Timeout

[Cass van der Berg]

OK, so suggesting she shouldn’t work was apparently not the best idea.
That was what he was talking about, there. The Carer guilt. It got under your skin, after a while, at times like this. You saw the people hurt and dying, and the one thought that got you through it was the fact that you were there doing everything you could – you couldn’t try any harder.
But the moment you left, it suddenly became clear that you weren’t doing everything you could. If you were doing everything you could then you would still have been in there, you would still have been helping.
And that kind of thinking was dangerous, because if it got too far, you began to think that the people who were hurt and dying were like that because you weren’t doing enough to fix them. You began to feel like it was your fault.
It was dangerous, and there was a ridiculously fine line to tread between trashing yourself physically and trashing yourself emotionally. It was almost impossible to get the balance right. Most people just ended up trashing themselves both ways, and Cass was – probably – one of them.
But Will seemed a little better now, he thought as he sat beside her in silence. She seemed… calmer. More optimistic, anyway. He thought about saying something else, but decided not to. If she felt good enough not to talk about it, then that was an improvement. And really, Cass was probably better not trying to give her any more advice. It’d worked out well so far, but he wasn’t going to push his luck.
After a couple of minutes, Will got up and started pacing, and Cass watched her. Maybe she was getting agitated again, he thought.
But he still didn’t say anything. If she wanted to share she would. There wouldn’t be anything to stop her, now – she must have known by now that she could talk to him about this. No, if she wasn’t saying anything it must have been because she didn’t want to, not because she didn’t think she could.
So Cass stayed quiet, thinking, instead, of music. Of course. He was getting too predictable for his own good –
And then, suddenly, Will was gone.
And he heard her voice from outside, “Cass, come and help me!”
She was shouting. She sounded terrified.
Oh, God.
“And bring a towel or something!”
Oh, God, no…
A moment, and Cass had flitted across the room and grasped the first aid kit under the sink (an unloved kit which had been left abandoned in the staff room years ago), and got out to the hall in a millisecond.
He flinched slightly when he saw the boy lying, bleeding, on the ground, but he collected himself quickly.
Will was holding her coat on the boy’s side, so Cass quickly unzipped the first aid kit and started handing her rolls of bandages, loads of them, and he said, “Press those on it; they’ll soak it up better.”
And having handed her the bandages, he quickly started into the primary survey. Cass couldn’t deal with things like this without a system. And if the guy was in cardiac arrest, then the bleeding would have to wait.
Danger, no. Response – clearly no. There was no need for Cass to check if the guy was going to respond to his voice, because the pain check was clearly underway – he had a massive gash in his side, and he still lay there unmoving. So –
Airway and Breathing. This was one of the few times when Cass’s power was actually useful – he quickly tipped the boy’s head back carefully so that the airway would remain unobstructed, and as he did so, he could see using his other power that the boy was, at least, breathing, albeit very rapidly and shallowly.
Circulation.
The boy had lost a lot of blood, Cass could see that quickly, and he was losing more with every passing second. His brain and heart were both losing oxygen rapidly. And the grey-blue colour which was visible on the inside of his lips left little doubt as to what was wrong with him.
“He’s in shock; he’s out,” Cass said quickly, and began telling everything he could see to Will. “He’s getting hypoxic, he’s tachycardic, hypotensive, hypovolemic – Will, you need to heal that wound right now, or we’re going to have an arrest on our hands.”

[Will Wright]

