On A Cold Winter's Night

by Leanne Burroughs

  "Even the matching holiday sweaters we used to wear every year for the family greeting card photo and Christmas Eve party? You know, I think I still have a few in a box up in the attic we could pull out."

  "Let's not push it,” Elle grumbled.

  "Now that tone certainly does bring back memories. Far too many holidays have gone by without you here with all of us to celebrate the season. I don't know how in the world you managed to get away from Indianapolis to be here on Christmas Day, let alone a whole week of vacation time. I guess the hospital staff at St. Anne's wanted to reward you now that you're a resident after all of those holidays you worked as a medical student and intern."

  "Not exactly, I'm still pretty low on the totem pole compared to the rest of the staff. But there are times and circumstances that will cause even the most uptight attending physician to show a little flexibility."

  "Naturally, Elle, everyone should be considerate after last year."

  "What are you talking about?"

  Marla spun away from the new tree that caught her eye and looked back at her incredulously. “Well, Philip, of course."

  Elle rubbed her aching forehead, stunned that the recent chaos that had taken over her life in the last few weeks had been so dire it had even numbed a pain she once thought she would never recover from.

  "Forget I said anything,” her mother insisted, her voice hushed and hurried as she wrapped a comforting arm around her. “You're wise to have put it behind you."

  "It's no longer my top priority, but I haven't put it behind me yet,” Elle replied wearily while images of Philip Wagner, a fellow ER resident, dressed in a Santa suit, giving her a diamond ring on bended knee in front of their cheering co-workers flashed through her mind.

  "And there I go acting like a fool and bringing it up."

  "It's okay, Mom, really. It's gotten much easier to accept that we won't be saying ‘I do.’ It's the little things that are the worst, like just talking to him. That's what I've missed the most lately."

  "You haven't even spoken to one another since calling off the engagement?"

  "No, we just went our separate ways a couple of months ago. I don't even know which hospital he transferred to."

  "That's such a shame. You and Philip were so close and seemed so happy. Your father and I were actually hoping you might be able to work things out."

  "It just wasn't in the cards. But it's nice to know I have dated one guy Dad didn't hate."

  Marla chuckled. “Well, you know your daddy isn't willing to give you away to any man, but he would have been willing to share you with Philip. But just between the two of us, I think he's pretty pleased to have you to himself for Christmas. And did I tell you your big brother and Kimmy are driving down from Terre Haute to help us decorate the tree tonight? When I told Archie you'd be here, he and your sister-in-law decided to come down early. We're going to be making a lot of memories this year."

  Elle stared down at the now bare ring finger on her left hand. She sighed and stuffed her hands into her coat pockets. “You're right. It's definitely going to be memorable."

  "Come on, let's just buy that first big pine I liked and get out of the cold.” Her mother gestured to an employee. “We can go across the street while they're tying the tree to the car and I'll treat you to a nice, hot French vanilla cappuccino and lunch. That'll help perk you up and put a little color in those pale cheeks."

  "That's an offer this caffeine junkie can't refuse.” Leaning back against a nearby lamppost while her mother paid the salesman, Elle gazed at the holly and ivy lining every storefront window, and the large city Christmas tree inspired by the Rockefeller Center staple. She listened to the children's choir singing on the sidewalk. “You know, Mom, I had forgotten how festive the riverfront is at this time of year."

  "I wish you could have been home for the holiday parade I used to take you to every year when you were younger. Maybe this weekend we could all go over to the Reitz Home Museum and create a new tradition. They always do such extravagant Victorian displays in December."

  "We don't have to do anything special. Honestly, I'm perfectly content just being here with you. My life has mainly consisted of school and work so for long that it might be nice to just enjoy your company while I can without having the hindrance of a hospital beeper."

  Marla linked her arm through Elle's and guided her across the street. “That sounds like a grand idea to me. I always enjoy bragging about my little girl, the doctor, but it will be even better just to have you at home instead of sharing you with patients. And selfishly, I don't mind telling you, I'm hoping being back in Evansville around your family and friends might dampen your views of Indianapolis and lead you to ask for a transfer to the St. Anne's sister hospital that just opened over the summer."

