The Gifted

By Karen E. Wallace and Mandy Helm

Elyse Tyler leads an ordinary life as an ER nurse until, from the ashes of disaster, she is handed a gift that changes her life forever. Adversity, and a long history of secrets, constantly battle against her natural instinct for truth and justice, but will the truth be worth the dare? Follow Elyse down this road of adventure and mystery, but beware of your own secretsthey may not be as safe as you think.

• Language: English
• Publisher: WestBow Press
• Release date: Nov 16, 2011
• ISBN: 9781449730062

Karen E. Wallace

As the daughter of an English teacher, Mandy Helm was raised to have an enjoyment and respect for the power of words. Mystery and adventure are close friends of hers, but truth will always set her free. Her favorite books seem to embrace these same interests, and so her own book does as well. Her hope is that, while reading this child of her imagination, you will agree in the importance of truth, realizing that to stray from truth brings unnecessary pain and, potentially, danger. The other key feature she finds to be essential in a book (or in a friend) is a sense of humor—laughter is not only good medicine but also a calorie burner! Finally, it is a pleasure for her to share her story with you, and she hopes it brings as much enjoyment to you in the reading as it did to her in the writing. Mandy is a nurse currently serving in the United States Navy, and none of her characters or ideas represent the navy or its members. While her permanent residence is listed as South Carolina, she resides wherever the navy sends her. In her own words, it is an honor and a privilege to serve her fellow soldiers, their families, and all of this great country, and her only request is that you pray for those who serve and for those who send their loved ones to serve so selflessly in this time of war.

Book preview

CHAPTER 1

We all end up dead; it’s just a question of how and why.

—William Wallace, Braveheart

My story begins much like everyone else’s; I was born head first, causing as little trouble as possible under the circumstances. My life was blessed, though not special in extraordinary measures. I was raised by parents who loved me and taught me appreciation and responsibility for my life and for others, and I learned to be strong and of good courage, as the Bible would say. Though never one for big displays of emotion—the onset of tears always made me want to run screaming from the room—I tried to respect the feelings of others.

One emotion that I was prone to, however, was road rage, and speaking of road rage, I thought that man told me to turn left at the cathedral, but it’s a one way street that definitely does NOT go in the lefterly direction. Lefterly is a word someone like me uses—someone who would never know when to use easterly or northwestern or anything else without a definite direction implied. Jane, my dark and mysterious GPS friend with a British accent, would have been more helpful than the little man at the gas station, but she doesn’t ride on my motorcycle. I really should invest in the appropriate Garmin. Road construction, or whatever blocked the road this time, was inevitable, as was my inability to adjust with an alternate route.

Being on time to work is, in my experience, professional and thoughtful, and I always do my utmost to fulfill this requirement—but today I am late. Not to make excuses, but I do have a really good reason: the voices in my head. No, that’s not exactly right. They aren’t voices, really, but feelings. Words can’t express how difficult the adjustment period has been for me. Nothing in my past ever taught me coping mechanisms for the changes I am feeling, and it distresses me beyond all comprehension to feel so out of control. What was once a simple, thoughtless task has been convoluted into a source of panic or intense dread. Maybe, if I focus on the first appearance of the symptoms, something will begin to make sense.

I’m a nurse from the United States, working in Naples, Italy in the emergency room at a hospital run by the United States Navy. English is the predominant language here, so I can speak it without fear of being misunderstood. Sometimes, as in cases of mass casualties in which civilians are brought to us for lack of room elsewhere, we get the stray foreign language that nobody hopes to understand. For some unknown reason, yelling and gesticulations are attempted, as though deafening the poor traumatized patients will help teach them English faster and thus expedite the rendering of services. I don’t recommend it. Headaches and tinnitus, or ringing in the ears, usually occur before an understanding can be reached. It’s a vicious, irritating circle that spirals quickly down the toilet.

