Sacred Trust

by Hannah Alexander

  The paramedic, a seasoned veteran familiar to Jarvis, studied the situation and stepped up beside him. “Any luck?”

  “Not yet.”

  “Let me try,” she said. “I’ve done quite a few of these.”

  Jarvis nodded and stepped back, too relieved to be offended, too weak to argue. His hands continued to shake. Even as he watched the paramedic work, his vision blurred once again. He slumped against the counter, hoping no one would ask him any more questions.

  They got the tube in place, repackaged the patient for shipment, and cleared the room. Jarvis heard himself thank the flight crew as they wheeled Dwayne out toward the chopper.

  “Jarvis.”

  The voice came from somewhere beside him, but through the growing murkiness he couldn’t tell who it was except that it was female.

  “Jarvis.”

  This time Estelle’s face floated into view. “Jarvis, how’s our patient?”

  “Stable, I think.” He heard the tremor in his own voice.

  “I’m not talking about Dwayne, I’m talking about you.”

  He raised a brow and looked at her. “I’m not—”

  “You’re relieved of duty,” she said. “I want you to see a doctor. Today, if possible.” She glanced at her watch. “It’s five o’clock. Dr. Simeon should be off duty soon. I’ll call him to come over and check you.”

  “No.”

  “I’m not asking, Jarvis. You are off duty as of now, and you need—”

  “I’ve seen a doctor.” His voice grew weaker. He felt weaker all over. “Ran tests.” He gave up and leaned against the wall.

  Estelle gently took his arm. He didn’t fight it because he didn’t have the strength. He even allowed her to help him walk toward the call room.

  “What were the results of those tests?” she asked.

  “Negative CT.”

  “That’s all? A CT isn’t the only test they can run, you know.” She turned and called over her shoulder, “Claudia, I need you to get some vitals for us over here. I think Dr. George has finally—”

  The E.R. doors flew open, and Theodore Zimmerman stumbled in carrying Tedi in his arms.

  “Help my little girl!” he cried.

  Lukas unlocked the door to his house, feeling more relaxed than he had felt in months. It was great. He glanced down at his feet, then bent over and untied his hiking boots. They were caked in good old Missouri mud and river water. Wonderful mud. His jeans still smelled like fish, although he hadn’t caught a thing. Fishing wasn’t as much fun as hiking, but it wasn’t bad. Being out there in the beauty of God’s natural creation always helped put everything else into perspective, and he no longer worried as much about what was going to happen to his career. God would be faithful. He always had been.

  Lukas had made it halfway across the bedroom floor in his double-stockinged feet when he caught sight of the flashing light on his answering machine. He punched the play button as he passed the machine on the way to the kitchen to get a tall glass of lemonade.

  The sound of Estelle’s voice stopped him in his tracks.

  He raced back out the door, into his mud-caked boots, and off toward the hospital.

  “Put her in two,” Jarvis said as he pulled from Estelle’s grasp and wearily turned to meet Theo and Tedi at the room.

  Estelle did not protest. She couldn’t and Jarvis knew it.

  “What happened?” he asked Theo, giving the younger man a sharp glance.

  Claudia immediately came into the room and started taking vitals.

  “She hit the back of her head on the edge of a bookcase.” Theo wiped at his nose with the back of his hand. He was a mess and reeked of alcohol. “It knocked her out. I couldn’t wake her up.”

  Claudia glared at Theo, suspicion obvious in her eyes. “Why didn’t you call an ambulance?”

  Theo stared at her dumbly. “I…I didn’t think it could get her here as fast—”

  “How long has she been out?” Jarvis asked.

  “I don’t kn-know. Maybe twenty or thirty minutes.”

  “Why did it take you that long to get here?” Claudia demanded.

  Theo’s face crumpled and he dissolved into sobs.

  Jarvis motioned to Estelle, who stood at the doorway. “Get him out of here. He’s not doing us any good like this.”

  As the administrator began to coax Theo toward another room, Jarvis turned to her again. “Estelle, get another doc in here now.”

  Jarvis pulled his penlight out of his pocket and gently lifted Tedi’s eyelids. His hands continually shook now, and the ends of his fingers felt numb. Tedi’s pupils were equal and reactive. The light did not wake her up. He checked for a wound and found a large contusion at the right parietal-occipital region of her head.