Replace, replace, replace, replace... Will moved fast. Faster than she had in her life. Cass had his head tilted back. He was still breathing. As she moved the patients gown to the side to get at the wound better she saw the stitching...if you could call it that.
Whoever did this stitching is in serious, serious trouble. The stitches were all over the place.
Will concentrated on trying to stop the copius blood flow that was coming from him while Cass checked him. It didn't look good. And what Cass informed her off next, although she already knew from what she could see and what she was trying to stop, made her scared although she knew not to show it and knew how to deal with it, “He’s in shock; he’s out, he’s getting hypoxic, he’s tachycardic, hypotensive, hypovolemic – Will, you need to heal that wound right now, or we’re going to have an arrest on our hands.”
Ok. Not good.
"If I move my hands, he'll just start spurting the blood everywhere and then I won't be ables to see what I'm doing!" but she did anyway. She sure as hell wasn't going to let him bleed to death.
She quickly took away the bandages and blood started spurting and flowing more than before but she preservered. Putting her hand to the deep gouge it started to let out a golden glow. Keeping it there for about three minutes or so so that she could make sure the wound would have healed properly, she removed it.
What the.. she put her hand over again and tried. Nothing.
"Cass, this wound isn't healing. I can't stop the-" she looked at him and then back at the guy, "He's not breathing. We need to Defibrillate him, I can't move otherwise he'll just keep bleeding out. Cass you need to go at get help, now!"
There was no hesitation. Cass was away like an arrow which had just been released from the bow. This is not good. So, so, so not good. If I move from here the blood will flow faster but if I don't do CPR it'll be harder to resusitate. Crap!
Will looked around her. There had to be something here that could apply the pressure to his wound. No, nevermind that. Just do the d**n CPR! Will took less than thirty seconds to think. She left the wound and moved to his chest and started doing compressions. Her arms straight and she put the heel of her left hand on the center of his chest and interlaced her fingers with her other hand and started to push.
One, two, three, four, five, six Will's concentrated on her hands. She never really had to do this. She had done it about five times in all of her school life and all of them had come out alive.
Eighteen, nineteen, twenty, twenty-one, twenty-two, twenty-three..
She wasn't about to lose one now. He was going to live.
Thirty. she leant over and opened his mouth while pinching his nostrils closed and breathed two breaths into his mouth before going back to do another thrity compressions.
Come on Cass, hurry up. He'll bleed out otherwise.

[Cass van der Berg]

When Cass flitted back into the room, another six Carers were following him, replete with crash cart.
Will had just finished her rescue breaths and was moving back to chest compressions once more, and she had left the wound at his side alone. Bleeds were ignored if there were issues with breathing, Cass knew that.
But the wound was what had caused this, and Cass didn’t like leaving it there. The guy was losing more and more blood by the second, and he was going to bleed out. But there wasn’t anything he could do, he needed to –
Ahh.
Cass had air. And air had pressure.
He brought a cushion of air around so that it pressed down on top of the wound, and stemmed the flow of blood. It wasn’t flawless, it couldn’t stop it completely, but it slowed the blood loss, and that was what they needed to do.
And then he leant down and touched the side of the guy’s throat, and saw –
“V-fib.”
He didn’t need to say it; Will had already figured it out, but still he couldn’t stop himself. His heart throbbed in the side of his throat and adrenaline began pounding through his veins.
He’d only ever done this once before. Cass had the power of diagnosis, so he wasn’t exactly prime Field Medic material, and most of the times that he’d seen this happening in the hospital he’d been too young – someone more experienced, a sixth-former or a teacher, had always taken over. He’d only done it once before he’d left.
The crash cart arrived, and Cass swallowed. While Will was giving rescue breaths, grabbed the papery material of the patient’s gown and ripped it so that his chest was free.
“Pads,” he said, and he was handed them by a third-year who was one step away from hyperventilating, she was breathing so fast. He placed them on the boy’s chest, and then said to Will,
“We don’t need to intubate; I have air, so I can deal with that. And I’m keeping pressure on the wound with air as well – so you’re going to need to defibrillate, I’m sorry. I can’t keep focus otherwise.”

[Will Wright]

She heard the thudding of feet as Cass, along with six other Carers arrived. They had a crash cart, thank god. WIll kept doing compressions while Cass knelt down beside her and checked his wound. It was big and it was pouring blood out by the second.
Twenty-nine, Thirty. Will lent over and gave two more breaths while Cass ripped open the gown.
“Pads,” he said, and he was handed them by a third-year who was one step away from hyperventilating, she was breathing so fast. He placed them on the boy’s chest, and then said to Will,
“We don’t need to intubate; I have air, so I can deal with that. And I’m keeping pressure on the wound with air as well – so you’re going to need to defibrillate, I’m sorry. I can’t keep focus otherwise.”
Thank god for the first two. Will just nodded then started to instruct, "Give him a full shot of Epheniphrine."
Will looked at Cass, "Anything?"
"Nothing." he looked back.
"Right, charge to 200." Ross handed her the paddles and put gel on one and Will rubbed them together. They made a whizzing noise.
"Charged." Ross breathed.
"Clear!" Will put them to his chest and his body lurched forward, she checked his pulse; well the lack of one, "Charge to 300."
"Charged."
"Clear!" his body lurched again.
She looked at Cass who shook his head.
"Again." she barked.
"Charged."
"Clear!" again the body lurched. This time she felt a pulse, "We got him. Now go get a gurney. Hurry up!" she shook her head and looked at Cass, "Someone is going to have hell to pay and me to answer to once I find out who did those d**n stitches."
She kept her two fingers on his wrist to make sure he didn't flatline again, "d**n it. His pulse is too weak."