I had been here about six months when we got the call on a mass casualty, train versus car, in which the train derailed to the destruction of most people and objects involved. The local civilian hospital could not accommodate all of the injuries, so we were to get the overflow. All noncritical patients were moved to the wards, and the overflow staff was called in to cushion the blow. One hall was saved for such disasters but was, unfortunately, full of extra supplies and equipment. Just as the last patient was moved and the last of the extra supplies was being hauled off to the lounge and locker rooms, the first of the ambulances rolled up. From this point on, it’s all a blur. Head wound stabilized and sent to CT; chest tube in the pneumothorax; stitches and splints to any staff who couldn’t handle another crushed limb or internal hemorrhage. The emergency room is rarely tea and crumpets, but this was a chaotic, endless nightmare!

My shift had been over for two hours, and I was feverishly trying to report off and go home to my bed when another call came in. A single female was found underneath all the rubble; she was apparently the driver of the car in the train versus car disaster. The emergency transport team was bringing her to us, and I was asked, as a special favor, to take her and get her set up before going home. If I stayed, I could come in later tomorrow, which was supposed to be my day off, so I agreed. She was reportedly, and understandably, really banged up and not expected to live. The paramedics were doing CPR as the report was being called in by the driver who spoke fluent English, and I asked all the questions I could while I had him on the phone. It was a rare and beautiful thing to have such a plethora of communication, and I didn’t want to waste the opportunity to find out as much as possible about my patient.

I set up an area as best I could and tried to anticipate what equipment and medications I should have nearby before going outside to wait. Not five minutes later, the ambulance pulled in and delivered a very dirty and mangled body onto my gurney. She was past being a mess but past caring about it as well. Those patients are almost worse than the ones who do care. Probably the screaming and cursing make the biggest difference, but the lack of hope is the most devastating factor. Hope always makes a difference; however, this poor woman didn’t have the luxury, or the challenge, of hope. Amazingly, she fought for each breath and clung to life with a surprising fierceness that is impossible to describe.

Hello, my name is Elyse. I’m going to take care of you now.

This was said as we wheeled her gurney into the area I had set up minutes before her arrival. As an afterthought, I asked the paramedics if she spoke English. Their own English was brutal at best, so my hopes of their evaluations were miniscule. They shrugged as if to say, Such is life. I returned my attention to my patient.

"Are you hurt? Do you have pain? Dolore?" My questions were quick and urgent.

Her features, at least those I could distinguish, were not angular or dark enough to be Italian, but I thought that I should try whatever I could to communicate with her. The effect of my voice was immediate and shocking. She grabbed my arm with surprising strength and squinted in my direction. I was relieved that, either she understood me and could indicate her needs and injuries, or that she had, at the very least, the mental capability of recognizing help. Nurses live in the realm of small miracles. With her anxious eyes boring into mine, I gently repeated my inquiry, "Pain? Dolore?"

At this, she seemed to remember herself, and her body violently arched in pain. By now, my team had her hooked up to our monitors and had IV access. The monitor wailed in protest to her dropping blood pressure and rising heart rate, the indicators for a multitude of problems most assuredly all centered around shock. Based on her physical appearance, I was guessing internal bleeding from perforated organs and/or broken bones to be the culprit. The doctor was making quick work of her assessment; I was trying to get her vice grip from its lock on my arm. Just when I began considering more drastic measures, her grip failed, as did her heart. Flatline. That particular hum of the monitor is sure to give chills to the staunchest of hardened hearts. All movement ceased just long enough for one blink of an eye before the flurry of activity necessary to the saving of any life ensues.

Leads are good.

Beginning chest compressions.

Epi in at 21:12.

Break for intubation.

Resuming chest compressions.

Bagging.

Second dose of epi at 21:17.

And so we fought, ‘til at last we got a waveform. V-tach. Well, it was better than nothing. If only she had a pulse to go with it.

Paddles!

