Angels in the ER (12 page)

And then, there it was.

“Doc, I was at the wrasslin’ matches tonight.” His words came painfully through his injured jaw. “One of them Bruiser Brothers was tusslin’ with Jumbo Mullins, and Jumbo was givin’ him what for. Then Max, I think it was, started gougin’ Jumbo in the eyes and he got him pinned. That ain’t fair, especially after the way Jumbo lost his belt to Big Al Gargantua last month. Anyway, I’ve been pullin’ for Jumbo Mullins for about ten years and this just weren’t right. Gougin’ him in the eyes and all.”

He paused here and rubbed his swollen jaw.

“Anyway, I was a hollerin’ at the ref, but it didn’t do no good. When the bout was over, they came out of the ring and I was just standin’ there, mindin’ my own business, and one of them boys walked by and punched me! Just outta nowhere! You can ask my nephew, Skeeter. Busted my jaw, looks like.”

Funny he didn’t mention anything about wielding a hawkbill knife. I knew better than to raise that point.

“Let’s take a look there,” I said, stepping closer and gingerly examining his bruised and puffy face. There was an obvious step-off in the mandible and I could feel it grinding when he tried to talk.

“I think you’re right about your jaw,” I told him. “Looks like it’s probably broken. But we’ll need to get some X-rays to be sure. I’ll have
one of the nurses bring you an ice pack for that. Just stay put here and we’ll get you around to Radiology in a few minutes.”

“Dang-nab that boy!” he blurted out. “If he’d a’ come straight at me, I think I coulda took him. But no, he had to sucker punch me! Came outta nowhere. That ain’t right.”

“Well, don’t worry about that now.” I tried to calm him. “We need to get you taken care of. Just hold on right here.”

I pulled the curtain open and stepped toward the doorway.

“That just ain’t right!” he muttered again.

I glanced back and caught a glimpse of our would-be pugilist jabbing the air with a clenched fist. The sudden movement jarred his jaw and he flinched, moaned, and again grabbed his face.

I walked up the hall and reflected on what had just transpired. Here was Max Bruiser, a well-known and admired professional wrestler, felled by a wizened, anonymous old fellow, old enough to be his grandfather. I was reminded of a scene from the movie
Patton
as rendered by George C. Scott portraying George W. Patton at the end of his career. The general was telling the story of Roman conquerors who returned triumphantly from battle and proudly rode in their chariot through the city. A slave was instructed to stand behind them and repeatedly whisper a reminder of their fallibility: “All glory is fleeting.”

That hasn’t lost its meaning.

In further confirmation of this, I realized our elderly brawler’s bright and shining moment of glory was quickly coming to an end. Two police officers had just entered the department and were heading toward minor trauma.

It was 2:00 p.m. on a Wednesday.

“Dr. Lesslie, you might want to go see the guy in room 5,” Nancy remarked as we passed in the hallway. She had recently transferred to the department from the pediatric floor and was in triage today. She seemed to be a little perplexed.

Stopping, I looked at her and asked, “What’s the problem?”

She turned and faced me, shaking her head. “It’s an old man with chest pain. And boy, is he cantankerous. Had some left-sided chest pain for a couple of days and is just now getting it checked out. Blood pressure and pulse are okay, but he wouldn’t let me check his temperature. Said he had fever and he knew it and I could just write that down.”

“Did you check it anyway?” I asked, assuming that she had not given in to this patient’s request. Obtaining accurate vital signs on each patient was important, in addition to being our policy. Once you clearly explained this, most people usually settled down and let you do your work.

“Nope, I didn’t. And when you meet this guy, you’ll understand why.” She turned and walked to the back of the department. “I’m taking a break,” she called over her shoulder.

When I reached the nurses’ station, the clipboard of room 5 was on the top of the stack of patients to be seen. Curious, I picked it up.

89-year-old M with chest pain.

BP 148/82. Pulse 92.

Respirations 24.

Temp ?

I was glancing over to the closed curtain of room 5 when Virginia Granger walked up.

“Know who that is?” she asked, nodding her head in the direction I was looking.

“The man in room 5?” I responded, looking once again at the clipboard.

John Abernathy. The name was familiar, but I couldn’t quite place him. His address didn’t help. He lived on a street in one of the older, nice neighborhoods in the middle of town.

“That’s Dr. Abernathy,” she explained. “I watched him come in with Nancy. Hasn’t changed a bit since I last saw him. Ten years ago, maybe.”

Dr. Abernathy. Now I remembered. He had been a family physician here for forty-some years and had retired a few months before my wife and I had moved to town. That was almost nineteen years ago. Shortly after that, we had crossed paths several times at social functions, and then nothing. Like Virginia, I probably hadn’t seen him in ten years, maybe fifteen. And I hadn’t heard much of anything about him. Every once in a while someone would tell me that Dr. Abernathy used to be their family doctor. But those people were fewer and farther between all the time.

“Did you ever know him?” Virginia asked me.

“Not really,” I answered. “He had retired before I came to the ER. I’ve met him a few times, but I don’t really know him.”

“Well, you’re in for a treat,” she said, grinning. I didn’t like the look or sound of that.

“What do you mean, ‘a treat’?” I questioned.

“Let’s just say that John Abernathy is set in his ways, and can be kind of ornery. Or at least he used to be. Maybe he’s mellowed these past few years. But I doubt it. Why don’t you go on over there and find out,” she prodded, again tilting her head in the direction of room 5.

