As I stepped out of room 5, having examined a patient with a non-Halloween case of possible appendicitis, I almost ran into Jeff Ryan and the man he was leading back to minor trauma. Actually it was a scarecrow, or a very good imitation of one. It was a middle-aged man, looking for all the world like Ray Bolger in The Wizard of Oz. Only this scarecrow was gingerly holding a bloody rag to his forehead. He managed a smile as he passed me in the hallway.
Jeff had glanced over and grinned at me, nodding his head. When he came back up to the nurses’ station a few minutes later, he put the chart of minor trauma B down and said, “Where’s Dorothy when you need her? This scarecrow really does need a brain.”
“What are you talking about?” I asked, intrigued by what I had seen and now just heard.
“Just wait,” Jeff replied cryptically. “You know who that is, don’t you?”
“Sure,” I said, not looking over at him. “A scarecrow.”
“No, I mean who that guy really is.”
“I couldn’t tell,” I answered truthfully. “Am I supposed to know him?”
“That’s Jeremy Fowler, chairman of the county council,” Jeff explained. “You’ll recognize him when you get a good look.”
I slid the chart of room 5 over to the secretary.
“We’ll need a CBC and a urine,” I told her. “And don’t let him eat or drink anything.”
Then I picked up Fowler’s chart. 46 yr old M—laceration of forehead.
“Come on,” I said to Jeff. “What’s going on here?”
“Just wait,” he repeated. “He’ll tell you.”
Then he disappeared back into the triage room.
I had met Jeremy Fowler on a couple of occasions, and I remembered him as being a nice guy. He had been on the county council when we moved to Rock Hill, and now was the chairman. I wondered how he had lacerated his forehead, and on Halloween.
There were two other patients in minor trauma, both resting quietly and hidden from view behind their drawn curtains. I walked over to bed B, pulled its curtain aside, and stepped over to the stretcher.
“Jeremy,” I greeted him. “I’m Robert Lesslie. What happened to you tonight?”
“I’m glad you’re on duty tonight, Robert,” he said, extending his hand to me. His handshake was firm and strong, and he said, “It seems that I’ve had a little…mishap.”
He took the kitchen rag from his forehead, exposing a three-inch laceration that extended from his hairline down to just above the bridge of his nose.
“Wow,” I said softly. “That’s a pretty good cut. How did it happen?” I moved closer to him, gently examining the gaping wound and looking for any other signs of trauma.
“Well, I feel sort of foolish…” He stopped and peered around the edges of the curtain, as if making sure no one else could hear him. Then in a hushed voice he told me his story.
“I decided, since it’s Halloween and all, that I would do something different this year. We have a lot of kids in our neighborhood and I thought it might be fun if I put a little fear of the Lord in ’em. I dressed up as a scarecrow—wait, you can see that. Looks pretty good, doesn’t it?”
He held his arms out and cocked his head to one side. Actually, he had done a great job. There was straw stuffing coming out of the collar of his shirt and his sleeves. And his overalls were loose and well-worn.
“Good job!” I congratulated him, smiling.
“My wife helped me with most of this,” he said, looking down at his garb. “She didn’t like the idea of what I was going to do, but she helped anyway. She’s out in the waiting room and is pretty upset with me.”
He glanced around the room again and resumed in a hushed voice.
“Anyway, I got some bales of hay and put them on the porch by the front door, and got a couple of pumpkins and scattered them around. Then I sat down on one of the bales, leaned back, and got real still. I didn’t move a muscle. And pretty soon, the kids starting coming up the walkway. I could hear them whispering, and I’d peek a little and see them pointing at me. But I wouldn’t move at all, not until they got right up to the door. And then when they’d ring the doorbell, I’d jump up and holler and wave my arms in the air! And those kids would take off running—screaming and hollering and not looking back. I felt kind of bad—one of the kids’ candy bags flew up in the air and landed in the bushes. I hope they’ve gone back to get it,” he added, shaking his head a little.
He was about to go on, when we heard some giggling from the bed next to us. Someone was listening and enjoying this story.
Jeremy looked up and motioned for me to move closer. Then in barely a whisper, he continued.
“That went on for about an hour, and every single trick-or-treater got the willies scared out of them. Every single one. It was great! And I was having a blast.”
He paused and his brow, bloodied as it was, furrowed a little.
“Then the little redheaded Bates boy came up the steps. He’s about eight, and he was all by himself, dressed up like one of those Star Wars characters. Just like all the other times, I waited and didn’t move a muscle. He was more cautious than any of the others, and was studying me pretty hard. Never took his eyes off me, and kept a good distance, circling around the porch until he could reach the doorbell. When he rang it, I jumped up and hollered and started waving my arms and all. He took a few steps and then saw the pitchfork I had leaned against one of the bales of hay. That kid’s strong for his age, and quick. He dropped his bag of candy, grabbed the pitchfork, and whacked me on the forehead! Knocked me down! Then he grabbed his candy and took off. Never looked back, just kept running.”
Jeremy gently dabbed away the small trickle of blood running down his nose.
“Can’t blame the boy,” he said, smiling a little. “I probably would have done the same thing. Anyway, that’s the story, and here I am.”
