by Candy Crum
In other words… the new students are great fun.
“I’d love to,” I said. “Should I feel bad that I get a kick out of this? I’m going to be one of them soon enough.”
Andi laughed. “You probably should feel a little bad for it, but you won’t get to do clinicals here because you work here.”
“Exactly,” I replied. “So, I will be them when I go to a different hospital to train.”
She shook her head. “No. You know what not to do. You’ll be fine. Now stop overthinking everything and let’s go break ‘em in.”
As we made our way down the hall we saw a young woman run out of one of the patient rooms screaming for help. The day before, that room had belonged to an admitted patient of mine, but that changed from day to day.
“Change of plans,” Andi said.
All amusement drained from her face as her stony professional look replaced it. Relief washed over the woman as we ran to her side.
“Please!” she said. “My mom isn’t breathing!”
Andi and I ran inside, and there were a few things that I noticed…
One: That was, in fact, the same patient I’d had the day before. She was a cancer patient and had been admitted for some complications. Even with those complications, we didn’t foresee her having any life-threatening issues.
Two: The patient was pale, her lips were turning blue, and she appeared to be unresponsive.
Three: Standing and holding the young woman in his arms was Jax with Alex on the opposite side.
“It’ll be okay,” Jax said. “It’ll be okay.”
About that time Jax looked up and his eyes widened as his gaze met mine. I shook it off and went to work.
“What do you think?” Andi asked out of habit. Even in emergencies, she was always a teacher.
I lowered the head of the bed and placed my ear next to her mouth. There was no sound at all, and her pulse was non-existent.
“No pulse or respiration. Start CPR. This was my patient yesterday,” I said. My voice was monotone, fast-paced, and professional as I blocked every other distraction out of my head.
“Update me while you stop the IV,” Andi said as she began CPR.
“Female. Fifty-six. Suffering complications from treatment of bilateral breast cancer. She is not a DNR. The labs yesterday showed signs of kidney trouble, but failure didn’t seem probable. Most labs were within normal limits for her condition and treatment. She presented with fatigue, UTI, and low output. Heart rate and respirations were within normal limits and nothing strange came back on the EKG. There wasn’t much swelling and, what there was, the doc assumed it was due to the chemo. She has a lot of edema, now.”
“What would you suggest to do?” Andi asked as she motioned for me to take over CPR.
“Get her nurse in here. We need a report and the labs that were taken this morning. Possible kidney failure,” I responded.
“Solution,” Andi said.
“If the labs are consistent with that, once stable she needs dialysis and her medications need to be reevaluated until she is strong enough to continue,” I replied.
“Very good. Sounds like a plan to me,” Andi said.
“What happened?” a med student asked as he ran in. “She was fine over an hour ago.”
“Over an hour ago?” Andi asked.
“Elizabeth.”
His voice and the way he said my name was the most heartbreaking thing I’d ever heard. So soft. So scared. My eyes met his.
“Please tell me she will be okay,” he said.
“I’ll do my best,” I said. “You guys need to leave the room. We need to focus.”
“Defibrillator! NOW!” Andi shouted at the med student.
The outburst caught my attention, and I looked over to see the med student leaning against the door, arms crossed and watching us work to save this woman. This mother.
Leaning…
Against…
The door…
I wanted to come unglued on him, but Andi had already screamed at him and sent him running. Go Andi.
It didn’t take long for him to get back with the defibrillator. We went to work setting it up as quickly as possible.
“Go find her nurse!” Andi yelled at him.
“Yes, ma’am!” he squeaked out before tearing off down the hallway.
“Clear!” Andi shouted.
I backed away and she shocked our patient once. She pulled the paddles away, and I moved to check the pulse.
“Nothing,” I said.
Without hesitation I gave her two more breaths as Andi recharged the pads.
“Damn it!” Andi exclaimed. “He brought me a dead one.”
“I’m on it,” I said. “Go get another one.”
I grabbed the arm of the chair right behind me and swung it around. I used it to stabilize myself on the edge of the bed for a better angle. Being shorter had its disadvantages when administering CPR. Andi ran from the room. Time seemed to be standing still. Everything appeared to pass slowly, though only four minutes had passed since we’d walked in the room. My body ached, but I forced it to push through as I continued chest compressions.
“She can’t die!” the woman behind me shouted. “Please!”
She dove for the bed, the shake almost tossing me into the floor.
“Jax,” I said. “You have to get her out of here. I can’t focus on both of them.”
He nodded once before picking her up bridal style and carrying her out of the room. I had no idea who that girl was, but it was obvious that he cared a lot for her.
“I can’t do this anymore,” Alex said, tears in his eyes. “Please save her.”
His emotions began to overwhelm him. More tears spilled over as he started making his way out of the room. I did my best to block him and Jax out of my mind as I leaned over to give two more breaths. I felt resistance only a moment before a voluntary breath was taken. I pulled back and felt for a pulse. It was there. Faint… but it was there.
“I have a pulse!” I cried out.
Andi ran in, defibrillator in hand and two doctors behind her.
“She’s back,” I said. “I got her back.”
