by T. M. Meek
Glade knew right where to go as this was not his or Alex's first time in this ER (or others for that matter). The reason for such visits was nearly always the same: Dex. The only other times either of them had been to an ER for an injury not caused by Dex was the time Alex tried to retrieve a tangled kite from a high tree and lost her footing on a branch and fell ten feet to the ground. That was about six months earlier when she was out playing at the local park with her best guy friend, Chase. Glade had only been to the ER for two other instances where Dex wasn't involved.
The first time was when he was five and he was bit by a dog on his face at a family reunion. It only left him with a small scar by his nose and no other serious damage resulted. The second time was when he was eleven and he was trying a new trick on water skis during a family vacation. He sprained his neck and injured his collar bone but that was all. Alex and Glade were blessed in these instances that nothing worse came from their accidents. Glade had since become a much better skier. He'd found a way to balance the need to be more careful while also showing his water skiing tricks are better than ever.
"I'm Glade Opalstone. My dad, Dr. Opalstone, works at this hospital. This is my little sister, Alex, and she needs help," Glade said to the woman at the ER admitting desk while still cradling Alex in his arms. "We would really appreciate being seen as soon as possible..." he then noticed her name tag, "...Melanie," he said with a pleading smile.
The woman he spoke with looked a bit confused as she replied, "You said your father is Dr...Could you repeat the last name again?"
Before Glade could respond, he saw a woman walk up from behind Melanie and look right at Glade and Alex with a look of concern. "Melanie, I'll handle this one," she interrupted so Glade would talk to her instead. She then quickly instructed Melanie further. "Tell Dr. Staff to come find me and talk to me immediately while I take these two back to an exam room. I also need you to contact Dr. Francis R. Opalstone up in cardiology. Let me know once you've got him on the phone. Do it as quickly as you can." Melanie was quick to follow her orders.
The woman who spoke with such polite authority to Melanie was the ER Director, Dr. Clarissa Johnson. She was an attractive woman, mid-forties, black wavy hair and sparkling blue eyes. She then spoke to Alex and Glade.
"I know your dad well. He's a good friend. Follow me and I'll get you to an exam room." She seemed sincere and determined to get Alex the best care as quickly as possible. She grabbed a nearby wheelchair and helped seat Alex in it.
Glade had been to that ER a few times before but he hadn't recalled ever meeting Dr. Johnson. He was right. He hadn't met her. But she knew who Glade was. She recognized him instantly and she even remembered who Alex was from the last time she was in. But since Dr. Johnson usually worked more behind the scenes at the ER, it was expected that neither Glade nor Alex would recognize her.
Both Glade and Dr. Johnson helped Alex up onto an examination table that had the usual white paper cover laid across it for sanitary purposes. The sound of crinkling paper that was heard as Alex sat down was quickly drowned out as Alex cried loudly in pain, "Ow! Ow! Ow!" Glade had accidentally moved her injured shoulder as he sat her down. He felt terrible as he was trying so hard not to cause her anymore pain.
"What's going on? What happened?" Dr Johnson asked Glade. At first, both remained silent and Alex looked to Glade for direction. "Look. Both of you have got to give me a straight answer. I may think I know what happened, but unless you tell me––and I'm talking about the truth, I need the truth––I won't know how to help you guys," Dr. Johnson said in an almost pleading tone to get them to open up.
Glade swallowed hard as he considered how to answer. He knew they needed help––especially Alex. Although he tried to act tough on the outside, he felt humiliated that he couldn't protect his little sister or himself. But he also knew she was injured worse than he was and that even if Dex got ratted out by him at the ER that Glade wouldn't be home to get beat up for it. Glade felt he had nothing to lose and that he shouldn't waste any time getting Alex the help she needed. So he talked.
"It was our older brother, Dex. Dex hurt us. He said I stole his milk from the fridge but I didn't."
His answer didn't surprise Dr. Johnson at all as she shook her head and bit her lower lip trying to control her anger.
Glade let out a long sigh, "Her left arm is hurt,” he gestured towards Alex, “and I think maybe her shoulder. I'm not sure."
"My leg hurts too. Down near my foot," Alex added as she wiped away another tear and pointed feebly at her ankle. She took a quick look at Alex's foot before checking out Glade for any injuries.