  Elle bit her wind-chapped lips, too embarrassed to tell her mother she'd asked for and received a transfer months ago, but decided to renege after her engagement to Philip ended. “I thought you just wanted to focus on family time."

  "You're right. In fact, maybe I should cancel our Christmas Eve party so the five of us can have a more intimate gathering. Maybe something low-key would be better for you. After all, I could barely get you to wake up this morning."

  "That's because I was relishing a night of sleep free of beepers and alarm clocks. Please don't cancel on account of me. Besides, what would people think if the Queen of Traditions suddenly called off the party the whole neighborhood looks forward to all year?"

  "Well, if you're certain. And speaking of traditions, my holiday shopping procrastination is still a problem. There's only a few days left until Christmas and I haven't purchased a single present yet. Maybe we should pop into a few of the shops nearby after the coffee and warm food thaws our chilled bones. Perhaps they'll have some unique gifts. How do you always manage to get done so early?"

  "Because when you're living on a resident's salary and schedule you learn how to be quick and cheap and toss inexpensive gift certificates into greeting cards."

  "Maybe this year you could do something extreme and try wrapping them in boxes."

  "Mom, we both know I lack all of your domestic and artistic gifts and would end up with a crinkled mess, a dozen paper cuts and—” Elle stopped abruptly and paused outside the coffee shop doorway when she noticed a woman rushing out of the antique store next door, waving her arms about erratically.

  "Someone, help!” the woman cried out. “We need a doctor or a nurse, please!"

  "So much for leaving work behind,” Marla whispered.

  "What's going on, ma'am?” Elle asked as her professional demeanor took over and all thoughts of Christmas vanished. “Is someone hurt?"

  "My husband!” she sobbed. “He collapsed and I don't think he's breathing!"

  "Lead me to him and I'll see what I can do. Have the paramedics been called?"

  "Yes, my son called and they're on their way. But he needs help now. Are you a doctor? You don't look old enough to be a doctor."

  "I assure you I am,” Elle promised as she weaved her way through the crowded store filled with old odds and ends to the gentleman sprawled out on the floor. A teenage boy leaned over him.

  "Son, this girl is a doctor, she's going to help!"

  Elle knelt to the ground and began assessing the man's vitals. “Can you tell me what your father was doing when he collapsed?"

  "He was eating his lunch,” the young man answered in a shaky whisper.

  "Did he appear to be choking?"

  "No. He said he was feeling sick, then he just started gasping for air, but he never gagged. Just fell down."

  "Okay, what was he eating? Does he have any food allergies?"

  "Peanuts,” the boy's mother interjected. “But he was eating chocolate chip cookies. They didn't have nuts in them."

  "There could have easily been cross-contamination at the bakery that is causing him to go into anaphylaxis. Where's his EpiPen?"

  "He doesn't carry one anymore. He said they were more trouble
than good."

  "Then we're going to have to be creative.” Elle took a deep breath to calm her rising pulse, wishing she could give the adrenaline rushing through her veins to the unconscious man who dearly needed it. “Do you have a first aid kit?"

  "Yes."

  "Go get it. Hurry! And I need a knife."

  "Elle, is there anything I can do to help you, sweetheart?"

  Elle glanced away from the man's pale face to her mother standing a few feet away. “Do you have a pen in your purse?"

  "I think so."

  "Get it out, take it apart and snap off the blunt end, then wipe it with your hand sanitizer.” She faced the boy sitting across from her who held out his pocket knife in a trembling palm. “I'm going to need your help."

  "What? Are you crazy? I'm not a doctor. I'm not even out of high school!"

  "That doesn't matter.” Elle kept her voice firm but gentle as she tilted her patient's head and extended his neck. “All you have to do is keep him in this position, okay? I know this is scary. So, I want you to close your eyes and just focus on keeping your hands still."

