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The 15- by 20-foot rooms in the ICU feel crowded when just a handful of doctors gather for rounds, but as soon as Sabrina arrived the room literally filled, as every free hand on the medical staff -- a total of 15 doctors, nurses and technicians -- surged in behind the bed.

Julia and M.J. stood shoulder to shoulder with three other nurses on the right side of the bed, reaching over and around each other to connect Sabrina to breathing equipment, vital-sign monitors, and medication pumps. Anyone not directly working on the patient was forced to stand flush to the wall or get out. Making the quarters even closer, Crawford called for the door to be closed and the thermometer jacked up to keep Sabrina warm.

M.J. saw one problem immediately: ''We've got an access issue," she said. Because Sabrina had suffered chest injuries, doctors couldn't insert a line into a major vein near her heart where nurses could rapidly infuse her with medicine, blood, and fluids. Instead, everything would have to go in through smaller IV lines connected to vessels in her undamaged right arm and leg. M.J., Julia, and other nurses started probing for useable veins, then hanging blood, plasma, fluids, and medications from an overhead rack, creating a zigzag of plastic tubes to the patient.

Julia's anxiety ended the instant she saw Sabrina, her face swollen and her body bleeding. She needed to focus and felt her calm, professional self rise up. ''I was out of thinking of her as a person, and she was my patient," Julia later recalled.

As Sabrina's ''primary nurse," Julia was nominally in charge, but she knew she didn't have the experience to lead the nursing team. Of the five ICU nurses in the room, she had the least seniority by a wide margin; no one was waiting for her instructions. When Julia went to record Sabrina's vital signs, she found another nurse already doing it. Meanwhile, a doctor, trying to be helpful, started squeezing a blood bag to speed the transfusion, but M.J. stopped him because she feared a rush of blood would dilute the medication dripping through the same IV. ''Too many people," Julia said under her breath.

Rather than fight the tide, Julia gracefully settled for a subordinate -- though essential -- role, managing the medication pumps at the head of the bed as well as many direct injections, while keeping a written record of all the things being done to save Sabrina.

Too busy to chafe at her secondary role, she administered a sedative to ease the pain when neurosurgeons inserted a ''subarachnoid bolt," a device to measure the pressure inside Sabrina's brain. At the same time, as transfusions continued, she wrote down blood-bag serial numbers to doublecheck that Sabrina was getting the right type.

For long stretches of the afternoon, the nurses ran the resuscitation on their own. Crawford and the attending physician, Loreta Grecu, made strategic decisions about Sabrina's care, but they ducked out repeatedly, leaving M.J. to decide when to give more levo, to time the transfusions, to push the lab for quicker blood test results, and to direct the team.

''We need to finish rounds," Grecu said to M.J. as she and another nurse struggled to connect Sabrina's brain monitor. ''You guys can do this while we're rounding?"

''Absolutely," said M.J., never looking up from the monitor.

Julia, too, saw no need for the doctors to stick around. As desperate as Sabrina's condition was, this was ''pretty much technical nursing," as Julia described it, and she felt she had mastered the required tasks.

But M.J.'s and Julia's can-do attitude was matched by a growing sense that they might lose this fight; they couldn't get the blood into Sabrina's body fast enough to keep her blood pressure from crashing. ''I have four [intravenous] lines now, and I'm running out of IV ports," said a frustrated M.J.

By 5:30, M.J. started to wonder what was happening to all the fluids they were pumping into Sabrina, and why her pulse wasn't stronger. Then she took a closer look at Sabrina's left arm, black pins sticking out where the bones were held in place. ''This is where your blood loss is," she said, pulling a dripping, blood-drenched sheet from beneath the arm. A young anesthesiology resident unwrapped the arm, revealing that most of the skin and much of the flesh were gone.

While the resident dabbed at the arm in a vain attempt to stop the bleeding, M.J. looked up at Sabrina's vital-sign monitor. It showed her blood pressure perilously close to zero. ''Go prime another levo right now," she said, turning to Julia. ''Because if we run out of levo, we're cooked." Julia dropped what she was doing and went to the medication room. Blood loss wasn't Sabrina's only problem. The bolt in her skull showed pressure six times normal -- a potentially lethal level -- and rising. And they were running out of blood for transfusion.

''We're just losing the battle because I can't keep up," M.J. said to Crawford, when he returned briefly. ''Her husband needs to come in, because she is going to die."

Sabrina's husband, Kevin, had known about his wife's noontime accident for several hours, but when a social worker led him to the door a little after 6 p.m., it was the first time he'd seen her since they kissed good-bye that morning. M.J. moved quickly to greet him, removing her surgical glove and shaking his hand.

''Hi, I'm M.J., and I'm taking care of your wife, along with this team of people," she said politely, matter-of-factly. ''She looks a mess, and I'm really sorry for that, but I wanted you to be able to see her."

Kevin, a slender man in his 30s, had red-rimmed eyes, but he was calm as he moved to his wife's side. ''You can take her hand," said M.J., and he did, whispering into Sabrina's ear and resting his forehead against her extended hand.

With Kevin at her side, M.J. turned back to the increasingly desperate resuscitation. ''If you're not in here working, please leave. I need some space," said M.J., looking toward the second row of medical staff in the room. ''Not you, Kevin," she said, touching his shoulder.