"You look hurt too," Dr. Johnson said to Glade. "The bleeding has stopped on your cut," she added as she pointed near his right cheek bone. "You've got bruising that's starting to show around your right eye. Tilt your head back, please." Glade tilted back his head and she looked up his nose. She then gently touched the ridge of his nose and asked, "Any pain here?"
"Not anything I can't handle," he replied nonchalantly as if he ate bodybuilders for breakfast.
"Are there any other injuries on you? Do you hurt anywhere else?" she asked as she searched him compassionately with her eyes.
"No. I'll be fine. It's Alex I'm worried about," he said looking sympathetically at his little sister. Since Dr. Johnson saw no major swelling or any other cause for immediate concern for Glade's health, she returned her attention to Alex.
"What happened to your arm and leg?" she asked her tenderly.
"Dex yanked me," she sniffled. "He yanked my arm really hard 'cos he wanted the phone. I was trying to call my dad." More sniffles.
"What about your leg and foot?" she probed further.
"I tripped on a shoe while I was running."
"Before or after you were yanked?"
"Before. I was trying to go to another room to hide from Dex and call my dad but I couldn't run anymore after I tripped."
"So you were yanked by your brother Dex after you tripped?" she further clarified.
"Yeah. Just a few minutes after," Alex replied as she wiped away another tear.
"Were you standing when he yanked you or were you sitting?"
"Sitting."
"In a chair? Or on a table?"
"On the floor," Alex sniffled.
That response made Dr. Johnson visibly furious although she remained silent for a few moments as she tried to calm herself down.
As a medical professional, she knew what a dramatic difference it made for a male as tall and strong as Dexter was to reach down near floor level and yet remain standing to exert such force which would potentially lift Alex three or more feet off of the ground as opposed to a significantly shorter distance had she been standing or at least seated on a chair when he yanked her. That longer distance combined with the natural physical resistance of gravity from the full weight of Alex's body on the ground made it almost guaranteed that she would have a serious shoulder socket injury.
Depending upon what the x-rays would reveal, Alex could need major surgery that was often coupled with a very painful and long recovery.
Now feeling a bit self conscious over what the two likely and logically interpreted in her angry facial expression, she felt to quickly reassure Alex that she was innocent. "Alex, I'm sure you did nothing wrong, okay?" Dr. Johnson said clearly and compassionately to Alex. “You too, Glade," the doctor added as Glade fought back a tear.
She looked again at Alex's legs and feet and noticed the start of swelling in her left ankle. "Is this the foot that hurts?" she asked as she gently touched Alex's left foot and ankle.
"Ow! Ow!" Alex cried out in more pain.
"Can you move your left foot at all? Wiggle your toes?"
Alex tried but quickly stopped. "It hurts too much to move it any." She sniffled again and wiped away another tear.
Dr. Johnson moved to look at her other foot. "What about this other foot?" she asked as she repeated the same gentle in
spection.
Alex remained quiet and simply shook her head to indicate there was no pain with her right foot. She then moved on to inspect the damage done to Alex's arm and shoulder. Alex leaned away and plead, "No. No. Please don't touch it!"
"Alex, I just need to take a quick look." Glade gave Alex a look of assurance that Dr. Johnson really needed to look at her arm and that she should let her look at it. Alex quietly yielded. The doctor could see swelling around her shoulder and she began to gently touch each of Alex's fingers on her left hand without moving her arm in any way. "Do any of your fingers hurt?"
"No."
"Can you feel me touching your fingers?"
"Sort of."
"Just let me know if my touching you hurts, okay?"
Alex nodded in agreement.
She evaluated Alex's left wrist and forearm. She noticed signs of bruising beginning just above Alex's wrist. Alex's sharp inhale let the doctor know that part of her arm hurt and was tender to the touch. She then moved to inspect Alex's left elbow. "Does it hurt when I touch your elbow?" she asked as she gently felt around her elbow.
"No."
She then moved and created some distance between she and Alex. "Is there any way you can move your left arm without it hurting?"
Alex barely moved her left arm as her left hand moved more than her arm. This small attempt caused her to moan in more pain as she shook her head, "No."
She moved in closer to Alex again to take a closer look at her biggest area of concern: Alex's left shoulder. The bulging of her shoulder too much to one side revealed an imbalance between the way her uninjured right shoulder appeared in contrast with her left shoulder.
