Angels in the ER (5 page)

“Please get me somethin’ for this pain,” he pleaded.

Rita glanced at the nurses’ station, and then back at Slim.

“I’ll see what I can do, Mr. Brantley.”

She turned again to her charting. Slim waited a moment, and then again jiggled the electrode.

“Ooooooo!” Louder this time.

Rita looked at the monitor and there were those same strange, undulating waves. His heart was going in and out of some peculiar, chaotic, and obviously dangerous rhythm. Something terrible was going to happen if she didn’t do something. And then he was quiet, and the monitor resumed its steady
beep-beep-beep.

That was enough.

“I’ll be right back,” she told him, stepping toward the entrance of the cubicle, on her way to get some help.

She was met by Virginia Granger, head nurse of the department.

Virginia, our most seasoned veteran, held up her hand, stopping Rita in her tracks. She nodded at Rita and then indicated that she needed to follow her back to Slim’s bedside. She had been observing the whole affair.

Virginia indeed presented an imposing figure. She had turned sixty a few weeks earlier, and to her chagrin she had unsuccessfully kept her age a secret from the ER staff. Ramrod straight and always wearing a blindingly white and overstarched blouse and skirt, there was no mistaking her military background. She had worked in various army hospitals for more than twenty years and had brought that bearing and organizational experience to our ER. And she had brought the same pointed, black-trimmed nurse’s cap she had worn constantly since graduating from nursing school.

Virginia stood over Slim, hands on hips, lips pursed, and brow furrowed. She was a menacing sight.

“Slim Brantley,” she said, drawing out his name for effect.

His eyes slowly opened, and his chin sank to his chest. A schoolboy caught in the act of thumping the head of the girl sitting in front of him.

She waited a moment, then took his hand away from the electrode on his chest and placed it by his side.

“Slim, I don’t want you to ever do that again,” she admonished him. “Ever.”

Slim, still the little boy, said, “I won’t, I promise.”

Virginia nodded solemnly, winked at Rita, and then stepped out of the room.

Rita just stood there, staring down at Slim for a moment, perplexed and confused. When she finally realized what had been happening here, she turned to follow Virginia back to the nurses’ station.

“Ma’am,” a small voice behind her whispered. “Could I get somethin’ to eat?”

I had taken care of Slim for the past fifteen years, and amazingly he never seemed to change. He was six-foot-four, maybe six-five. You couldn’t really tell. Even when he was “well,” he slumped over, his long arms dangling by his side. And he was really skinny. He had probably never weighed more than 170 pounds on any occasion I had seen him. His face was wrinkled, craggy, and his eyes had the smoky appearance of too much booze over too many years. His teeth, those few left in his head, were yellowish brown and in sad repair. His hands were quite remarkable. His fingers were extremely long, as were his ridged and filthy fingernails. The index and middle fingers of his right hand were stained a deep and dirty yellow, attesting to a steadfast relationship with his Marlboros.

Today Slim seemed especially unkempt. His clothes were layered for the cold weather. He had on two pairs of trousers, the outermost a stained and torn green plaid. His black boots were well worn and, surprisingly, they matched. More surprisingly, the soles were intact. He had no socks. He wore two light-blue sweaters, the outer one at least two sizes smaller than the inner. Under this was what appeared to be an umpire’s jersey.

“Doc, can you give me somethin’ for this pain? It’s worse than ever! Ooooooo!”

I examined Slim, asking him where he had been staying, when the pain had begun, and whether there were any associated symptoms. The usual things I needed to know. All the while, I perfunctorily confirmed that his exam was normal, or at least as normal as it could be for Slim.

Convinced nothing serious was going on, I picked up the clipboard for room 2 and began writing. “Slim,” I said. “Your belly checks out okay. Doesn’t seem to be anything bad going on. Do you think if you had something to eat, you would feel better?” Somehow, I knew the answer to this question.

Slim began to rub the hollow that was his stomach. “Well, Doc, ya know, that would probably do me a lot of good. The pain seems to have eased a little. What do you think they’re servin’ in the kitchen?” He looked hopeful and a lot more comfortable.

“I don’t know, Slim, but I’ll try to find out.”

Walking over to the nurses’ station, I pulled his curtain closed behind me.

“Amy, would you call down to the cafeteria and see if they could send up a tray for Slim?” I asked her.

“Already on its way,” she replied. “A double.”

Like me, Amy had helped take care of Slim for a lot of years. She was thirty-two years old and one of the best unit secretaries who had ever sat behind the nurses’ station in the ER. And that was saying a lot. It took a lot of savvy, patience, and gumption to handle the almost constant barrage of telephone calls and frantic orders being thrown at her. In addition to possessing all of those important traits, she was also our resident NASCAR enthusiast. In quieter moments she would sometimes remind us of the time she shook the hand of Junior Johnson.

Thirty minutes later Slim was eating, quiet and content. The department had gotten busier. A cardiac arrest was on its way in, and we had two patients with carbon-monoxide poisoning who had been fortunate enough to make it to the ER to be treated. They should recover without any problems.

