Angels in the ER (18 page)

The door latch clicked behind me, and I waited for one of them to speak. It was Mrs. Stroud.

“Dr. Lesslie, I think we know what’s going on now. And we think you are right. Sam
is
pregnant,” she told me, smiling. I stood before them, tense, my head tilted to one side, waiting. “And,” she continued, almost triumphantly, “she’s not a virgin.”

I slumped a little in my disappointment, but was careful not to lose my balance and fall over.

“So she’s not?” I repeated, placing her chart on the exam table and thrusting my hands deep into my lab-coat pockets. I was struggling to find my comfort zone.

“No, and we figured out what happened,” she went on. For the first time Sam was looking at me, as she listened to what her mother was saying. And there was the hint of a smile on her face.

“Yes,” Mrs. Stroud went on matter-of-factly. “Back in the fall, maybe even late August, we had a family reunion out on our family homestead. About an hour or so from here, I’d guess, out in the middle of nowhere. Well, there were eighty, maybe ninety of us, with a whole bunch of youngsters. Teenagers too. Mainly we sat around talking and eating and the kids were swimming and fishing in the old pond.”

She paused here and looked down at Sam. “It seems that Sam here and a bunch of her cousins went down behind the pond dam with some wine one of them had sneaked along with him. Before long, they were pretty soused. Right, Sam?”

Samantha only nodded and continued to look at me.

“Well, Sam says that was when Uncle Freddy came down and… well, he got her all alone and he had his way with her.”

I was stunned. Not so much by what she was saying…I had heard much worse. But I was astonished by the manner in which she was saying it. Here was a woman who only a short time ago had been angrily confronting me for asking about the chastity of her daughter, and who now was calmly and coolly relating a tale of incest.

“That Freddy,” she continued, “he’s no good. He’s part of that Tennessee side of the family. But not my family! He’s on my husband’s side. Or ex-husband, I should say. Anyway, he’s no good, and it doesn’t surprise me, not one bit. I’ll have a word with him, you can be sure of that.” She said these last words while patting Samantha on the shoulder.

I picked up the clipboard for the sole purpose of just doing something, anything. I didn’t know what to say.

Mrs. Stroud came to my rescue. She took her arm from around her daughter, stood up straight, and asked, “So, Doctor, what do we do now? You think Sam’s four to five months pregnant?”

We talked for a few minutes and I told them they would be given the name and phone number of an obstetrician in town. “You can follow up with him next week.”

They both thanked me and walked out of the ER. I stood in the hallway for a moment, watching them leave. Poor Sam, and poor Uncle Freddy.

And what about my miracle? I guess I would have to wait.

As it turned out, that wait would be short-lived—only about six months.

“Dr. Lesslie, we need you in here
stat.
” Jeff’s voice was calm, but I recognized the tone. He meant business, and I immediately headed into the cardiac room. I had been walking up the hallway, talking with one of our surgeons about a young boy with appendicitis in room 5.

“What’s the problem?” I asked, entering. My eyes were immediately drawn to the elderly man on the stretcher. I was not yet aware of the arrival of this patient and didn’t know anything about him.

He was pale and obviously afraid. He looked from side to side, all the while tightly clasping the hand of a woman I assumed was his wife.

“Seventy-eight-year-old, history of heart disease,” Jeff told me while starting an IV. “Came in from one of the doctors’ offices in town. POV (privately owned vehicle). Blood pressure is 60 over zip.”

Stepping closer to the stretcher, I reached out and put my hand on his uncovered shoulder. His skin was cool and damp to the touch. I glanced at the cardiac monitor and could see the telltale changes that suggested an acute heart attack. His rhythm was regular, about seventy a minute, and then…

“Jeff, get the defibrillator over here!” I turned to the woman standing at the side of the stretcher. “Ma’am, would you step back for a minute?”

She immediately released her husband’s grasp and put her hand to her mouth, shrinking back against the equipment carts lining one of the walls.

Jeff was reacting quickly. He’d seen the same thing I had. The regular rhythm on the monitor had suddenly deteriorated into the spiked, choppy pattern of v-tach (ventricular tachycardia), an unstable and life-threatening electrical pattern. As confirmation of this change, our patient had turned dusky and was staring up at the ceiling, his facial muscles now lax. His low blood pressure must have dropped even lower. Then, just as quickly, we watched as the v-tach deteriorated even further. The tracing on the monitor screen told us he was now in ventricular fibrillation. His heart had lost all electrical organization and was simply quivering in his chest, a failing, purposeless “bag of worms.” He was dying.

It was his good fortune this had happened in the ER, in front of us, and with the necessary equipment readily at hand to revive him. He would surely have been doomed had this happened at home or in his car.

I immediately applied the defibrillator paddles to his chest and shocked him once. Nothing. The monitor still revealed only the chaotic, undulating pattern of v-fib. I shocked him a second time, and then a third. Then…there was a faint
beep-beep-beep
coming from the monitor.

“Looks like he’s back in a sinus rhythm,” Jeff reported. And then pressing two fingers against the man’s left carotid artery, he said, “And I can feel a faint pulse here. Sixty a minute, now seventy. Regular.”

Our patient was responding. We watched as he took some deep breaths and began to look around the room, though still obviously confused. But his color was better and now he had a good, strong pulse.

One of our other nurses had come into the room and was now
leading the man’s wife out into the hallway, where her daughter and son-in-law were waiting.

