Angels in the ER (35 page)

Before I could say anything, she raised her hand and shook a finger at me. She didn’t have to say anything, and would have found it difficult to do so between her labored respirations.

“I know, I know, Macey,” I said. “We’ll do everything we can to keep you out of the hospital. But you’re pretty tight this time. You know that.”

She nodded, and she was smiling as Lori fitted a mask across her mouth and nose. The mask was connected to a machine that was delivering a vaporized concoction of oxygen, water, and a bronchodilator. Macey knew the routine and was sucking the misty medicine as deeply into her lungs as she could.

We started some other medicine through her IV, and I ordered a portable chest X-ray. We would need to know if a pneumonia or some other problem was contributing to the problem.

I told her what we would be doing and she nodded her head, smiling through the steam that was escaping from the mask on her face.

It was the smile that always struck me. But it was more than just a simple and pleasant smile. There was a twinkle in Macey’s eyes, and a glow that seemed to surround her. It didn’t matter how sick she was or how bad her asthma was. She was always smiling, and through
that smile she was expressing her love. I could clearly see that with her grandchildren. But amazingly, I could see and feel it with us as well, the staff of the ER. I didn’t know anyone who was not affected by this, and who didn’t want to help take care of Macey when she had to come in for treatment.

Virginia Granger was affected by that smile. But that had been going on for more than fifty years.

Virginia and Macey had both grown up in Rock Hill. When they were in grade school, back in the forties, the schools were segregated. Any “mixing” of the races was frowned upon, if not strictly forbidden. Macey’s father had worked at one of the large textile plants in town, as had Virginia’s. The two girls had met at one of the company functions, where they had inadvertently bumped into each other. They had become fast friends and had managed to see and play with each other on a regular basis. Macey’s disarming spirit and Virginia’s tenacity, which brooked no meddling in her personal affairs, withstood the stares and occasional slurs of less enlightened “friends” and townspeople.

This relationship had grown and flourished until time and life choices intervened. Macey finished high school and took a job at a dry-cleaning establishment in town. Virginia had dreamed of becoming a nurse, and she left Rock Hill for college to pursue that career. For years they hadn’t seen each other. Only chance had brought them back together. Chance and Macey’s asthma.

Several years earlier, Macey had come to the ER in the midst of a severe asthma attack. Virginia and I were working that day, and she was taking care of Macey when I entered her exam room.

“I’m just so glad you are here today, Ginny,” Macey had said, looking up at her friend. “I’m glad you’ll be the nurse taking care of me.”

I had glanced over at Virginia upon hearing this.
Ginny.
Now there was something I could use. Then Virginia looked at me over the top of her glasses, and I knew for certain I would never utter that nickname in her presence.

“You know, Ginny,” Macey continued between her gasping respirations, “the Lord has blessed me mightily. He truly has.”

She paused to catch her breath and I listened carefully, curious as to how she would continue this thought. She was in the ER, in significant respiratory distress, and suffering from a disease that was not going away. And yet she spoke of being blessed.

I would soon learn about the blessings of Macey Love. She told us about her granddaughters and the many things they did together. She reminded Virginia about her father and the tireless days and nights he had worked to provide for his wife and children. And she told us of her complete lack of fear as she faced the uncertainties of her worsening asthma and failing health. And in the midst of all of that was her smile, and those twinkling eyes.

The only time I had seen that smile even hint at fading was one morning when the two of us were talking about her granddaughters. She was going to have to be admitted to the hospital on this occasion, and she seemed more aware than ever of the gravity of her medical condition.

“Dr. Lesslie,” she had said to me. “If something happens to me, I just don’t know what will happen to those girls. They’re all the world to me, and I’m afraid I’m just about all they have. There’s Patrice, my sister, but…I just don’t know.”

And then she was silent, thinking. She closed her eyes, and after a moment she nodded her head. She opened her eyes, and the smile was back.

On this particular visit, Macey was responding to our treatments. Her breathing was much less labored and her oxygen saturation had improved to 95 percent. We would continue the inhalers and the medications, but I was planning on being able to send her home in an hour or so. She would be relieved, and I walked over to room 5 to let her know.

I pulled the curtain back and Macey looked up at me, smiling. Sitting by the side of her stretcher was Virginia Granger. She glanced up as I entered and then looked back at Macey.

They were holding hands.

I stood there for a moment, watching these two women, these two friends.

“I’ll be back in a few minutes,” I stammered, and backed out of the room.

Macey is gone now. She died during an asthma attack at home one night before one of our EMS units could reach her. It’s been more than fifteen years since I last saw her in the ER, but I can see her face before me now as clearly as if she were in the room with me. I will never forget that smile, those twinkling eyes, and the special feeling we all experienced in her presence.

The writer of the book of Hebrews advises us to always be hospitable, lest we be in the presence of an angel and not realize it. With Macey, I knew.

And with Virginia.

Emma and Sarah Gaithers lived in one of the older neighborhoods in town. The two sisters, both in their eighties now, had lived in the same house all of their lives. Their father had been middle-management in the largest textile mill in the city, and he had built their home when large and square and white was the thing to do.

The family had lived four or five blocks from the mill, comfortably located between the homes of the hourly mill workers and the exclusive neighborhood of the mill owners, the bankers, and the town’s doctors.