After I finished examining him, we sent the scarecrow around to radiology with the order—Skull films—whacked by Darth Vader.
It took a while, but I was able to put our scarecrow back together. I couldn’t help him with a new brain, though. He would just have to learn to use the one he had.
I was still thinking about Jeremy Fowler and must have been smiling when Susan repeated herself. “Dr. Lesslie!”
This time she was louder, and she snapped her fingers, trying to get me to refocus.
“Whatever you’re thinking about, I don’t know if I want to hear it,” she told me. “But what are you goin’ to do with the woman in ENT?”
I glanced down again at Elva Wilson’s chart and made up my mind. Sometimes you just don’t need to go by the book. I looked back up at Jeff and said, “We’re going to x-ray that pooch.”
With a broad smile on his face he turned to Susan and said, “We need a doggie-gram in ENT, stat!”
18
With a Little Help from My Friends
12:45 p.m. It turned out that Princess had indeed ingested Grand Ma-ma’s diamond ring, and I informed Elva and Barney that they would have to wait a day or two to retrieve it. Elva seemed happy with that plan, but Princess seemed a little disconcerted when she heard talk of Milk of Magnesia and castor oil. I would leave that part up to them.
I was standing at the nurses’ station when Virginia Granger appeared in the doorway of her office, motioning for me to join her there. I had just finished treating a child in room 3 with an ear infection and was tossing his chart in the discharge basket.
“I’ll be in Ms. Granger’s office,” I told Susan. “If you need me, just holler.” I walked around the nurses’ station and passed the door of the medicine room just as Lori was coming out.
“Lori,” Virginia called to her, still standing in the doorway. “I need you in here for a few minutes.”
The two of us walked into her office, and I closed the door behind us. Virginia was already sitting behind her desk, and without a word she pointed to the two chairs in front of her. We obediently followed her silent instructions and took
our seats.
“Now that was a lot of fun,” Virginia said, shuffling some papers on her desk. “Three hours in a management meeting. It’s like having your fingernails pulled out one at a time.” She sighed and added, “I guess it’s important, but we could have handled the significant stuff in about fifteen minutes. Oh well.” She pushed the papers to the side of her desk and looked up at us.
“So, Dr. Lesslie, I assume Lori has told you about what she discovered this morning in the medicine room.”
“She did, and I—”
She raised her hand, interrupting me. I knew better than to continue, and I waited, knowing she had a plan, and knowing she would unfold it when she was ready. Lori and I looked at each other and then back at Virginia.
She reached across her desk and pulled her telephone over in front of her. Then she dialed some numbers, pushed the speakerphone function button, and hung up the receiver.
We sat there, all of us silently looking at each other, while the phone began to ring. Virginia adjusted her glasses, then peered at me over the top of their heavy black rims. What is going on? I wondered.
“Hello.”
It was Amy Connors. My head jerked over toward Lori, whose mouth was now hanging open. She was staring down at the phone.
“Hello,” Amy repeated.
I looked over at Virginia for some understanding. Still looking over her glasses, she raised her hand and with a ramrod-straight index finger pointed directly at me.
Out of the corner of my eye I could see Lori’s head turning toward me.
I was afraid Amy might hang up so I quickly said, “Amy, this is Dr. Lesslie.”
There was silence on the other end, and I sat there, waiting.
Finally I repeated myself. “Amy, this is Dr. Lesslie.”
“I heard you.” The voice was quiet, subdued—and my heart sank a little. “What is it, Dr. Lesslie?”
I looked over again at Virginia, seeking some kind of guidance here. What could I tell her? How much should I share?
Virginia nodded her head, and I thought I saw a flicker of a smile at the corners of her mouth.
“Amy, I’m in Ms. Granger’s office with Lori, and the three of us are on speakerphone.”
Silence again.
“Amy?” I spoke.
“I’m here,” she answered, still quiet and restrained. “What do you want?”
I took a deep breath and began telling her about what Lori had found this morning. She didn’t say a word as I explained how more narcotics were being stolen, and that the problem was continuing.
“It’s what we’ve known all along,” I told her. “You couldn’t have had anything to do with this. And pretty soon it will be obvious to everyone else. The administration has made a big mistake and we’re going to be sure they make this right.”
“And just how are you going to do that?” she asked, with an edge of sarcasm in her voice. “I’ve been fired, remember?”
“That was a mistake,” I persisted. “We all knew that, and we’re sorry that happened. I’m sorry that it happened. It never should—”
“Amy, this is Virginia Granger,” the head nurse interjected, moving the phone closer to her and nodding at me. I gladly let her take over.
“This has all been a terrible mistake, and handled very poorly,” Virginia continued. “No one in this department has ever doubted your innocence, and I hope you know that. Our hands were tied once the administration made their decision. But now, with this new evidence, we’re going back to Mr. Chalmers and clearing this up. We still have to find the person responsible for this, so I’m asking you not to say anything to anybody about what we’ve talked about. You are the first person, other than the three of us, to know anything about it.”
She paused, waiting for some acknowledgment from the other end.
