Secure Again

by R L Dunn

  Elizabeth bit her tongue. She didn't find Reverend Brookfield helpful, but she wouldn't speak for her patient.

  She directed Paul Young to Carol's room. "Carol, this is Detective Young from the Silverton Police Department."

  Carol Whelan's heart rate escalated on the monitor. "Detective, I'm not pressing charges against my husband." Her breaths came faster. "You can leave now."

  "I'm not here for that, Mrs. Whelan. I'm sorry to tell you, Karl is dead," Detective Young spoke in a soft tone. "I'm sorry for your loss."

  Her mouth clamped shut until she found the words. "How did he die?" Her eyes bulged.

  "Ma'am, someone slit his throat in your bedroom." The detective pulled up a chair, his eyes remaining on Elizabeth. "Mrs. Whelan, did Karl have any enemies?"

  She shook in the bed. "No. Karl had some temper issues, but he also could be kind." Her heart rate rose again. "His throat? Our room?" Even when he was dead, she still protected the abusive man.

  Elizabeth glared at the detective. "Carol, I need you to take a few deep breaths for me, okay?"

  "Dr. Reed, my chest hurts." Carol became pale and sweaty.

  Detective Young took the cue. "Get some rest, Mrs. Whelan. I promise I will keep you updated. I will check on you tomorrow."

  Elizabeth listened to her rapid heartbeat. “I'll order something for the discomfort. Slow breaths. I'm so sorry about Karl." Reverend Brookfield crossed her path as she escorted the detective out of the room.

  "Thank you for sharing every horrific detail,” Elizabeth snipped at him the second they were out of earshot.

  "Who is assigned to Mrs. Whelan? She requires nitroglycerin, morphine, a stat ECG and another set of enzymes," Elizabeth said to the approaching nurse and training doctor.

  Young ignored Elizabeth's comment. "Where's Austin Bailey? I want to extend my prayers to the family."

  "Sergeant Bailey is in room three. Do you need anything else?" She frowned.

  "Yeah, where were you between eleven last night and six this morning?"

  "Eleven to five-thirty, home. I walked into my office around 6:00."

  "What size gloves do you wear?"

  She almost answered before it occurred to her. "You can't possibly think I had something to do with Karl Whelan's death?" Young shrugged and headed to Austin's room. "Talk to my lawyer!"

  Elizabeth had no more time to think about Young's latest accusation. Mr. Fitzgerald began to throw up bright red blood. She barked orders as she approached the bedside with the pack of residents. "I'm Dr. Reed. We’re going to fix this." The basin filled fast.

  His wife screamed, "Save him!”

  Elizabeth stood back to watch her residents work. As panic ensued with the patient failing, Elizabeth took over. "I need that blood, and page endoscopy again, STAT.”

  Nurse May Palmer ran in with the endoscope and two units of blood. "Endoscopy said they will be here in fifteen minutes.”

  In fifteen minutes, her patient would bleed out. She also knew a July resident couldn't do this. Elizabeth displayed a calm exterior as her residents, interns, and students crowded the room. "If you’re not participating, put a butt against the wall and take the volume down, please.”

  Elizabeth blocked out the noise. The door to the room opened. Patrick Hedges gloved and gowned at the sight of the profuse bleeding before starting to give orders. “One of the nurses told me you were teaching a class.”

  Elizabeth pressed her tongue to the top of her mouth to steady herself. The technique she learned in med school never failed her. "Here we go." As Patrick gave directions to the staff assisting her, she tied off eleven leaking vessels until the bleeding turned to an ooze.

  Her heart still pounding, she hoped she maintained a steady appearance as she removed the scope with care and reinserted a nasogastric tube.

  "Continuous sedation. I want that bloodwork STAT," Patrick said.

  The secretary took Mrs. Fitzgerald into the conference room after Elizabeth explained what happened and what would happen short term and long term if her husband survived and didn't stop drinking.

  Patrick went with Elizabeth into the lounge. "Job well done, Beth. You didn't appear surprised to do that without the endo team."

  "We serve a huge area. This corporation tries to maintain a bottom line. Truth, I thanked my lucky stars when you walked in." She worked to slow her breathing.

