Silent Fear, a Medical Mystery

by Barbara Ebel

  Casey decided to let Danny know. The Neurosurgical Group of Middle Tennessee has enough of a doc shortage, Casey thought. Giving Danny information about incoming trauma may help them juggle their morning surgeries, rounds, and office appointments. He rang Danny also knowing he wouldn’t be in surgery yet. “Danny, it’s Casey, you should expect major head trauma this morning. Mark and I are going out now.”

  “Thanks for the heads up.”

  “And Julia was still sleeping like a baby when I left, along with her new guardian, Dakota.”

  Danny pictured it. “Thanks. What an unexpected team. Okay, have to run.”

  “Me too,” Casey said. He hung up and Mark jumped into the driver’s seat and started the ignition.

  En-route to the southern interstate accident, continuous chatter from police and first responders sounded on their radio. For some reason, even seasoned accident first responders registered shock upon arriving at the scene. Mark drove furiously fast, but kept a step ahead of other automobiles that could present problems. He slowed once because an old gentleman, barely high enough in his seat to see out the front window, continued to drive in the fast lane. Mark peeled onto the shoulder lane, hugged the median, and zipped past him.

  Finally they came upon traffic barely crawling, so the ambulance drove on the shoulder the rest of the way. They slowed to a minimum speed as troopers on foot guided them into a safe, yet close, spot to park. Casey and Mark piled out of the vehicle.

  Wreckage, glass, police, and first responders dotted the highway. The first vehicle planted in the right lane was a humongous semi, the front cab not touched. But the next vehicle was the remnants of a white sedan, which had its front end all the way to its rear seats jammed under the truck. The top of it didn’t exist anymore, at least to the naked eye. A car had also hit this vehicle from the back end.

  Another ambulance’s personnel slipped a patient on a stretcher into their vehicle as Casey and Mark met a trooper half way. “What happened and what do you have for us?” Casey asked. His adrenaline had kicked in. He wanted to save a life.

  “The truck here wasn’t responsible, but the driver’s hurt and they’re taking him now.” He nodded to the departing ambulance.

  Casey stared at the main gnarled mess of the car wedged under the back of the truck. It was as bad as they get. He looked at the trooper. “I told my neurosurgeon buddy we’d be bringing in a head case, and it looks like we’re going to deliver.”

  “Not from this one.”

  Casey and Mark huddled closer to him. The surrounding noise and commotion made it difficult to hear him. “Why not?” Mark asked.

  “Because the guy in this car was decapitated. His head is in the back seat. He was texting while driving, drove right underneath the semi. It was the last text he’ll ever deliver.”

  Casey felt sick. He’d been to a lot of accident scenes, but this topped them all. He tasted the instant coffee he had sipped on earlier. His heart sped faster and he wanted to scream out that it should be against the law to text while driving. However, the guy probably shouldn’t have had a driver’s license in the first place.

  He looked at Mark, who’d turned pale. The officer was making a valid attempt to lure them to the next car which had plowed into the mess. “Mark, are you alright?” Casey asked.

  Mark nodded. “What’s wrong with this world, anyway?”

  “Fellas, here’s your patient,” the officer said, breaking into their thoughts and discussion.

  The woman they extracted was clearly a patient for the trauma service and Dr. Danny Tilson.

  ----------

  On Monday morning, police officer Evan Parks itched to call the distressed lovely lady who had paid him a visit on his evening shift the night before. He felt it would be all right if she called in the status of her baby girl’s whereabouts, but he wanted to contact her first personally. She had grabbed his attention. However, she hadn’t left a phone number for him to reach her.

  As he walked out of his office to pour more generic stationhouse coffee, he grabbed his ringing phone. “Officer Parks,” he said.

  “Oh, they put me through quickly,” a velvet-voiced female said. After talking with her only once, he would recognize her voice anywhere. “Officer, this is Rachel Hendersen. We met last night. I am calling to confirm that I am ready to plunge from the George Washington Bridge if I don’t get my baby back. And I don’t even live in New York.”