  Claudia finished her vitals. “Dr. George, her BP is 110 over 75, heart rate’s 85, respirs 18, no temp. Her O2 sat is 96 percent. Do you want oxygen?”

  Jarvis hesitated. The nurse’s words seemed to blur together. He looked at her. “What?”

  “Oxygen, Doctor. Do you—”

  “Yeah.” He glanced down into Tedi’s face. “I can’t do this,” he muttered, pulling over the stool to sit on.

  “You’ve got to,” Claudia snapped. “We don’t have another doctor yet.” She opened the glass cabinet and took out a c-collar from the supply. “Do you want an IV?”

  He looked at the nurse again. “What did you say her BP was again?”

  Claudia placed the c-collar on the child’s neck, then reached for an IV tray. “It was 110 over 75. I’ll do a heplock.”

  Claudia raised Tedi’s left forearm, prepared it with an alcohol wipe, and expertly slid a 20-gauge needle through the skin into the vein below.

  “Ow!” came the sound of the little girl’s voice.

  The sudden cry startled Jarvis. He scooted the stool forward and leaned toward the child as Claudia continued to work.

  Tedi’s eyes slowly opened; then she squinted in the light, focusing on him. “Jarvis?” She reached out her right hand and touched his face. “Jarvis?” She looked around, her dark eyes gradually filling with apprehension. “Why am I here again?”

  He nearly cried with relief. “Sweetheart, it’s okay.” He patted her arm. “It’s going to be okay now.”

  “Did I get stung by another bee?”

  “No. You bumped your head.” Jarvis leaned forward and rested his forehead against the edge of the cot. She was safe.

  He heard Claudia talking to Tedi, but he only picked up snatches of the conversation as his vision blurred in and out of focus.

  “We were wondering if you might remember what…”

  “I just came home from school. Someone was inside…”

  “It’s okay, honey. Don’t force…”

  He heard Claudia ordering a head CT, and then he felt hands helping him move sideways until his head and arms rested on something harder and flatter. There was silence, and he allowed himself to sleep….

  “Jarvis?” The voice was Estelle’s. He heard her footsteps draw near, and the echo of them pounded in his head, which he could not raise from the desk for the moment. She laid a hand on his right shoulder.

  He forced his eyes open. His whole body trembled as he made himself straighten in the chair.

  “How are you feeling now, Dr. George?”

  “I’m okay,” he heard his own voice croak. He blinked and glanced around the room. “Have they taken Tedi to CT?”

  “They did that ten minutes ago. Jarvis, you’re sick. Dr. Bower is here now, and I’ve asked him to check you out.”

  “I told you I’ve been checked out,” he growled, sudden irritation giving him momentary energy. “I don’t want him touching me.” He struggled to his feet, then walked unsteadily past her out the door toward the central desk. He knew she was following, but he didn’t care. “Claudia, have you heard anything about Dwayne yet?” he asked.

  The nurse turned and looked up at him, then glanced at Estelle.

  “Go ahead
and tell him, Claudia,” Estelle said.

  “Yes, Dr. George. I called Cox South as soon as I made sure Tedi was going to be okay.”

  “How is he?”

  Estelle laid a hand on his shoulder. “Dwayne coded about five minutes out, Dr. George. They did a hot offload, but they couldn’t get him back. I’m sorry. He died.”

  Jarvis could not respond. He stared at Estelle for a long moment. Then the room went black. He felt himself topple forward.

  “Help me, Claudia!” Estelle cried as she caught Jarvis and eased him to the floor.

  A full-body spasm caught Jarvis in its relentless grip.

  “Where’s Dr. Bower?” Estelle demanded.

  “He’s in room six,” Claudia said.

  “Get him now!”

  Chapter Thirty-Three

  Lukas heard Mrs. Pinkley cry out, and he rushed out of exam room six to find Jarvis on the floor, his hands and legs flailing in a classic seizure. Mrs. Pinkley knelt before him, watching helplessly, but wisely not restraining him.

  “What happened?” Lukas asked.

  “He just passed out and started seizing. What should I do?”