  Patrick laughed. "Look, my PAs are on top of Austin. I don't expect to encounter any complications until around noon. Until then, can I help? I do have privileges, and I won't break the bank, since I'm not being paid by the hospital."

  Elizabeth nodded. "I'll never refuse an offer like that. When did you round last?"

  "Two days ago. I’m the medical director of Chase Medical's Denver Center. They require I remain active as a trauma surgeon at LifeCare Medical Center on the outskirts of Denver. It’s a level 1 trauma receiving hospital."

  "Chase Group is some organization. Want one?" She poured a cup of coffee.

  "Thanks, black. Chase Medical is a remarkable place to work.” He described some of their projects and plans for expansion.

  "Primary care is a huge investment with a negative return." Elizabeth did the mental math.

  "Ian and Kieran believe in affordable access to healthcare for all. All medical directors are required to hold licenses in multiple jurisdictions. For situations like this, it is necessary. All the PAs possess a minimum master's degree-level training and are licensed to practice in multiple states as well. Pete, as medical COO, and Seth, as a facility director, hold multiple sub-specialty training as well as business or health management degrees."

  "Wow."

  "Interested in joining us? Ask Pete Walter. With the restructure and expansion, we’re hiring."

  "How did you find them?" She cocked her head.

  "I joined the Chase Group two and a half years ago. In my first life, I served as a combat controller for the Air Force. Did school on the GI bill. Chase posted a help-wanted on a military job listing. It paid very well and insisted that I keep my hospital affiliation, plus it came with amazing benefits.

  “Martin sat in on my second-to-last job interview. He's worse than facing the medical board orals. I guess I said the right things. Then he asked if I would like to provide medical support on an occasional Chase Security assignment. The next thing I knew, we were at the training center in Virginia. Martin ran me into the ground. At the end of the fitness test, picture this, he looks fresh as a daisy, and I'm lying flat on my back hoping they had a defibrillator. He offered me a tactical physician position. My final interview, they offered me the director position too."

  "Assignments?"

  "Sometimes Band-Aid patrol. Other times, it can be a security job. It can run from accompanying a large group on an overseas assignment, to a client getting hurt on vacation, to something serious.” He turned pensive.

  "Serious?" Elizabeth met his gaze.

  "My first mission was tough. Animals kidnapped the six-year-old son of a wealthy couple." His voice changed to a monotone. Patrick explained the child was likely on the open water in a dinghy.

  Elizabeth's hand went to her mouth to stifle the sob. "Nine days."

  He nodded. "Our helo circled over the boat in heavy winds. The little guy and a young woman lay in the raft, both badly sunburned and not moving. A group of sharks circled and buffeted the boat. After discussing options, Martin made the final decision to try a rescue. I learned over time, Martin never asked for more from his team than he asked from himself. After rescuing the girl, halfway down the second time, the little guy stirred and fell into the water."

  "Oh my god." Her eyes widened.

  "Without a pause, Martin cut himself free, hitting the water after him. The rest of us fired at the sharks. One shark grabbed the little guy and submerged. Martin followed. Five long minutes ticked by before Martin surfaced with the boy.

  "We ended up doing a trapeze catch. Troy hung by his knees and grabbed Martin one-handed from the w
ater. I saw some crazy stuff in the Air Force, but this was insane. Onboard, I pronounced the girl. The whole flight into Texas, the little guy drifted in and out, dehydrated, blind and hallucinating. Martin rocked him in his arms the whole way. A couple of times he called Martin Daddy. I had nothing to offer. Martin sang the sweetest song to him, and he died at peace. I wrapped him in a papoose, and we wheeled him into the hospital. I remember standing at attention, listening to Martin explain to his parents."

  Patrick stood and poured another cup of coffee, then wiped away a tear. "Returning to our hotel, we all took a shower and went to the mandatory debrief. The usual way is we sit around a table and rehash everything, discuss the good and bad, like grand rounds. That day, Martin, in the humblest way, displayed his leadership.” Patrick turned back and smiled.

  Blinking slowly, she asked, "How do you go back?" Tears stained her cheeks.

  "For the days you have success, same as being a surgeon. A little birdie told me you had a rough one the other day?" Patrick offered a sympathetic smile.

