by Barbara Ebel
Danny extended his hand to Floyd. “Nice to meet you both, although I’m not happy it’s under these circumstances. I helped with your son’s care as I was readily available and deal with head injuries.”
“And we’re grateful you did,” Floyd said.
Danny smiled. “We wanted to check David out as soon as possible after the dreadful spill he took on the court. I can fill you all in but perhaps Sara and Annabel can leave as there are rules for confidentiality of a patient’s information.” He tilted his head in a pleading manner while exchanging glances with the both of them.
“If it’s okay with my mom and dad, I’d like them to stay,” David said.
“Please, yes,” Tara said to Danny.
“I’d like to interject, too,” Floyd said. “First, do we have to worry about the CT results? And I hear about head injuries or concussions occurring in sports quite often so I’d like to know about David’s fall in simplistic terms but also in more detail than that … as much as I can understand from a neurosurgeon’s perspective.”
“I can explain,” Danny said, “but if you want me to stop, just say so. First, I ordered the CT scan because it can reveal any of the four types of intracranial hemorrhages or bleeding in the brain, swelling in the brain, or to detect a skull fracture. It’s quick, cheap and easier than getting an MRI. The good news is that David appears to be clear of those problems. Otherwise, he could be in surgery right now to fix, for instance, a subdural hematoma.”
“Having said that, what we are also concerned about is a concussion. They are sneaky because they are injuries we may not see and they don’t show up on CT scans or most MRIs.” Danny shifted his weight and leaned against the table near David’s leg.
“So there’s no surgical dilemma here,” Tara echoed, “but David could have a concussion, which is what exactly?”
“I’m not being facetious, Mom,” David said while frowning, “but I think it’s more than a bump on the head.” He looked at Danny. “Our coach told us almost half of all sport-related concussions happen in high school football so I didn’t think basketball was that bad. Is it?”
“Coach Newman is correct about football which ranks the highest. Even soccer, lacrosse and wrestling come out ahead of basketball. Statistics are even worse for girl’s basketball than boy’s. And what I really hate to see are head injuries from bike riding,” Danny lamented, “because so many times a kid wasn’t wearing a helmet.”
“My parents always made me wear a helmet,” David said, smiling at his mom.
“We were the same way with our girls,” Sara chimed in, lowering herself into a chair.
“We should be grateful when our kids make it to twenty-one,” Floyd remarked.
Danny nodded, knowing the truth about that. “Anyway, to answer your question. A concussion is a brain injury; it’s caused by the movement of the brain inside the skull and that sudden movement causes the brain to swell. Many people think it’s only from getting a hit to the head or hitting the ground but you can get it by a sudden acceleration or deceleration force. Like a motor vehicle accident when you’re rammed from behind and your head lurches forward and backward.”
David inched himself further on the thin paper draping the table, extending his arms behind him and leaned back. Danny gave him a reassuring look.
“In David’s case, it appears he has a low-grade concussion with few complaints. We can all monitor him for the possible physical, mental, and emotional symptoms like headaches, nausea, balance issues, dizziness, light sensitivity; trouble remembering or concentrating. Let us know if you feel unusually sad, nervous or irritable and if your sleep patterns change, like getting too tired during the day.”
Danny stopped and then chuckled. “Now you’re not going to be happy with me at all. I’m going to prescribe that you have no physical or mental exertion for a week. No raising your heart rate, no studying or school work, and no partying on campus. For your brain to recover, it needs to rest. I’ll give you a cheat sheet with the do’s and don’ts and an office appointment in five days to see if I can give you clearance by the week’s end.”
David scowled and rubbed his hands together. “And I thought we were friends, Dr. Tilson. You’re going to cause me to have the symptoms of a concussion. How can I not feel irritable by doing nothing for the next week?”
“David, Dr. Tilson is looking after your well-being,” Floyd said.
“That’s okay,” Danny said, “I understand. But most people’s concussions get better in seven to fourteen days. When your brain is normal at rest, I’ll give you medical clearance. If it’s in one week, I hope you can be on track with your studies again and slowly get back to basketball.”
After a few more questions, Danny waited a minute for David’s parents and Sara to leave the room. Annabel sprang up to get David’s things from the counter so he could change back into street clothes. “And just one more thing to be clear,” Danny added as he started to walk out the door without looking at them, “no sex allowed either!”
-----
Clad in only long pajama bottoms, Danny emerged from the bathroom and sat on the edge of the bed where Sara sat against the headboard, covers up to her waist, book in hand. The door squeaked open and Dakota pranced in; he put his muzzle on the comforter and then turned sideways to give Danny his rear end to pet while giving Sara his face.
Danny laughed as Sara put her paperback aside and Dakota swiped her hand with his tongue. “Thanks a lot, Dakota,” Danny said, “for giving me your butt.”
“But you’ve got his happy end,” Sara said, rustling his head.
“So true.” Danny dug his fingers into the dog’s haunches and massaged. Dakota extended his head with pleasure, almost as if he were eating treats from the air.
“The basketball game tonight was full of surprises,” Danny said.
“I hope David is going to be all right. He was lucky you were there and able to help out.”
“His coach, his parents, and you and Annabel were important, too.”
“In all these years,” Sara said, “from med school until today, that was a first.”
“What was?”
“To see you working in your professional role. Well, I didn’t see you performing surgery or anything like that and, although we know David quite well, I nevertheless watched you interact with a patient and his family as a neurosurgeon. For me, that’s never happened before.”