[Cass van der Berg]

“We got him.”
Oh, thank God.
Cass’s heart was pounding. He forced himself to breathe slowly, keep himself calm, but it was hard to do. Harder than it should have been – because, for the sake of all that was holy, Cass was eighteen by now. He’d been doing this for six years, more or less; he should have been able to deal with cardiac arrest, but…
“Someone is going to have hell to pay and me to answer to when I find out who did those dàmn stitches,” Will said to him, and Cass nodded in agreement. But then, he couldn’t condemn the person who’d done it. They’d all been tired recently, and some of the treatment had had to be rushed at the start, with the original influx of casualties.
They still should have done it better, but it was understandable, at least.
“Dàmn it. His pulse is too weak,” Will said before he had a chance to answer her properly.
Right.
“OK,” Cass said, and looked over at the Carers who were still there. Two had left to get the gurney, one to get a suturing kit. He then saw that Gerard Leroy was still there, a fourth-year boy who, Cass knew, had the power of summoning.
“Here, Gerry, I want you to get” – how many? Cass wasn’t exactly sure, so he’d say a lot, to be on the safe side – “four units of” – and he looked inside the body, checking for blood type – “O-negative, ASAP. And you,” he said, gesturing at a young girl, “have you been trained how to do an OP airway?”
“Yeah, yeah, I ha –”
“Right, I want you to do that, then start with the BVM until we can get oxygen in here – in fact, Gerry, get us oxygen as well. And you.” He pointed at the final boy, who looked barely out of primary school, and whose face was covered with a sheen of sweat. “Get Nurse Gornray.”
He nodded, and ran from the room, practically tripping over his feet.
Gerry came up to them, the bags of blood in his arms.
“Will, can you set up an IV for that?” Cass asked. “I need to deal with this.” He gestured at the wound.
And he darted round so that he was beside it, and focused on keeping the cushion of air so that it put pressure on the wound, but wouldn’t press so hard that it led to internal bleeding. This was why he needed the girl to put in an OP airway – if he didn’t focus completely on the wound, he would make a mistake sooner or later.
He dragged the cushion of air so that it fit the torn edges of skin exactly, and the flow of blood out of the body was stopped; but the boy had already lost so much. If he didn’t get the blood transfusion soon…

[Will Wright]

Will took his right hand and looked for the most prominent vein she could see, "Needle." someone put the needle into her palm and she brought it down. She found the veing and carefully pierced the skin with the needle, "Plaster." and she stuck the plaster over.
"Right, IV's in..just need to wait for the blood. Um..." she was about to carry on when she heard Nurse Gornray moving fast down the corridor and arrived at an abrupt halt.
"What happened?"
"I-I don't know, Cass and I were in the staff room and I looked out and he was wondering around and then fell. Nurse Gornray...we need to find out who did his stitching. And where are those freaking units of blood?! You, go find them!" she sent one of the girls away.
Nurse Gornray had moved down to look at the stitching.
"You're right, who is he?"
"Erm..." Will jsut shook her head, "I don't know, I haven't seen him."
"Right well, Cass? Do you think he'll make it?"

[Cass van der Berg]

The bags of blood arrived as Will and Nurse Gornray spoke, and Cass immediately hooked up one of the bags into the catheter that Will had inserted in the back of the boy’s hand. Then he handed the bag to one of the Carers, said, “Hold that up, and you” – he gestured at a boy – “go get a stand for that.”
And then he turned back to Nurse Gornray, who was speaking to him.
“Right, well, Cass? Do you think he’ll make it?”
Cass placed his hand on the side of the boy’s neck again.
This was hard, doing this. Cass had never been very good at maths, but he got a pretty good sense of proportion by doing this. It was the closest that he’d get to thinking about it numerically, anyway.
The heart was beating regularly, if faintly and quickly. Blood was trickling into the boy’s veins, bringing oxygen and nutrients around the body, and replenishing the organs.
It wasn’t safe yet. But if it continued at this rate…
Predictions. If this continued the way he’d seen it do before, then they should be all right.
“There’s probably a sixty-percent chance or better,” he stated slowly. “Provided that there aren’t any complications, and that someone sews that up soon,” he said, gesturing at the wound. “I’ve been suppressing the blood flow with the air, but the air isn’t sterile. I can see bacteria in the cut… We’ll have sepsis on our hands if we don’t act soon. It’ll need to be disinfected first, and he might need some antibiotics if the infection develops.
“Otherwise, though,” he said, pulling his hand back. “Routine shock. He needs more blood, more people watching him, and then so long as he doesn’t arrest again we’ll be all right.”
He was fully aware that everything he’d just said was probably completely pointless to state to Nurse Gornray, but she’d still asked him.
And Cass was maybe getting a little too into this. But he had missed it, after all. And it was good to be needed, to be useful, again.
It was just good to be back.

