Anya Crichton shuffled down stairs in her Ugg boots and thick cotton gown. The house was still in darkness, but once she was awake there was no point staying in bed. All she could think about were the facial hemorrhages she may or may not have missed.
The events of the last few months now felt like a blur. Working on cases in New York and Mediterranean Europe had been exhilarating and exhausting. Flight delays had meant there had been no time to catch her breath before preparing for the Harbourn trial. At least she’d managed one day in Disneyland with Ben and Martin, seeing her son delight in meeting Mickey Mouse and begging to do the Pirates of the Caribbean ride again. In truth, it was a toss-up as to who enjoyed it more, Ben or his regressed, childlike parents. And Martin had been so affable, she’d almost remembered what had attracted her to him so many years ago-until the need for them to be organized brought his aversion to responsibility to the fore once again.
She checked for messages and updates from the various people she had worked with while away. A couple wished her safe travels, but nothing else.
Thankfully, Elaine had cleared the diary for the trial appearances and so Anya was free to rest and try to shake off the fever and chest infection. If she were being honest, it was what her body craved. Working overseas had challenged her in many ways, and now she needed a day to recuperate, stock up on some fresh fruit and vegetables and get back into a routine.
She filled the kettle, switched it on at the powerpoint, and wondered whether to catch up on paperwork or try to put together the bookcase for Benjamin’s room. He would be back next week and she hoped to have it completed by then as a surprise for his access visit. Besides, the wooden planks supported by bricks were bowing under the weight of his Mr. Men collection and beginner readers. The thought of assembling prefab furniture was a little daunting, though. It might be better for her health to go for a gentle walk to the greengrocer instead.
Pulling the milk from the fridge, she noticed some fresh vegetables in the chilling drawer and a home-cooked lasagna on the shelf, courtesy of Elaine.
Her secretary was always quick to criticize her eating habits-going weeks without having “proper food,” the stuff that was unprocessed and free of every preservative and artificial coloring known to man.
A dedicated foodie, Elaine didn’t appreciate that eating wasn’t high on Anya’s agenda. It provided sustenance and energy, but didn’t have to be consumed with clockwork regularity or even much attention.
That didn’t matter now, the lasagna was a mouth-watering treat and Anya was touched by Elaine’s thoughtfulness.
The kettle steamed the window and she felt a shiver. As she pulled her gown tighter, the phone pierced the quiet.
Anya let it ring a few times. Calls this early were never good news. Ben was not allowed to ring until eight o’clock at the earliest, no matter where he was.
It had to be work.
Anya lifted the receiver and instantly recognized the voice of Hayden Richards, from the sexual assault task force.
“We need you right now for a victim.”
“Good morning to you, too.” No apology for the hour, Anya noted. For Hayden that was unusual.
“I know it’s early, but we need you to come in.”
Anya lifted a peppermint tea bag from a plastic container on the bench into her World’s Best Mum mug and poured boiling water over it.
“Good news is, I’m not on call. It’s my day off to shake this chest cold. If you hang on, I’ll check who’s on instead.” She leaned over to the noticeboard in the kitchen. A new doctor on the sexual assault roster was listed for this week.
“Listen, Doc, I understand that, but we want you to do this one.”
Hayden sounded anxious.
“I wouldn’t ask if the victim was in better shape. Trust me, it needs someone with your experience.” He paused. “I’ve honestly never seen anything as bad as this.”
Anya had worked with the senior detective on a number of cases. His experience, knowledge and unflappable demeanor made him perfect for the SA squad. She thought by now he would have seen everything a deranged human being could do to another. Something had to be very wrong. In the background, she could hear muffled voices.
“I don’t have a good feeling about this. Where are you?”
“Western District emergency department.”
The relief in his voice was evident.
“Liz Gould is with me now and Kate Farrer’s at the scene.”
Anya swallowed. If Homicide were already involved, someone had been killed, or this victim wasn’t expected to live. It was unfair to expect a novice doctor to cope with the examination.
“All right.” Sleep, the bookshelf and groceries could wait. “I’m on my way.”
“Thanks, Doc, I’ve already sent someone from the squad to pick you up.”
The line went dead.
Anya forgot the tea. No time for a shower; upstairs she slipped into fresh underwear, dark jeans and a navy shirt, then scraped her hair into a ponytail with her fingers, securing it with an elastic band.
She heard a knock on the front door. A detective constable introduced himself as Shaun Wheeler and already had the car’s passenger door open and the engine running. She slung a leather satchel over her shoulder, collected her doctor’s bag and slipped her feet into the damp court shoes still positioned by the door.
“I need to check the windows,” she called, but the constable was back in the driver’s seat.
She went back to the lounge room and clicked on the television. It would sound as though someone was home, in case anyone had noticed that the house had recently been empty.
In the car, the detective said little apart from telling her he had driven Bevan Hart home after he had given his statement at the station yesterday. Anya could picture the broken man and his estranged wife and wished things could have been different.