The textile plant was gone now, and the neighborhood had been left to do the best it could. Many of the houses had been torn down or boarded up, and “For Sale” signs dotted distressed and overgrown yards. The exclusive neighborhoods were now located in the suburbs, but the Gaither sisters remained. In reality, they had nowhere to go. Their parents had died forty years earlier, leaving them with a mortgage-free house and little else.

The fact they had been able to stay in this house was remarkable. Sarah had been a schoolteacher and had taught long enough to qualify for state retirement benefits. But Emma had never been employed. She had suffered some unspecific accident during her delivery and had never developed normally. Her mental age was probably around three or four years, and she had been confined to a wheelchair since the age of five. Her legs were twisted and useless, as was her left arm and hand. She was able to use her right hand, but she had never developed any significant dexterity. After her mother and father died she had been totally dependent on her sister.

Sarah assumed this responsibility unflinchingly. She had attended college and earned her teaching degree, but she had never married. If there had ever been a romantic interest in her life, it was a closely guarded secret. Emma was her only family and had been the focus of her life.

Now in her mid-eighties, Sarah was having a more difficult time taking care of her sister. While Emma did not have any chronic medical problems, Sarah had developed diabetes and hypertension. This was beginning to take its toll. In spite of her dedicated and indomitable spirit, she was growing weaker, and the daily routine of taking care of Emma was becoming more difficult.

“Come on this way, Sarah,” I heard Lori say, but I didn’t look up.

I was sitting at the foot of bed D in minor trauma, trying to get a suture into the squirming, curling great toe of a noncompliant four-year-old. It was summer, and he had been swimming at the lake and had the misfortune of stepping on a broken bottle. So here he was. For a split second, his toe extended and I grabbed my chance. The curved needle with the suture went through one edge of the laceration and out the other. I cinched the thread firmly, tied it securely in place, and leaned back on the stool.

“There, Momma,” I said to the young mother who had ineffectually been trying to control this youngster. “That should do it.” She was relieved, as was I.

I looked behind me and diagonally across the room to bed B. Lori was transferring Emma Gaithers from her wheelchair up onto our stretcher. It was an awkward undertaking, helped only by the fact that Emma weighed a little less than 90 pounds. Sarah stood at Emma’s side, helping steady her.

Before I could get my gloves off and cross the room to help, Lori had managed to get Emma on the bed and was pulling up the guardrails. Sarah looked up as I approached.

“Good afternoon, Dr. Lesslie. Good to see you,” she said to me. She was holding Emma’s alpaca sweater in her hands, gently smoothing the worn garment over her forearm. A sweater, in the middle of July.

“Hello, Sarah,” I answered, meeting her eyes and then looking down at her sister. “What’s the problem with Emma today?”

The answer seemed obvious. Lori was using sterile gauze to gently clean Emma’s forehead. A large laceration extended from her hairline to the bridge of her nose. Blood had clotted in the wound, and the front and collars of her blouse were soaked.

“Hmm,” Sarah murmured. “Emma was having her bath, and I was getting her out of the tub. I guess my strength just gave way and she slipped. Her forehead struck the edge of the tub, and…well, you can see what happened,” she explained, pointing to her sister’s forehead.

Emma was looking up at me while Lori cleaned her face. She was smiling, but it was a vacant smile, and as always I wasn’t sure how to respond. I’ve never known how much she comprehends. Sarah would say that she recognizes us, that she knows the people in the ER. But I’ve never seen any evidence of that.

Leaning closer to her, I smiled and nodded. “Hello, Emma. Looks like you’ve got a little cut there.” I gently examined the wound, checked her eyes, and looked for any other obvious injuries. Other than the laceration, she looked okay. “We’ll get that fixed up in just a minute,” I said, patting her shoulder. She continued to smile, but made no sound.

Turning to her sister I said, “She’ll need some stitches, probably quite a few. Has she acted like anything else was hurting her?” I asked.

“No, other than that she’s fine,” Sarah responded. She would know.
To my knowledge, Emma had never uttered a word. Yet she and Sarah communicated in some unspoken way. If Sarah said she was okay, that was enough for me.

“Good,” I said. And then I noticed a small but brilliant sparkle of light in the middle of Sarah’s left eye.

“Sarah, I thought you were going to get that cataract fixed,” I said with feigned sternness. I looked closer and noted that it had gotten larger since she had last been in the ER.

She just shook her head and didn’t say anything.

“How’s the vision in that eye?” I asked her, taking the ophthalmoscope from its holder on the wall. “Open both eyes real wide,” I instructed her while examining her right eye. A cataract was starting in the lens of that eye as well and would soon cloud what remained of her vision.

“Not very good, is it?” I answered for her.

“Dr. Lesslie, how am I supposed to have eye surgery? Who will take care of Emma? I just don’t have the time right now. Maybe…maybe in a couple of months or so…We’ll just have to wait and see.”

“Sarah, it’s not going to get better on its own,” I gently scolded. “And how are you going to take care of Emma if you can’t see?”

We had been down this road before, and we both knew there was no good solution to the dilemma. Sarah and Emma had no other family members, and what few friends they had were either long since dead or were in nursing homes.

One of my younger partners had made a significant mistake on this issue. That mistake had brought the only instance I had ever known Sarah to demonstrate anything resembling anger.