So, the morning was dedicated entirely to visiting patients who would undergo surgery in the next twenty-four hours. For most of them, there was no turning back–they had to go under the knife.
Jeff demonstrated impeccable bedside manners, although I found him a little terse when it came to explain what was going to happen in the operating theater. He later told us that an operating theater is and has to remain a place where surgeons, doctors and nurses are working diligently to restore wellbeing into a patient. It is not a place of worship; not a place for discussion; not a place to be decorated or furnished with unnecessary encumbrances. In other words, it’s a sanctuary, a sacred room where only a few are admitted.
We were reaching the last of the patients to be visited when suddenly the PA system called all doctors to the emergency lobby. That meant trouble. Something had happened somewhere and injured patients were coming in, in droves.
We ran to the front of the hospital on the ground floor to be met with a sight I never hoped to see in my entire life. A dozen gurneys were lined up against the one wall with an injured child laying in each of them. I froze. The sight horrified me. One of the EMTs replied to my query, saying, “There was a school bus accident on I5–a semi jack-knifed and collided with the bus; five kids killed and about thirty others injured.”
Oh God, I prayed silently, give me the strength.
But there wasn’t any time for prayers. Dr. Kerry was heading the triage in the lobby and writing a chart for each child. We were assigned three kids per intern and Jeff, as well as a few other doctors, supervised the lot or went down to the dungeon to perform emergency surgery on those little bodies.
I had never witness such pain first hand. It had been a book I did not want to open. It had been something at the back of my mind that I didn’t want to discuss with anyone.
Stabilizing their conditions was primordial. Before any care can be given to an injured adult or child, a doctor needs to stabilize the patient, meaning that all their vital signs need to come back to normal before we can treat them. When it comes to kids, there is an added dimension to the problem. A mother or father’s attention, a hug or kisses, are often the only things that will return the child’s vital signs to normal. In this instance, however, I didn’t have the luxury of having mom or dad’s assistance when it came to the kids I was to look after. The first and only bruised little boy suffered a concussion, whereas his two friends were badly injured. I told the nurse to take the concussed boy to the children’s ward and admit him for a day, under observation.
The little girl who was bleeding from her right leg was unconscious. I could not offer her any comfort, but I asked the nurse to clamp the wound until I would have time to close it with some stitches. In the meantime, she was put on an I.V. while she regained consciousness. She was going to be okay.
While the nurse was attending to the little girl, I had my eyes on her brother’s injury. Some sort of nail had pierced his liver–he was bleeding to death. Exsanguinations kill more people than many other injuries. I had to get him on an operating table, get that nail out of his abdominal cavity, and stop the bleeding. As the nurses’ aids and I were running down the hall in the dungeon, trying to reach an operating theater, the boy began coughing blood. I knew it was the end. I stopped everyone and took the little guy into my arms. He was dying and I could not save him. I hadn’t been fast enough. I saw life leave his eyes while a silent prayer went up to God to take care of his little soul.
As if frozen in the moment, I couldn’t let go of him until the nurse pulled him out of my arms. I looked down at myself. I was covered in his blood. I was choking. I tried holding back the sobs that were menacing to burst forth. I couldn’t. I slammed my back against the wall, sunk down to the floor while the nursing staff took the gurney directly to the morgue.
As I was sobbing my heart out, Jeff came out of an operating theater and rushed to my side.
“What happened?” he asked, pulling me up by one arm. “You need to get washed up…”
“I need to get out of here,” I blurted, enraged at my incapacity to save the boy. I was still sobbing.
“Come with me,” he ordered, taking me by the arm again. I was stubbornly standing my grounds and looking at my blotchy lab coat, my bloody gloves and the floor–I was still dripping with his blood. “No use looking at it, Heather. Let’s get you washed up,” Jeff insisted, gripping my arm tightly.
“I can do that by myself,” I said, walking beside him now. “Maybe you should go back upstairs; they’re bound to need all the helping hands they can get.”
“They’ve got all the help they need, I’m sure. Besides, you’re the one who needs help right now.”
When we reached the scrub room, a couple of doctors came out of the theater and threw a glance at me. They lowered their gazes. “It’s a mess upstairs,” Jeff commented by way of an explanation for my blood-covered coat, face and gloves.
Jeff helped me out of my lab coat, threw it in the laundry cart and stood beside me as I washed myself. As I saw the blood going down the drain, I broke down again. I couldn’t erase the boy’s face from my mind. He had died in my care. And I had been unable to be fast enough to save him.
“Are you going to tell me what happened now?” Jeff said, as he turned me to face him, and away from the basin.
“It’s one of the boys in the bus,” I began, avoiding his gaze. “I failed him. I managed to save his sister. She only had a nasty gash on her leg, but her brother, I could not save him. He bled to death. I wasn’t fast enough.”
“Do you remember what Dr. Clemens told you on your first day in the dungeon?”
“I can’t really remember exactly but he said…”
“That “If God decides it’s time for this human being to leave this earth, there is nothing anyone of us can do. Right or wrong, the life of that patient is in your hands until God decides otherwise”. You need to remember these words every day of your career, Heather. You cannot break down every time you lose a patient. You cannot control destiny.”
