Daniel Martin pulled his car into the ER parking lot and swung it into the space
marked “Doctors Only”. As he turned off the engine, he let out a soft sigh and
looked at the nearly empty patient lot and vacant ambulance bay. “Perhaps it
will be a quiet night,” he hoped within his mind.
As he walked into the staff entrance, he met Doctor Nancy Covington, who had
just finished her shift and was leaving. “So?” he asked her as she stopped and
faced him.
“Sorry, Dan, quiet. You know what the means,” she said with fake sympathy.
He looked at her and raised one eyebrow. “Hopefully not. I’ve lucked out a
couple of times and continued the trend.”
Nancy laughed and said, “I don’t think so, Doctor, they’re predicting a full
moon tonight.”
“Thanks,” he responded and lightly squeezed her shoulder in his usual
affectionate manner. He looked at his watch and realized it was almost 4 PM when
his shift started.
“Try and have a good one,” Nancy said as she breezed through the automatic door
into the cold autumn afternoon, where the New England sky was quickly turning
dark.
Dan walked down the pungent antiseptic halls to the doctor’s lounge, went to his
locker and absentmindedly twirled the combination lock, having done so many
times. Placing his coat inside, he then grabbed at the pile of cleanly laundered
scrubs stacked high on a utility metal shelf. Finding his size he quickly
dressed, grabbed his name badge from the locker shelf and then reached into his
coat pocket. He withdrew a gold plated stethoscope and slung it around his neck.
He slammed the door and snapped the lock shut and twirled it once around.
The emergency room hallway he walked down was quiet as he headed to the front
desk. Glancing at the wall board he noticed only two patients listed. He reached
into his message box and saw that Lori had left him a message only minutes
earlier. He absentmindedly touched the gold stethoscope she had lovingly given
to him upon graduation. The note simply said that she would be at her parents
that evening if he needed her. He smiled to himself, thinking of how considerate
she was and tucked the paper into his pocket.
Just then the ambulance radio crackled and Amy, who Dan thought was one of the
best ER nurses he had ever worked with, responded. “NNEH”.
“Yeah, Northern New England Hospital,” the EMT’s voice answered. “We’ve got an
eighty one year old female, clammy and pale, complaining of shortness of
breath.”
Amy looked over at Dan and then briefly glanced into the radiology room where
Doctor Naylor was checking out some X-Rays to see if she should take the call or
not. Dan nodded and said, “I’m going to get a cup of coffee. If it’s more than
you think you can handle, just go and get Ray Naylor.” He then knocked on the
glass partition between the radiology room and the front desk and Ray looked
away from the X-Ray he was examining. Dan pointed to the radio and him and
understanding, the other doctor nodded in acknowledgement.
He then strode down the opposite hall he had entered and took a sharp left into
the little galley kitchen that the staff and, at times, patients or family
members used. The stale odor of old, thick coffee greeted him. He proceeded to
go through the cupboards and make a fresh pot. Waiting for it to brew, he pushed
his wire-rimmed glasses up and rubbed his eyes. He knew this wasn’t going to be
a good night because he was having those self-doubts again if he had chosen the
right field of medicine. While he wanted the fast-paced, decision-making on a
second’s notice, if even that, which made his adrenalin flow, the years had
taken their toll. He had learned to deal with the mother who came in, her
screaming child with a simple earache that should have been seen during the day
by his pediatrician. Then there were the bloody cuts and bruises that had to be
attended to by a physician, and were most certainly not life threatening. But
the senseless, severe, car accidents, the sudden, deadly heart attacks, the
unexpected medical emergency like the twenty-five year old woman last night that
presented as a simple indigestion, or at best the stomach flu. It turned out to
be a good catch for him. Having that familiar gut feeling, he ran her through a
couple of tests and called in the hospital’s best gastro guy. Just as he was
going off his shift, the physician came down and told him congratulations on his
call. The woman would have died from a ruptured abdominal aneurysm had he not
gone that extra step that he was known for. Those were the type of cases that
got to him. The ones that made him question God, never mind himself. Why did
some live, why did some go on despite his best efforts?
“I see you made the leaded stuff,” a voice broke through his thoughts. Dan
turned and saw that the petite, young nurse named Beth, was standing next to him
with an empty cup waiting. She looked into his steely blue eyes and saw the
darkened circles under them. Doctor Martin was a handsome man, slender, with
unnaturally white hair for his age, mixed with blond, and with a well defined,
short beard to match. But more so, she found him to be the kindest, most
compassionate of the physicians’ staff. After graduation, on her first day in
ER, she was so nervous it seemed that everything she did was wrong. Yet he took
the time to patiently talk to her and explain the various procedures. Yes, this
doctor did not have the ego that many did and now that she had worked for a year
with him, she was still grateful that he was there when she started.