  “Make sure he doesn’t hit his head against the desk.” Lukas walked over and grabbed a cot. “Claudia, get out the Ativan.”

  The severity of the convulsions slowed, and in thirty seconds they stopped. “Did he hit his head when he fell?” he asked.

  “No,” Mrs. Pinkley said. “I was able to break his fall.”

  “Good.” Lukas reached beneath the doctor’s arms, lifted him from the floor and manhandled him onto the cot. “Claudia, is that Ativan ready?” He pushed the cot into exam room two.

  “Coming.”

  “Good. Grab a gram of Dilantin on your way. Put it in 100 CCs of normal saline. We want to get this in by IV if possible. We’ll need extension tubing. I don’t want him pulling the IV out if he seizes again. You concentrate on the IV. I’ll take care of the rest.”

  He had Jarvis hooked to oxygen and had padded the bed rails with blankets by the time Claudia walked into the room.

  “Do you want blood drawn?” she asked.

  “Yes, but do it fast. We want to be able to break the next seizure if there is one.” He applied monitor patches and attached the leads.

  “How fast do you want me to give it?” she asked.

  “Fifty milligrams per minute. You’re just in time,” he said as he watched her secure the IV with tape. He stepped to the door and called out to Carol for stat blood work. Jarvis’s arms and legs had begun to tense for another round. “Claudia, hold the Dilantin. Give the Ativan—2 milligrams per minute should break it.”

  Jarvis jerked violently and it started again. Claudia pushed the drug Lukas ordered, and the length of extra tubing prevented the IV from being pulled out. Within two minutes the seizure broke.

  “It’s working.” Lukas watched as the spasms once again grew less intense. “That’s enough Ativan. I think we can start the Dilantin now.”

  “Gotcha.” Claudia switched the medications quickly. She shot Lukas a broad grin. “Good to have you back. I can’t tell you how much I’ve missed you.”

  Lukas reached over and straightened Jarvis’s oxygen mask, which had slipped sideways during the seizure. “I haven’t even been gone a whole day.”

  “It’s been a rough day.” She lowered her voice. “We’ve lost two patients already. Sweet old Mr. Verris had an MI, and he had a DNR sheet, so we couldn’t code.”

  Lukas felt a swift rush of pain. “Frankie?”

  “Sorry, Dr. Bower. I know you really liked him.”

  Frankie had been looking forward to his reunion with his wife, and he was ready. That knowledge brought Lukas peace. It must have upset Dr. George to lose a patient, especially considering the mental state he’d been in recently.

  “Let’s check for vitals since we didn’t get a chance to do so earlier.” Lukas reached for an ophthalmoscope and shined the light into Jarvis’s eyes. They were equal and reactive, and thanks to the seizure, there would be no question about the movement of all four extremities. “You say we lost two?” he studied the patient. “Jarvis? Dr. George? Can you hear me yet?”

  No reply.

  “The other one was Dwayne Little,” Claudia said softly.

  Lukas jerked around and stared at her. “What? How?”

  “He came seeking drugs again, and he got them this time, then drove away while we were busy with Mr. Verris. Wrecked his car. Jarvis seized when he got the news about Dwayne.”

  Lukas felt another rush of pain, and no peace followed this one. Another human life, a human soul, lost.

  Mercy pushed through the emergency room doors and saw Mrs. Pinkley coming forward from the desk to meet her. “Thanks for calling me, Estelle. Where’s Tedi?”

  “She’s in CT right now.” The administrator’s deep, familiar voice conveyed a sense of calm as she laid an arm across Mercy’s shoulders and walked with her, keeping up the brisk pace without apparent effort. “She was awake and talking when they took her over, so it looks as if the worst has passed.”

  Mercy took a deep breath and willed herself to slow down. She headed toward radiology. “What happened?”

  Estelle pressed her lips together thoughtfully. “She doesn’t remember it yet. Her father says she fell and hit her head against a wooden bookcase.”

  Mercy raised a brow at the older woman. Estelle caught the look and returned it. “I’m glad Carol was able to reach you. I’d been trying for some time.”

  “Oh? Why?”

  “Dr. George has fallen ill, and I needed someone to fill in for him. Dr. Bower came in just a few moments ago.”

