Angels in the ER (26 page)

Voodoo? Black magic? Demon possession? Mental illness? Nonsense?

You’ll have to decide for yourself from what I’ve told you.

But I know what I think.

 12 

If
Tomorrow
Never
Comes

You do not even know what will happen tomorrow. What is your
life? You are a mist that appears for a little while and then vanishes.

—J
AMES 4:13-14

I
n his song “If Tomorrow Never Comes,” Garth Brooks follows that phrase with “would you know how much I love you?” That’s a very pointed question. If there were no tomorrow, would we have said everything we need to say and done everything we need to do?

Probably not. Most of us stay focused on tomorrow and not enough on today, and things go unsaid and undone. That reality comes crashing home almost every day in the ER.

The light turned green and Jill Evans pulled out into the intersection, turning left. She was driving safely but was a little distracted, still upset about the argument she had had with her husband last night. She was trying to remember how it started. Dan came home late from work and was going through the mail. There was the phone bill, the electric bill, and then the credit-card statement. That’s what had done it. He had exploded when he opened the envelope.

She didn’t see the pickup truck as it ran the red light, its driver looking down to locate a dropped cigarette. He never applied his brakes and the truck T-boned Jill’s small sedan at full speed, caving in the driver’s side and flipping the car over. When the police got to the scene, the pickup driver was standing by the crushed hood of his
truck, rubbing his bruised and scratched left shoulder. Jill was on her way to the ER.

Jeff was waiting for the EMS team as they came through the ambulance doors.

“Bring her in here,” he told them, standing in the doorway of major trauma. We had activated our trauma response team and they were on their way in. I followed Jill’s stretcher into the room.

There was a flurry of activity as we moved her to the bed. She had one IV in place and another was being started. Blood was being drawn, and two X-ray techs were shooting films of her neck and chest.

Denton Roberts and his EMT partner had told us of the scene and of Jill’s initial condition. She was unresponsive and had an obvious head wound and a crushed left chest wall. They had managed to secure her airway with an endotracheal tube and maintained her blood pressure with rapidly administered IV fluids. Her condition had worsened when she got to the ER. Her blood pressure was falling, and she was exhibiting signs of a devastating brain injury.

“Does she have any family?” I asked. I glanced down and saw that the fingers of her left hand were mangled and obviously broken. And I saw her wedding band.

“Her husband’s on the way,” Denton answered. “He was at work and should be here any minute.”

We continued to work with Jill, inserting a chest tube to re-inflate her left lung and stabilize her chest. And we called Radiology to arrange for an urgent CT scan of her head. The on-call neurosurgeon and general surgeon were on their way down.

Virginia Granger pushed the trauma room door open and walked over to the stretcher.

“Her husband is here,” she told me. “He’s in the family room and only knows his wife was in an accident. He doesn’t know how bad she is.”

Sam Wright, our general surgeon, had followed Virginia into the room. As he began his examination of Jill, I filled him in on what had happened thus far.

Then I turned to Virginia. “Okay, I’ll go talk with her husband. Do we know his name?” I asked her.

“Dan Evans,” she answered. “And he’s by himself.”

It was another lonely walk down the hall to the family room. Jill wasn’t dead, but her prognosis was very grave. Sam Wright had agreed with my assessment. “I don’t believe she’s going to wake up, is she?” he had observed. Her head injury was extensive, and I had to agree.

Dan Evans was on the sofa in the family room. He sat there with his head hanging down and his hands clasped together. He looked up as I entered, an expectant expression on his face. He was in his late twenties and was dressed in a dark business suit and red tie.

“Are you here to tell me about Jill?” he asked me.

I walked over to the chair beside him and sat down. “Yes, I’m Dr. Lesslie. And you are Jill’s husband?”

“Yes, yes. I’m Dan Evans,” he answered. “How is she? When can I see her?”

I held her chart in my hands and was considering how to begin this when he said, “We, uh, we had a big fight last night. It was about something stupid. A credit-card bill, I think.”

He put his hands on his knees and stared at the floor, shaking his head.

