By Necessity: Chapter One

The following is the opening chapter of By Necessity: A Private Rebellion, a grounded thriller by Jackson Parker, available now from Firewatch Press.

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Paul was hot. Not only was sweat beading down his back, but the circulating nurse was delivering a dissertation about guns and her opinion, “Europe doesn’t have any gun deaths because they got rid of guns over there.” He glanced at the thermostat on the operating room wall, 78 degrees, and wondered if the nurse remembered the stabbing victim they had in this same room last week. No matter how many trauma cases he went to the OR with, he never got used to the temperature in operating room 12. This was the operating room that always stood at the ready, everything set to receive the unfortunate patient who was brought in as a Level I Trauma at Carilion Roanoke Memorial Hospital in Roanoke, Virginia.

Oren Paul Roark, a physician assistant, was operating with Dr. Ralph Giordano, the general surgeon on call, on 17-year-old Gerry Broadnax, who had been brought in with 3-year-old Victoria Johnson. Both were brought into the hospital by ambulance with serious wounds on a sunny Friday afternoon. Victoria had been riding in the back seat of her family’s white Chevy Tahoe with her mother at the wheel driving east down Melrose Avenue when the windows exploded. Gerry had been walking down the sidewalk with two “associates” when he was recognized by two crew members of a rival gang to the north of Melrose. Gerry had been accused of taking certain liberties with the sister of one of their crew and was marked.

Gerry noticed the blacked-out Nissan Altima as it slowed down, matching his pace opposite the concrete median. He reached under his hoodie to the front of his low-slung pants and grabbed the pistol grip of his 7.5-inch AR-15. Before he could fully present the weapon, the barrels of two Glock 19 pistols with “switches” were out the windows spraying 115-grain 9mm rounds in his direction. The friend to his right dove back behind a traffic control box. The friend to his left opened up with his own modified Glock 19, collapsing to the ground before the magazine was empty. Gerry had his unbraced AR-15 pistol up and level as the Altima sped away. He depressed the trigger, sending twelve wild rounds after the car before it jammed and the Altima disappeared around a corner. He turned around to see where his crewmate had gone and, taking a few steps toward him, felt like he needed to cough. Noticing some pain in his core, he bent over to help his prone friend get up. Straightening himself back up, he felt the scene start to spin. As he opened his mouth to yell that they needed to bounce, his knees buckled.

Sirens and screams followed. The female Tahoe driver was screaming incoherently when the first patrol officer on scene drew his weapon and approached the two black-clad bodies sprawled on the sidewalk. Drawing near, the officer yelled for them to show their hands but got no response. The portly second officer arrived on scene with fire and EMS and, noting that the two bodies on the sidewalk were covered by the first officer, moved to open the back passenger door of the Tahoe. She was not prepared for what she saw. A little blonde head was slumped forward in the car seat, the long hair smeared with blood and glass. She called for EMS, “We have an injured child in here!”

One individual was pronounced dead on scene, and two ambulances raced toward Carilion Roanoke Memorial as the hospital overhead called, “Level I Trauma alert ten minutes, Level I Pediatric Trauma alert ten minutes.” Paul had just finished his afternoon rounds on his ICU patients when the call came in. With a sigh, he pulled out his phone, punching out a message to his wife, Becky:

Beck, 2 level ones coming in right now. I’ll meet you at the game if we get done in time.

He knew she understood that it came with the job. He hoped 8-year-old Emma wouldn’t resent his occasional, but often last-minute and always disappointing, absences from her game.

Donning a disposable gown and knee-high leg and shoe covers in the trauma bay, he asked the nurse, “What do we know?”

She replied, “Not much, just what they yelled across the hall. Young adult male with GSW and a GCS of 9 and female child about 3 years old, with a GCS of 13 with a possible GSW and head injuries.” Paul’s jaw tightened at the description of the 3-year-old. Kids can’t compensate for long.

By some miracle, the child only had the crown of her scalp lacerated by a passing projectile. It had bled severely, and in her panic and pain, young Victoria had grabbed and pulled at her scalp, mixing clotted blood and shattered glass throughout her hair. Through distress and shock, she had temporarily lost consciousness at the scene. CT imaging showed no internal head injuries. She was now stable in the pediatric trauma bay receiving fluids, sedation, and pain control while an OR was being prepped for the pediatric general surgeon to debride and close the nasty scalp wound.

Paul and Dr. Giordano were about ready to close Gerry’s abdomen, having resected the perforated sections of intestine. The thoracic perforation and resultant pneumothorax were simply treated with a chest tube. The cardiothoracic surgeon would follow him the next day. They flushed out the abdomen, running the bowel one more time, looking for leaks while the scrub tech and nurse counted sharps and sponges, ensuring nothing was left in the patient. He was glad they had a medical resident with them. He couldn’t remember the last time he saw Giordano close a patient after surgery. With the resident present, he could pass the closing on to him and beat feet.

As he was doffing his gown and gloves, he thought about telling the rabidly anti-gun circulating nurse he was late for his lane reservation at the shooting range but noticed she hadn’t returned from supply with the requested drains yet. Grabbing his phone, pager, and hospital ID, he noticed three missed calls from his sister, Andrea, in North Carolina. She rarely called, but they texted almost daily. He also saw the text:

CALL ME!!

He hastened his pace through the maze of hallways. His phone could never carry a steady signal in this part of the hospital. Reaching the hall from the trauma bay to the ambulance bay, he hit dial and headed for his truck.

“Paul! Are you there?!” Andrea nearly shouted.

“Yes, I’m here. What’s wrong?”

“I don’t know what’s going on, but Mom’s dead, Paul!” She broke down.

“What happened? Are you okay? Are you with her?” Paul asked.

“Frances from church works as a secretary at the hospital. She just called me and said something horrible had happened. She couldn’t say much because she’s not supposed to be calling. She told me that when she got to work today, she saw Mom’s name was on the census for her floor. Before she could go down to see her, she heard them call a code to her room. She’s gone, Paul, and I didn’t even know she was in the hospital.”

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Nancy Roark showered in water from her own well one summer morning. Two days later she was dead in the sheriff’s custody, and her son was driving south to find out why.

By Necessity: A Private Rebellion by Jackson Parker. Available now.

[KINDLE VERSION] https://www.amazon.com/dp/B0HPXW9N1J

[PAPERBACK VERSION]

Jackson Parker writes grounded thrillers from the rural South, drawing on firsthand experience with rural communities, emergency medicine, and the outdoors. By Necessity is his first novel. Follow him on X at @jxnparkerbooks or at jacksonparkerbooks.com.