“Yeah,” he chuckled seeing her bright, youthful eyes peering at him. “Told it
just might be a busy night.”
“Well, it sure hasn’t been that way on my shift and I’m off in two hours so
actually that would be fine with me. Helps the time to fly,” she said as she
poured a cup of coffee for herself and one for him.
“That, my dear, is true,” he responded affectionately. “But at what toll,” he
thought to himself, again slipping into that depression that blackened his soul
at times like this.
Simultaneously they both left the galley kitchen and walked down the hall toward
the front desk. From that vantage point they could make out the waiting room and
it appeared to be filling up with people. Also, the ambulance call was just
pulling in with the elderly woman’s case that Amy had taken care of. “Yup, it
was going to be one of those nights,” he thought.
Fortunately, within three hours of his shift, Doctor Coates came on and with the
increase in ER patients there was now three physicians and six nurses to handle
the caseloads. Good thing because it was one patient after another, streaming in
either with the virus that was sweeping through the town or a housewife who had
burnt her hand while frying chicken for supper. Other than the elderly lady who
turned out to be dehydrated because she had been abusing laxatives, as many of
the elderly did who believed that to be “regular” they had to go every day, it
was rather a humdrum evening so far. But without the help of an extra doctor,
such as Coates, things could have gotten a bit stressed for the staff.
Dan looked at his watch and realized that he still had a long night ahead of him
and decided now that there was a lull he would go grab another cup of coffee,
hoping that one of the staff or patient’s family had made a fresh pot. He
decided that he would take ten minutes to himself in the patient’s lounge to
just quietly sit back. He always preferred to go there instead of the staff room
because it was so soothingly decorated in soft pastels and a countryside theme.
It was usually used for the physicians to discuss their patient’s problems with
family members, or, at times to let them know of a loved one’s death. He jotted
down on the board where he was and swiftly left.
After he had gotten his second cup of coffee of the night, he went to the dark
lounge and noticed that the lights were out. “Good,” he thought to himself. “All
mine if only for ten minutes.” Going inside he flipped on one of the lamps on an
end table, instead of the bright overhead light and shut the door behind him. He
sat on the couch but sprawled his long legs out and took a sip of his coffee.
Trying to keep his mind blank, he put his cup down and closed his eyes.
Suddenly, through the silence, a voice spoke. “Hard night?”
Startled Dan’s eyes flew open and he saw a well-dressed man sitting in a wing
backed easy chair across from him. He had on a plain, but well tailored, light
tan suit, with a white starched shirt and wore shiny, dark brown loafers. He
appeared to be about thirty and his neat, gold-colored, hair barely touched his
shoulders in an outdated style.
“Sorry,” Dan said starting to stand up. “I didn’t know you were in here.”
The man put his hand up in a gesture to stop him and sit back down. “I could use
the company, if you can,” the man said in a soft voice.
“Sure,” Dan said sitting back and once again taking his coffee cup in his hand
and drank from it.
“So?” the man asked.
Puzzled Dan looked at him wordlessly.
“Hard night?” the man asked again.
“Oh, right, you did ask that didn’t you?”
The man nodded in agreement.
“Not really. Just your usual run of the mill stuff,” Dan answered.
“Sure about that?” the man asked with a slight smile flickering over his kind
face.
“What do you mean?” Dan asked and leaned forward to the man, his elbows on his
knees, and continued to sip at his coffee.
“Well, it seems to me that the look on your face means you might be having a
tough time of it tonight. And I don’t mean the amount or severity of your
patients problems.”
For some reason, Dan immediately felt connected to this man and answered him
honestly. “I’ve been practicing emergency medicine for fifteen years now and it
seems that for the last couple I’ve just been questioning lots of things I see
around here.”
“Such as?” the man said raising an eyebrow, yet not changing the kind expression
on his face other than that.
“Well,” he said taking a heavy sigh, “why some make it and some don’t. I’ll have
what looks like a simple case of the flu that turns out to be congestive heart
failure and the guy is one S.O.B. who could care less about the world, never
mind the poor lab technician he just told off who didn’t draw his blood the way
he thought she should have. We catch the CHF and after diuretics and the other
protocol, he’s stabilized and on his way out the door without a thank you. Then
across the room is a kid who just got his driver’s license and wasn’t doing a
thing wrong. Just inexperienced. Along comes a drunk driver careening down the
hill and flies right through the red light and broadsides him. He’s hanging on
for dear life and we’re doing everything we can to keep that thread between life
and death disconnected and he suddenly goes into heart failure and is gone.
Where’s the justice?”
The man did not answer right away and there was dead silence in the room. Then
his soft voice spoke. “God is not fair but he is just.”
“Meaning?” Dan asked in frustration.
“Just something you’re going have to find out in time yourself,” the man
answered. “Some things you have to go on faith. Faith that He, and he lifted his
eyes upward, “knows what He’s doing.”
