Angels in the ER (34 page)

I took the receiver. “Ms. Flanders, this is Dr. Lesslie. What did you find out?”

“I talked with Jim Watson, head of PT,” May solemnly informed me. “And he said, ‘No way.’ It will not be possible to use his tank for this purpose. Cleaning it, and…and…you know. Just impossible. So the answer is no. You will just have to find some other means of—”

“There are no other means,” I interrupted. My face was flushing, and I was becoming angry. “Why don’t you just come down here and look at this guy, and then tell me what we’re supposed to do.”

There was silence. And then, “I suppose that is your problem, Dr. Lesslie.” Then she hung up.

I wanted to throw the phone across the room. But somehow I managed to calm myself and hand it back to Amy.

She hung up the receiver and then looked at me as she tapped the eraser end of her pencil on the desktop.

“What about the administrator on duty? I can find out who that is, if you want,” she volunteered.

That was another good idea. It would be going over the head of May Flanders, but that was of no consequence to me at this point. Charlie needed to be taken care of, and we were getting nowhere. And this was just the start. First we had to rid him of the ants, and then we
would need to find a physician on staff to admit him to the hospital. That was going to be another significant challenge.

It was 11:45 when Amy again answered the ringing telephone.

“Mr. Waterbury, this is Amy Conners in the ER. Sorry to bother you this late, but Dr. Lesslie needs to speak with you.”

Nodding my thanks, I took the receiver. “Ken, Robert Lesslie.” Ken Waterbury was one of three assistant administrators. Thirty-five years old, he had made his way through the hospital ranks, having started in the dietary department. I wasn’t exactly sure what he did as an assistant, but he had drawn the duty for administrative coverage this night.

I explained Charlie’s situation to him and the problems we were having obtaining access to Physical Therapy and the Hubbard tank.

“Well Dr. Lesslie, this is a pickle, isn’t it? Have you considered sending him back to his home and notifying social services in the morning? That might be the best solution. After all, you say he has no ID, and I’m sure he has no insurance. We don’t want to saddle him with a huge hospital bill, now do we? Perhaps—”

“Ken, this man
has
no home,” I explained, feeling my face once again turning red. That’s part of my Scottish ancestry, and unfortunately it makes it very difficult for me to disguise my emotions. “If we send him out, he’ll die in the cold. And we have to do something about his skin condition. He needs to be admitted to the hospital.” I was adamant with this last point.

“Well…” he responded. From the tone of his voice, I knew where this was headed.

“Just a minute, Ken,” I said, and then held out the phone at arm’s length but where I was sure he would be able to hear what I was saying.

“Ms. Conners, who is the chief of medical staff this year? Isn’t it Dr. Burns?”

“Yes, that’s right. Dr. Burns,” she answered. “And he’s on call for his group tonight. Do you want me to get him on the phone?” She had quickly picked up on what I was doing and spoke loud enough for the administrator to hear.

“Yeah, would you? I need to talk with him about this problem.”

Ken Waterbury was saying something over the phone, and I again held it to my ear.

“What was that, Ken?” I asked. “I didn’t hear you.”

“Don’t, uh, don’t call Dr. Burns just yet. Let me, uh, let me check on a couple of things,” he stammered. “I’ll get right back to you.”

He hung up. I had pushed a button, and knew it. The one thing an assistant administrator didn’t want to do was create a big problem, especially in the middle of the night. And Dr. Sandy Burns would do just that. He was the head of the largest orthopedic group in town and had been one of the leading admitters to the hospital for more than twenty years. More important, he was an outspoken champion of patient care and didn’t mind butting heads with anyone who stood in the way of achieving that end. Ken Waterbury knew where Sandy Burns would come down on this issue.

As it turned out, I never had to talk with Sandy. Miraculously, somehow, we were able to send Charlie to PT and have him treated in the Hubbard tank. And thankfully this worked. He was soon free of the ants that had plagued him. There was an occasional confused insect that would crawl from a hidden crevice, but it would be quickly removed. He was much more comfortable now, with the ants gone and with the medicine Lori had given him to control his itching.

We managed to find someone to admit him to the hospital for a dermatological evaluation and hopefully some form of treatment. I had no illusion he would be cured—or even substantially improved. But I hoped he could at least be made more comfortable, and that whatever support systems we had in the community for a person like this could be brought into play.