I shoved the chair back after climbing down. I took my stethoscope off my neck and listened to her heart. It wasn’t very strong, but it was there, and she was breathing.
“I’ll get an intubation kit,” I said.
“Good job,” Andi said with a smile.
“Very good work,” Doctor Saunders said. “This is why we need more like you.”
I smiled as I ran out of the room. Though the scare wasn’t over yet, it was still nice to get a compliment during a high like that. There was no drug on earth that could compare to the rush one gets from saving a life. It’s unlike anything else.
“Elizabeth!” Jax said as I walked out of the room. He reached for my hand, but I had to pull away.
“I can’t right now,” I said. “It’s not over yet. We have to get her intubated to keep her breathing and try to stabilize her. Once we do that, we can get to the bottom of what’s causing it. I’ll be right back.”
Jax only nodded as I turned and ran down the hall to the supply closet. I put in my code and walked in, grabbing an intubation kit and a few other things we might need. When I got back to the room they were ready. Her breathing was shallow, and her heart rate was abnormal. They were in the process of administering medications to help things along. Jax had come back into the room, but Alex and the woman were still in the hall.
“Elizabeth,” Doctor Saunders said. “Would you like to assist?
“Yes,” I replied.
I came to stand next to him, helping him prep.
“This is a teaching hospital,” he said. “Have you ever done one?”
“Yes, I have. I’ve done several, actually. I worked in a long-term care facility for a while before I came here. We were all trained for emergencies.”
“Then I want her to do it,” Jax said.
I turned to see his eyes locked on mine.
He’d come back into the room.
“What?” I asked.
“I trust you. Do it.”
There wasn’t time to argue, and the doctor apparently didn’t think so either. We’d just finished setting everything up. They were ready. After quickly putting on gloves, I stepped up to the metaphorical plate. I tilted the patient’s head back and positioned the laryngoscope. I had perfect view of the vocal chords and was able to slide the tube in place. Though I’d seen it done a hundred times, and had done it multiple times myself, Doctor Saunders stood over my shoulder giving me step by step instructions and monitored my every move.
Once I’d placed the tube and removed the laryngoscope, I placed the bag that I’d grabbed from the supply closet and then used my stethoscope to listen for breath sounds.
“Bilateral breath sounds heard,” I said.
Doctor Saunders checked as well for safety.
“Very good work, Martin,” the doctor said with a smile. “You stay here and speak to the family, as well as the nurse and med student assigned to this patient. Go through those labs. I want to know what happened and why it wasn’t caught earlier.”
I nodded. “Yes, sir.”
“Let’s get this patient to ICU,” Doctor Saunders said to the remaining team in the room.
Everyone was quick getting her mobile. They only had to move one floor up. I silently hoped that she would stay stable for that long. Once everyone was out of the room, I took a deep breath before I began the conversation with Jax.
“What’s happening?” Jax asked.
“They’re taking her to ICU. She’ll be in good hands there. They’ll closely monitor her labs, and there’s a heart monitor that the nurses will have constant access to in the nurses’ station. If it makes even the slightest blip, they’ll be in that room,” I said. “I know that ICU sounds scary, but it doesn’t mean danger. She’s stable right now. Shaky, but stable. ICU means that she’ll be constantly monitored to make sure this doesn’t happen again.”
“What even happened? I’m so confused. Yesterday we promised that we’d meet her for her appointment. That was the only reason why we left the park yesterday, or I’d have stayed much longer. When we got here, she’d been admitted already, which I didn’t understand…”
“I was the one that recommended her to be admitted,” I said. “She came in for a routine appointment that morning but had another with a surgeon that afternoon. I’m assuming that’s the one you came to meet her for.”
He nodded. “Yes.”
“When she came in, it was right at the end of my shift. She was the last patient that I saw. She had only just started her treatment when she started feeling very sick. I’ve treated her before, and she’d never reacted that way. Instead of risking it, I decided to recommend to her doctor that she be admitted. It seems that he took my advice,” I said.
“That means that this has been happening since yesterday,” he said.
I nodded. “It seems that way. As I said before, her labs were normal for her condition, so I’m not sure what changed, but I’m going to find out. Labs are done every morning around 5:00 a.m. if the patient is admitted. That’s what my job is now. I need to go look through those and find any changes from yesterday, no matter how small.”
Jax stood staring at me. I couldn’t read the expression on his face. His dark eyes were slightly pink, and his lashes were damp and clung to one another. He’d cried at least once.
“You saved her,” he said finally.
“That’s my job,” I said. “And I love it more than you could imagine. I’m so happy that I could help.”
“That’s my mom. She taught me everything I know. She raised us by herself. She’s the reason why my brother and I ran those guys off yesterday. If she saw a man treating a woman like they did the two of you, she’d beat him first for doing it and then beat us for not intervening. That’s a woman whose wrath I wouldn’t want to suffer.”
He smiled as he said that last bit. “She’s the strongest woman I know, but right then I saw her at her weakest. I thought we were going to lose her, but you were there. I know it physically exhausted you to do it. I could tell how tired you were, but you didn’t stop. You didn’t give up on her. Thank you for being the strength she needed.”
