Authors: Susan Worley-Bean
DASHED DREAMS
DASHED DREAMS
by
Susan Worley-Bean
“My mother and her mother often spoke about ‘Dashed Dreams.’ In my youth I questioned the phrase several times, but never got an answer as to what it was; I had to find out for myself.”
Jillian James arrived at work earlier than usual, since today was Thursday, a day when a four-day vacation started. The March sky was cloudy with a chance of rain and the weatherman said it wouldn’t be above 40 degrees all day. She pulled her coat around her neck, thinking: This is supposed to be the banana belt.
She stood about 5’ 7” had a healthy athletic build, with shoulder-length brown hair, usually worn either in a ponytail or a braid. At 35 years of age,
Jillie
, as her friends called her, was pleased with her life. She opened the back door marked
Private,
walked down a long hallway with two smaller rooms on the left side of the hall and three rooms on the right, some occupied with early-morning workers.
The office décor was in a Western motif, with colors in muted tans, browns, beige, mauves, blues, and greens. Along the hallway hung photos of various scenes of Yerington, Nevada and the outlying area. The carpet was an industrial type with variegated colors the same as the walls. All the workstations throughout the office were of rich golden oak, polished to a high gloss. Jillian noticed she’d arrived before most of the other employees. She nodded at a few workers who responded with, “Good morning” or “Hey, it’s almost Friday.” Jillian reached her office.
The office was bright, with a bay window and seat on the left side of the room. Jillian made a mental note, to clear off the seat, as the floral seat cushion was piled with books, papers, and open boxes. What was in the boxes, she’d forgotten. If a person wanted to sit, they couldn’t. A large floor-to-ceiling bookcase on the opposite wall was stuffed with books, papers, and photos. The color theme of the office was the same décor as the outer offices, a muted mauve with a border print of meadows, clouded blue skies with horses throughout. The carpet, like that of the rest of the building was muted beige. She hooked her purse on the arm of a corner oak coat rack and hung her outer coat on another one of the coat rack’s arms. Jillian slipped on a white lab coat from the rack. She glanced over to a massive oak desk in the center of the room. Behind the desk was an overstuffed leather desk chair and a three-shelf bookcase, overflowing with books and journals. On the top were framed photos, plaques, and a huge basket of mauve silk flowers. She sat at the desk, ready to begin her day. She started reviewing a large stack of colorful charts. After finishing her review of the patients’ charts, she carried them out to one of the workstations. Pausing to look back at the name plaque on the door, Jillian smiled and touched her lab coat on the mauve-colored stitched lettering on the pocket: Jillian L. James, M. D.
She’d been practicing Orthopedic Medicine in Yerington for almost five years. Desert Orthopedics, Inc. included her partner, Mark Morrison and Jillian. The business had grown to such that they were hiring a new physician to join the practice. Cynthia Renfrow was to arrive in a few months and would be a welcome addition. Being the only Ortho group in Yerington and with the population boom the area was experiencing, they’d become quite busy. Joy Leonard’s the office manager of Desert Orthopedics. Her task was to set a new schedule for the three doctors.
Jillian stuck her head in Joy’s office.
“How are you this morning, Dr. James? Ready for a well-deserved time off, I’ll bet. Where you goin’ this time? You three girls really travel around on your days off. Are you playing golf? We have a light schedule of patients, but you’re on call until 5 this evening. There are three post-ops, two new patients, and seven follow-ups this morning. Your afternoon surgery schedule has three patients on it: Ed Moore, Tina Grist, and Linda Hughes,” Joy said.
“Joy, did you remind Mark that I’m going to be gone over the weekend and ask him to do my in-house on Mr. Moore? I haven’t seen him for a couple of days. I’ll be really glad when Dr. Renfrow arrives.”
“Yep, we all will. Maybe this office won’t feel so much like a zoo!”
Christine came around the corner. “Dr. James, your first patients are here and they’re in the exam rooms.”
“I’ll be right with them,” Jillian replied.
The morning passed quickly, at 11:00 Jillian walked across the street to the hospital for lunch before starting the afternoon surgeries. The air was crisp and cool; the wind was blowing directly from the west. Jillian thought: Maybe we’ll get some snow tonight. As she waited for the traffic to pass, she felt chilled and wished she’d brought her heavy coat. She thought about calling over to the office and asking one of the girls to run it over when they came for lunch, but didn’t really want to ask. Jillian had always vowed that she would never ask for special treatment, expecting people to wait on her. Some doctors had a reputation of having a,
“Look at Me, I’m God”
complex. She certainly didn’t ever want to fall into that frame of mind.
The 75-bed Yerington General Hospital was located on the corner of Surprise and Mountain streets, built in 1947. Originally a 7-bed hospital, it grew with the community. The second floor was added a couple of years ago to accommodate extra beds and a new maternity ward. Before that time, maternity patients had to go 60 miles to be seen, at either Fallon or Carson City. Attached to the hospital on the south side was a Rehabilitation and Long-Term Care facility, which housed 49 patients. Between Rehab and LTC was a park-like area dedicated to Dr. Mary Fulstone, who was instrumental in the growth of the Mason Valley medical community. In the 1950’s Dr. Mary, as she was called throughout the valley, arranged “rotating” doctors to practice in Yerington. Now, “satellite” offices are commonplace throughout the “out” counties in most rural states. The hospital employed approximately 325 people, serving all facets that a larger hospital would offer.
Walking in the front door of the hospital and through the main waiting room, Jillian nodded to the hospital switchboard staff. The Operator spoke to her as she passed, “Dr. James, the Emergency Room’s trying to locate you. I called your office and they said you were headed this way.”
“Tell them I’ll be right down. Thank you.”
