Angels in the ER (27 page)

“She’s had a bad day today, hasn’t she?” Jenny said.

“Yes, she has,” Polly sighed. “And they seem to be getting worse, don’t they?”

Jenny disappeared into the evening and Polly went back to her daughter’s bedroom.

“Momma, you need to get some rest,” Christy said, her voice a mere whisper now.

“Don’t you worry about me,” Polly said, making sure all of her daughter’s medications were in order and easily accessible.

“You just haven’t been sleeping much,” Christy added. “And I don’t want you to wear yourself out.”

Polly looked down at her daughter. She was proud of the remarkable way Christy had handled the past few weeks. Her body had betrayed her, but her spirit had seemed to grow stronger with each passing day. Yet a bitter and unnamable fear was growing within Polly.

She had to look away from her daughter and busy herself. “Have you heard anything from Jane?” Polly asked her.

The turning aside of Christy’s head was answer enough.

Jane was Christy’s older sister. She lived in California with her husband, Jeremy, and their six-month-old son, Azure. The two sisters hadn’t seen each other in more than five years, and they had only spoken once during that time. Even that one occasion had occurred by accident. It had been Christmas Eve and Jane had dialed her mother’s house and Christy had picked up the phone.

“Let me speak to Mother,” Jane had said.

The girls had been very close growing up, sharing clothes and friends, and occasionally boyfriends. Then Jane had gone to school in Los Angeles and met and fallen in love with a fellow student, Jeremy. He was a self-defined “free spirit,” and when he had come to Rock
Hill to officially meet the folks and declare his intentions, there had been immediate friction. Polly and Mat McKenna had done the best they could to make him feel welcome and a part of the family, but there had been a growing rub.

It had all exploded one afternoon when Mat sat down with Jeremy and expressed his thoughts about marriage.

“Jeremy, I guess you know this is very important to us,” he had told him. “I don’t know about your religious convictions, but I think you know what Jane believes. She was raised in the Baptist church, and I assume she wants to be married here in Rock Hill.”

Jeremy had sat quietly during this conversation, studying the backs of his hands.

“Our minister strongly recommends several premarital counseling sessions,” Mat told him, “and he can meet with the two of you this Saturday, if that suits. He’s a low-key guy and I think you’ll like him.”

Jeremy looked up and said, “Mr. McKenna, no offense, but I’m not into that stuff. I guess you would call me an agnostic, or maybe a universalist. Jane and I have agreed to disagree on that one. Anyway, we’ve decided to get married in California, at a friend’s house that overlooks the ocean. It’ll be a civil service, so I don’t suppose we’ll be needing to meet with your preacher.”

That had started a widening rift. Mat and Polly had talked with their daughter and soon realized there was no common ground and no room for compromise. They were disappointed and concerned, but reluctant to be the ones to place a wedge between themselves and their daughter, who would be living a continent away.

Christy had not been as complacent and accepting. She and Jane had gotten into a bitter argument late one night, and hurtful things were said and cruel accusations made. In the end, Jane had felt she had to choose between Jeremy and her family, and she chose Jeremy. She faulted Christy for being what she saw as the “tip of the spear.”

The couple had been married on a bluff overlooking the Pacific Ocean, with none of Jane’s family members present.

“She hasn’t called?” Polly persisted.

“No, she hasn’t,” Christy answered weakly.

“Well, maybe I’ll—” Polly began but was interrupted.

“No, just leave it alone, Momma. She’ll call when she’s ready.”

Polly wasn’t sure about that. Jane was in some sort of denial and had been since the diagnosis of inoperable cervical cancer had been made. She and Mat had called her and tried to explain what was going on.

“Jane, your sister is very sick,” they had told her. “Dr. Simmons performed a routine examination and found a tumor on her cervix. It turned out to be cancer, and a CT scan showed that it’s spread through her abdomen and to her liver. He can’t operate on it, so they’ll be trying chemo and some other things. He said that if she had just had a Pap smear…”

Jane had been silent to that point and then she’d interrupted. “I had an abnormal Pap smear a few years ago, some inflammation or something like that. I just had to take some medicine and then it went away. Everything’s fine now.” And then she went still. That was all she said. No questions, no messages for Christy, nothing. And she hadn’t called her sister in all these months.

This was a heartache that was hard for Polly and Mat to bear. They had called Jane on several other occasions, but the response was always the same. She didn’t seem to be hearing them.

Polly kissed her daughter’s forehead, told her goodnight, and quietly left the room. She made sure the night-light was on and the door was slightly cracked.

That night, they panicked. The people from hospice were wonderful, and they had clearly and accurately explained the dying process to Polly and Mat. The staff had been uncanny in their ability to map out these final few weeks and days, and had told them the end was fast approaching.

The McKennas thought they would be ready for this, but at midnight when Christy began making gurgling sounds and was no longer
responsive, they panicked and called 9-1-1. Then Mat called Jane and told her Christy was dying.

I was in the ER when they came in. The paramedics took Christy to the Cardiac room and Jeff and I followed.

I had never seen Christy before, but it was obvious to me she was terminally ill. Her wasted frame caused me to look up at Denton, the lead paramedic, and start to ask a question.

