Angels in the ER (22 page)

The puppy was now actively squirming in my hand. She was going to be fine. I laid her on the towel beside Scooter and watched as she gamely tried to stand.

The sound of clapping and cheering came from the other side of the porch doors and I looked up. The kids were jumping up and down and yelling. And then I saw that my wife was crying. Without words, she thanked me and told me she was proud of what I had just done.

Scooter would deliver five more puppies. Only two responded to her maternal ministrations. The other three required the same resuscitative efforts, and did fine. We lost just one puppy that morning, the first one. And the last little girl pup, Ivey, was the runt of the litter. She would be a member of our family for almost thirteen years.

That was a bright and shining moment for me, one I will never forget. But the experience would prove to be something else, something much more consequential.

2:00 a.m.
Two weeks later.

Sheila Rice had just returned from Radiology. She had taken two auto accident patients around for some X-rays. Nothing serious, just a few bumps and bruises. At the moment they were our only patients.

She walked over to the nurses’ station and sat down beside me. “Doc, I’m gonna need some coffee here in a minute. How about you?”

“No, I’m fine right now, Sheila,” I answered, not looking up from the day-old newspaper I was paging through. “Maybe later.”

Sheila was one of our regular night nurses. For some reason, working the graveyard shift suited her home life. But most important, she was able to sleep during the day. She had been doing this for a long time, ten or twelve years.

I was always glad to have her working with me. She had a lot of experience in the ER and was cool and calm in an emergency. Maybe most significant, she was a great Password partner. When we had some downtime, usually three or four in the morning, a couple of the lab techs would come over and challenge us to a game. The outcome was always the same, and they’d limp back to their department.

“Well, I’m going to the lounge, so should you change your—”

She wasn’t able to finish her sentence. The door to triage had burst open and one of our business office secretaries came barreling towards us, pushing a young Asian woman in a wheelchair.

“You better come get this one!” she yelled in our direction. “I think she’s havin’ a baby!”

Sheila was instantly on her feet. “Madeline, take her over there to room 1,” she directed, pointing in that direction.

Madeline put her back into it and gained even more speed with the wheelchair. She wanted no part of this and was determined to make her own delivery as quickly as possible.

It was then I noticed a young Asian man following them. He spoke quickly yet quietly to the young woman, in a language I couldn’t understand. She didn’t say anything, just nodded her head.

Madeline and Sheila transferred our patient from the wheelchair to the stretcher, and then Madeline escorted the man out of the department.

“Come on with me,” she said to him. “We’ll need to fill out some paperwork.”

I had remained seated during all of this. Sheila would call me when I was needed.
If
I was needed. Usually when expectant women came to the ER like this, a quick assessment by the nurse would determine they either were not in labor, or were in its very early stages. In either circumstance, we would immediately send the patient to the OB floor to be evaluated. Only very rarely, maybe once or twice a year, would we deliver a baby in the ER or in the parking lot. And that was fine with me. It was fun to do this every once in a while, but we really weren’t set up to handle deliveries, and it was always a stressful situation.

“Dr. Lesslie, get over here now!”

It was Sheila, and I was immediately on my feet.

I reached for the curtain but Sheila pulled it open for me, grabbing me by the arm and pulling me into the room.

“Here, do your thing,” she said. “This baby’s crowning. I’ll go and get the delivery kit.”

“Are you sure?” I asked her, still hoping we could just send this lady upstairs.

“Well, you tell me,” she answered. She stepped to the side of the stretcher and gently spread the woman’s knees. The top of the baby’s head, covered with thick black hair, was just visible. What I could see was about the size of a 50-cent piece.

Whoa!
Now it was more like a tennis ball!

“Get that kit, Sheila, and hurry up!”

I grabbed some gloves from a box on the countertop and snapped them on. Looking up at this patient, I suddenly realized she hadn’t made a sound, not a moan or anything. And I realized I didn’t know her name.

“Ma’am, everything’s going to be fine here, okay?”

Ma’am?
Where did that come from? She just looked at me, no evidence of pain in her face, no sound coming from her lips. She obviously didn’t understand what I was saying, so I just looked at her and nodded. She smiled, and nodded back at me.

Sheila came up behind me, tearing the blue paper from the delivery kit. With one foot, she pulled an instrument stand from the corner of the room to the end of the stretcher. Then, throwing the paper on the floor, she opened the kit and dropped it on the stand.

The contents of the kit were limited and straightforward. There was an umbilical cord clamp, scissors, a pile of gauze, a couple of small blue towels, ring forceps, and a suction bulb for the baby’s nose and mouth. If we needed anything else, we could quickly find it in the supply closet.

Then the young woman made the first noise we had heard from her. It was only a faint grunt, but Sheila and I both reacted to it. I stepped to the side of the stretcher and Sheila moved closer to the head. Then she once again gently spread the woman’s knees, softly speaking words of encouragement.

“There, there, honey, it’s going to be okay,” she reassured her. “Now don’t start pushing just yet.”

Too late. I could see one ear now. It was time to deliver this baby.

I reached down, located one shoulder, and delivered it with ease. The second shoulder quickly followed. And then in one slithery, slippery instant, the baby, a little girl, was lying on the stretcher between her mother’s legs.

