Miracles in the ER (23 page)

Step Aside

The door to major trauma flew open and Grayson Peerman stormed into the room.

“Okay, what have we got here? Heard there was a stab wound.”

Grayson was one of the general surgeons on staff—not one of our favorites. He was known for his short temper, arrogance, and unwarranted outbursts. He was wearing a sweat-stained surgical cap, scrubs, and blood-spattered shoe covers. He must have just come from the OR. I looked over at Lori Davidson and shook my head.

In three giant strides, he was beside the stretcher, staring down at our newly arrived patient, TC. TC had just been brought in by EMS after an altercation somewhere downtown, and we didn’t have a last name yet. He had been stabbed in the belly and left on the sidewalk. He was awake, but his blood pressure was low and his skin was pale and pasty.

I had just stepped into the room myself and Lori was starting an IV. The two paramedics were gathering their equipment and trying to leave as fast as they could. We all knew Dr. Grayson Peerman.

The surgeon placed his huge hand on TC’s abdomen and began prodding around the bullet hole, which was located four or five inches above his belly button. Then with no glove and no warning he probed the wound with his index finger, his head tilted to one side while he stared at the ceiling.

TC objected, or so his string of profanity would lead us to believe.

“Calm down, son,” Peerman chastised him. “If I’m going to save your life, I need to know what I’m dealing with.”

Peerman withdrew his bloody finger and wiped it on the stretcher sheet.

“I’m on call and was passing through the ER. I’ll take over now. When’s the last time he ate?” He glanced over at Lori.

She flushed and stammered, “We haven’t had time to—”

Peerman silenced her with an opened palm, then looked down at TC. “When’s the last time you had something to eat?” he asked loudly, as if the young man must be hard of hearing.

TC shook his head and held his abdomen. “I don’t remember. Maybe—”

“Doesn’t matter,” Peerman waved his hand and turned to Lori. “Get some routine labs and type and cross for four units. Then call the OR and tell them what we’ve got. And turn his IV up, wide open. Got that?”

“Yes, Doctor,” Lori answered. She walked over to the phone sitting on the countertop. “Do you want a chest X-ray, Dr. Peerman? His breath sounds on the left side are diminished and he was stabbed by a
man.
He might have—”

“Don’t have time. It’s a stab wound, young lady—of the abdomen. And it doesn’t matter if he was stabbed by a man or a woman or a monkey. He sounds fine to me.”

My heard jerked around at this.
When had he listened to this guy’s chest?

The surgeon turned to the stretcher, held out his hand for Lori’s stethoscope, then placed it on TC’s chest—first the right side, then the left, and finally over his abdomen.

“Sounds fine to me.” He tossed the stethoscope onto the stretcher and walked out of the room.

I looked at Lori and reached for the stethoscope draped over my left shoulder. The radio of one of the paramedics sounded its alarm just as I was bending over to listen to TC’s chest.

“This is EMS 3. We’re at the back door with a twenty-three-year-old unknown overdose. Unresponsive.”

“You’d better go.” Lori nodded at the door then picked up the phone. “I’ll call the OR.”

I was opening the door when she added, “And Dr. Lesslie, I
do
pay attention to you sometimes.”

I chuckled but didn’t turn around. I knew what she was talking about. She remembered a comment I had made—maybe a couple of years ago—about the difference between how a woman stabs someone and how a man does it. A woman will usually grab the handle and stab downward, while a man will poke the blade into his victim. If TC’s assailant had been a man and they had both been standing, that poke could have been aimed upward and pierced his diaphragm and then his lung. If it collapsed—

The ambulance doors opened and EMS wheeled their OD patient into the department.

“Cardiac?” the paramedic asked me.

“Yeah,” I answered. “Let’s go.”

A few minutes later, I stepped into the hallway, looking for Amy Connors. Grayson Peerman was still standing at the nurses’ station, writing on some scattered pieces of paper. We both heard the mechanized rumbling of the portable X-ray machine as it rolled down the hallway and turned into major trauma.

“Hold on there!” he shouted at the two young techs. “What’s going on? I didn’t order a chest X-ray.”

He stomped over to where they stood and leaned into their flushing faces.

“Who ordered this?”

“The anesthesiologist said—” The X-ray tech was frightened, whispering, and I could barely hear what she was saying.

“Speak up, young lady!” Peerman’s nose was only inches from the young woman’s.

“The anesthesiologist said the patient needed a chest X-ray!” she blurted, looking down at the floor and backing into the machine. “He said he wouldn’t put him to sleep without one.”

“Why that…” Peerman’s face was beet-red and he was spraying spit everywhere. He looked from side to side and finally said, “Do what he says. I’ll deal with this later.”

He spun around and stalked back to the nurses’ station. I nodded at the techs and they wheeled the machine into trauma, glancing over their shoulders a couple of times before disappearing into the room.

Our OD patient was stable, and I was at the nurses’ station when one of the X-ray techs returned with TC’s chest films. They slid them onto the countertop, glanced at Dr. Peerman, and scurried back down the hallway. Out of the corner of my eye I could see his head tilt down toward the X-ray folder and then quickly snap away.

The phone rang and Amy picked it up.

“Okay, I’ll let him know.”