  “Good. Where’s Theodore?”

  “I left him in the private waiting room.”

  “Has he been drinking?”

  Mrs. Pinkley nodded.

  Mercy didn’t say another word. She would deal with Theodore later. Right now Tedi needed her.

  When she stepped into the CT room, she caught sight of her daughter’s brave expression where she lay in the center of the shooting match. It made Mercy want to cry. The technician completed her final orders and gave Tedi some encouraging words. The press of a button slid Tedi out from beneath the X-ray cameras.

  “Can I talk now?” Tedi asked.

  “Yes, go ahead. We’re finished here,” the tech said, nodding to Mercy. “You can come and get her if you want, Dr. Richmond.”

  Mercy stepped around the lead-lined partition and bent down to kiss Tedi, taking care not to move her any more than necessary. She still wore the c-collar. Mercy studied Tedi’s skin for signs of abuse and found nothing. No marks. Still, children often failed to show signs of trauma.

  “How are you feeling, honey?”

  Tedi blinked and yawned, then raised her hand and touched the collar. “My throat hurts.”

  Mercy’s interest sharpened. “You have a sore throat?”

  “No.” Tedi tapped the collar with her fingers. “It’s my neck, right here.” She indicated the left side of the collar.

  Mercy gestured toward the tech. “Ann, has she shown any physical changes since they brought her in?”

  Ann shook her head. “She’s been perfect. She did everything I told her to do, didn’t cry, didn’t complain. I wish all my patients were so good. Time to get her to the plain film room so we can clear that c-collar. Maybe her neck will feel better then.”

  Fifteen minutes later, Tedi continued to pick at the c-collar with her fingers. “This thing really hurts, Mom.” The X-ray tech had just finished with the final shot, and Mercy stood brushing the hair from her daughter’s eyes and watching her face.

  Something didn’t seem right. Tedi did not seem to feel as well as she had earlier. She should be getting more alert, not less alert.

  “Mom, that machine’s still buzzing in my ear. It’s too loud.”

  Mercy frowned and glanced at the tech. “Buzzing? I don’t hear anything.”

  Tedi looked around and pointed towar
d her left. “It’s coming from over there.”

  “Are you hurting anywhere besides your neck?”

  Tedi yawned. “My head hurts.” She raised her hand toward the right back side of her head and blinked sleepily.

  Mercy checked the movement of her daughter’s pupils. They were fine. Mercy turned to the tech. “Please have Dr. Bower come over here for a stat exam. Something’s wrong.”

  The tech brought Dr. George’s lab printouts to the exam room. Lukas studied them, frowning. “I don’t see an obvious explanation here. We’ll have to do a CT of his head.” He stepped toward the door to give Carol the order.

  “No.”

  Dr. George’s sudden, gruff voice startled Lukas and Claudia. Lukas turned back toward the bed. The lids of Jarvis’s eyes were half-open in a struggle for more complete consciousness.

  “Dr. George, you’ve had a seizure,” Lukas explained. “The blood work shows no obvious cause for it, so a CT scan is the next step.”

  “Done it,” Jarvis growled.

  Lukas blinked at him in surprise. “When?”

  “Monday.” His eyes opened farther, and he turned his head to glare at Lukas.

  “What did it show?”

  “Nothing.”

  “Then we’ll need a lumbar puncture. You’re in trouble, Dr. George. We’ve got to find out what—”

  “Not here, and not by you.” Jarvis struggled to sit up. Lukas laid a hand on his shoulder to stop him, and Jarvis knocked it away. “Get me to Springfield!”

  “Jarvis, you’re already seizing, so you know time could be—”

  “Dr. Bower.” Carol rushed into the room. “Sorry to interrupt, but Dr. Mercy’s calling for you over in radiology. She thinks there’s something wrong with Tedi.”

  Jarvis lay back against his pillow. “Get over there and take care of that little girl, and get me an ambulance.”

  Theo was slumped at the end of the sofa in the private waiting room. His head hurt so badly he could barely hold it up, so he sat with his face buried in his hands, tears dripping between his fingers. He heard the door open and heard footsteps on the carpet, but he didn’t look up. If it was Mercy, he’d rather not see the attack coming.