“Amy?” Virginia gently prodded.
“I’m here,” she answered. “And I’m not going to say anything.” Her voice was still quiet, and I sensed some suspicion in it. Or maybe it was a lingering hurt.
“This is all going to move pretty fast now,” Virginia continued. “And it should all be out in the open soon. In the meantime, though, I want you to be thinking about something.”
I looked up at our head nurse, my eyes questioning this last statement. Where was she going with this?
Virginia met my eyes, but there was no clue there.
“Amy, we want to have you back in the ER,” she said.
There was silence again, and I added, “That goes for all of us. I want you to come back too.”
Lori leaned over the desk, close to the phone.
“Amy, this is Lori. I miss you, and I love you.”
I glanced over at Virginia and this time there was no mistaking it. She was smiling. When she saw me looking at her, smiling myself, she pretended to scowl at me and turned her head away. But there was that smile again.
Then she once more faced the telephone.
“Amy, this is a lot to be giving you, we know. But just take some time and think about it. And know that when this is all over, we want you back here in the ER.”
The three of us sat there, staring down at the telephone, waiting.
“Thanks for calling,” Amy finally said. “I’ve got to go now.”
And she hung up.
I leaned back in my chair and let out a long sigh.
Lori looked over at Virginia and asked, “Well, what do you think?”
Virginia had taken off her glasses and was cleaning them, intently studying the bifocals.
“Well, it’s about what I expected,” she began. “At least she didn’t hang up right off the bat. She could have done that, and I wouldn’t have blamed her. She’s been put through a lot, and for us to call her out of the clear blue like that—well, I think she handled it pretty well.”
“But do you think she’ll ever come back to the ER?” Lori persisted.
Virginia put her glasses back on and looked at her.
“Only time will tell. Only time will tell.”
I was about to say something, when Virginia stood up and said, “Lori, I need to speak with Dr. Lesslie for moment. Would you mind?”
She got up, and with a look of relief on her face said, “I’ve got plenty to do.” As she stepped toward the door she turned and faced her head nurse.
“Ms. Granger, thanks for letting me be here for that.” Then she turned and headed out into the department, closing the door behind her.
“We’re lucky to have her,” Virginia said. “She’s a good nurse, and a good woman.”
Then she settled back down in her chair and started drumming her fingers on the desktop.
“Now, what are we going to do?” she asked thoughtfully. I knew she wasn’t expecting an answer, so I just waited for her to collect her thoughts.
“At some point, we need to let the administration know about this,” she mused. “Probably sooner rather than later. But considering how they’ve handled this so far, I would rather it be later.”
“Did you get a chance to look at the narcotics log?” I asked her.
“No, but Lori told me Darren was the last to sign the morphine count. I know how you feel about him, but it’s time we sit him down and have a talk. I would rather resolve this without getting Stevens involved again, if we can.”
“Are you convinced it’s Darren?” I asked, thinking I knew her answer.
“Who else could it be?” she asked. There was sincere concern in her voice, and I knew she wanted there to be some alternative. But there didn’t seem to be one. Everything seemed to be pointing to Darren Adler. Maybe I had been wrong all along.
When I didn’t answer, Virginia said, “We need to bring him in this afternoon and confront him with all of this. He’s your friend, and you know he needs help. This needs to stop before something really bad happens.”
She was right, and I knew it.
“When does he work again?” I asked.
She had already taken a copy of the sche
dule out of the top drawer of her desk and was studying it.
“He’s working the three to eleven shift this evening. Why don’t we meet with him as soon as he gets here?”
“Okay,” I told her. “If I’m busy, just grab me.”
There were a couple of patient charts in the To Be Seen rack, and I picked up the first one, room 4.
Kim Carlton—26 yr old F—fever. Good. Maybe this would be straightforward. The triage nurse had recorded her temperature as 99.9, and her blood pressure was normal. I checked her heart rate—it was high at 118. Then I noticed that this was Kim Carlton’s third visit in as many days. That was always a red flag. So much for being straightforward. Any time a patient came back to the ER, you had to check things a little deeper, pay a little more attention, and look for something serious going on. A third return visit just compounded all of that.
I glanced over the two previous charts. Both times she had come in with a complaint of fever, both times nothing had turned up, and both times she had been sent home. Liz Kennick had seen her initially, and Ted Nivens had seen her just last night. I would be surprised if they had missed something significant.
Kim Carlton was waiting for me in room 4, sitting comfortably on the stretcher. Her husband, Elliott, was sitting on a stool in the corner of the room and got up as I entered.
“Hello, Doctor,” he greeted me, shaking my hand. “I’m Elliott Carlton and this is my wife, Kim.”
“I’m Dr. Lesslie,” I introduced myself. “Kim, tell me about this fever you’ve been having.” I leaned back against the counter, while Elliott sat back down on his stool.
“When did it start, and what other symptoms are you having?”
Kim proceeded to tell me her story. She had been doing well up until three weeks ago. She started having some mild headaches and a low-grade fever, and occasional knee and shoulder pains, but nothing else. No cough or vomiting, and no weight loss.
Angels on the Night Shift Page 19