He handed me a clean towel from the nearby pile on the shelves.
I took it and dried my hands and face. Fortunately, there were also a couple of clean lab coats in one of the open closets. He handed me one.
“I don’t know if you understand how I feel, Jeff. I feel as if I could not reach him in time. He fell down the precipice and I wasn’t strong enough to keep him from falling. The worst part was when I saw him die. If only I could have taken that nail out of his side, maybe I could have saved him.”
“Probably not, Heather. You know as well as I do that once a patient, especially a child, has lost too much blood, there’s no coming back from it. Besides, you’ll learn that you will not be able to save everyone.”
He sounded callous, unfeeling, almost cold. I hated him for it.
“Okay,” he went on, “let’s get you back upstairs. You’ve got to see to the one you saved. Let’s not forget her. That little angel is probably all her parents have left.”
“I can’t, Jeff. I can’t face them,” I said as staunchly as I felt. In my mind, there was no way I was going to face another second of pain. Facing the boy’s mother would be impossible. Dr. Kerry’s detachment, at that moment, was nowhere to be found.
“And I say you are. I’ll stand right beside you. But you’re the one who’s going to say the words.”
“I can’t, Jeff…I just can’t.”
“Heather, listen to me,” he said, taking me by my arms as if he were ready to shake me. “You are going to become a fantastic surgeon, but you will not be able to save everyone that comes in your operating theater. You will not be given that luxury. The circumstances, such as the one surrounding this little boy’s injury, were out of your control. So, now, you need to pick up the pieces, if only for his sister’s sake. And remember, you didn’t make a mistake, okay?”
He released my arms.
“You will stand beside me?” I asked as if I were a kid ready to receive a heck
of a scolding from Dad.
“I said I would, didn’t I?” He peered into my eyes. “Come on, let’s go.”
When we arrived upstairs, Dr. Kerry was waiting for us in the lobby. She had been informed of what happened in the dungeon.
“Okay, Dr. Williams, let’s go to Isabelle Grundy’s room. She is the young lady you saved today.”
“Are her parents with her now?” I asked, frightened again.
“Yes, Dr. Williams, they are.” She turned to Jeff. “Haven’t you got somewhere else to be, Dr. Aldridge?”
“No, Dr. Kerry. Actually I don’t. I arrived just as the boy closed his eyes. I thought I would give moral assistance to Dr. Williams, since it’s her first loss.”
“Very well then, but you will leave Dr. Williams to do her duty, won’t you?” Jeff nodded. “It’s important that you do, my dear,” she added, looking at me. She turned and we followed her down the hallway to the elevators.
During our initial tour of the hospital, we had visited the children’s ward. It was one of the wards I favored. It was cheerfully decorated. Many of the rooms were fitted with 3-D Walt Disney characters glued to the walls.
When we arrived in Isabelle’s room, as expected, her mom and dad got up from their chairs. I stepped forward. Mrs. Grundy looked into my face. She knew immediately what I was going to say.
“Where is he?” she asked, her voice trembling with every word.
“I am very sorry, Mrs. Grundy,” I said, “I tried to…I mean we all tried to do everything we could for your son…”
“His name was Jimmy,” the father cut-in, “We call him Jimmy.”
“We tried to save Jimmy, sir. But he had just lost too much blood when he arrived at the hospital. I couldn’t save him. I am sorry.”
“Oh God,” Jimmy’s mother blurted, nestling her face in her husband’s chest.
“How is Isabelle?” I asked, approaching my little patient’s bed. “How are you doing, sweetie?”
“Fine. My leg hurt. Where’s Jimmy? Is he coming up to my room?”
“No, Izzy,” her mom said, sitting on the side of her bed. “Jimmy is gone to visit Jesus.”
“Really? Why didn’t he wait for me? I would have gone with him.”
Good Lord. Please grant me another ounce of strength. This is not happening….
Dr. Kerry stepped closer to the foot of the bed. “I think you better think of getting better, young lady. Jesus and Jimmy are watching you right now, don’t you know? Jimmy needs to know that you’re okay. And Dr. Williams will help you all the way. Right?”
“Okay, Dr. Kerry. I will do my best.”
When I turned to leave the room, I noticed Jeff standing near the door, his back leaning against the doorframe. He wasn’t looking at anyone. He had his eyes focused on the floor and his arms crossed over his chest. He looked as if he was about to cry.
“I’ll be back in a bit, Mr. and Mrs. Grundy,” I told at the parents. “But you should get some rest…” I looked at Dr. Kerry. She nodded. “If one of you wanted to stay with Isabelle, we can arrange for a cot to be brought in.”
“Yes, that would be nice,” Mrs. Grundy replied. “I’d like to stay, if that’s okay?”
“We’ll see to it. No problem,” Dr. Kerry added. “But for now, we’ll leave you…”
“When will we be able to see Jimmy,” the father asked, looking at Jeff.
“As soon as the coroner has prepared his body for viewing, sir, you’ll be able to see him,” Jeff said. “I’m sorry. I’m Dr. Aldridge. I was there when your son passed away. I just wanted to offer my condolences to the both of you.”