[Will Wright]

Nurse Gornray kept still and straight-faced while she listened to all that Cass was telling her. It looked like they had gotten things under control.
"I think everybody will need aother leasson or two in suturing again. Whoever did this guys was either in a big hurry or didn't know how to suture. And if this is the case then they should've come to get one of the older students to do it or take the time to do it and say they were doing this or again, passed it on to one of the other students," as she spoke the gurney arrived.
"Right you two on this side and you two on that side. On three push him over here and you two, pull that sheet under him," all them did as they were instructed, "Cass, make sure you have pressure on that wound otherwise there'll be more blood lost. Right, one. Two. Three." he was rolled towards her and the other two while the boy and the girl slide a sheet under him.
"Make sure it's all thew way under an there are no trapped bits. Right, next is next. I want all of you to lifet him very carefully. Someone needs to support his head and his feet and while transferring him, keep him as straight on his back as possible. We don't want anymore injuries sustained." Nurse Gornray's voice was slow, clear and calming. She wasn't using her ususual strict voice.
"One, two, three!" Will counted and all of them lifed him simultaneously. The slowly manouvered him so that he got on the gurney in the same position as possible. Will then pulled the railings up and her and Cass got ready to move him.
"Ready?"
Heavy footfalls echoed through the hall way. Gerry rounded the corner with his arms full, "I've got the blood."
Poor boy was breathless.

[Cass van der Berg]

Having got the IV sorted out, Cass turned back to Nurse Gornray and Will, and he said, “I’ll need to go with him – with the gurney, I mean. For the air –”
“No, you won’t, Caspar,” Nurse Gornray said. “We’ll be handling it from here.”
Cass furrowed his eyebrows. “But – but Nurse Gornray, the blood loss will –”
“Be dealt with in a prompt and timely manner. We have ways of dealing with this that don’t involve either of you, never fear. You did the CPR; that’s all we’re going to ask of you now. Tanya!” she said, and a girl beside the gurney said, “Yes?”
“You have psychokinesis, correct?”
“Yeah – Yeah, I do –”
“Excellent. I want you to apply a firm pressure to the wound to replace that of Caspar’s air, please.” And she turned back to Cass. “Release the air pressure now, please.”
And Cass did so. There was a brief bubbling of blood at the wound, but soon after the flow was stemmed again by the application of psychokinesis.
“You see, Caspar? We Carers are very resourceful. Now, you two were on a break before this started, were you not?”
Cass hesitated, feeling a little out of his depth as he watched Nurse Gornray quickly deal with one thing after another, almost mechanical in her efficiency. “Uh, yeah… Yeah, we were.”
“I suggest you return to it. The day is only halfway over, after all. Caffeine may be helpful.”
And she turned and directed the Carers stationed around the gurney, “To Ward Two, please.”
The gurney was wheeled around the corner, and soon left Cass’s field of view.
And after Nurse Gornray had left, Cass blew out gustily, so that the hair that fell over his face was lifted by the air. “Well. Wow. That was… intense,” he said, his voice suddenly filled with relief.
The boy was going to be all right. They’d got him out of the worst of it, and provided that there were no complications, Cass couldn’t see any reason why he shouldn’t be fine.
And thank God for that. Cass had… Cass needed a win, by now. What with everything that had been happening.
And he didn’t want to speak too soon, but it was looking like they’d got one.