Leaning back, Dan put down the now finished coffee cup and folded his arms over
his chest. “Well, I don’t get it, even after all these years. Just too many
questions.”
“Questions are alright, they mean we care. And if you don’t get it, as you say,
we’re not always meant to at that moment. But then again sometimes if you look
closely, you’ll see the answer in the unknown. It may only be a glimmer of
truth, a symbolic cast iron frying pan that comes up and hits you on the side of
the head or even a solution that won’t be answered until you leave this world.
But there’s always a just answer. Just keep your eyes and your heart open and
you’ll know what to do.” Leaning close to Dan, he looked directly into his eyes
and softly added, “and remember, Dan, you’re meant to be a part of someone’s
life, an integral part. You may not know it at that moment. Be it briefly as you
walk by a patient who belongs to Dr. Coates and simply give him a quick smile of
reassurance, or are with a patient for five hours attempting to enable him to
continue to live and be back with his family. Each and every second in your life
does affect someone else.” With that the man wordlessly got up and walked out of
the room and shut the door behind him.
Taking in what the man said, Dan realized that he had called him by name and
wondered how he knew. Then, realizing, he had his name tag on, he answered his
own question. Still, it was as if he really knew who he was, not just a tired,
confused ER doctor.
Just then there was a soft knock on the door and Marilyn, the front desk
receptionist who had been with the hospital for years, opened the door. “They’re
asking for you out front, Dr. Martin,” she said. “There’s a patient the
ambulance just brought in that you’ve seen before and it appears he may be
critical. The other docs are swamped.”
Dan immediately got up and walked out into the hall. He looked in both
directions but the man was gone. ”Did you see that guy who was with me just
leave,” he asked the older woman.
“What guy?” she asked looking surprised.
“Right before you knocked on the door, a man in a light tan suit stepped out of
the room,” he said incredulously.
“Sorry, but I didn’t’ see a soul,” Marilyn answered, worrying that perhaps it
was time for Doctor Martin to take a vacation. After all it had been months
since she had remembered him doing so. “This always gets to the good ones,” she
mused as she turned away.
Dan shrugged his shoulders and quickly went down the hall and checked in at the
desk.
Betsy, a nurse who had come down from Canada, walked up to him and with her
heavy, French accent attempted to fill him in on the patient. “Dan, it’s John
Hunt again.”
Dan immediately felt a stab in the pit of his stomach. A seemingly robust
middle-aged man, he had just seen John the weekend before for problems,
unrelated to the cancer he was valiantly fighting and appeared to be winning,
until of late. Turned out that the problem was related to extremely low blood
sugars which were unusual because he was a Type II diabetic. Leafing through the
notes, as he rushed to the trauma area, he saw symptoms that made him more
concerned.
This patient was one of those special ones. He had a wonderful sense of humor
and despite the war he was waging always seemed concerned as to the feelings of
the medical staff who were there to help him. He once asked Dan about the gold
stethoscope and when Dan had told him that Lori had given it to him as a gift,
John proudly told him of his great love that he and his wife had for each other.
He would tell anyone who cared to listen, “We’ve got twenty-eight years
together. Can you believe it? I love her more with every passing day.”
John’s wife, Laura, would just smile, squeeze his hand and almost always gently
kiss him on the lips with a sweet, “I love you”. It was apparent in every
conversation that Dan had with John that not only were these two people one of
the rare couples who were still madly in love after many years of marriage, they
were both good, caring people who gave to the world and did not take.
“What’s going on Buddy?” he now asked with grave concern, but attempting not to
show it to John. The man kept asking for his wife and Dan quickly looked to the
nurses for an answer. “She’s following the ambulance in their car and should be
here any second. She said she had to get him some clothes to go home in since he
just has his briefs on.”
Looking up to the monitor, he heard the alarm that showed it could not register
a blood pressure and the team immediately began working on John as Dan gave out
orders.
Within minutes the intake nurse came up and said that the wife had arrived and
they had her waiting in the reception area. “For crying out loud, get her in
here,” Dan said softly.
Having been through these emergencies so often in the past couple of weeks,
Laura immediately sat down in a chair near the scene and shaken, watched Dan
give orders and then waited for an appropriate medical reaction from John. When
a side of the stretcher was empty from any personnel she got up and walked up to
her husband. He was seemingly in and out consciousness. She gently kissed his
lips and whispered, “I love you.” John kissed her ever so softly twice and was
barely able to respond but managed a caring, “I love you too”. Then he closed
his eyes and seemed to be incoherent once again.
