Angels in the ER (24 page)

Putting the pen in my lab-coat pocket, I returned to the ENT room. Brad Jenkins was still sitting on the exam table, but now he was leaning back against the wall, his hands folded in his lap. I closed the door and walked over to the stool in the corner of the room. Sitting down, I looked at him and our eyes met.

“Mr. Jenkins,” I began, a little unsure of where this would lead, but determined to take this course. “I need to ask you a couple more questions.”

“Sure, Doctor, what do you need to know?” he responded flatly.

“On one of your previous visits, you mentioned you were having trouble sleeping. You told me that it was due to some cough and congestion—but how long has that been going on?” I asked him.

“Oh, a couple of months, I suppose,” he answered. “Why?”

“And tell me about your daily routine. What do you do for fun?” I pursued.

A puzzled look appeared on his face, and he was obviously struggling for a response. “I, uh, I…you know, I really don’t know,” he finally answered.

After asking a few more questions, I came directly to my point. “Brad, have you ever had any problems with depression? Ever felt really down and disconnected?”

He stared at me for a moment and then looked away, hanging his head.

When he didn’t say anything, I asked, “Have you ever thought about hurting yourself?”

Upon hearing this question, his chest heaved and he whispered, “Yes.”

This was painful for him, but I had to go on.

“Have you thought about how you might do that?” I asked him.

He took a deep breath and looked straight at me. “Yes, I have. There’s a .38 in my car, and I was planning on leaving here and driving out to the lake. I can’t go on like this anymore.”

Brad Jenkins told me about his failing marriage, his estranged teenage son, and the ever-increasing stresses of his high-profile job. His life was coming unraveled, and he didn’t know where to turn.

“We’re going to get you some help, Brad.”

He would be admitted to the hospital under the care of one of the staff psychiatrists. While Amy was making those arrangements, I took
Mr. Jenkins’s car keys and, with a security guard, walked out to the parking lot. We identified his car and unlocked the driver’s door. I reached under the seat and felt the cold metal of a handgun.

God does speak—now one way, now another—
though man may not perceive it.

—J
OB 33:14

 11 

Possessed

In the synagogue there was a man possessed
by a demon, an evil spirit.

—L
UKE 4:33

I
t was two o’clock in the morning, the middle of April. Remarkably, the ER was completely empty of patients. We had just discharged our last visitor, an alcohol-infused college student who had met a sidewalk up close and personal. He had sustained a laceration of his eyebrow, a badly swollen lip, and three fractured teeth. The morrow would be a tough one for him.

I was sitting at the nurses’ station with my feet on the desk when the phone rang.

“Dr. Lesslie, it’s for you,” said Lynne, the night-shift secretary, handing me the receiver. “One of the ER doctors in York.”

York is a small town fifteen miles from us, and they have a small but moderately busy ER. A phone call from there, especially in the middle of the night, was never a good thing. This would be no exception.

“This is Dr. Lesslie,” I spoke into the receiver.

“Dr. Lesslie, this is Dr. Frost in York. I’ve got the duty here tonight, and I need a little help.” He sounded young and a little perplexed.

“Okay. What’s going on?” I responded, putting my feet on the floor and sitting a little more upright.

“Well, I’ve got a lady here, thirty-five or thirty-six, I think, and, uh, she needs some attention, and it’s…it’s more than we can provide here,” he explained.

“What kind of attention?” I asked him, becoming curious and not a little apprehensive. “What’s her problem?”

There was momentary silence.

“For one thing, she’s crazy. I’m sure of that. But that’s not her main problem,” he stated with a newfound assurance. Yet there remained an undercurrent of consternation in his voice. Now I had a sense he was holding something back. When he had said “crazy,” my mind had immediately shifted to a process that concluded quickly, with an acceptable and familiar disposition. The mental-health system in his county was a good one, and they were able to get people the psychological help they needed when they needed it. But he should know that. The York ER had its share of psychiatric emergencies.

“She, uh, she also has a medical problem that needs attention,” he continued.

He waited for my response.

“And what is that?” I asked, now growing a little impatient.

“She swallowed her tongue,” he stated flatly. “No, wait. She pulled it out first, and then swallowed it.”

I sat there expecting more, but it was not forthcoming.

“She what?” I asked, needing clarification. “Swallowing your tongue” conjures up images of someone having a seizure and losing control of their musculature, with the attendant risk of their tongue limply falling back into the airway and causing a real problem. But of course no one “swallows” their tongue. And no one “pulls out” their tongue. It would be too painful and too bloody. This Dr. Frost on the phone must be nuts too.

“Just how bad is this injury, and how about her airway?” I gave him the benefit of the doubt.

“Oh, her airway’s fine,” Dr. Frost told me, now seeming more comfortable in this clinical dialogue. “And her tongue is pretty messed up, what’s left of it. But it’s not bleeding too much. She, uh, she won’t let me get a good look. But she’s breathing just fine.”