And shock. Her body arched then settled. Resume CPR. Pause for evaluation. No change. Shock again and CPR. Then, calm as a summer breeze, normal sinus rhythm. Such a symphony even Beethoven could not create. Her eyes opened as if in appreciation for such a sound and, instinctively, she reached for the tube down her throat. Crap! One good yank and it would be out. As one, the team dove for her hand, and as one, we failed. She took one raspy breath, grabbed my arm as it hovered over her offending hand, and pulled me closer to her face. She glared at me as before, willing me to understand, and moved her lips as if to speak. The effort was too much, and she sank into the gurney, lightening her grasp on my arm. She again took a raspy breath and attempted to focus her eyes on my face. Instinctively, I leaned even closer to hear the words that were costing her so much effort.

I … must, a deep, rattling breath, pass …She closed her eyes and grunted, as if in exasperation. A frown wrinkled itself between her brows.

It’s okay. I said, now assured of being understood. Just rest. We will take care of you. You can tell me later.

She grunted at this and frowned more deeply, obviously unhappy with my attempt to comfort her. She weakly shook her head, but it may have been more impressive had not the neck brace held her so firmly. The woman was certainly a fighter.

"To you!" She gasped.

Opening her eyes, face full of panic, she arched her back for a better breath. The monitor blared, but I know not of what it warned. The team was a blur in my periphery, but I was caught in a trance, useless and immobile. I leaned yet closer to hear what she was so anxious to communicate with her final breaths.

I pass … to you … now. She took a small breath, a little less sure of herself. Run! They … follow. Her voice was now barely a whisper. S … s … arr. Gone again. In that second, my entire world seemed to shift and change.

The hum in the background was beyond my comprehension. I saw the last fall of her chest. Somewhere, in the professional part of my understanding, I noted that it did not rise again, but nothing moved beyond that. My mind was a stagnant, muddy pool—too full to capture any one thing, and too full to move past a ripple. There were raised voices, and my name might have been called, but I comprehended nothing. I was appropriately shoved aside, so that more useful people could perform the necessary life-sustaining functions for the corpse on our gurney. It seemed odd to me, and not very efficient, that so many people were working so diligently over that lifeless body lying there. Slowly, I realized they felt the body could be revived. Oh yes, I knew the name for that feeling. It was Hope. My eyes wandered around the ER. Hope, Sadness, Anxiety, Frustration, Anger, and even, rarely, Relief and Happiness. So strange that I knew them all, and yet never had we met so thoroughly before as we were meeting now. It was as if their weights were added to mine—as if I knew them intimately. It was overpowering in its intensity.

All that emotional weight was too much to bear at the same moment, and the focus it took to separate the intense emotions was crippling. My entire body ached. In an effort to find relief, my eyes moved back to the activity closer to me. The people were still working furiously over the body, but, in reality, it had not been that long since I had been pushed aside. I focused on the body but felt nothing. The woman was silent, peaceful. All other bodies in the room screamed at me, filled me with emotions, and confused me by swamping my body with their conflicting feelings—but not that body. In a moment of singular thinking, I stepped forward and, again, took the woman’s hand.

She’s dead. Leave her in peace. I spoke quietly, dazed.

I tried to form a prayer for her but, wasted and spent, I finally walked away. The charge nurse, Susie, found me a few minutes later as I was changing clothes in the locker room.

What was that? Her appearance was calm and unaggressive, but she somehow screamed anxiety almost to the point of hysteria. Her mental agitation reverberated through my mind as I made an effort to look around me and assess my own activity and surroundings in the hope of finding whatever was amiss. I really wanted to help her. If I remembered correctly, she was grossly afraid of rodents. Perhaps a mouse had run by while I had my back turned. With all the other noises bombarding my senses, I could hardly be blamed for not hearing it. She should know that much.

I’m talking to you! Her voice went up an octave. It wasn’t necessary though, because I could feel her sentiments exactly. I was too exhausted, in every way possible, to be able to account for anything at that point.

"What were you thinking?"

I wondered how many ways she could reword the same question before I really knew how to answer. Maybe I should let her continue while I finished what I was doing. Venting, I recalled, was very soothing to the emotions she was feeling.

