Angels in the ER (7 page)

I picked up Frank Giles’s chart from the countertop. “How about later, Virginia? I need to take care of a few things right now.”

She put her glasses back on and studied my face, her head canted to one side. “Are you alright? Is there a problem?”

Glancing in the direction of the Gileses’ room, I noted that the curtain was pulled closed. “I’ve got some bad news for the people in room 2, and it will take a few minutes.” I briefly told her what I had just learned.

Virginia pursed her lips, nodded her head slightly, and said, “Why don’t I go in there with you? Maybe I can help.”

I looked up from Frank’s chart and into her eyes. They were a steely gray. What most people found cold and intimidating, I found compassionate and incisive. Her years in the military and in the ER had tempered this compassion with an edge of reserve, but had not defeated it. And I knew she had delivered equally devastating news to too many people like Frank and Katie Giles.

I appreciated her offer, and for a moment considered taking her up on it. “No—but thanks, Virginia,” I told her. “I’d better just do this myself.”

Katie stood at the head of the stretcher, her hand resting on her husband’s shoulder. They looked up as I came into the room. I pulled the curtain closed behind me and sat down on the stool that stood against the wall. There was an expectant look on their faces, and the traces of a smile on Katie’s. Frank sat stiffly, the fingers of his hands interlocked and resting in his lap.

What should I say? How was I going to begin this? And then Katie helped me. “Well, what have you found, Doctor? Is everything all right? Can we resume our trip?”

I held Frank’s chart against my chest and leaned forward.

“Frank, Katie, I’m afraid I have some bad news.”

She tensed, and her hand, which had been gently resting on his shoulder, now gripped it tightly. Her eyes widened.

“The CT scan was not normal. There’s a problem.”

“What kind of problem?” Katie asked, insistently. “What’s the matter?”

Frank was silent.

“Frank, I’m afraid you have a brain tumor.”

Katie gasped, and her hand went to her mouth.

The color drained from Frank’s face. “A brain tumor?” he echoed. There was a brief pause. “How bad is it, Dr. Lesslie?”

This was something I could handle, a clinical question. This was familiar and more comfortable turf.

“First, I’m not a neurosurgeon,” I explained. “But this thing is pretty large. It’s in a bad location and it looks aggressive.”

“What does that mean?” he asked.

“The radiologist that looked at your scan thinks it is most likely a certain type of tumor that grows quickly. One that’s not going to do well.”

There was silence for a moment, and then Katie spoke. “And what does that mean?”

“Again, Mrs. Giles, I’m not a neurosurgeon. But this is a bad problem. And it’s something that needs to be taken care of, as soon as possible.”

“No, what I want to know is—” she persisted, but her husband patted her on her arm and interrupted her.

“Doctor, what do you think we should do? What should we do right now? Do you think it’s safe to go on to Myrtle Beach, or should we just head back home?” he asked me.

I had already thought about this, and I told him what I would do in this circumstance. “My advice would be to cancel your trip and head back home. You’re going to need to see your personal physician, and together you can decide how you want to proceed with this. The episode this morning was something small, but I’m afraid something worse could happen at any time. I think it will be safe for you to travel—but Mrs. Giles, I would advise that you do the driving.”

Katie had tears in her eyes, and she nodded her head.

“But what about our friends at the beach?” he asked, looking up at her. “They’ll be expecting us this afternoon.”

Katie was silent.

I stood up. “Why don’t the two of you talk this over for a few minutes? If you decide to go on to Myrtle Beach, I will call down there and see if I can arrange for some help if you should need it. Whatever you decide, you’ll need to take a copy of your CT scan with you, and I’ll arrange for that. I’ll be back in a couple of minutes.”

Pulling the curtain closed behind me, I walked over and sat down beside Amy. I was drained.

The couple of minutes turned into half an hour as the elderly gentleman with abdominal pain demanded my attention. His X-rays revealed that he had perforated his large intestine and would need the services of a surgeon. When this had been arranged, I stepped back into room 2 to check on the Gileses.

The atmosphere of the room had been dark and oppressive when I left. Now it had completely changed. He was dressed, and they were both standing by the bed, their arms around each other’s waists. And they were smiling.

Frank was the first to speak. “We’ve decided to take your advice and we’re going to head back home. We’ll need to make a few phone calls and then we can be on our way.”