As she gently supported Alex's left elbow with her left hand, she used her right hand and tried to feel around Alex's abnormally protruding shoulder but the inspection lasted only a few moments as Alex cried out loudly again in immense pain. The doctor stopped the exam and got some distance to show her she wasn't touching her anymore.
"Okay, Alex. Okay. I'm done for now. You're going to be okay."
She then grabbed a nearby box of tissues and began to wipe away Alex's tears. But Glade felt that after watching Alex's pain helplessly, wiping away her tears was the one thing he could do, so he intervened.
"Here. I'll help her," he said as he reached for the box of tissues and Dr. Johnson handed them to Glade. He then finished wiping away Alex's tears. "See? The doctor says you're gonna be alright," he smiled. Both of them were glad it seemed the examination was over––at least for now.
Dr. Johnson let out a deep sigh. "We've got to get her shoulder x-rayed. From what I can tell it may actually be stuck, caught halfway in the socket. If that's the case then that could be good news since she may not need surgery. But we won't know for sure until we get an x-ray," she said talking to Glade as she looked at Alex. "I'm going to have her ankle x-rayed as well just to be sure it isn't broken. I suspect, though, that's it's probably just a sprain," Dr. Johnson added.
"So if her shoulder is stuck and she doesn't need surgery, how do you fix it?" Glade asked her.
"By pushing it back in," she said matter-of-factly. Glade winced his face in sympathy over the pain that might cause Alex. Alex looked petrified. "But we need to get an x-ray first. If it's stuck partway, like I think it is, and if the x-ray shows no broken bones or other damages that might interfere, then with one sure, fast push, she'll be likely on her way to a fast recovery with no surgery. But even if we push it in, she'll probably want to take it easy on her shoulder for a few days."
Alex appeared worried as she looked at Glade since she wasn't sure if the x-ray would hurt her shoulder but she remained quiet.
"You're gonna be okay, kiddo. One way or another, you'll be okay," he smiled as he gently stroked her head.
"What about you? What about your face and your eye?" Alex asked in concern to Glade.
Dr. Johnson agreed. "You're pretty banged up, Glade. Checking out your face and eye a little further is not a bad idea. It would be no problem," she added.
"I'm fine. Really," he half-smiled and hoped what he said was true.
"Okay, you guys. You know I have to ask." Both Glade and Alex looked worried and a little confused as to what she might be referring to. "Where's your mom?"
"She's at work," Glade lied. "She got a new job," he lied more. But Dr. Johnson wasn't buying it.
"Alex?" she asked giving her a look to show she wanted the truth. But Alex looked down and remained silent. Dr. Johnson sighed, "Look, you guys. I told you that the best way for me to help you and your dad is only if you tell me the truth. Both Alex and Glade remained silent.
"Glade, come talk with me for just a minute," Dr. Johnson said with a hint of frustration in her voice. "Alex, we'll be right back. If you need anything, just holler. We'll be just outside the door," Dr. Johnson said. Alex simply watched as she walked Glade out into the hall to talk. They stopped just a few feet outside of the exam room. Dr. Johnson began trying to give Glade a glimpse into the bigger picture of things.
"We both know that this isn't the first time you and Alex have been in here because of Dex. But this is, however, the first time you have come in without your mom––or any other adult for that matter." Glade wasn't sure where she was going with this. She continued. "Technically, I'm not supposed to be helping either one of you without the consent of a legal adult. Usually a legal guardian. And that means one of your parents is supposed to be here."
"I can be Alex's legal guardian for today. Do you need me to sign something? I'll sign anything that you want..." Glade replied eager to get things rolling. He kept rambling on about how he was the most responsible kid in their house and how good he's been to Alex.
Dr. Johnson interrupted. "Glade. Glade! Listen to me! Listen." Glade rolled his eyes and listened. "I'm thrilled that you love your sister so much. And I truly believe that you really are good to her and it's obvious that you two are close. Okay? I get that. But there's no way we can consider you to be Alex's legal guardian..."
"Yes, there is! I brought her here! I care about her!..."
She interrupted him again. "Stop. Just stop. Glade, how old are you? Hmm? How old are you?"
Glade folded his arms across his chest in frustration. "I'm fifteen," he replied quietly.