  "A little girl. I just fixed the injuries. If I connected the depravity to her...the cop told me I was cold. I wouldn't function if I felt every case, every time. The nurses nicknamed her Victoria. Who is that evil to a child?" She covered her mouth with her hand.

  "I stopped asking the whys long ago. I can tell you something, though: you’re not cold." He pressed down on the door handle. "Rounds?"

  As they walked toward each patient's room, they discussed the patient. "Female pedestrian, age thirty-one, struck by a motor vehicle resulting in the amputation of both feet. She won't let me get close enough to examine her," a second-year resident said.

  A woman curled into the arms of a man in a uniform white shirt and navy pants. He rocked her against him, trying to ease her pain. Her elevated pulse and breathing on the monitor attested she was in agony. "Mrs. Heinz, my name is Dr. Patrick Hedges. I'm sorry to meet you like this, but I want to find out what I can do to help you. Would you allow me to examine you?"

  "I'm Ted Heinz. Please, can you help stop Avery's pain?" the man in uniform beside his patient pleaded.

  "I'll do my best, Lieutenant."

  Her hands held tight to her husband. "Don't touch me. It hurts too much."

  "You can hold on to your husband, you can even yell at me, but I need to understand what's going on. We’ll start with the easy stuff: listening to your lungs?" Patrick slipped the head of the stethoscope between the couple. An approving smile curved Elizabeth’s lips. "Avery, tell me where it hurts the most."

  "My right leg. It..." She writhed against her husband.

  Patrick examined her from her neck to her mid-thigh, using a gentle but firm touch. Her left leg to the site of the amputation at the ankle was healing well. He repeated the exam on her right side, and when his hand touched a spot behind her knee, she screamed.

  "I'm sorry, Avery. Dr. McCann, could you come here? Avery, hold on to your hubby. I won't touch you there again, but I need to roll you on your left side. “What do you see, Dr. McCann?"

  "Redness, swelling," he muttered.

  "What does that indicate to you?" Patrick's gaze narrowed.

  "Possible clot."

  "And?" Patrick took the doctor-in-training through the chain of diagnosis and treatment. He sighed watching the deer-in-the-headlights reaction form. "Dilaudid, 4.0 mg. Now." The resident flew out of the room at the snapped command. "We’re going to try this, Avery. If you’re still hurting, we’ll try something else. We’ll keep you comfortable."

  A nurse came in the door with the syringe behind the anxious resident. "I have it, Doctor." Confirming the medication, she injected it.

  Relief dawned over the patient's face. "Give me a little time, Avery," Patrick said.

  Outside the room, Patrick turned to the group. "We do not let patients suffer like that. Remember, there is more than one med. Doctors, is it all right to let the patient dictate your examination? These are people, not procedures to check off. Each one is different. Some you may like, some you may not. Some are easy to care for; some are very difficult. That doesn't dictate the level of care. They come to us on the worst day of their lives. They all need someone to care for them and by extension their family. Are we clear?" Patrick's voice cracked like a whip. Elizabeth bit her cheek to hide a cheer.

  "Dr. Reed, pick up on two," the clerk broadcast over the loudspeaker.

  Elizabeth listened as the emergency department doctor described the unit's newest admission. "Get images and then send her up in thirty minutes." She hung up the phone before the ER doctor could respond.

  "What?" Patrick asked.

  "Are you sure you want to help?" Patrick's eyes crinkled. "All right, eighteen-year-old body packer, meth overdose with signs of an MI. Police custody."

  The ER couldn't tell time. Twenty minutes later, screaming echoed down the hallway. "Take these off me. I'm going to kill you all. Let me go!"

  Martin stepped from Austin's room at the sound of the woman's shrieks. In the company of Silverton PD and a resident, two ER personnel wheeled an agitated and thrashing woman, handcuffed and tethered to the stretcher, down the hall. When Elizabeth stepped into the fray, Patrick flashed an okay sign.

  "Shh." Elizabeth ducked between one of the police officers and the patient. "Honey, we’re here to help you."

  "You don't understand. I can't go back to jail."

  "Shh, you aren't going anywhere except into another bed."

  The clerk ran out and handed Patrick a piece of paper. "Beth, she's HCG positive."