“It was really stupid, something so small. But I blew it out of proportion, and we started yelling at each other. We didn’t even talk this morning. Hey, I didn’t even see her before I went to work. And now this.”

He paused and I said, “Mr. Evans—”

He interrupted again, as if I were not in the room.

“I didn’t even say ‘goodbye,’ or ‘I’m sorry,’ or anything. I just got up and got dressed and got out of there.” He looked up at me and stopped shaking his head. “You know, we have a rule, Jill and I. We made a promise when we first got married that we would never let the sun set on our anger. I think it comes from the Bible, or somewhere. And most times we’re able to do that. One of us will remember our rule and remind the other, and we’ll take a minute and figure things
out. One time we…” He seemed to lose his focus for a moment, gazing at the chart in my hands.

Then he looked up again. “Don’t you think that’s a good rule?” he asked me. “Anyway, last night, I didn’t think about it and neither did Jill. We just yelled at each other, and then I went in the bathroom to take a shower. When I got out, she had gone into the guest room and locked the door. I went to bed, and that was it.”

When he paused this time, I knew he had finished. But I waited a moment, just to be sure. He sat before me, silent, his eyes searching my face.

“Dan, let me tell you about Jill…”

Dr. Simmons was in the middle of his examination when he glanced over at his nurse. With a barely perceptible tilt of his head, he silently signaled for her to step over behind him. He shifted back and to his left so she could see through the pelvic speculum. Her eyes widened as she looked at the golf-ball-sized ulcerated mass that had engulfed this young woman’s cervix. She looked at Dr. Simmons in disbelief and shock.

“Now tell me again, Christy,” he said to the twenty-eight-year-old lying on her back on the exam table. “When did this problem start?”

Christy McKenna repeated her story. She had noticed some bleeding a few weeks ago, unrelated to her periods. At first it had not been very much, but over the past few days it seemed to be getting worse. She didn’t have any pain and had no other symptoms.

“And when was your last Pap smear?” he asked.

She was silent, and Dr. Simmons’s nurse looked up at her. Christy had flushed and avoided her eyes.

Christy had grown up in Rock Hill and had left town to attend college. She had been offered a job right out of school and stayed in that same community. She hadn’t established a relationship with any physicians there. She had come home to spend a few days with her
folks and to see Dr. Simmons. He had been her Ob-gyn doctor since she was seventeen.

“I’ve been real busy lately, Dr. Simmons,” she told him. “You know I stayed in Columbia after college, and with my new job…I just haven’t had the time. I know that’s not a good excuse, but I’ve just been going in too many directions.”

“Uh-huh,” he murmured. “So, when do you think your last exam was?” he persisted.

“It would have been, uh, probably the summer after my sophomore year. I think that’s when I was last here,” she answered.

“Hmm, that would be six or seven years,” he calculated.

“I didn’t realize it had been that long, but I suppose you’re right,” she replied sheepishly.

“Well, Christy, we’ve got a problem here,” he began to tell her. “You’ve got a growth on your cervix, and it’s pretty angry-looking. It may very well be cancer.”

He paused to let this thunderbolt have its effect. Christy was silent.

“We won’t know for sure until we send some tissue to the lab and have one of the pathologists take a look at it. That should take a couple of days, so why don’t we plan on seeing you again at the end of the week. Maybe Friday?” he asked.

Christy was still silent, shocked by this devastating news.
I’ve got to call Momma,
she thought.

“Christy, is Friday okay?” he repeated, not having received a response.

“Friday?” Christy echoed, trying to focus on what Dr. Simmons had just said. “Yes, Friday should be fine. And I’ll bring my mother with me, if that’s alright.”

That had been six months ago.

“Christy, Mrs. McKenna, I think everything’s in order,” the hospice nurse told them. “Your pain medicine is right here, and if you need anything, just call me.”

Polly McKenna, Christy’s mother, walked the young nurse to the front door. It was already dark outside. Only six o’ clock, but it was mid-January and the days were still short.

“Thanks, Jenny,” she told the nurse. “Thanks for everything. You’re so good with her.”