“ Exactly. You're fifteen. Not eighteen. This means you’re not considered an adult yet under law. Usually a legal guardian must be at least eighteen years of age and even then you'd still have to be court appointed, which means getting permission from a legal court of law and that's not something that happens in five minutes with a simple phone call or signing of a pen." Glade shifted his weight as he tried to remain interested in what she had to say. "Besides. You and Alex already have parents so you don't need a legal guardian. So I'm going to ask you again. Glade, where is your mom? And don't tell me she got a new job. I want to hear the truth."
Glade was thinking about whether or not he should tell her the truth when Melanie from the ER front desk returned with her update of how she carried out Dr. Johnson's previous instructions to her. "I finally found Dr. Opalstone. He's in O.R. and finishing a triple bypass. He should be able to call back in about fifteen or twenty minutes."
"And where's Dr. Staff?" Dr. Johnson asked.
"I just saw him again on my way here to talk to you. He's finishing with the patient who was shot in the chest. He said he'll be over here in a few minutes," Melinda replied dutifully.
"Thank you, Melinda," Dr. Johnson said. Melinda then nodded and returned back to her desk to continue managing the constant inflow of patients. Dr. Johnson let out a heavy sigh and then asked Glade again, "You were about to tell me the truth about where your mom is right now."
Glade reluctantly replied, "She's at home. In bed. Asleep." He stood with his hands in his back pockets as he looked off at the ceiling. He sighed and waited for her reaction.
"Then who drove you two here?" Dr. Johnson asked trying to believe him. She w
ondered if some other adult had been negligent to only give them a ride but not see to it that the two received proper care. But Glade was quiet. She was growing increasingly tired of Glade's apparent game of hide-and-seek he seemed to be playing with the facts.
Venting a bigger sigh of frustration, Dr. Johnson said in subdued tones, "Alex needs help Glade and she needs it now and I can't give it to her until you tell me everything I need to know so I can do it in the right way to provide the best help for everyone involved––including the best help for you and your father."
"And yourself," Glade added in a cynical tone.
"You're right," came her quick retort. "I don't want to lose my job. But I also am not looking to get anyone else in trouble who is truly innocent, if it can be avoided."
"Fine. I drove."
"What?" Dr. Johnson looked dumbfounded. "Do you have your driver’s license?"
"No."
"Or a learner’s permit?"
"Not yet."
As the pieces of the puzzle start coming together in her mind of just how bad the neglect is in the Opalstone home, she saw Dr. Staff approaching and she sent Glade back over to the exam room to wait with Alex so she could talk privately with Dr. Staff.
"Sorry it took so long for me to get to you. That chest wound was a gusher and the order for the blood transfusion took longer than expected. But Dr. Hamblin has taken over. She's got it under control. Now, what can I help you with?" Dr. Staff asked her in an apologetic tone.
"Look. I'm just glad you're here. I need you to do me a favor and not question my reasons.”
“I'm here. How can I help?" he replied without hesitation.
"I've got a case that needs to be your top priority above all other cases until I say otherwise."
"What have you got?"
She then told him about Alex's need for x-rays and how she and Glade were Dr. Opalstone's children. She gave him a summary of the incident that happened at the Opalstone home according to Glade's and Alex's stories and she was quick to add that she had no reason not to believe them as the injuries sadly, but clearly coincided with what they revealed. She told him she was fairly certain that there was a pre-signed Consent for Treatment form on file somewhere from Dr. Opalstone that automatically gave them the legal authorization to treat any of his children in the event of an emergency where neither he nor his wife or other legal guardian could be present to provide consent for health care. She planned on looking for it but she knew it might take some time for her to find it.
In the meantime, Alex needed care and Dr. Johnson made it clear to Dr. Staff that under no circumstances is another doctor to be made aware of the Opalstone children's case without first talking to her. She explained to him that she needed him to provide her regular updates on the progress of Alex's case beginning with the completion of x-rays and their results.
As soon as she could reach Dr. Opalstone, she planned on bringing him with her to meet with Dr. Staff and the Opalstone children. She then reminded Dr. Staff again that complete confidentiality is needed and no other doctor should know unless Dr. Staff personally cleared it with her first.
Dr. Staff was quick to comply and respect her request. "Full confidentiality. I'll only report to you until you say otherwise."