My work schedule didn’t bring me back to the ER for three days. When I got the chance, I went upstairs to check on Charlie. He had been admitted to the medical ward on the third floor, room 314. When I got there, the bed was empty. I asked the head nurse of the unit about Charlie. She shook her head and told me he had been
discharged two days earlier. She didn’t know anything else—not where he went, not about any follow-up. He was just gone.

A few days later, Denton Roberts brought a patient into the ER again, and I had a chance to ask him about Charlie.

“Seen anything more of the guy with the ants?” I asked.

“Nope, Doc. In fact, we were on Oak Park yesterday, and I noticed the trailer was gone. That whole lot is empty. Looks like it was bulldozed. Don’t know what happened to him.”

No one did. I never saw Charlie again. And to this day, have heard nothing about him. I sense that he’s out there somewhere, alone and miserable.

But we can’t fix everybody. Sometimes I wonder if we can really fix anybody. We couldn’t fix Charlie. He was one of the invisible people who drift among us, unknown and unloved, one of the “untouchables.” One of the ones we are called to touch.

I picked up the next chart on the counter. “Sore throat and fever.”

What value has compassion that does not take its object in its arms?
A
NTOINE DE
S
AINT
E
XUPÉRY
(1900–1944)

 16 

Angels
in the
ER

Do not forget to entertain strangers, for by so doing some
people have entertained angels without knowing it.
—H
EBREWS
13:2

I
f you don’t believe in angels, you should spend some time in the ER. You will soon learn they do in fact exist, and they manifest themselves in a variety of forms. Some are nurses, a few are doctors, and many are “everyday people,” passing through our doors and into our lives. Sometimes you have to look hard for their wings. And sometimes you have to shield your eyes from the glow that surrounds them.

Macey Love came through the triage door in a wheelchair. She was leaning forward, tightly gripping the handles of the chair as Lori pushed her into the department.

“We’re going to 5,” Lori said. “It’s her asthma again.”

I was standing on the other side of the counter and had looked up as they entered. Macey saw me and smiled, nodding her head. She was struggling for breath, and I could hear her wheezing from across the room.

“I’ll be right there,” I told Lori. And then to Amy, “Give Respiratory Therapy a call and tell them Macey is here.”

Macey Love was well known to the staff of our emergency department. She was a sixty-two-year-old woman who had suffered with asthma all of her life. Over the past decade or so the disease had
worsened, necessitating frequent visits to the ER. Usually we could turn one of her asthmatic attacks around with aggressive treatment, keeping her in the department for several hours and watching her closely. She didn’t want to be admitted to the hospital and made her feelings perfectly clear on that point. “Dr. Lesslie, I’ve got to get back home and take care of my two grandchildren, so you’d better get me tuned up,” she would tell me, sometimes shaking her index finger for emphasis.

On a few occasions she was too sick to go back home, and we would have to send her upstairs for a few days. Those occasions had become more frequent of late.

Still, we would do everything we could to get her “tuned up” and back home. We knew about her grandchildren and the responsibilities she had with them.

The two girls, eight and ten years old, had been living with their grandmother for the past six years. Their mother had decided to move to New York and had abruptly left them with Macey. She hadn’t returned. Sometimes at night or on a weekend, the girls would come to the ER with Macey. We didn’t want them sitting in the waiting room alone, so they would come into the ER with their grandmother. They were neat kids, friendly, smiling, and well-behaved.

Macey had devoted this time of her life to caring for these girls. Before asthma had robbed her of her lung capacity, Macey had been the choir director for the largest AME church in town. Each Sunday morning she had made sure her two granddaughters were in the choir loft with her. And on Wednesday night they would be there for choir practice.

Macey was proud of them. It was easy to see that, and they loved her dearly.

The girls weren’t with her this day. It was around noon on an April Thursday, and they were in school.

Lori was starting an IV in Macey’s left hand as I walked into room 5.

“Pulse ox is 87 percent,” she informed me. This number came from
a device that was placed over one of her fingertips, pressing gently over the nail bed. It measured the amount of oxygen in Macey’s blood, and while 87 was low, I had seen her much worse. “Oxygen going at three liters a minute,” Lori added. “Do you want a blood gas?”

Macey winced when she said this, anticipating once again the painful needle stick in her wrist as blood was drawn from the radial artery. It would give us a more complete picture of her oxygenation status, much more so than a simple pulse ox measurement. But it was pretty painful.

“No, let’s hold off there and see how she does,” I told Lori, to Macey’s obvious relief.

Her lungs were really tight today, with audible wheezing but not a lot of air movement. After listening to her chest, I stood back and looked down at her, my arms folded across my chest.