  “Okay, Miss Hendersen. It is miss, correct?”

  “Yes sir.”

  “Okay, let’s see what we can do about this.” But this time, he was going to get her phone number.

  ----------

  Dr. Bruce Garner slipped a patient’s chart over the desk to the office billing clerk. “This patient is getting dressed and will be out in a moment. If she can’t pay her co-pay today, just waive it for later.” Matthew Jacob came up alongside him and also slipped billing paperwork on the desk.

  “One office person out sick and we all feel the shortage,” Bruce said, grimacing. “Plus, I can’t wait for Dr. Jeffrey Foord to start.”

  Matthew shifted his eyes as Bruce continued. “Danny’s got his hands full seeing all our patients and doing surgeries today. And you should have limited hours today after being on call this weekend. It must seem like residency again to you two.”

  “I must admit,” Matthew said, “it’s a challenge. He gazed out to the waiting room as the door opened and two uniformed officers entered. Matthew’s eyes grew wide. He’d never seen holsters and guns in their office. Bruce still blabbered about the practice, so Matthew tapped his hand on the counter and motioned ahead.

  One policeman stayed at the door while the tall one approached the desk. Patients reading magazines in the waiting area lowered them away from their eyes and mumbled amongst themselves.

  “Who’s in charge here?” the tall one said across the counter. “We’re looking for a Dr. Danny Tilson.”

  Bruce felt like he’d swallowed his tongue. What the hell did Danny do now? “He’s over at the hospital seeing patients. He’ll be in surgery at some point, too. Is there something I can do for you?”

  The officer listened while he gazed at the three doctor’s business cards on the counter. He picked up Danny’s card. “No. We’ll take care of this with him. Good day, docs.” He turned, surveying the office, and exited with his partner. He waved the card in front of them. “I’ll never go see this guy,” he said.

  Chapter 21

  Danny continued rounds before his delayed late morning surgeries started. He had Bruce’s and Matthew’s patients to see, too. The list of names was so long, he kept looking at it and shoving it back into his pocket. The paper now resembled a wad of paper that had been tucked into a pants pocket and gone through a washing machine cycle.

  The clerk at the desk checked off Danny’s orders from the previous patient and helped him find the last chart he needed. He finally sat, looked through his patient’s progress over the weekend and any additions Matthew had made, and went to see his craniotomy from late last week. When he went in the man’s room, the man looked up from reading a paperback. His face soured. “I heard you left a sponge in my brain last week,” he said.

  Danny froze. No way, not that he was aware of. His pulse quickened. But maybe Matthew had discovered it over the weekend by CT. Not one more thing. Plus, he better get the man to surgery if there was any truth to it.

  “Does that mean you’ve given me a memory like a sponge?” the man said, breaking his seriousness. “And do I owe you extra for the craniotomy?” The man chuckled.

  Danny could walk again, but the patient’s remarks this morning didn’t strike him as funny. “I think you’re off the hook but I don’t think I’ve improved your mental status. However, the sponge idea may be a good one for dementia research.”

  Finally, Danny smiled back. He unwrapped the man’s head bandages and discussed his discharge from the hospital. When he returned to the nurs
es station and finished discharge orders, his beeper went off. They needed him in the ER stat.

  He made it down the stairwell at topnotch speed to the sleepy emergency room, except around the trauma room and hallway. Danny wiggled his way through where Mark gave report to the ER doc with Casey behind him. The female patient with Spanish features and an endotracheal tube already in place also wore a neck brace. Danny nudged Casey’s arm, and they both went to the head of the table.

  The first thing Danny did while listening to Casey’s account of the accident scene was to evaluate her head and reaction to light. He kept working while Casey added the story about the texting driver. Danny shot him a mournful glance, and then continued.

  Casey stepped back as an orderly tugged at his sleeve. “I think those guys are looking for Dr. Tilson,” he said. At the doorway, a police officer grinned at the scene.

  “Are you sure?” Casey asked.

  “That’s what I heard.”