  "Here's the kit!"

  Elle opened the kit pushed into her hands, expertly slipped on the pair of latex gloves inside, and opened the pocket knife.

  'W-What are you doing?” the woman shouted hysterically. “You can't operate, not here!"

  "I wish I had another choice, ma'am,"—Elle swabbed the blade and her patient's neck with alcohol wipes—"but there isn't time. Your husband's lost his airway and has already developed tachycardia and cyanosis. I have to do a cricothyrotomy now."

  Blocking out the sobs in the background, she gave a quick turn of her head to toss aside her long, strawberry-blonde strands that obstructed her view and spread two fingers across the patient's neck to keep the skin taut. With a silent prayer, she lifted the knife with her other hand and made a thin incision. She wiped away the scant amount of blood with a handful of gauze, then slid the knife through the exposed cricothyroid membrane and slipped a finger into the incision.

  "I need the pen now,” she ordered.

  Grasping the dissected pen pressed into her palm, Elle carefully removed her finger and guided the tube into the widened incision, reluctantly hopeful when the membrane adhered to the material. She moved a hand to his chest and released the breath she had unknowingly been holding when she felt the weak, bilateral rise and the fall of his chest gradually strengthening and relaxing the rigidity.

  "He's breathing!"

  "Oh, thank God!” The man's wife fell to her knees at her husband's side, her tears sprinkling his cheeks. “And thank you, oh, thank you!"

  "H-He's alive?” The son nervously opened his eyes.

  Elle nodded. “Yes, you did a good job. Why don't you go wait outside, so you can direct the ambulance and get a little fresh air, okay?"

  "Elle, you're amazing!” Her mother beamed with pride. “Just amazing!"

  "I was just doing my job."

  "Maybe it was just a job to you,” the store employee whispered, wrapping her in a hug, “but to us it was so much more. You gave us a miracle, a Christmas miracle! If there's ever any way we can repay you, you just let us know. “

  Elle returned her embrace, futilely wishing the grateful lady could actually return the favor and give her the miracle she so desperately needed. * * * *

  A mixture of moans and groans echoed in the St. Anne's emergency room as Dr. Philip Wagner weaved his way through the crowded halls filled with patients. “Good grief,” he said breathlessly when he reached the front desk. “I've never seen this place so crowded."

  "All hospital ERs are packed at Christmastime, Doc,” a nearby nurse told him. “The holidays tend to be universally hazardous to your health."

  "I thought I had seen it all in Indianapolis. But today marks the first time I've ever seen a patient roll in through the doors with a pen sticking out of his neck."

  "Just wait. Last year we had an intoxicated guy come in with hypothermia who thought he was Santa Claus and got stuck trying to squeeze down a chimney."

  Philip released a tired sigh while he wiped away from the white board the names of patients he'd recently discharged. He grabbed a new chart. “You know, something that crazy actually makes me look forward to the normalcy of flu season."

  "Excuse me.” A woman stood near the receptionist's desk. “Could someone help me, please? I'm trying to find out the status of a patient who came in that I treated."

  The soft voice was instantly recognizable to his ears. Its sweet whisper blocked out all other sound, leaving him utterly flustered when he glanced out of the corner of his eye at a long mane of thick red and gold hair and a glimpse of ivory skin. The chart slipped from his hands with a loud splat that caused her to turn away from the receptionist toward him.

  "Elle,” he whispered when he fully saw her heart-shaped face gazing up at him—the beautiful face of the only woman he'd ever loved.

  She gasped and fumbled for words, before finally sharing a barely audible “Hello."

  "What are you doing here?"

  Regaining her composure, she coolly replied, “Checking up on someone I helped when I was downtown today. And that's the only reason I'm here."

  "A man with anaphylaxis?"

  "Yes."