That night, I had the first of a series of recurring nightmares. My hands covered in blood were blinding me and dripping over my mouth until I choked myself awake. Tiffany thought I had hurt myself, I screamed so loud. When she came in to see what was going on, I told her what happened and was finally able to cry for having lost Jimmy–a little boy I didn’t even know.
Chapter 14
The next day, I tried not to show any of the scars that were to decorate my heart for a long time to come. I tried, with Tiffany’s help, to act as if nothing had happened. Our schedule had changed slightly since most of the interns had someone to look after. We had our patients to visit. I had to discharge the first boy I treated and I had to pay another visit to Izzy. Tiffany had her own kids to visit; in fact, every intern had someone to look after in the Children’s ward.
Dr. Kerry escorted us to the floor, but she let us deal with our kids on our own–except for my looking after Izzy. Dr. Kerry was well aware of the ordeal I had faced the previous day and was probably aware of the images that were floating in front of my eyes as I looked at the sick kids populating the ward.
“Come now, Dr. Williams,” she said, falling in step with me as I was walking toward Izzy’s room. “Izzy will be with us for a week, so we better get our act together and give her and her parents what they need. If it is difficult for you to accept Jimmy’s death, can you imagine what Mr. and Mrs. Grundy and Izzy herself are going through right now?”
Dr. Kerry was right. I had been thinking of my own grief. I was feeling sorry for myself. And that is not what a parent or a loved one expects from their doctors. Shake it off, girl, I told myself, the fight is done. You lost. But their fight has just begun. So you better shape up and get a grip.
I smiled at Dr. Kerry and nodded. “I know. Thanks for the pep talk. I think I’ll be okay now.”
“Perhaps you won’t be for awhile yet,” she countered, “but your support will be needed in the next week. These parents need you.”
An hour later, we were back on the fifth floor for our daily powwow–the one we missed having the previous day. Dr. Kerry was ready to hear each of the battles we fought the day before. She made comments about the procedures each of us adopted and then my turn came.
“Dr. Williams, I know yesterday was difficult for you, and I also know that you would rather forget about it. Unfortunately, that’s not the way it works. We all know Jimmy Grundy died as a result of his injury. Could you explain to us what you would have liked to do?”
“Well, to tell you the truth, Dr. Kerry, in hindsight, I couldn’t have done anything differently under the circumstances. However, what I would have liked to do is slightly different from what happened. I would have preferred being able to get Jimmy into a room and take the nail out of his side right there and then. Even if we had reached a theater in time, we could not have saved him. The time we would have taken to scrub, to change into our gowns and do all that is required before an operating procedure, would have been too long. He would have died before we were ready.”
“So, what you’re saying is that we should have taken him into the emergency room immediately upon arrival, is that what you mean?”
“Yes, Doctor. Honestly, I didn’t see why he was not on top of the list. Was there something you noticed during the triage that I didn’t see?”
“Yes, Dr. Williams, there was something you noticed, too, but only later. Jimmy Grundy was bleeding out. The boy had no more blood to give when he arrived. He bled out already.”
“But what about all the blood that seemed to seep out of him when I looked after him?”
“His liver was full of the blood resulting from the puncture, but that’s all he had left in him to give.”
“Do you mean he would have died anyway?”
“Whatever you would have done, Dr. Williams, would have amounted to the same result. Jimmy Grundy was practically dead when he arrived in the lobby. That’s the reason why I didn’t put him on top of the list.”
That was certainly a sobering thought. It is true, though. Most of us only see a patient after the fact. We only see the person after the accident occurred. Often times EMTs cannot reach the injured parties for quite a while. They could be trapped in a car, a house, even somewhere not readily accessible. And when help arrives, it’s too late. Subconsciously, it was perhaps why I didn’t want to work in the emergency room
. Too many times I would fight a losing battle. However, it was on the schedule. Each intern would spend at least a week in each department of the hospital. We had no choice. We had to take the good with the bad. It was unfortunate that I landed in the arms of circumstances with Jimmy dying on me. I just hoped the week I would have to spend in the ER would be furnished with a lot more healing than deaths.
The other thing that I couldn’t readily grasp was Tiffany’s desire to work in the ER. She didn’t look that tough to me, but I guess it takes all kinds to make a world. Pronouncing someone’s death at any time is something I could not bear doing again soon. It’s so definite, final, a point of no return. And Tiffany was looking at doing it at least once a week. She must have had an incredible stamina, I told myself.
At lunch that day, we sat at a large table at the upstairs’ terrace café. It seemed as if we needed to be together. We needed to comfort each other. It was our first real incident. This is what we spent all these years with our heads in the books for–we were doctors now. We had to apply what we learned and heal people. It seemed as if reality punched every one of us in the face and left us bruised.
We talked about this and that, avoiding the subjects of our patients’ conditions like the plague. We came back to the previous day’s events slowly, when we felt more secure or more relaxed, I suppose. Of course, the subject of Jimmy’s death came back to everyone’s mind. No one, apart from Jeff and the nursing staff, had seen what happened in the dungeon. And my companions wanted me to describe what occurred.
Destroy (A Standalone Romance Novel) Page 10