  Casey weaseled his way through. “Who are you looking for, officer?” In the hallway, Casey spotted another uniformed cop by the back door.

  “Dr. Danny Tilson. That’s him in there, right?”

  Casey nodded. “Can it wait a minute?”

  The narrowed-eyed man didn’t respond, but stepped against the back wall. Casey went back to the trauma patient as Danny conversed with the ER doc, discussing the need for a head CT as soon as possible.

  “Danny,” Casey said, “there are two cops here asking to talk to you.”

  “I just had a joke pulled on me upstairs. I’ve had my quota for the day.”

  “Danny, I wish it was a joke.”

  A path cleared and Danny spotted the man in blue. “What the …” He didn’t say the expletive as he joined the deputy. They went into the hallway with Casey trailing.

  “Let’s go somewhere quieter.” Danny pointed to the kitchen. The three of them stepped in, where the room was empty of personnel.

  “You’re Danny Tilson?”

  “I am.”

  “Your baby girl has been reported missing,” the officer said as he eyed the coffee pot. “The mother filed a report in Knoxville. She thinks you have her and you’re not supposed to.”

  Danny’s anger welled up. His pulse banged against his temples. Casey handed a Styrofoam cup to the officer, eyeing his friend. “This is backwards,” Danny said. “It is I who should be reporting her. Unfortunately, I couldn’t get this mess cleared up because it was the weekend and my attorney didn’t call me back.”

  “And….,” the officer said, as he poured a cup. “Where’s the baby? You’re not a baby snatcher or crazed lunatic, are you? We often don’t get too involved with vindictive domestic troubles and you seem like you have more important things to do. However, kids or babies often have to be found quickly if they’re missing as the odds are unfavorable once they’re gone for more than a day or two. We’re just doing our job.” He finally took a sip of the coffee.

  “Rightfully so,” Danny said. “I have Julia. This is my friend, Casey, and he lives with me and can attest to her safety.”

  The officer eyed the both of them. “Oh no, it’s nothing like that,” Danny said. “He’s engaged to my sister and we all live in my deceased parent’s house.”

  The officer rested his brow and shifted his weight.

  “Anyway,” Danny continued, “I got Julia from her mother on Friday night and we found evidence of child abuse. We even had her seen by a pediatrician on Saturday. I couldn’t give her back until this gets resolved. Imagine if I had handed her back to suffer the same treatment. She’s peppered with broken bones and cigarette burns.”

  “Ouch,” the deputy said. “Is this true?” he asked Casey.

  “Regrettably so,” Casey said. “She’s at the house with my fiancée right now getting appropriate care.”

  “I’ll get my attorney today to do something,” Danny said. “You can go by the house if you’d like.”

  “I think you two are credible. As a matter of fact, aren’t you one of the guys all over the news these days with this brain epidemic?”

  “That’s me,” Danny said.

  “You’re saturated with problems, but you all better get a cure.” He took his half cup of coffee with him out the door. “You two have a good day, gentlemen,” he waved. “We’ll call the Knoxville police station. And stay out of trouble.”

  ----------

  Noon came all too quickly. Danny’s first surgery patient had enough anxiolytics, IV meds on board for anxiety, to let him sleep the rest of the day. The OR personnel still had a few more instruments to ready for the case, so Danny made use of every minute in the doctor’s lounge. He’d had a break. After reviewing the trauma patient’s CT scan of her head, he ruled out any intracranial injury. The patient’s hemodynamics from multiple organ injuries had caused her morbid mental status.

  He readied a sandwich, the first thing to eat all day, slapping three types of cheese on a robust rye bread and added cole slaw to the plate. He bused a coke over to where he sat at the corner table and moved a nearby telephone beside him mumbling under his breath at his attorney. Since all the major dealings of his divorce and child support to Rachel had been finalized, it was like Mark Cunningham couldn’t be bothered with the small stuff.

  Danny dialed, expecting the worst scenario having to leave a voicemail. But Mark answered on the second ring.

  “Danny, you’re in my pile of phone calls to make.”