She hung up the receiver and looked up at Peerman. “They’re ready for your patient in the OR, Doctor.”

“Hmm,” he muttered, and didn’t look up.

I picked up the X-ray folder and walked across the hallway to trauma. The door was open and I stepped in, turned to the view box, and snapped the film into place.

“Well, would you look at that.” I glanced over my shoulder and beckoned Lori with a nod.

“What is it?” She walked over behind me and stared at the X-ray. I didn’t say anything, but just waited.

“Oh,” was all she said. Her right index went to the view box and traced the edge of his collapsed left lung. It was down by at least 50 percent.

“You were right, Lori. This would have been a disaster.”

“Right about what?” Grayson Peerman was standing in the doorway, scowling, his clenched fists on his hips.

I looked over at Lori and raised my eyebrows. “Your turn,” I whispered.

“Right about what?” Peerman repeated, louder and more agitated this time.

This was a great opportunity for Lori to educate this obnoxious, overbearing man. If ever there was a time to say, “I told you so,” this was it.

I cleared my throat and stepped around Peerman and out into the hallway. I stopped just out of sight and listened.

“Dr. Peerman, you might want to look at this.” That was all she said. As she walked out of the room, she caught my eye and winked.

That was it? “You might want to look at this”? This was her big chance!

But then, this was Lori Davidson.

Suddenly from inside the trauma room: “What th—!”

The Teeth of the Dragon

The metal basin clattered down the hallway, and everyone in the department jerked their heads toward the doorway of major trauma. Wait…wait…there it was—another shiny object sailed through the door, ricocheted off a stainless-steel supply cart, and clanged loudly before coming to rest against the far wall. It was only a matter of time—moments—before the dragon would appear.

And there he was. Edward Morgan burst through the doorway and into the hall. He stood there, fists on hips, feet wide apart, face flushed to a fire-engine red. If it were physically possible, steam would be escaping his ears. He was the picture of—of—Edward Morgan.

Morgan was one of three neurosurgeons on the medical staff of the hospital and had the well-earned reputation of having a hair-trigger temper, total disregard for anyone other than himself, and a proclivity for causing the biggest disturbance possible. (Hence the metal pans scattered in the hallway.)

“I need some help in here!”

It wasn’t a calm, quiet request. His angry scream quickly grabbed the attention of everyone in the ER, including nearly all of the patients. Those who were able were peeking around curtains, eyes large, mouths hanging open. For those of us who knew Edward Morgan, it was just another day at the office.

I looked down at Amy Connors. “I thought someone was back there with him.”

She kept her nose in the logbook and slowly shook her head. Finally she looked up at me. “Angie Davis was assigned major trauma, and I thought—”

Her words hung in the air. She was staring down the hall in the direction of Dr. Morgan. I turned just in time to see Angie slip out of trauma
and scurry toward the back of the department. Her cheeks were a fiery red and she was dabbing one of her eyes with Kleenex.

She didn’t escape the attention of Morgan. He glanced over his shoulder, pointed at her with an angry index finger, then glowered in my direction.

“I need some
competent
help! And I need it right now!”

He stomped back into major trauma and slammed the door.

“Man, where is Virginia Granger when you need her?” Amy shook her head again and once more buried herself in the logbook.

Virginia, our head nurse, was on vacation this week. But I wasn’t sure she would be able to do any good with a ballistic Edward Morgan. She had tried in the past to calm him down. We all had—even the administration—but the outcome was always the same. He might get quiet for a few minutes, but then something else would set him off and he would explode.

Like the time with the telephone.

We had called him about a young man involved in an auto accident—possible neck injury. We needed him to take a look at the guy. He hadn’t been exactly pleasant on the phone, and by the time he got to the ER he was pretty fired up.

“Drunk, I bet.”

The huffy accusation had been rhetorical, but I made the mistake of picking it up.

“Actually not, Edward. He was driving home from work and hit a patch of ice. Slipped off the road and into a ditch. No alcohol involved.”

He jerked around and speared me with a piercing stare.

“Careless, then. Just careless.”

I smiled at him and turned away.

“Get me the radiologist on the phone.” It was a demand, not a request.

Amy reached for the receiver but Morgan was quicker.

“Never mind, I’ll do it.”

He dialed the extension for radiology—8242. No answer, silence. He dialed again—the same thing. Silence.

Amy must have noticed that he hadn’t punched 9 before dialing the extension.

“Dr. Morgan—”

“What th—!”

He snatched the phone from the desktop and ripped the cord and face plate from the wall, scattering pieces of Sheetrock around the nurses’ station. Not satisfied with this level of destruction, he heaved the phone at a nearby trash can, knocking it over and spilling its contents across the floor.

“Never mind! I’ll go over there myself !”

He snorted and grumbled down the hallway and out of the department.

“Amy, shouldn’t we call X-ray and warn them?”

“With what?”

And then there was the time Virginia refused to call the administration and complain about the lack of an operating room for one of his patients. Morgan had a simple elective procedure to do, and all of the ORs were occupied with emergency cases.

“Dr. Morgan, I’ve called the OR supervisor,” Virginia explained for the third time. “And they will call us as soon as one of the rooms is available.”

“And just what am I supposed to do? Just sit over here and wait?”

Amy shifted in her seat and quietly slid her phone out of view.