"I really appreciate it. I'll make sure your other cases get handled by someone else until this one’s resolved," she smiled gratefully. "Here. Let me introduce you to Dr. Opalstone's kids," she said as she led him back to the exam room where Alex and Glade were waiting. Dr. Johnson introduced Alex and Glade to Dr. Staff and let them know he would be taking care of things until she could find their dad and bring him down to see them.
She then spoke to Alex reassuringly, "When you’ve done the x-rays, Dr. Staff is going to call me and I'm hoping by then that I'll have spoken with your dad and maybe he'll be able to stop in and see you not long after that."
"I'll take care of them," Dr. Staff smiled loyally to Dr. Johnson.
"I'll see you two soon," Dr. Johnson said to Alex and Glade. "And remember, I don't think you guys did anything wrong. Okay?" she added with a sympathetic smile. Both Glade and Alex nodded and Dr. Johnson left to go find Dr. Opalstone and any consent form he may have already signed.
"Looks like you two have seen better days," Dr. Staff said trying to lighten things up. "Here's the plan: You, young lady, will be getting some x-rays so we can see what the best treatment will be for your shoulder and ankle. So I need to do a few things first to make that happen. I've got to go get a few simple forms to fill out so I have some more information on you so that your x-rays are properly matched to stay organized with your file. I've also got to get you an appointment upstairs to get the x-rays done ASAP in our radiology department. A nurse is going to get a wheelchair and make sure you get to your x-ray appointment safely and on time. I'll be with you when that happens. Glade, I really think you could use an ice pack to help with the swelling near your eye."
"I'm fine. It doesn't hurt," Glade replied stoically.
"It's okay if you need help, Glade," Dr. Staff said quietly in an effort to help Glade realize he understood Glade's tendency toward pride as most young men strove to be more independent at that age.
"I'm fine. But thanks for your concern," Glade replied.
“ Well, I can't make you get any help that you don't want," Dr. Staff sighed. He then directed his concerns back to Alex.
"I need to go get some forms and I'll be right back," Dr. Staff smiled and then left to get Alex's x-rays ordered as quickly as he could.
Alex looked at Glade and said as if she were tired, "I don't like all of this hospital stuff and I'm afraid of having surgery."
"But Dr. Johnson said she thinks you won't have to have any surgery. She said maybe the x-ray would prove it," Glade said trying to console her.
"I'm tired. I wish I could lay down but I don't want anything to touch my shoulder."
Glade moved to stand closer to Alex’s right side. "Lean on me for a bit." She scooted herself over, wincing in pain as she moved, until she was close enough to lean her head and right shoulder against Glade's torso. It wasn't very comfortable for her physically but his love and concern for her provided a soothing element for her to an otherwise physically and emotionally weary afternoon. She rested her eyes for a few moments only to be interrupted as Dr. Staff walked back in.
"I actually found most of your information on our data base from previous files. I just need to confirm that the information we have is current." He then proceeded to review the information with she and Glade regarding the usual information, such as home address, phone, date of birth, allergies, and parents’ names etc.
"Now I need to go get a nurse and a wheelchair and get you up to radiology for some x-rays. I'll be right back." He started to leave but then looked thoughtfully and turned back to ask, "Are either one of you hungry? Can I get you some food or something to drink?"
"I would love a sandwich," Glade said as his hand covered his stomach in hungry anticipation of food.
"Turkey? Ham? Chicken Salad?" Dr. Staff quizzed.
"Ham... Ham with mustard, if that's okay."
Dr. Staff nodded to Glade that it would be no problem. "How about you, Alex?" Dr. Staff asked politely.
Alex sat up more straight as she thought for a moment before answering. "A Chicken Salad sandwich would be nice."
"Okay. Anything to drink?" he asked both of them.
"Water's fine for me," Glade said as he looked to Alex to see what she might like.
"Water is okay for me too," she smiled.
"Okay. I'll go see what I can do while I go round up a nurse…” he then looked around for the wheelchair that was used for Alex earlier but another nurse had taken it, “…and apparently another wheelchair," he said rather cheerfully. "One ham with mustard, one chicken salad, two waters. Be right back."
Although food was on the way like the calm before a storm, another doctor would soon be bringing Alex and
Glade a storm they would never forget. A storm that would change their lives forever.
Chapter 4: Glade’s Escape