Deciding they needed a chest X-Ray because John was extremely short breathed, a
portable machine had been called for. It promptly arrived and Dan went to John
and asked him if he could sit up. Once again he opened his eyes and obeying,
John attempted to do so, but quickly collapsed backwards. It was then that once
again, that quick thinking was called for and Dan decided instead to put him in
the cat scan. Quickly the team of nurses began setting up the stretcher to
transport him and they practically flew down the hall and toward the cat scan
room. Laura stood outside the door and a nurse glanced back at her, her heart
skipping a beat in compassion as she saw the worried expression on the tired
woman’s face. “You’ll have to stay out here.”
“OK,” the woman barely audibly said. “I’ll take this time to use the rest room
and be right back. Is there enough time?”
“Yes,” the nurse said as she shut the door behind her.
Dan was at the front desk, pouring over the medical notes on John, his mind
quickly running through possible scenarios and diagnoses when he heard the Code
Blue alarm go off and Amy came running up to him.
“John Hunt appears to have arrested,” she stated and they both took off in a run
to the cat scan room.
John was laid flat on the cat scan table which had been pulled out from the
machine and his eyes were open and pupils fixed. Soon there were medical
personnel not only from the ER but other departments nearby who had heard the
Code Blue and had come to assist. They pulled John onto the stretcher and
immediately began working, attempting to revive him. As he began CPR, Dan did
not see John’s wife quietly enter the room and stand back as the staff swiftly
moved all around the stretcher, each working in synchronism.
Knowing that she could not get near her husband, without endangering him because
someone may need to be next to him working to pull him through this, she slipped
back out of the room.
Oblivious only to his work, Dan looked at the clock and said, “How long?”
meaning how much time had occurred since they had begun to attempt to revive
John. A voice called out fifteen minutes. He then asked for the shock paddles
and asked, “Where’s his wife?” knowing how important it was that this man’s soul
mate be here at this time. Again the same voice said, “She’s standing outside.”
Indeed, Laura calmly stood in the hall and the attending doctor from the
oncologist’s office, Anne Hadden, put her arms around her shoulders, sharing in
the scene before them. Soon the wife broke away and pointing said matter of
factly, “No one can stand at the end of his bed! That’s where his angel who is
waiting for him belongs.” Laura recognized a woman as having been the head floor
nurse from the time John had been in her ward for emergency surgery recovery the
summer last year. The nurse went to her side and held her as Doctor Hadden had.
Anne Hadden immediately went to the stretcher and said, as she calmly took a
nurse by the arm and moved her aside. “No one can stand at the end of John’s
bed, because that is where his angel is waiting for him.” She said it loudly
enough for everyone to hear. Satisfied that all had heard, she went back to
John’s wife.
Just then Dan applied the first attempt with the life-saving paddles. His eyes
darted from the monitor, hoping for a reaction when he saw out of the corner of
his eye someone standing in front of the open door and at the end of John’s
stretcher. In but a brief moment of time, he realized it was the same man who
had spoken to him when he was in the patient’s lounge. Not having the time to
dwell on what he was doing there, he quickly applied the paddles again.
Laura watched as John’s body jumped in reaction to the electricity pulsating
through him and grabbed at Dr. Hadden, who again stood by her. “Enough!” she
said. “Give him some dignity. Some respect.”
With compassion, Anne answered, “Let them try to intubate him. If that doesn’t
work, I will end it.”
The wife nodded in understanding.
“Within minutes, everyone stood back and stopped what they were doing. Dan
looked at the clock and announced the time which a nurse jotted down in the
records.
Instinctively the wife went to her husband. His eyes were now cold and black.
She begged for someone to please close them and a hand slipped over and did as
she requested. Then she bent down to his lips and ever so wistfully kissed him
and whispered, “I know you’re not here anymore, Johnny, but I want you to know
how much I do love you. Just be there at the gate, waiting to greet me when I
come home,” she said. She slowly took in his face and lightly caressed his cheek
then turned and walked from the room.
Dan watched, his heart breaking with the loss he felt not only for the loving
wife but John who had tried so very hard to battle his fight between life and
death. He looked up just in time to see the man in the tan suit standing next to
a vision of John, his arm around his shoulders, kindly turning him away and as
quickly as Dan saw him, they disappeared.
Realizing how exhausted he was, he didn’t react and instead looked up to again
see Laura leaning against the wall, seemingly commanding every part of her being
to hold herself together. As he dejectedly passed her, he heard her say, “It’s
OK,” comforting the doctor and nurse near her. “He’s with our Lord now and he’s
happy.”
Somehow Dan could not imagine how this woman, who had given so many years of her
life to this man in deep, loving commitment, could be so strong in her
statement. Then he remembered, the words, told to him by the stranger he now
knew, “Each and every second of your life does affect someone else … Some things
you have to go on faith.” Dan realized that this was the beginning of what he
had been told. Look closely not only with his eyes and his heart and he would
see. Importantly, from now on he would ensure that the end of every bed or
stretcher would have no one standing there with the patient. No one that could
be seen…
Laura M. Boldosser Jballsta1@aol.com
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