"Hello! You could at least acknowledge my presence."

So much for the therapeutic effects of venting. I was becoming annoyed.

I can hear you perfectly, but I don’t understand what you are asking. What, exactly, is your question? I strained to keep my voice even and controlled.

"What were you thinking?! She must have recognized the look of exasperation on my face as it perfectly mirrored her own expression, because she huffed before continuing in an even louder tone with, when you froze up during the code, looked around the room, then told everyone to leave the woman alone. That she was dead and should be left at peace? You don’t just say something like that and walk away!"

Maybe I’m just so tired, after working a mass casualty for ten hours of my fifteen hour day, that calling a halt to ineffective measures and sending the help to someone who could benefit from it doesn’t seem so irrational to me. I just want to go home, away from the yelling and chaos, to my quiet bed.

I literally wanted to pass out, to be oblivious, to feel nothing.

In the middle of my disclosure, the charge nurse look confused and looked toward the door as if it would tell her what she wanted to know. When I was finished, she mumbled something about "Maybe you do need your whole day off tomorrow and followed it with a very promising Never mind coming in for an extra shift."

She continued in her good will by picking up my bag and roughly pushing me through the door, through the ER that looked surprisingly in order for all the noise I heard, and toward the sign for the metro.

I rode my bike to work today. I don’t take the metro unless it’s raining.

"As far as you’re concerned, it is raining. You are taking the metro home and going straight to bed. She looked me over and added, Well, you might consider showering first, and maybe eating a meal, but really, nothing else before a good night’s sleep. I don’t want to see you or hear about your coming in tomorrow."

She would get no quarrel from me.

With that, she patted my shoulder and returned to the open arms of the ER.

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By this point, I was on autopilot, existing only as shadow. In a blink, I was on the train; in another blink, it was shutting down for the night. How late was it? How much time had passed during my stupor? It hardly seemed worth the effort to figure out the answers to these questions, so I didn’t bother. Someone told me to get off, and I got off. All I recall of the mental lapse was the incredible noise. Not noise that I could hear, but an inward noise that overwhelmed my senses. I tried to disappear into the seat, but my disheveled appearance and attempt to avoid drawing attention to myself seemed to have the opposite effect. The more the other passengers looked my way, the louder the noise seemed to grow. The only way I can describe it is to say that all of my insecurities swallowed my mind and left me ravaged and naked—like the dream everyone must have in which they find themselves walking naked down a common passageway, maybe at work or at school, panicking at the mere mortification and strangeness of it. I was in no state to analyze the distinction, but my self-preservation demanded that I silence it. Wherever it was that my feet took me brought that quiet peace, and, exhausted, I slept.

Sunshine, and something that felt close to shock, awoke me the next morning. Dazed, I rolled away from the blinding sphere and found, to my dismay, that I was covered in sand. It was everywhere, the way only sand and water can be, except that sand is gritty and coarse and uncomfortable. My sleep had been sound, but a heavy fog seemed to have settled over my brain’s higher functions. In an effort to clear the mist, I sat up and looked around, hoping to get my bearings. How did I get on a beach? The jumbled reactions of the early beach-walkers didn’t help my confusion. Again, it was as if all of my worst flaws were under a microscope, being judged and disapproved of. What could they possibly know about me? I was being silly. I told myself to shake it off.

I had to get back to some place that I knew, where I belonged. This was craziness! What was wrong with me? And then it dawned on me, like Adonis and the spring, that I had not had coffee in ages. Brilliant. Coffee, train, home, shower—the Hallelujah Chorus was almost piercing at the mere thought. Normally, these quests would not be so challenging, but today was special. First, I had slept on an unidentified beach; second, the constant hum of the people around me distracted me beyond reason. Did I mention that the sensation was indescribable and utterly confusing? The metro took the most time, due to my lack of attention on the previous night, but the shower and clean clothes worked like magic. I was a new woman. Correction: I was a new woman without transportation. Blast. My bike was still at the hospital. Oh well, what would a day off be without swinging by the hospital?