I gave a sad smile. His words ripped me in two, but they were warm and meant more than he could know.
“You’re welcome,” I said. “I’m just glad that I could help.”
He smiled. “You said that before.”
“I’d better go check on those labs,” I said.
“I’m going to take my sister home. She’s hysterical,” Jax said. “Alex is only holding it together for her, but he’s not much better.”
“You’re the oldest, aren’t you?” I asked.
He nodded. “I am.”
“I can tell. You take a lot onto yourself,” I replied.
“Can I see your phone for a sec?” he asked.
It was an odd request, but I handed it over. He unlocked it, and I heard it click a few times before he locked it back and handed it to me.
“I put my number in your phone,” he said. “Please call me if anything happens or if you get any news. It’s going to take all I have to get them home, but I have to. They’re going to go crazy if we stay here. You don’t have to call me from your phone. You can use the hospital phone if you don’t want me to have your number. I understand. This is just very important, and you’re the only one that I trust.”
“You barely know me,” I said. I realized that wasn’t the proper response as soon as I said it. I just wasn’t used to anyone having that much faith in me. “I mean… I’m very glad that you do. Though you don’t know me very well, I’m happy that you’re putting trust in me with your mother’s health. While I can’t promise outcomes, I can certainly promise to update you whenever possible.”
He nodded. “Thank you. You should know that I trust you as a human being, not only as my mother’s caregiver. There’s just something about you. The way that you approach people. The way you hold yourself. I thought you were pretty great yesterday, but today… after seeing you do what you did… Wow. All I can say is wow. You have low confidence; I can see it. You shouldn’t. Not ever.”
Before I could reply, Jax turned and walked out of the room. I wanted to talk to him more. I loved the sound of his voice. The way his mouth moved. I loved everything about him. He was perfect. But… I had a patient to consider, and apparently, a reputation to uphold. I said nothing as he left with his siblings. Instead, I headed to the nurses’ station to get the labs situated and get the information on the patients that I would have that day.
Chapter Five
Later that day, after checking in on all of my patients and getting my first med pass done, I was able to give Jax a call. I went through everything, and I found that her kidneys were, by lab standards, shutting down. Her body was weak already, but the medications were taking a toll on her kidneys. More tests had to be ran, but she was already recovering the last I’d checked. Chemotherapy was hard. It hurts the body in terrible ways. That kind of effect wasn’t rare, but it was fortunately something that didn’t happen all the time either.
It took a while for me to decide if I should call him from my phone, giving him my number, or if I should use the hospital phone. Since it was a professional reason, I decided to use the hospital phone. When he arrived, he surprised me with a coffee and small box of cupcakes.
“What are these for?” I asked. “You didn’t have to do this.”
It was incredibly sweet, but I felt terrible about it. His mother was on the floor above mine, which meant that he’d made a special stop to deliver them.
“I thought you might be hungry,” he said.
“Well… I am. Thank you very much,” I replied with a smile. “But you still didn’t have to do this.”
He shrugged. “You’re busy saving lives and thinking about everyone else. Someone should think of you.”
My mouth fell ope
n slightly. I had no idea how to respond to what was probably the nicest thing anyone had ever said to me.
“Thank you for thinking of me,” I said. How’s your momma?”
“Better. Thanks to you.”
Andi wandered by then. As she passed and Jax’s back was to her, she gave two thumbs up and exaggeratedly mouthed the words, “You go girl!” to me. I did my best to ignore her, but it was difficult with her acting like an idiot.
“I’m glad to hear that she’s doing better,” I said. “Once I told the doc about her labs he was able to make the necessary changes. Is she handling her new medication alright?”
“She is, but I think she’s changing her mind about her course of treatment,” he said.
“Oh?”
“Yesterday she talked to the surgeon about the possibility of doing a mastectomy because the cancer is isolated. He talked to her about reconstruction and all that went into it, but she just didn’t want to. She said that it made her feel like less of a woman. It was only an option if it was the last option. After today, however, I just want her to do it. I want her to do what makes her comfortable, but... she’s my mom. I want her around, too.”
“So, if she isn’t considering a mastectomy and she isn’t wanting to do the meds anymore…” I paused. I couldn’t imagine saying what it sounded like. She was young and otherwise healthy. To just give up… It didn’t sound like the woman that Jax had spoken about earlier.
“She doesn’t want to continue at all,” he said, his eyes turning toward the floor.
I sat the cupcakes down and opened the container. After grabbing two of them, I turned and handed him one.
“First – eat one of these,” I said.
He half-smiled before taking it. We stood in silence as we each ate our impressively delicious cupcakes. They were unbelievable.
“Where did you get these?” I asked. The box was unmarked.
“Lizzy J’s,” he replied.
He’d gone to an actual bakery for those yummies.
“I’ve wanted to go there forever and haven’t. That was the best cupcake of my life. My inner fat kid is loving you right now,” I said.
He laughed. “Good! I’m glad you liked them! That is my favorite place to go.”