I felt an enormous relief. While reaching for the suction bulb to clear the baby’s airway, I quickly glanced at our new mother’s face. Her forehead was glistening with sweat and a smile spread on her face. Her eyes met mine and she nodded, still silent, still calm.

“What in the world is that?”

Sheila’s shocked concern immediately drew my attention back to the baby.

“What are you talk—” I stopped mid-sentence and stared at the newborn. In the midst of the precipitous delivery, I hadn’t noticed.

“What is this thing?” Sheila asked again, now pointing at something that completely enveloped the baby.

My pulse quickened and my chest tightened. The relief I had experienced just seconds ago was now gone.

And then an image flashed before my eyes and I suddenly remembered.
Scooter.

The newborn girl was covered with a transparent, glistening sac. It was still wet and slippery, and it would prevent her from breathing. “Intact membranes” is the medical term. I had read and heard about such a thing, but with our modern delivery techniques this was a rare occurrence. Rarer still for an ER doctor.

Dropping the green bulb on the stretcher, I told Sheila, “Get me a number 15 blade.” The calmness in my voice surprised me. But I
was
calm. I knew what needed to be done, and I knew how to do it.

Almost without looking, Sheila reached behind her to a shelf on the wall and quickly located the needed scalpel. She peeled back the sterile wrapper and held out the exposed handle.

Taking the blade, I quickly made a careful incision through the membrane, and peeled the glistening capsule away from the little girl’s head. Grabbing the bulb syringe, I then suctioned her nose and
mouth. Then, thankfully, the three of us heard her first loud, strong cry. She was as tough and resilient as her mother.

Sheila picked up the baby and used one of the towels to remove the remainder of the membrane and dry her off. The cord was then clamped and cut, and Sheila placed the girl in her mother’s arms.

I slumped onto the stool at the side of the stretcher, enjoying this moment as the remains of the adrenaline surge washed through my body.

“Have you ever seen anything like that?” Sheila asked me as she gazed down at our new mother and child.

“Nope, sure haven’t,” I answered. And then I thought about Scooter again and the back porch. “Well, as a—”

“But how did you know what to do?” she persisted. “I’ve never seen anything like it.”

I was thinking of where to begin when the voice of the unit secretary interrupted us. “Sheila, we got one out here,” she called from the nurses’ station.

“Hmm,” she sighed. “Well, let me go see what that is. I’ll call OB and have them come down and take this lady upstairs. I guess we should call the pediatrician too.”

She walked out of the room, pulling the curtain closed behind her.

Later, when it was again quiet, I would tell her. And Sheila would understand. This was not some fortuitous coincidence. I believe Einstein was wrong when he said that “coincidence is God’s way of remaining anonymous.” Our Creator doesn’t choose to remain unknown or in the background of our lives. He wants us to know Him, and to walk with Him, and to talk with Him. And if we will listen, He wants to talk with us.

For that, this night, I was grateful.

Willis Stephens’s head was trembling. Not badly, but sitting where
I was in the pew behind him, it was noticeable. Subtle, but noticeable.

I had been studying the back of Willis’s head for the past minute or so, and a strange thought crossed my mind.
What if Willis were to collapse? What if right at this moment, he slumped over in the pew?

We were at a point in the worship service where such thoughts were not too intrusive, or at least not completely disturbing. The organist was playing some quiet music, and my ruminations were not distracting me from a prayer or the sermon.

I’m not sure why I was considering this possibility. When my wife and I had slid into this pew, Willis had turned around and offered me a solid, firm handshake. He was almost ninety and still going strong. For all of the years we had been members of this church, Willis Stephens had been a fixture, a bastion of the congregation. He was known for his humor and generosity, and for his love of young children.

Yet on this particular morning, something caused me to consider the back of his head, this mild tremor, and what I would do should he suddenly collapse in front of me.

What would I do?

I glanced beside me at my friend, Francis Wood. He was about my age and strong and agile enough. But how would we be able to help Willis?

The vestibule just in front of us, to the right of the choir loft, would be the logical place to take him. There was enough room there, there was a telephone for calling 9-1-1, and we could close the door behind us to shield the congregation. But how would we get him there? I had dealt with this before, the issue of “dead weight.” If a person completely loses consciousness and muscle tone, he or she becomes extremely difficult to pick up and carry.

Once, before I had learned to call for a male nurse or any available EMT, I had run out into the parking lot of the ER to help get a patient out of a car. The person had apparently had a heart attack and collapsed on the way in. A young female nurse and I had reached the vehicle, followed by another nurse pushing a stretcher. What ensued
was something I never want to repeat. We tried to get a middle-aged man, weighing maybe two hundred pounds, out of the car and onto the stretcher. Arms and legs were everywhere. I thought I was in pretty good shape, but it was extremely difficult to maneuver the man onto the gurney. Somehow we managed to get this accomplished and get him into the ER. We were all exhausted.

Now, here was Willis. He probably weighed more than two hundred and twenty-five pounds. What would Francis and I do?

Then, like a flash, there it was, right in front of me: the “fireman’s carry.” That would do it. Let’s see if I could remember…I would grab one of my elbows with one hand, and one of Francis’s elbows with the other. He would do the same thing, creating a sort of chair seat made with our forearms. We would do this under Willis’s slumping body and then be able to lift him with relative ease. Standing, we could then take him to the vestibule and carefully place him on the floor.