From what Nancy had said, the chances he had mellowed were slim.

“Hmm,” I sighed. “I guess I’ll just do that.”

I picked up the clipboard and was turning in that direction when Virginia added, “Oh, and I think I remember hearing his wife died about two years ago. Don’t think he has any family in the area, so he might be all alone. Thought you might need to know that.”

“Thanks, Virginia,” I told her. “That might be helpful.”

Pulling aside the curtain of his room, I found Dr. John Abernathy sitting bolt upright on the stretcher. His arms were folded across his chest and there was an unpleasant scowl on his face.

“Do I know you?” he asked, more accusing than questioning.

I pulled the curtain closed behind me and sat down on the stool beside his gurney.

“Dr. Abernathy, I’m Dr. Lesslie,” I said, introducing myself. “I think we’ve met a few times in the past.”

He studied my face. “Hmm, you do look a little familiar,” he conceded, a little less harsh now. “You work here in the ER?”

John Abernathy appeared younger than his eighty-nine years. He still had a full head of wavy gray hair, and his eyes were clear, blue, and piercing. He was a slender man and appeared fit. He had donned a hospital gown but had kept his T-shirt on, making a quiet but unambiguous statement of defiance and autonomy.

“Yes, I’m an ER physician here at the hospital. This is where I work,” I explained.

“Don’t have a private practice in town?” he pursued. It occurred to me that John might not be familiar with the practice of emergency medicine and with the staffing of emergency departments with full-time physicians. It had been twenty years since he had been in practice, and things were different now.

“No, I don’t have a practice in town. This is where I hang out. After medical school I trained in emergency medicine. It’s a specialty now, just like family practice or surgery. You were a family doctor, weren’t you?” I asked him, becoming more comfortable now that we seemed to be finding some common ground.

“Yeah, yeah,” he answered, stroking his chin and staring up at the ceiling light. “I was a family doctor for forty-three years.” Then he looked straight at me again. “Worked right here in this hospital, ya know. Delivered babies, had patients in the ICU with heart attacks, strokes, all of that. Changed some since then,” he added, glancing around the room. “Probably couldn’t find my way to the cafeteria, much less the ICU.”

I began to remember more about John Abernathy, or at least what I had heard about him from other physicians and friends in town. He had been one of the first GPs in the area and had developed the largest practice in the county. By all accounts he was a good physician and people trusted him. They didn’t necessarily like him, though. He had a reputation of being blunt and unyielding. And he made it clear
that he was the physician and the one in charge. There apparently was little negotiation when it came to treatment decisions or alternatives.

Outside of his office and the hospital, he was still “the doctor.” That was his accepted and expected persona. Should some unsuspecting waitress or clerk address him as “Mr. Abernathy,” he was quick to inform them he was a physician. “That would be Dr. Abernathy, young man.”

“Yeah, come to think of it, I’ve heard something about you ER doctors. TV show, or something. Tell you what, though. When I was in practice, we took care of our own. Didn’t have a doctor spending all of his time in the emergency room. If someone came to the hospital, the nurse in the ER would call us, and if it was something she could handle, she’d just send ’em home or to the office. Something more serious, we’d just stop what we were doing and come on in. Didn’t matter whether it was day or night.”

He paused, nodding. Then he added, “Yep, we took care of our own.”

I thought better of informing him that we were now seeing more than 150 people a day in the ER, as opposed to the 10 or 12 per day who had come through twenty-five years ago. Things
had
changed.

“You know,” he went on, “one of the medical wings upstairs is named after me.” He studied my face for an acknowledging response.

I struggled momentarily and then suddenly remembered.

Nodding my head and smiling, I said, “Yes, the Abernathy Wing. It’s up on the fourth floor. It’s a postsurgical area now, but it’s still the Abernathy Wing.”

A look of satisfaction appeared on his face and he said, “Yep. Named after me. Been a while since I’ve been up there.”

That was a good thing. Though I was glad I had been able to retrieve this information from my remote memory banks, he didn’t need to see the plaque bearing his name. It was scratched, tarnished, and mostly hidden by a plastic plant placed in front of it. Its existence had stuck in my mind because of my curiosity about its origin. Now I knew.

“Yep, the Abernathy Wing,” he repeated.

Standing up, I placed his clipboard on the counter behind me and asked, “Dr. Abernathy, tell me about this chest pain you’ve been having.”

He looked up and pointed to the left side of his chest, about a handbreadth below his armpit. “Hurts right here when I take a deep breath or lie down. I’ve had some cough for a couple of days and now a fever. Don’t know how high, but I’d guess about 102. I think it’s probably pneumonia.”

That would be my hunch as well.

“We’ll need to get an accurate temperature here, don’t you think?” I asked, as benignly as possible.

He looked askance at me and then nodded his head. “I suppose so,” he conceded.

Lori had pulled the room curtain aside and stuck her head through the opening. “Everything okay here?” she asked, looking at me. “Do you need anything, Mr. Abernathy?”

He rolled his eyes and was about to speak. I cut him off with, “Lori, we’re fine. But would you tell the secretary we’ll need some blood work, blood cultures, and a chest X-ray? Thanks.”

She left the room. “Does sound like pneumonia, doesn’t it?” I remarked. “We’ll see what your chest X-ray looks like and if it is, you need to plan on staying in the hospital.”

“Thought I might,” he answered, frowning and gesturing to a small overnight bag on the floor. “Brought a few things with me, just in case.”