“What can you tell me about the victim we’re seeing?” she asked, keen to change the subject and prepare for the task ahead.
“Sorry, all I know is that I have to get you to the emergency department-p-p-pronto.”
The constable’s stuttering might have explained why he was loathe to engage in conversation. Besides, a junior constable may not have been privy to any details about the case, or have been warned not to divulge confidential details by his superiors.
Traffic slowed when a delivery truck parked in one of two lanes on Victoria Road. Wheeler opened his window and put the blue flashing light on the car’s roof. With the siren blaring, they crossed the median strip and bypassed the obstruction.
In record time, Shaun Wheeler delivered Anya to the casualty entrance; the same double doors through which she had begun and ended numerable shifts during her internship and residency.
Homicide detective Liz Gould paced inside, talking on her mobile. Last Anya heard, she had been on maternity leave. Her presence was reassuring. A kind, warm manner complemented Kate Farrer’s more brash approach. Hayden Richards stood nearby.
In the reception area a uniformed officer sat with a middle-aged man on plastic chairs that, like everything that could possibly be stolen, were bolted to the floor. The man glanced up at Anya with partially raised eyebrows, almost pleading for something. She had seen that look many times before in people desperate for the smallest bit of hope.
The waiting room was almost empty. Staff would be handing over soon. A cleaner whirred a polisher across the floor, preparing for the daily onslaught that made every day in this place feel like Groundhog day.
The place looked exactly the same. Only the familiar blue vinyl chairs lining the walls now had holes in the padded armrests with yellow foam poking through. So much for prioritization of health care, she thought.
Liz hung up and led Anya to a small examination room, often used for breaking bad news to relatives. Neither woman sat.
“Victim’s name is Sophie Goodwin. Fourteen years old. She was found about an hour ago on the roadside, with serious stab wounds to her neck, chest and stomach. The paramedics brought her in a few minutes ago.”
Anya knew that was longer to deliver an acute trauma patient than the protocols permitted. “What took them so long?”
Liz shrugged her shoulders. “They had to protect her neck, they said.”
The detective spoke without emotion, simply stating the facts. But her eyes concentrated on the door, as though she were expecting someone to come in at any time.
Lowering her voice, she explained, “From the blood trail, Sophie crawled about forty meters to the road from the house she was in. A neighbor out looking for his dog found her and called the paramedics. They worked on her all that time, but apparently the doctors here don’t give her much chance.”
Anya knew the injuries had to be extensive and blood loss substantial if the girl had left a trail of blood that far. Protecting the neck meant either her airway was compromised, cervical vertebrae were broken or a wound was life-threatening.
“Are you sure she was sexually assaulted? Was she conscious?”
“No, but she was found naked below the waist and bleeding vaginally.”
Anya thought of the poor man in the waiting room. The young woman sounded as though she had already defied all odds by surviving this long. “Is that the father outside?”
Liz nodded.
“He isn’t ready to be interviewed yet. He’s in shock. Whoever did this raped and murdered her older sister during the night. We found her body back in the house by following Sophie’s trail.”
One daughter dead and the other in critical condition. Anya did not want to think about how their father might be feeling.
“The girl is the priority,” she said. The surgeons have to do what they can to save her. You have to understand that collecting evidence comes second.”
“I know that, but I want you in there. You understand about preserving anything that can help us. Photograph the wounds, get the clothes, do a rape kit. If you have to, follow them to the operating room.” Liz grabbed Anya’s arm. “Whoever did this needs to be found. What happened at that house was beyond horror. The sister was tied down and stabbed over a dozen times.” She let go and stepped back. “We have to find whoever did this before they attack again.”
Hayden Richards opened the door.
“The head doctor told the triage nurse you could go in now.”
Anya stepped out of the room and tried not to look at Sophie Goodwin’s father.
The triage nurse handed her a white gown, which she pulled on and tied at the back of her neck. “Gloves are on the wall inside.”
“Thanks.” Anya took a deep breath to steel herself before pushing through double plastic doors. A male nurse carrying two bags of blood rushed behind the curtain to the first resuscitation bay.
“Blood warmer’s coming. Group specific is still a couple of minutes away. They’re still working on the full cross-match.”
“Hurry them up,” a male voice boomed. “She’s leaking like a sieve.”
Two paramedics hovered near the central desk area, sipping from paper cups. Judging by their proximity to the cubicle, they were the ones who had brought Sophie in.
Anya peered through the gap in the curtains but could see only the lower part of the girl. Heads and hands moved quickly, each with a specific role.
Inside the cubicle she recognized Mike Monsoor, a surgeon she had trained with, and emergency specialist, Greg McGilvray. The hospital had quickly mobilized the acute trauma team.
A small figure lay on the bed, naked, her flesh covered with mixes of dried and fresh blood. One gloved nurse put pressure on a blood-soaked bandage over the girl’s abdomen.
A woman in blue surgical scrubs was at the head end, with a nurse, squashed between the bed and the wall.