His eyes and a nod of his head indicated I should look behind me. Mat and Polly McKenna had come into the room and were standing at the foot of the stretcher, their arms around each other. Polly was looking down at her daughter and was crying. Mat looked at me with reddened eyes and a hopeless and helpless look on his face.

They told me Christy’s story, and I understood what needed to happen. She was near death, with agonal respirations and a slowing and weakening pulse. It would not be long. Once I was sure Mat and Polly understood what was happening and would be all right, Jeff and I left the room. The telemetry monitor at the nurses’ station would tell me when it was over.

Jane had caught the first flight she could arrange out of Los Angeles, but there had been several delays. She made it to Rock Hill in time for the visitation and the funeral.

Stewart Donaldson was on his way in again. Denton Roberts had just called in on the EMS radio and given us a report: chest pain, shortness of breath, low blood pressure. We had been here before.

Stewart was 61 years old and was a retired chemist. He and his wife, Maggie, lived in a small house on the outskirts of town where they had raised their three children and where she maintained one of the finest rose gardens in the county. Five or six years ago Stewart had suffered a heart attack, a massive one. He had barely made it to the ER. I had been on duty that night, and we had struggled to stabilize him and then get him to the cath lab. The cardiologist told him he had small-vessel
disease and it was not amenable to bypass surgery. They had placed a couple of stents in his coronary arteries, and this had worked for about a year. Then he’d had another heart attack, not as bad as the first, but it had knocked off a little bit more of his heart muscle.

Stewart had tried everything: medications, diet, exercise. Nothing seemed to be working. He’d continued to have episodes of chest pain and then several additional small heart attacks. With each of them he lost a little more of his heart. The last time he had been in the ER he’d been in congestive heart failure, his diseased heart failing to pump out the blood that was returning to it. His lungs had filled with fluid and he had almost died. He had survived that episode but now he was on a precarious balance beam, with any new stress or new development threatening to tip him into failure again.

Stewart and Maggie had considered a heart transplant but had decided against it. The chance of his surviving the surgery was too small, and the aftermath was too frightening. And they weren’t even sure they could get on a waiting list.

They had resolved to deal with his heart condition as best they could and accept what each day brought. Recently, not many of those days had been very good.

It was a little after three o’clock in the afternoon when Denton wheeled Stewart into the department. Stewart looked up and smiled at me as he passed the nurses’ station. His color was bad, and he was struggling for breath. Maggie followed a few steps behind.

Lori was waiting for them in Cardiac and helped Denton transfer him to our stretcher.

“The last reading I got was 60 over 40,” he told her. That was a dangerously low blood pressure and would limit some of the interventions we would be able to try.

Lori attached his electrodes to our heart monitor and waited for the screen to come alive. An irregular beep…beep-beep…indicated that he was in an unusual rhythm and that his heart rate was rapid, somewhere around 120. None of this was good.

I walked over to the side of his stretcher and said, “Stewart, I thought you were going to stay away from this place.”

He looked up and smiled. “Well, Dr. Lesslie, I tried. But I suppose I just wanted to come and visit.”

He had difficulty speaking, and this brief sentence tired him. I patted his shoulder, noting that his skin was cool and sweaty.

“That’s okay,” I told him. “We’re always glad to see you and Maggie.” She had come into the room with him and was standing behind me, making sure she was out of our way.

“Are you having any pain today?” I asked him.

He shook his head, conserving his energy.

“Just the shortness of breath?” I pursued.

This time he nodded and as he did so, the nasal prongs that were delivering oxygen slipped from his nose. Lori reached over and gently replaced them, tightening the straps that went over his ears.

After I examined Stewart I said, “We’ll need to get a chest X-ray and EKG. And we’ll need to check some labs to see just where we are. That shouldn’t take long.”

Turning to his wife I told her, “Maggie, you can stay in here with him if you want. We’re going to try a few things to help his breathing, but you won’t be in the way.”

“Of course,” she said. “And I’ll just stay right over here.” She patted the countertop behind her and stepped closer to it. “Oh, and Dr. Lesslie,” she added. “I brought you something.”

She had a rose in her hand, its stem wrapped in aluminum foil. It was a single dark red bloom, and it was beautiful.

“I was hoping you would be on duty today,” she said, smiling. “I remember you liked the darker roses, and my Black Magic is just now blooming. Here, this is for you.” She handed me the flower.

I vaguely remembered talking with her at some point in the past about her roses, and I must have expressed my preferences. Her memory impressed me.

“Maggie, you didn’t have to do this,” I said, taking the rose from her. “This is really thoughtful.”

“Just be sure to put it in some water,” she instructed me, wiping her hands together.

I took the rose and stepped out of the room just as the X-ray techs entered, rolling their portable machine.

Thirty minutes later we had enough information to know that Stewart had suffered another heart attack and was in worsening heart failure. He had responded a little to the oxygen and the small amount of medicine we could give him to reduce the fluid in his lungs. There just weren’t many options for him at this point.

I had called his cardiologist and he had mentioned trying the things we had already done.

“Well, Robert,” he had told me, “there’s just not much else we can do for Mr. Donaldson. If you want me to put him in the hospital, I will. But it sounds like this is going to be the end for him.”

This was blunt, but his words were true. This reality had been hovering around me, but I had been unwilling to grapple with it. Now I must.