have a wife, and the white board needed another tick mark next to “screwdrivers”.