I thought for a moment. “Well, it sounds to me like she needs an ENT doc, or maybe an oral surgeon. Have you called anybody?”

The medical community in York was rather limited, with mainly family practice physicians on the staff. There were no specialists, and patients needing the services of one were usually sent to Rock Hill.

“I tried a couple up your way, Dr. Woods and Dr. Smith, but they weren’t interested,” he told me. “They won’t accept her in transfer. No luck there. They both thought she should be seen by someone from mental health first, and then some kind of decision could be made.”

He should be able to handle this, but I sensed he was trying to make his problem mine, and I was determined not to let that happen. This was my chance. I would advise him to pursue this last option, the psych referral, and let them resolve his dilemma.

Before I could speak, he continued. “And I called mental health, but they said her medical problem had to be stabilized before they would get involved. See the predicament I’m in?” He was trying to hand this off to me, but I would have none of it.

“Well, it does sound like a tough situation. Have you tried anyone in Columbia or Charlotte? Maybe someone there would be able to help out. And what about your medical doctor on call in there? Maybe the patient has a family physician you could call?”

“Nope, I’ve tried all of those,” he said. And then here it came. “I was hoping that—”

I interrupted him. “My advice would be that you keep trying. Or maybe keep her stabilized until morning, and see how things shake out then. It’s usually easier to make some of these tough dispositions in the light of day,” I advised him. Anticipating a rebuttal, I continued, “But I don’t think we can help you here. It sounds like you’ve done everything we would do. I’d just keep trying and, well…good luck.”

I had no qualms about my response to his predicament. He was working as an ER doctor and should be able to take care of this situation. Besides, there was an unspoken law among the brotherhood of ER docs: “Thou shalt not dump on one another.” And this would really be a dump.

There was silence on his end of the phone. And then a resigned, “Okay, I’ll keep trying and see what I can come up with. Thanks.” He was clearly disappointed as he hung up.

Lynne looked up at me. “What was that all about?” she asked.

“The poor guy in the York ER has a real mess on his hands. He’s got a psych case, and he’s not sure how to handle it. I guess he was looking for us to bail him out, but this is something he needs to handle on his own. Hopefully.”

“Hmm,” was Lynne’s response as she resumed work on her crossword puzzle.

I went to our office for a cup of coffee and to continue work on next month’s schedule. It had the promise of being a quiet night, one to be appreciated, and one that presented an opportunity to catch up on some paperwork.

Thirty minutes later I walked up the hall to check on things at the nurses’ station. Kathy Neal, a recent graduate from nursing school, was restocking the minor trauma room as I walked by.

“Still quiet,” she said, clearly relieved, and certainly hopeful. She had been in the department for only three weeks and was still green. She was maybe a little too sensitive, but the consensus was she would be a good ER nurse. She would need some experience, but the ER of Rock Hill General would provide that pretty quickly.

“Yeah,” I responded. “It’s been a good night.” I looked at my watch. 2:40 a.m.

At the nurses’ station, Lynne had set aside her puzzle and was organizing her work area, making sure the next shift would have plenty of the multiple forms and reports necessary to carry on the business of the unit secretary.

The ambulance doors suddenly opened, activated by weight on the outside floor mat. Reflexively, I glanced in that direction.

“Are we expecting something?” I asked Lynne.

“Not that I know of,” she answered, looking up at the entrance. “Nobody’s called me.”

Through the doors came a stretcher guided by two EMTs, one
holding onto each end. I immediately recognized the two young men and their uniforms. They were with the York Rescue Squad.

On the stretcher, sitting up and straddling the gurney with one leg dangling over each side, was a young woman. She looked angry, and her lower lip was protruding as she stared straight ahead. She seemed completely oblivious to her new surroundings. Her hands were folded in her lap, and on the top of her head, falling almost into her eyes, was a tattered and soiled blue rag. It appeared to be some sort of a small towel.

“Whatcha got?” I asked Danny, one of the EMTs. I already knew the answer to this obligatory question.
Dr. Frost.

Lori had heard the ambulance doors open and had come back into the department from triage. She was having the other EMT wheel the patient to room 5.

Danny stopped at the nurses’ station, releasing the stretcher to his partner. He had a clipboard tucked under his arm, and he placed it on the countertop. He opened the metal flip-top and began making a few notes.

“Well, Doc,” he began, “got a call from the York ER to bring this lady up this way. Dr. Frost said he had talked with you and you would be expecting her.”

I felt my face flush, but didn’t immediately say anything.
Don’t shoot the messenger
and all that. Danny had nothing to do with this. He was just doing his job. My first instinct was to pick up the phone and blast this young Dr. Frost. But what good would that do? Nothing, at least not at this point. I couldn’t turn the stretcher around and send this woman back to York. She was mine now. But I would be having a chat with Dr. Frost in the not-too-distant future.