  Sick, pregnant, and in danger of dying, Tonette Torres continued to fight the restraints and scream. Elizabeth palmed her face. "You need to stop this. You’re going to kill yourself and your baby."

  She stopped cold. "Baby? Doctor, please save my baby and me.” Her screams became a whisper.

  "I need you to work with us." Elizabeth stroked her cheek.

  Elizabeth and Patrick directed the residents working to stabilize the young woman. Testing showed she had a moderate heart attack. “Pat, it’s close to noon; you need to go back to Austin. Thank you for your help.”

  Sweaty and out of breath, Tonette asked to speak with her. "Dr. Reed? Can you figure out how pregnant I am?"

  "The obstetrician will be able to figure that out. Do you remember your last period?"

  Tonette started to shake. "If I tell you something, will anyone else know?"

  "Your health information is private.”

  "I got out of jail two weeks ago." Her hand rubbed at her throat. "I spent six months inside."

  Holding her hands, Elizabeth leaned in close. "Tonette, did someone rape you?" She swallowed hard.

  Tonette's eyes rolled back in her head, and her heart stopped. With the work of the team, Tonette's heartbeat came back. Even with the prompt intervention, she remained unconscious and on a ventilator. Elizabeth's cheeks brimmed red with anger.

  Reverend Brookfield sat at the nurse's station, listening to Elizabeth speak on the phone. "Lois, can you come up here? New patient, meth OD, MI, vented, unresponsive, unknown status of pregnancy. Possible assault. I ordered an ultrasound to determine how many balloons are still buried inside her and to look at the pregnancy. Cardiology is with her now." She glared at the reverend and took a huge sip of her coffee.

  Before she could make her next call, Reverend Brookfield interrupted her. "Elizabeth, you need to accept that some things are God's will."

  Irritated, she remembered the words around Martin's tattoo. Her voice rose above the sounds of the busy floor. "You know what, Reverend? God may judge, but my skills decide the time of the meeting. Now, if this..." she swept her hand in the shape of the horseshoe of rooms, "…is God's will, then I have a dinosaur bone to pick. I have a cop who was doing nothing but his job and is fighting for his life because some evil person shot him. There is a corrections officer who tried to kill himself for some unknown reason, and he will likely succeed. There is a man who almost bled to death because he won't stop dr
inking, and a woman, who, despite being offered every program known to man, let her husband beat her. Thankfully, he is no longer able to do that.

  “I have a man who refuses to follow directions to help keep the disease that just robbed him of his foot stay under control. A girl who took drugs and packed her body with more and is carrying a life that might be over before it begins. Another man whose carotid artery was slit by an exploding vape pen. I can go on, Reverend.

  “Let's talk about the woman who flew into town to attend a bridal shower, got run over by a drunk driver and lost both her feet. Or the college kid whose friends thought it would be funny to give him a vodka enema. Each one of these twenty-four patients has a story. I'm sorry, but none of this is God's will." Her tone was bitter.

  "Proverbs 15:1 says, ‘A soft answer turneth away wrath, but grievous words stir up anger.’ Elizabeth, you could use God's love in your life."

  She turned her rolling chair, putting her back between them, her hand grabbing the receiver.

  "Dr. Reed." Her head picked up. Martin was standing in front of the station. "I thought you might need this." He gave her a raspberry yogurt.

  "Thank you, Mr. Bailey. I appreciate this." As she took it from him, his fingers brushed against hers. The simple touch soothed her more than any possible food. "I'll be in to see Austin in a bit."

  Elizabeth opened the container, remembering the times they picked raspberries together. She closed her eyes as she swallowed a spoonful of the delicious treat.

  Brookfield spun her to face him. "‘Ephesians 5:6, ‘Let no man deceive you with vain words.’"

  "Reverend, you are here because some of our patients request your prayers. I am not one of them. So please, let me be." She put her back to him again.

  She swallowed a few more mouthfuls before tossing the almost empty container of yogurt into the trash and walking into Austin's room with Doctors Caine and Perry. When Amanda jumped up and hugged her, Elizabeth forced her body to relax into the embrace. The hug was soon joined by Olivia.

  "Marty told us. Oh, honey. We are so sorry." She became enveloped in Amanda’s arms. Her residents stayed silent.