“Still inverted, but now he’s compressed even tighter. And he’s screaming about not being able to breathe.”
My heart races as I process this information. Increased compression, respiratory distress, prolonged inversion—this has just gone from bad to critical.
The rescue team huddles, discussing how to rig a new pulley system. I catch fragments of their conversation—“different angle…might need to widen the passage…could take hours.”
Hours this man doesn’t have.
“He needs medical assessment now,” I interject, stepping into their circle.
Reeves shakes his head. “We tried. The way he’s positioned, there’s barely any room to maneuver. We could only reach his legs, so we set up an IV and pushed pain meds. But we can’t get to his torso or head to properly assess.”
A younger firefighter looks me up and down, eyes lingering on my small frame. “You might fit,” he says thoughtfully.
Before I can respond, Noah’s hand clamps around my arm. “Absolutely not.”
“I’m just saying,” the firefighter continues, “if we need someone to get in there and check his status, there might be just enough room for Dr. Chang to make it work.”
I pull away from Noah’s grip. “I’ll do it.”
“Holly,” Noah’s voice drops, pitched for my ears only. “It’s too dangerous.”
I turn to face him fully, keeping my voice level and professional. “This patient has been inverted in a confined space for hours and is now in acute respiratory distress. I’m an experienced caver, and I’m the smallest medical professional on site.” I hold his gaze steadily. “If it’s too dangerous, I’ll back out. But we have to at least make the attempt.”
I can see the struggle playing out across Noah’s face—the doctor warring with the alpha, the professional with the packmate. Around us, the rescue team watches with curious expressions. If Noah overrules me without clear medical justification, people will notice. They’ll wonder why he’s so concerned about me specifically.
Finally, he gives a short nod. “Gear up. I’m coming in as far as I can behind you.”
Relief and determination flood through me as I quickly strip off my bulky outer jacket and exchange my medical bag for a smaller kit I can strap to my waist. One of the firefighters helps me into a climbing harness and helmet with a headlamp.
“The passage narrows about thirty feet in,” he explains, sketching a rough diagram in the snow. “That’s where Derek is stuck. You’ll need to squeeze through here—“ he indicates an impossibly tight section, “—to reach his upper body.”
I nod, mentally preparing myself. “Let’s go.”
The cave entrance is deceptively large, a mouth in the mountainside that quickly narrows into a twisting throat of stone. I move carefully, testing each handhold and foothold before committing my weight. Noah follows close behind, his breathing steady in the confined space.
The passage grows tighter, forcing me to turn sideways in places, my headlamp casting stark shadows on the rock walls. The air grows warmer—a reminder that these caves are connected to Heat Mountain’s hydrothermal system.
“Derek?” I call out. “Derek, my name is Dr. Holly Chang. I’m coming to help you.”
A weak voice answers, “Please…help…”
I push forward, ignoring the scrape of rock against my shoulders, the claustrophobic press of stone all around me. The passage takes a sharp downward turn, and suddenly I can see him—a man suspended upside down in a vertical chimney, his body wedged at an unnatural angle.
“I’m here,” I tell him, maneuvering as close as I can. “They’re still working on setting the pulley back up, but I wanted to check on you.”
Derek’s face is alarmingly red, his eyes bulging slightly from increased pressure. His breathing comes in short, labored gasps.
“Can’t... breathe...” he manages.
I reach for the oxygen mask in my kit, carefully securing it over his face. “This will help. Try to take slow, deep breaths.”
Behind me, I hear more than see Noah’s approach.
“How is he?” he calls.
“Conscious but in respiratory distress,” I report, my fingers finding Derek’s carotid pulse—rapid and thready. “Tachycardic, skin cool and clammy despite the ambient heat.”
I run my hands carefully along what parts of Derek’s body I can reach, checking for obvious injuries. His position makes a thorough exam impossible, but I can see the problem clearly enough: the prolonged inversion and compression have caused fluid to build up in his lungs. Without intervention, he’ll essentially drown in his own fluids.