  "I treated him when he was brought in.” Philip observed the curious looks from the receptionist and nurse that locked in on them, eyeing them like they were two soap opera characters preparing to have an epic lover's quarrel. “I'm taking my lunch break now. If you'd like to know what limited information I can give you, we can step into the lounge."

  "Fine."

  Once again, he made his way through the horde with Elle close behind, thankful when he stepped into the employee lounge to find it atypically vacant.

  "You do realize taking me aside is going to cause your co-workers to gossip more than they would have if you'd just told me if the gentleman was stable and I went on my way,” Elle said after the door shut behind them.

  "That's not really a priority for me right now."

  "Me either. How's my patient?"

  "My patient is stable, luckily. I can't believe you played MacGyver M.D. Do you realize the lawsuit you could have been facing if it hadn't worked?"

  "At the time, I wasn't thinking about the legal system. I was busy focusing on the man lying in front of me who wasn't breathing! What would you have done if you were in my shoes? Just stand there and hope for the best?"

  Philip sighed. “I hope I would have had the courage to do the exact same thing you did. You always have been an incredible doctor. The paramedics probably would have been able to spare his life in time, but you spared him brain damage."

  "I just hope I didn't cause any other damage with such rustic techniques."

  "I didn't see any evidence of that during my exam and antibiotics have already been started to help prevent an infection. Most likely he'll be discharged soon with a lengthy lecture about keeping an EpiPen on hand and sent off to spend Christmas with his family."

  "Good."

  "And speaking of Christmas, is that what brought you to Evansville?"

  Elle tightened her jaw and rubbed a hand over her tense neck. “I think a better question would be: What brought you to Evansville? You know my family lives here."

  "And you know we both received the okay in August on the transfers we put in."

  "Yes, but if memory serves, you were reluctant to come here and finish out our residencies when I suggested it after we both decided to leave Indianapolis. You were far more intrigued by the idea of transferring to the Chicago or Detroit branches. Why didn't you go there after we ended our engagement?"

  Philip swallowed roughly, feeling a pang of sadness from the reminder that two months of separation had yet to heal. “Chicago and Detroit are both crowded places. It was hard to find a last minute slot. That's why I originally agreed to transfer here anyway, because I thought it would be easier for both of us to get accepted. And after our plans changed
and I found out through the grapevine that you were staying in Indy, I decided to go ahead and come here for a change of scene. There are a lot of perks to being in a smaller city—"

  "I'm well aware of that.” Elle turned away from him. “That's why I recommended it. On a personal level, it would allow me to be near my family and your relatives are only a half hour away in Kentucky. And you can live in a better neighborhood and actually afford a house instead of an apartment. On a professional level, there are many advantages of working with a smaller staff."

  "Are you considering moving back here?"

  "I'm weighing the pros and cons. There's a lot to think about right now.” She walked to the door and turned the handle. “Thanks for the update on the patient."

  "Wait. Come on, Elle, why waste this chance to talk?"

  "What's the point, Philip? What's done is done."

  "Even though this city has hundreds of thousands of people, we both know there's a chance we'll run into each other occasionally even if you stay in Indy—at conferences or in passing when you're here visiting, and it might be nice if we weren't on bad terms anymore."

  "Can ex-lovers ever really be on good terms?” Elle asked sarcastically, ripping off her coat as she spun away from the door. “Gosh, why did you have to decide to talk in a room that's so hot?"

  "It's not hot in here,” Philip replied calmly. “You're just getting yourself worked up. You always do that when you're angry."

  She leaned heavily against the wooden table in the corner and glanced back at him over her shoulder. “I'm not angry. I'm just overwhelmed. I wasn't expecting to shove a pen into someone's neck today in the middle of shopping, let alone run into you."

  "It seems crazy that we're both this flustered just by seeing each other and only months ago we were expecting to eventually wake up beside one another everyday."

  "Philip,” Elle murmured wearily. “Stop, please. I've got so much on my mind. I'm just not up to discussing this right now."

  "Are you okay?” He stepped closer when he saw her hands shaking as she lifted them to rub her eyes.