It was Katie’s turn. “And we want to thank you for your help, Dr. Lesslie,” she told me. “This has certainly been a surprise, and not what we ever wanted to hear. But it is what it is, and we needed to know about it.”

I just stood there and listened.

“Katie’s right, Doctor. And we’ll handle this. We’ll be all right with whatever comes our way.”

There was a pause, and I was just about to turn from the room when Frank continued. “We are spiritual people, doctor. Not religious, necessarily. There’s a difference, you know.”

A movement from Katie drew my attention. It was then that I
noticed the small silver cross that hung by a chain from her neck. Her hand had gone to the cross, and she clutched it gently.

“I’m not an old man, by any means. Or at least I don’t feel old,” Frank chuckled. “But I’ve had a lot of good years and we’ve done a lot of good things. If this thing, this tumor, is a bad one and it can’t be fixed—well, then, so be it. And if I thought this life, these few years we have on this earth, were all that are given us—well, I suppose I would have something to be upset about. But that’s not what we believe. This is just the first part, the first step. And I’m okay with this thing. We’re okay.”

Katie looked up at her husband and smiled, then pressed herself closer to him.

Standing at the nurses’ station, I was finishing the work on Frank Giles’s chart as Virginia Granger led him and his wife out through triage. His eye caught mine and he gave me a nod of his head, and then, amazingly, a wink. Then the couple disappeared behind the closing door. They were beginning a new and unexpected journey.

Frank’s ticket had been punched. He was on his train, and Katie was with him. Wherever that train was headed, they would be on it together. And I sensed that wherever the journey ended, they would be okay.

I have set the Lord always before me. Because he
is at my right hand, I will not be shaken.

—P
SALM 16:8

 4 

All
God’s Children

Every man naturally desires knowledge; but what good
is knowledge without fear of God? Indeed a humble
rustic who serves God is better than a proud intellectual
who neglects his soul to study the course of the stars.

—T
HOMAS À
K
EMPIS

O
ne universal truth is that the ER is the great leveler of personages. We reach a common ground and find ourselves dealing with the same problems as everyone else around us: pain and suffering, health and disease, and sometimes life and death. At that point, our addresses make no difference, nor do our titles and degrees, nor do the quality and purchase price of the clothes we wear.

Another infallible truth of life in the emergency room is that just as soon as you believe you are good at what you do, that you are capable of handling anything thrown at you, at that moment or in the not-too-distant future, you will be brought low. We have to learn not to take ourselves too seriously and to get our egos out of the way so we can be useful to others. This is the case not only for those of us who work in the ER. As it turns out, this is a challenge just as much for the patients, no matter what their walk in life.

2:15 p.m.
It was a Tuesday afternoon, mid-May, and the weather outside was beautiful. It had been a manageable day thus far, and the staff was in good spirits. Lori Davidson was working triage. She opened
the door out of that area and brought Mrs. Betty Booth out into the department, leading her toward the observation room.

As they passed the nurses’ station, Amy Conners looked up from behind the counter.

“Good afternoon, Mrs. Booth,” she said, smiling at the elderly woman.

“Good afternoon, Amy,” Mrs. Booth responded, nodding her head but not returning the smile. “I hope my room is clean and ready,” she added.

It wasn’t exactly
her
room, but maybe it should have been. She had been coming to the ER each afternoon for three weeks to receive special medication for a bone-marrow condition. Her doctor had ordered that it be given intravenously, and the process took about two hours. During that time she would be our guest in one of the observation room beds. At this time of day, these beds were seldom used, and she usually had a moderate degree of privacy.

“I’m sure everything is ready for you,” Amy responded, rolling her eyes for my benefit once Lori and our guest had passed by.

Mrs. Betty Booth was a pillar of the community, as had been her family for several generations. Her lineage was dotted with a few mayors, city councilmen, and even a state senator. She was a widow now, with no children, and she represented the last vestiges of “old Rock Hill.” This appellation was important to her and she wanted to be sure that those who attended her understood it. She was very demanding about her care and surroundings. She brooked neither inattentiveness nor any avoidable disruption of her established routine. We had suggested she come to the ER in the early afternoons, as this was usually our quietest time. Still, it was an ER. We couldn’t guarantee peace and tranquility, even in the observation room.

On this particular day, she would be alone in OBS. The room was clean, quiet, and she would be able to choose her own stretcher.