  “Mark, I depended on you calling back,” Danny said in an irate tone. “I can understand over the weekend not hearing from you, but you could have called first thing this morning. My message was clear.”

  “I have motion hour over in the courthouse on Monday mornings, Danny. You should know that. I’m catching up in the office right now and have clients waiting in the waiting room. But I was going to call you shortly.”

  “But I was paid a visit this morning by two policemen while a big trauma came in. Rachel went to the cops because I kept Julia. They wondered if I was a baby kidnapper or something.”

  “Well, did you keep her?”

  “What do you mean, did I keep her? Would you send your own kid back to be tortured by someone?” Danny tried to keep his passionate voice low.

  “Okay, sorry Danny. We’ll have to straighten this out temporarily until the bigger picture gets resolved.”

  “What do you mean temporarily? Rachel obviously shouldn’t have her daughter full time.”

  “Danny, you haven’t been in the system long enough. There’s nothing permanent in family court.”

  Danny fought to gather his composure. He waited a good ten seconds, but Mark spoke first.

  “Give me the name of the pediatrician and tell him I will contact him today. I will get something in front of the judge by tomorrow. We’ll try and get Julia to stay with you for the present time and Rachel to only get supervised visitation. You are probably quite aware, it’s difficult to prove child abuse, so I don’t know if you’re considering filing charges. Plus, you don’t know if it was the mother. Single mothers get involved with some strange bedfellows.”

  Finally, Mark was making more sense. At the heart of it, Mark usually knew what he was talking about. “Okay, do the utmost you can. Besides looking after a baby’s welfare, we can’t have me visited again by the police. I thought I was going to be handcuffed and transferred to jail.”

  “I’ll come down hard about that issue. That was your former lover’s, I mean girlfriend’s, attempt to be malicious. You have been sending her the allotted child support, correct?”

  “I have. But I did have to switch my weekend’s visitation with Julia from last weekend to this weekend. That probably upset her.”

  “Rest assured I’ll be on the phone with Rachel’s attorney, Phil Beckett, when I get off the phone with you. So what’s the pediatrician’s name?”

  “Dr. Saul Thomas.” Danny gave Mark his number.

  “Why don’t I m
eet you at your office at five o’clock? I’ll talk to that pediatrician first, prepare paperwork, and have something ready for you to sign.”

  “Okay, see you later.” Danny took a bite of the cheese sandwich which he’d forgotten about.

  ----------

  After an uncomplicated intracranial surgery, Danny’s last case for the day was a back. Unfortunately for the young adult patient, he had a nerve root compression which resulted from the extrusion of some nucleus pulposus caused by a tear in his annulus fibrosus. In other words, Danny told him, a little too much sport’s practice. The young man had initial pain, was treated conservatively and had resumed routine activities, but relapsed.

  Danny kept his thoughts on his case, his patient turned prone and doing extremely well, with little bleeding. Dean did the anesthesia, the first case with Danny for the day. He chit chatted with staff more than Danny and finally stretched his legs and walked to the bottom of the table to evaluate the blood loss.

  “Danny, I just heard someone say in the doctor’s lounge that you may be under arrest.” Dean had stopped on the other side of the patient’s open back, blue drapes clean, and few red lap sponges on the field.

  “What?” Danny exclaimed.

  Dean shrugged his shoulders. The scrub tech looked with scrutiny at Danny.

  “I dismissed them saying that, but they said they saw two cops haul you out of the trauma room this morning.”

  “Not to worry, I don’t have someone’s brain parts in a jar in my closet.”

  “You know how the rumor mill is, Danny. I’d rather let you know what’s being said. Actually, you’re a bit of a holy man around here, being that health care workers can’t figure out how you escaped your patient’s meningoencephalitis.”

  “Actually, Dean, the police thing is a personal family matter. But suffice to say, they talked to me because I’m involved with preventing more harm occurring to someone else.”

  “So in a way, you are a holy man,” the scrub tech said, handing him an instrument.

  “No,” Danny said, “far from it.”