“Doctor Crichton, I heard you’d been called.” Dressed in a sterile procedure gown, Greg McGilvray held a plastic bone-gun in a gloved hand. The gun was used in the army for administering fluids to injured troops in the field. Instead of wasting critical time trying to find venous access, the plastic gun drilled directly into bone. Advocates claimed it could save large numbers of lives.
Anya hoped Sophie Goodwin’s was one of them.
“We’ve just lost the antecubital cannula. It’s tissued,” a younger doctor said, feeling for a groin pulse. “My concern with a femoral line is that any fluid could just fill the abdomen. We need to go in to know what damage is in the belly.”
He had to be a surgical registrar.
“I’m in the humeral head,” Greg announced from the girl’s right shoulder. He flushed the line with saline and attached the blood for immediate transfusion. A nurse stood, arms above her head, squeezing the blood to get it into the body faster.
The monitor beeped seventy-five, a dangerously low blood pressure. Even if the girl survived, there was a chance she could suffer organ damage because of the prolonged poor blood supply.
The number on the monitor slowly increased with each squeeze of the bag. The blood was doing some good.
“Everyone, this is Doctor Crichton, a pathologist and forensic physician,” Greg introduced.
“Aren’t you a bit early? Business must be slow in the morgue,” the surgical registrar muttered and stepped outside the curtain.
Some things in hospitals never changed.
“Don’t suppose you want to put in a subclavian line?” Greg looked up. “Your anatomy is better than all of ours put together.”
“Not today thanks. But I will bag her shirt if anyone knows where it is.”
“Ah, I listened to your last lecture and split it along the buttons so knife cuts stayed intact.”
“Much appreciated.” For the first time, Anya had a clear view of Sophie’s head and neck. The wound gaped from one ear to the other, exposing veins and vital structures.
“I’ve never seen a wound that deep on anyone alive,” Anya thought out loud.
The breathing tube was placed straight into the trachea, bypassing the mouth and upper neck, kept stable by a towel clip attached to the sheet. In this instance, everyone was improvising as best they could. Textbooks couldn’t cover situations this complicated.
No wonder the woman at the top was keeping the head stable. Even a slight movement could tear large veins and prove fatal.
Greg glanced at Anya, then paused to look at his patient. “God knows how she crawled all that way without severing a vessel completely. The ambo officers did a top job getting her here alive.” Gloves on, he wiped his forehead with his forearm. “You know, I’ve got a daughter the same age.”
Moving a piece of hair from the neck area, he paused. “It’s hard to believe someone did this deliberately.”
Blood pressure hovered at eighty to eighty-five.
The surgical registrar returned. “Vascular surgeon’s upstairs prepping. No time for a CT scan. As soon as that other line’s in, we’ll take her straight to theater.”
“What about gynecology?” As the forensic physician, Anya was concerned about Liz’s mention of a bleeding vaginal injury.
Greg explained, “Registrar’s upstairs standing by. You might as well photograph what you can. It’s the best chance for the neck and stab wounds you’re likely to get.”
Anya already had the digital camera in her hand. Any opportunity to examine the wounds would be gone once surgeons started operating. With no time to grab a tape measure, she pulled the lid off a pen and placed it on the skin near the girl’s left shoulder. The lid would be the consistent measure of scale for each wound.
She recorded a number of stab wounds on the chest without interfering with the resuscitation. The woman at the head mentioned marks on the forearms and Anya gently collected images of them as well as of the hands and fingernails with the assistance of another nurse. Classic defense injuries, she thought. Sophie had tried to fend off her attacker, or attackers. She had probably seen whoever stabbed her.
“Thanks, Greg.”
“They should know to expect you in theater as well. Any problems, get them to ring me.”
“Give us a few minutes,” said the woman still quietly holding Sophie’s head. “You can meet me in the anesthetic bay. I’m Jenny Rafferty.”
Anya recognized the name of the Director of Anesthesiology and Intensive Care. Sophie was in the best possible hands.
Moving out to let them take the bed away, Anya turned around. The two paramedics were still by the nurse’s station. One was in his thirties, the other in his fifties.
“Excuse me, Doc,” the older man said. “But if you’re going to stay with Sophie, could you give her this?”
In his hand the man held a silver and gold medallion on a thick chain.
“Does it belong to her?”
“No…but, it’s got me this far safely and now I figure Sophie needs it more than I do.”
Anya took the medallion. On it was the image of Saint Jude, the Catholic patron saint of hopeless cases.
“I don’t know if she’s a believer or not, but it might protect her. Can you make sure she gets it?”
Anya nodded. “I’ll do my best.”
An alarm sounded as the bed wheeled past them, Jenny Rafferty clinging to the young girl’s head.
“Blood pressure’s dropping. She’s bleeding again. We need to get to theater now!”
The older paramedic’s face tightened as he closed Anya’s hand around the medallion. “Don’t let it out of her reach. It may be the only thing than can save that poor kid’s life.”