[Will Wright]

"I'll say...is it wrong to say I actually enjoyed that? The whole blood, seeing his insides, CPR and shocking him stuff? You know in a..ahem, medical way?" she giggled and looked at the both of them, "We should probably get changed..though I just can't be bothered."
They walked back to the Staff Room together, Will held the door open for him as they walked through. She was about to join him on the couch when a sudden thought occurred to her.
Could we...probably not but if we could it would be so so so much easier on me and Nurse Gornray and everybody else...A Diagnostics department, ER, Psychiatric, Field Carers and General. Hmm
"Cass? I had a sudden idea," she bounded over to him and sat down with an excited look on her face, "We should have departments."
And if I can get him thinking on this with me it means I won't have to talk about Jack again. Please bite the bait, Cass, please bite it.
Smiling widely at him, "What do ya think!?"

[Cass van der Berg]

His mouth moved into a lopsided grin to mirror the wide smile on Will’s face.
There. She seemed happy now, didn’t she? That was good. That was what he’d been going for.
Maybe it was… It was that Carer thing, again. Cass felt better, now, that he’d got a win – that he knew, categorically, that he’d helped someone, and that they’d done it right, and that the guy had a much better chance of living now than if they hadn’t acted. It was good, it was life-affirming. Better than any rambling advice that Cass had to do.
She seemed happier, and Cass knew that it had been a win for Will too. So he was glad.
“Departments?” he asked. “You mean like neurology, and immunology, or… What kind of departments do you mean?”
And it was good, now, that she was thinking about something else, even if Cass wasn’t exactly sure yet where she was going with it.

[Will Wright]

"Yes!" she she brought her arm up beside her head and then brought it back down while clicking and pointed at him at the end, "That's exactly what I mean. Departments like, like....A Diagnostics department, ER, Psychiatric, Field Carers and General. You know, those sort of things? I think that would be awesome if we did do that. Do you not? And also make things slsightly easier to keep track of."
Ok, she was getting a little to excited about this for her own good. But it would make things so much easier. IT would mean she could keep track of patients and records and how much medicine was used instead of sitting for hours on end doing it the way she was doing it at the minute.

[Cass van der Berg]

Departments.
Hmm, it had never really occurred to Cass before, but that wasn’t really surprising. Departments were a form of organisation, and organisation was always something that had managed to evade him. He could do it if he really had to, but what constituted “really having to” for Cass was a lot more than what it would be for anyone else.
But when he thought about it, it made sense. The Carers did so much, and while it was good in a way for them to be jacks-of-all-trades, they would probably be able to get more done if there was some sort of a system.
“Yeah, actually,” he said slowly, then more quickly – “That’s actually a really good idea, Will. You should speak to Nurse Gornray about it; I think you’re on to something there.”

[Will Wright]

"Hahaha, you'll be coming with me when I do. But what departments should we have exactly? I mean we need some to give her an idea of what we want. She's not an easy person to explain stuff to or you know..get your own way with. I mean what kind of departments would you usually have? A part from the ones we won't need." she sat there beside Cass and thought about it.
If they did this it would be a first.
They'd be the only school to have anything like this.
The first.
Anywhere.
Will's smile grew as she kept thinking about it.
It'd be like having your very own hospital beside you at all times. A proper one. With all the different departments and all.
Then she wondered if she was the first Head of Carers to ever think about doing this. It would be kind of awesome if she was. It would be a first, proper, thought that she was actually serious about and not one of the most random thoughts she usually had. It was weird having normal, justified thoughts that weren't going to cause damage or sound totally insane. They weren't for fun and recreational purposes. They were serious.
Will was being serious.
Well, this is new.

[Cass van der Berg]

“Well, I don’t know,” said Cass. He thought about it for a moment.
He hadn’t really known a lot about hospitals for more or less the first seventeen years of his life, and even now, after he’d spent around three quarters of a year visiting one daily, he still hadn’t managed to pick up much. That was his scatterbrain side rearing its ugly head again; he’d walked through the hospital every day, but now, trying to think back and remember the departments, he couldn’t for the life of him remember any of the signs.
“I think that there’s usually a different one for each body system, or something like that. I mean, there’s neurology, and… uh, there’s oncology, and… stuff… OK, right,” he laughed. “So I don’t know a lot. But I think… here, we don’t get a lot of diseases, though, do we? It’s more injuries – you know, like now, and otherwise from battle training and spy training and things like that. We might be better focusing on… Like, we could have an ER-type thing. And we already have the Field Carers, of course.”
He thought for a minute longer.
“But that’s all I can think of, I guess,” he laughed. “That’s kind of useless of me, I know. A hospital with only two departments… Can you think of anything else?”