“I’ll be out in just a minute,” I said to his wife, “and we’ll let you know what’s going on. For right now, he looks okay.” I looked up at the clock on the wall: 5:35 p.m. The next hour or so would be critical.

We quickly determined that our patient, Wylie Stanfield, was indeed having a heart attack, his third. While we were doing the necessary things to stabilize him, our unit secretary was making arrangements to have one of our cardiologists admit him to the CCU.

I learned that Wylie had started having chest pain sometime in the mid-morning. Prudently, his wife, Margaret, had become concerned. They drove to their family doctor’s office and, after sitting for an hour and a half in the waiting area, were taken back to an exam room. Their physician was equally concerned and recommended they drive the fifteen minutes over to the ER for testing. Our triage nurse had observed the low blood pressure and his cool, clammy skin. Wylie was brought immediately back to the cardiac room, where Jeff had met him. And here we were.

“Jeff, you okay here?” I asked him. “I need to step out and speak with the family.”

“Sure,” he answered. “He looks pretty good now.”

In the hallway, Margaret Stanfield anxiously waited with her daughter and son-in-law.

“Mrs. Stanfield, I’m Dr. Lesslie,” I introduced myself, not having had the time to do this in the chaotic cardiac room. I then informed them of our diagnosis, our current plan, and the seriousness of his condition. The daughter, Theresa Streeter, and her husband, Mac, stood on either side of Margaret, their arms around her, holding her steady.

We talked for a few minutes until I was sure they knew what was going on.

“Can Mother and I go in there with him?” Theresa asked.

I thought Jeff had had enough time to get things straight, so I said, “Sure, but we need to keep him calm.” I said this while looking at Mrs.
Stanfield. She seemed in control and nodded her understanding. The last thing we needed was for an emotional outburst to trigger another episode of v-tach, or worse.

The two women went into the room, and I was left standing in the hallway with Mac Streeter.

“What do you think, Doc?” he asked. “Do you think he can pull through this?”

“His chances are fair,” I told him honestly. “After all, he is seventy-eight and he has a bad heart. We’ll just have to see. Right now though, he’s okay.”

This seemed to satisfy him, and I turned, heading toward the nurses’ station.

“Dr. Lesslie, do you have a minute?” he asked, tentatively. He was obviously concerned about something.

I stopped and said, “Sure. What’s the problem?”

“Is there somewhere private we can talk?” He said this while glancing at the closed cardiac room door.

Curious, I looked down the hallway and thought a moment. Across the corridor, the ENT (ear, nose, and throat) room stood empty and dark.

“Let’s go over here,” I said, leading him away from the cardiac room.

I turned on the lights of the ENT room and closed the door behind us as we stepped inside.

I pointed to a stool in the corner of the room. “Have a seat, Mac. What do we need to talk about?”

Without any hesitation Mac Streeter began to tell me about the Stanfield family. “My first concern is for Wylie,” he told me, “first and foremost,” he stressed, looking squarely into my eyes. “And I don’t want anything to happen here that might upset him and cause him trouble. I know he’s not very stable.”

And then he told me about the Stanfield’s son, Phil. He was two years older than Theresa and lived with his wife and three children in a small town about an hour distant. Theresa had called Phil and told him
of their father’s condition. He was on his way, and his wife was staying at home with the kids. He would be arriving at the hospital shortly.

“The problem, Dr. Lesslie, is the relationship between Phil and his mother. They don’t get along.” I was soon to learn this was an understatement.

Mac explained that about five years earlier, something had happened at a family gathering. Words were said, misunderstood, and blown out of proportion. Phil and his mother were soon at odds and not speaking. It had been a trivial thing, but it soon became an open, festering wound. Attempts had been made to heal the break, but to no avail.

“You need to understand, Doctor, that while Margaret is a good woman, she is hardheaded. There’s a side of her that’s, well…She’s just become bitter about this. She won’t talk to Phil, won’t answer his calls or return his letters. And she’s put Wylie right in the middle of it.”

“What do you mean, ‘in the middle of it’?” I asked him.

“She won’t let Phil talk to his father or see him. And if he does, she stops talking to Wylie and makes his life miserable. It’s a real mess,” he explained.

Mac and Theresa had tried to intervene, but unsuccessfully. Margaret was intransigent. The situation had worsened over the years and had taken its toll on all of them. Wylie had not been able to see his son or the three grandchildren, even though they lived only an hour away.

“I’m really afraid that when Phil gets here, we’re going to have trouble,” he continued. He shook his head. “Phil hasn’t seen his father in five years. Or his mother. He’s a good guy and I can’t believe he would let anything blow up. But Margaret, on the other hand…I just don’t know. We’re going to have to keep them apart somehow.”

What a mess. Wylie was barely clinging to his life, and this dys-functional family dynamic was assuredly going to make things more difficult for everyone. Mac had been right to share the family skeletons with me. And we all had them. Some worse and some bigger than others, but they were there, usually hidden away. If a family thought itself immune to this, they weren’t looking in the right closets.

We talked about the spiritual aspect of this situation. I opened that door with a simple question. “Have you and Theresa talked with a minister about this?”

Mac looked at me, seeming relieved I had been willing to ask this. He then told me he and his wife prayed about it every day. They prayed for reconciliation, and for Margaret’s heart to be softened.

“We’ve talked with Margaret about this too, and she says she prays all the time about it and is just waiting for Phil to apologize. The frustrating part of this is that when Phil tries to apologize and make things right, she will have nothing to do with it. She says he’s not sincere.”