The operator nodded, picked up the phone and dialed, as Jillian continued on her way. She walked down the hallway towards the ER. Passing the Lab and X-Ray departments, she noticed the outpatient waiting room was busy.
“What’ve you got?” she asked the nurse at the ER’s nursing station. The nurse smiled and handed her the chart.
“A 11-year-old girl with an elbow injury. She’s in Room 2. Dr. Knight, our attending today, didn’t have a chance to evaluate yet, but he did order a set of X-rays. They’re hanging on the light board in #2.”
“Thank you.”
Jillian softly knocked on the door to Exam Room #2. She found Allison Smith, a tall lankly girl, sitting on a gurney, holding her left elbow. Her mother sat beside the gurney, talking to her child.
“I’m Dr. James. What do we have here?” Jillian briefly made eye contact with the mother then fixed her attention on the young girl and her injury.
“After I jumped off the swing at school, I fell.” she said.
Jillian placed her hand on the girl’s fingers and asked her to squeeze her fingers as hard as she could. The young girl cried as she tried to squeeze, but Jillian’s fingers felt little pressure. Jillian started to examine the elbow, talking all the time, asking questions to take the girl’s mind off the pain, as she started the examination.
“Do you remember how you landed after flying through the air?”
“Like this, I think,” she showed her right arm stretched out palm-down.
“Let’s look and see what’s going on. Have you ever seen inside your arm?”
Allison nodded no and looked inquisitively towards the light board.
Jillian flipped on the switch. Both sides flickered, then illuminated with the x-ray of the child’s left elbow and forearm. She looked at four x-rays of the child’s distal humerus (the upper arm), radius and ulna (the forearm), and a picture of the olecranon bone that forms the elbow. She placed the elbow film back on the light board, turned and spoke to Allison and her mother. “You have a Type II fracture of the olecranon, which is the large bump of the ulna behind your elbow joint. In general terms, you’ve broken the sharp pointy bone of your elbow.” Allison nodded. Her mother asked, “What can you do about that?”
Trying to include Allison in the conversation, Jillian spoke to both her and her mother. “I feel surgery to repair the elbow is the only course of treatment.” Jillian paused for all this information to soak in and for the mother to respond. Jillian glanced over to Allison, who was still trying to wiggle her fingers with not much luck. Jillian’s decision was made.
“I’ll go in, align the bones, and depending on how much damage is in there, I may have to place a couple of screws to hold things together. It’d be only an overnight stay just to watch her vitals.”
The mother sat motionless for a moment, then quietly asked, “When?”
“Well, today’s my surgery day and if we could get everything approved with your insurance company as an emergency surgery, I could do this repair this afternoon. Allison, when’s the last time you had anything to eat?"
“I had my breakfast at…” she paused.
Her mother finished the sentence. “About 7:45, honey.”
“Let’s see . . . it’s almost noon. I’ll bet you’re getting hungry? Jillian asked.
“Yeah, it’s my lunchtime right now at school,” the young girl said.
Jillian reached for the doorknob. “Shall we proceed today?”
“Yes, but I need to get ahold of her father and the insurance company,” Mrs. Smith said.
“Don’t worry about the insurance company. We have a fine staff to get all this approved. It’s their job, so don’t worry about that. How’s this with you, Allison?”
“I’m scared. I don’t want to stay overnight. Mom, will you stay with me?”
Her mother placed an arm around her daughter’s shoulder and nodded yes. Jillian saw that Mrs. Smith was close to tears, but held them back.
Jillian spoke to Allison. “I know you’re scared. You’ll take a nap and when you wake up, it’ll be all over. Your arm will be bandaged, and you’ll be ready for something to eat. Also, I’ll bet none of your friends have screws in their elbows.”
“Will I be sick? My friend Courtney had surgery and told me she was really sick.”
“You shouldn’t be sick. A nice lady, Dr. Nancy Dwight, will come and see you. She’ll be your anesthesiologist, and let her know anything that’s bothering you. Okay?”
“Anessth..?” Allison tried to pronounce the word.
“Just say Sleep Doctor, it’s easier.” Jillian chuckled. “I’m going to have the nurse come in and get you started. Allison, please ask whenever you have a question. You’re going to be okay. Just think what a story you’ll be able to share with your friends.”
“They saw me fall. I’ll bet they’re really worried about me.”
Her mother said, “After I get ahold of Daddy, I’ll call the school and let them know what’s happening. Is that okay?”
The young girl nodded.
Jillian left the room. At the nurse’s station she ordered, “Let’s get her set for surgery. I’m going in and repair her left elbow.” Jillian placed a call to Surgery.
“Surgery, this is Dixie.” Dixie Johnson was the Surgery Supervisor.
“Dixie, this is Dr. James. I have three on for this afternoon. Can you squeeze in one more? …a young lady."
“How much time do you need?” Dixie asked.
“An hour or so. It’s a repair of the olecranon. Arm vs. ground.”
The nurse chuckled, “Sure, we have the space, as two of your others are pretty quick. Where do you want to place her? How old’s the patient?”
“Eleven years old. Well, it’ll take awhile for everyone to get her ready. We need to get some labs. I don’t want her to have to wait long, because of her age, so let’s put her second. Shall we move Mr. Moore to first, as he’ll take the longest? Okay? ”
“Done.” Dixie replied with one of her favorite responses.
“Will you please let Dr. Dwight know?”
“Done.”
“See you in a few. I’m going to grab a bite of lunch.”
“Done.”
Jillian sat for a few minutes writing orders, dictating her emergency room evaluation, and calling Joy at the office to inform her of the new patient. She asked her to let Mark know that he’d have one more for rounds tomorrow. Joy finished the conversation with a reminder to have a great trip and she’d see her on Monday.