Fortunately for me, my apartment and the hospital were conveniently located for metro use. While I waited for my bike to warm up, Susie, the nurse who had escorted me out the previous night, walked by. Well, crap. If I had been a betting person, I would have hidden under a rock until something miraculous happened to show me that my luck had changed. Sadly, there was no such mystical rock in the parking lot. Only Susie and I existed in that wasteland, and she had an unmistakable frown on her face. My intuition, and maybe a bit of that obvious facial expression on her part, told me that she disapproved of my presence.

I thought I told you not to show your face here before your next shift. Her body language screamed annoyance—hands on hips, furrow between the brows, transfer in body weight to one side—not good.

"I’m not going inside. I just had to get my bike. I found this new, relaxing beach … the other day … and I thought I would ride out this afternoon."

I plastered on what I hoped was a sincere smile, not too bright, but not too sassy. It wouldn’t do to get suckered into a shift now because I was too convincing.

She gave me the once-over and lifted a brow. Fine, but you still look rough. Go eat or something.

And with that, she climbed into her Saab and drove away, shaking her head in my general direction. Something she had said struck a chord. Oh yeah, the eating part. I had forgotten that necessity entirely.

Over the next two days, I tried to recover some kind of equilibrium. I mentioned before that I had never been an emotional person, had never been accused of being overly sensitive, and suddenly it was as if I had my own emotions plus everyone else’s—like emotional ADD (acute dramatic disorder) on steroids. Well, that was one theory. Italy was just so much noisier and more overwhelming than I had previously noticed. Shake it off became my mantra, but it didn’t seem to benefit me at all. Maybe work would refocus my mind. A person can’t think about herself as much when she’s focusing on others. That’s what I needed. Otherwise, I tried to stay away from crowds and curious people. They irritated me. And so, with this positive inclination in mind, I left the safety of self-analysis at home and ventured back into the dynamic Italian city, to the emergency room, and to all the best and worst of mankind.

CHAPTER 2

You see, the key to this game is being able to read people.

—Benjamin Barry, How to Lose a Guy in 10 Days

Maybe the two days off would have been better spent trying to mingle with people instead of trying to hide from them. Work was excruciatingly painful. Every man, woman, and child in our emergency room was like one more needle in my eye, and that wasn’t including the staff. What drama goes on between co-workers!

I took the three-by-five note card out of my pocket again; it was already frayed and stained, and I had just written it this morning. Psalm 23 had always been a comfort to me in hard times, but today I carried just a piece of the passage: He leads me beside quiet waters; He restores my soul. My dad is a retired Navy chaplain now, but when he was active duty, we always lived by an ocean somewhere. Whenever my mind was in turmoil and I could not find peace, I would go to the ocean. The sounds of the waves, the feel and scent of the breeze, and the solitude of being alone with God would wash an amazing sense of tranquility over me. The vastness of the ocean reminded me of God’s greatness, and the ebb and flow reminded me of His control over all things, even a huge, unpredictable ocean. If He could control such an amazing thing, and all within, beneath, and above it, surely He could set things right for me. Then the peace that passes all understanding would envelop my worries and drive them to the deep. So now, in this new crushing tempest, I held the promise of my peaceful ocean in my pocket on a three-by-five card. It was my lifeline and my anchor.

As the day wore on, I started paying more attention to my particular patients’ auras (for lack of a better word). I found that it actually made me better able to help them, unless they were manipulative liars. My first realization of the former came when I was at lunch.

It had been a steady, though not hectic, day which made a comfortable lunch possible. I grabbed my bag and went straight for the smoking deck. In the States, the smokers were always stuffed onto a boring concrete pad somewhere in the corner of an abandoned parking lot. The Italians have no insecurities regarding lung health, so the smokers actually got a cozy little garden. It was usually a haven from a noisy atmosphere, and today it was exceptionally so. I meditated on the