Chapter One Emergency in Mexico

Nicole stands on the quiet sands at the Cancún resort, staring out at a calm ocean of turquoise beauty. Her mind darts back to months earlier when events on this same beach changed her life in a way few people would have the courage to confront, let alone survive. Even she wonders how she’s pulled through. The beach is eerily silent. The hush is somewhat overwhelming, a bit sinister. Is the quiet because it’s off-season, with fewer people enjoying the posh vacation destination? Or do the few guests know of her circumstances? Perhaps they are keeping their distance, allowing her time and solitude, out of respect. Soon the camera crew that has followed her out of Toronto to Mexico — uninvited — will be there to record the compulsion she feels she cannot avoid: facing her fears head on. Nicole Moore is determined to step into the Caribbean Sea at the exact spot where she was attacked months before. She will master the influence that has become the ruler of her existence. But the silence is undermining her resolve. A small silver fish suddenly breaks the shallow surface, the unexpected splash causing her neck to jerk back. Off in the distance she hears the muffled howl of a siren. She blinks her eyes, shaking her head to banish the memory of the fateful ambulance ride that only months ago was truly a race against time. That very phrase can be a little over the top, but in the case of Nicole Moore being rushed to Hospiten Cancún on the afternoon of January 31, 2011, nothing could have been closer to the truth. She was as near to death as anyone could be. Minutes — seconds — mattered. Her body scarred and deformed, missing her left arm and much of her left leg muscles — painful realities she is forced to endure every waking moment — Nicole shuts her eyes. Her mind summons up that earth-shattering day where she had to cope with a treacherous ambulance journey, strapped to a backboard that was not well secured, flapping about as the inexperienced driver tackled the mounting bumps in the road, while paramedics struggled to find any blood pressure reading at all. This was the point when Nicole realized she had probably reached the end of her life. She was racing to the hospital less and less as a survivor, more and more as a fatality. Her memories take over. She is propelled back to feeling the fear in her gut, the helplessness, and especially the frustration of that terrible day. She begins reliving the experience of horror in a surreal manner. She’s back in the ambulance. She’s being hurled about. She’s recognizing that her body has started to shut down peripherally. She’s already lost 60 percent of her blood. Her skin is ashen gray. Circulation has slowed to her legs, arms, and hands, and her organs are shutting down. She fights for each gasp of air; there isn’t enough blood left to make her lungs do their job. And she knows that in the fifty minutes since she’s been attacked and severely wounded, little anyone has done has seemed to help. As an experienced nurse, Nicole knows her situation is bad. Really bad. She understands she has mere minutes left in her life. Only her heart and brain are functioning now, and they are down for the count. Once her heart checks out she’ll have maybe two minutes before brain damage sets in. And then death. At home they’d call her condition “critical, life threatening.” But the young ambulance driver comes through, making it to the hospital, where staff members whisk her inside and plant her on a trauma bed. But nothing will be simple. Already there is a problem: they’ve never dealt with this kind of attack before. They seem unsure of what to do. Nicole panics because she fears for her life, while the people around her seem more focused on whether she has adequate insurance coverage. They ramble on in Spanish about her capacity to pay for what they are unsure they will do in the first place. “Where and what is her insurance situation?” one administrator asks. “Who is going to pay for her treatment?” another demands. Finally an on-duty doctor arrives. “We need to do something now!” he commands in English. And the medical staff members go into action, for which Nicole gasps her heartfelt thanks. The doctors determine one thing: they cannot put in an IV because Nicole’s body has already experienced so much trauma that her system has given out, denying blood to her major organs. Her veins continue to shrink as her circulation decreases. They are afraid that not enough blood is getting to her brain, so they make a snap decision to insert a central line directly into her heart. It is an urgent attempt to keep Nicole alive. They use a subclavian approach in her right shoulder to try to access the aorta. This is a complex procedure with the potential for life-threatening complications; the lung can easily be nicked making it difficult for the patient to breathe. Unfortunately, the approach doesn’t go well and the team isn’t able to insert the central line on the first try. Despite their best efforts, Nicole Moore is dying. The clock is ticking, but the medical team still can’t insert the central line. Seemingly in desperation they tell her: “We are now going to put you to sleep.” She’s frightened because she can no longer breathe. [SPACEBREAK] But we’re getting ahead of ourselves. How did Nicole Moore end up fighting for her life in a Mexican hospital?