As I came out of room 3, I walked past Slim’s curtain. I was stopped in my tracks by an offensive odor. I looked around and then glanced at the nurses’ station. Amy was staring at me. She was shaking her head, pinching her nose with one hand and pointing accusingly at room 2 with the other.

“Not again!” I said to her, exasperated.

She simply nodded in response.

One of Slim’s major problems over the past few years was the development of an untimely loss of bowel control. Untimely in that it usually occurred in our department, right after he had eaten. To his credit, he was always apologetic.

My opportunity to reflect upon this unwanted circumstance was cut short by the bursting open of the ambulance entrance doors. Two paramedics hurried a stretcher toward the cardiac room. It was our heart attack.

The patient was a ninety-two-year-old man with extensive cancer and advanced Alzheimer’s disease. There was nothing we could or should do for this elderly gentleman. I instructed the paramedic to stop chest compressions, and we studied the monitor. Flat line. We watched for a few minutes but nothing changed. He was gone. He had no family members, and no one would be coming over from the nursing home.

Thanking the EMS crew, I started writing up his record and walked back to the nurses’ station.

As I passed room 2, I happened to glance over and was able to see through the partially parted curtain. I stopped and watched.

Lori was in the room with Slim. Gloved, she was cleaning him up from his gastrointestinal mishap. And she was smiling at him.

“Ma’am, I’m awful sorry about this,” he said to her, his eyes lowered, looking away. It’s hard for a man to maintain his dignity when he’s sitting in the middle of a public place with his pants down.

“Slim, it’s alright,” Lori said, still smiling. “Accidents happen. And I’m just glad you’re feeling better.”

She continued to clean him. The odor was still terribly strong.

Then she was finished, and she peeled off her gloves and tossed them in the contaminated waste container. She washed her hands in the sink and was stepping toward the entrance of the room when she paused, stopping by the head of his bed. She put her hand on his shoulder, patting it gently.

“Slim,” she said softly. “You need to take better care of yourself. You need to stop your drinking.”

“I know, Ma’am, I know. It’s just hard,” he responded. “But I’ll try.”

“Good, Slim. That’s all we want you to do. Just try.”

Lori had been down this road many times with Slim. And yet she was still offering her support, again demonstrating that somebody cared about him.

She turned from the stretcher and took her hand away from his shoulder. As she did so, Slim reached up and gently grabbed her wrist. Lori stopped and looked down at him.

“Lori.” It was the first time he had ever used her name. “Thanks.”

That was all. “Thanks.” Lori looked at Slim for a moment and then just nodded. He let go of her wrist, and she walked out of the room. She came up to where I stood and stopped, realizing I had been watching. A little color came to her face. No words were needed, though, and she just smiled, nodded, and walked away.

That was one of the last times I saw Slim. He died a few years ago. Yet I remember this particular ER visit well, and Lori’s unflinching care for the man. This had been more than just doing her job. It was a manifestation of her spirit and her selflessness. I’ve tried to respond more like Lori when I find myself in similar circumstances. Sometimes I succeed. Sometimes I don’t. But when I don’t succeed, when I back away from an unpleasant circumstance or a patient who is less than attractive, I at least realize my shortcoming. Maybe that’s the first step.

The King will reply, “I tell you the truth, whatever you did for
one of the least of these brothers of mine, you did for me.”

—M
ATTHEW 25:40

 3 

A
Turn
in the
Road

For a little while you may have had to suffer grief
in all kinds of trials. These have come so that your
faith—of greater worth than gold, which perishes even
though refined by fire—may be proved genuine.

—
1
P
ETER
1:6-7

I
t seemed like a simple thing. Frank and Katie Giles were on their way from Cleveland to Myrtle Beach, South Carolina, traveling southbound on I-77 when it happened. They had driven this road many times in the past—in fact, each year for the past fifteen. Two of their best friends had moved to the beach years earlier, and the annual trek had become a tradition. Also, it was a chance for the Giles to take a vacation as winter was reluctantly beginning to lose its grip on the Ohio Valley. Frank had just turned sixty-six and had retired a few months ago, so this would be the first time they would be able to spend two full weeks at the beach with their friends.

It had seemed innocent enough, a trivial thing. They were still in North Carolina, negotiating the last remnants of morning rush-hour traffic in Charlotte, and Katie had asked Frank if he wanted her to drive for a while.

When he didn’t respond, she looked up from the magazine she was reading and repeated her question. “Frank, you’ve been driving for almost two hours. Do you want me to take over?”

His hands gripped the wheel perhaps a little too tightly, and he stared straight ahead. She studied his face for a moment. His eyes were tracking the busy and unpredictable traffic surrounding them,
and he was handling the van without any problem. And yet there was something wrong. His eyebrows were raised anxiously, something unusual for him, and his lips were trembling, as if trying to form a word or a sound.