Danny leaned in closer and gazed into her eyes. “That’s interesting … I never realized that. So how did I do?”
“I don’t want your head to swell or you may need one of your colleagues to do a bur hole.”
Danny laughed. “You have learned the lingo after all these years. Will you tell me anyway?”
“Your bedside manner is artful. You had empathy, the perfect tone of voice, and explained the overall situation as well as David’s personal circumstances excellently. You made sure they understood the gravity of his head injury as well as the optimism for him getting better.”
“Wow. I’m speechless. I appreciate that.”
“No wonder you are now the doctor in charge of your neurosurgical group. Things often happen for a reason.”
“I wish someday I could see you on the job, too.”
“You’ve been in my classroom before. Maybe not that much but as much as practical.”
“What I’ve seen is that you are one heck of a teacher and the high school kids adore you.”
Sara blushed. Her teaching meant a lot to her.
“As far as David and his parents go,” Danny said, “I stopped short of giving them more sport’s related information as they had enough to deal with.”
She looked at him quizzically while bending one leg under the covers.
“Like the fact that concussions due to sports have doubled in the last ten years and the fact that ninety percent of them don’t involve a loss of consciousness. I consider David to have a Grade I concussion without a loss of consciousness but, as athletes a
ccumulate them, about forty-percent will be catastrophic, leading to a permanent neurological disability.”
Sara shuddered. “Makes me glad I don’t have to worry about the girls since they aren’t really involved with contact sports. And if David rests on campus this week instead of going home, maybe Annabel can be influential in keeping him inactive.”
“I hope so.” Danny gave the Chesapeake one more animated massage. “Okay, that’s it, time to settle into your dog bed.” Dakota let out a loud breath as if disappointed and plopped down right next to Danny.
“I know we haven’t talked about it too much,” Danny said looking back at Sara, “but which day next week is your obstetrician’s appointment?”
Sara pulled down the covers and rubbed her abdomen. “On Monday.”
Danny put his hand down next to hers; Sara’s pregnancy was too early so he barely felt a bump.
“Even though it’s your second routine appointment, it’s going to be exciting because of the first ultrasound and baby pictures. But you know she’ll ask again if you want to schedule an amniocentesis.”
After a big sigh, Sara pulled the bedspread up to her chest. “Too bad I’m forty-eight. Otherwise, she probably wouldn’t have mentioned it.”
“It’s only because the baby’s risk for a genetic disorder rises with age. Your doc is making sure we’re given the option to diagnose a chromosomal abnormality.”
“I know,” Sara said. “Especially for Down’s syndrome which is why you and I are shying away from talking about it. But it’s an invasive procedure putting a needle straight into my womb and she said it carries a risk for a miscarriage. But I guess it’s just another way of helping a woman’s decision to abort a baby that she finds out isn’t as perfect as society would like.” Sara frowned.
Danny kept silent, then he took her hand. “Either way, I’ll stand by your decision.”
“What do you think?”
“I don’t know what I would have thought before getting more religious after last fall’s trauma in that tornado but, now, I’d prefer us not to have the amniocentesis. This surprise baby was conceived in love and deserves a right to life just like all living things.”
Dakota popped his head up, his brown eyes looking searchingly at Danny. Sara glanced at the dog and then Danny.
“Well, then, I guess we all feel the same way. No amniocentesis. And when I come home on Monday with our baby’s first ultrasound pictures, we’ll know if it’s a boy or a girl. We’ll all celebrate. And you and I, Casey and Mary, and Annabel and Nancy can make suggestions on naming her!”
-----
It wasn’t long before Sara was fast asleep. Danny quietly slipped out of the room and into the next bedroom. He knelt on the floor and studied Julia, her eyes closed, her small hand tucked beside her cheek. “Sleep tight, love. You’re going to be a big half-sister to a new baby girl or boy within a year. But Sara thinks she’s having a girl.”
Chapter 3
The night before, Casey had worked extra late, having transported a patient over the border to Kentucky at the end of their shift. He still wasn’t rested on Sunday morning as he headed downstairs with a big yawn. Mary sat at the counter with a mug of coffee and the weekend newspaper.
“Morning,” he said, giving her a rub on her shoulder.
He looked across the room where Nancy worked quietly on homework. In the latter half of her junior year in high school, her work load was substantial, especially since she was fanatical about grades; she had high hopes to be as smart as or more successful than her older sister.
“Yo, Nancy,” Casey said. “How about going to get Julia? Her mother is picking her up soon for the day.”
His niece closed a notebook. “I was just finishing. Do you mean that witch is coming over here?!”
Casey glanced at his wife who shrugged her shoulders. “Julia didn’t hear that,” Mary said, “so I can’t blame her for calling a spade a spade.”
Nancy quickly got up and disappeared down the steps while Casey opened the yard door. Dakota had been waiting to come in, his eyes glued on the door frame, his body quivering because he had yet to give Casey a hello.
“There you go, boy,” Casey said, rustling Dakota’s body in a double-handed greeting. “Your favorite little girl is on her way up so I better enjoy you before you leave me flat.”
The basement door opened up, Julia ran in and headed straight for the dog.
“Da-Ka!” she squealed and Dakota play-bowed as she plopped on the floor in front of him.
“Sara had her all ready,” Nancy said coming into the room, “and had packed a few things for her. She’s had breakfast, too.” She placed the small duffel bag on the counter.
As Casey poured his wife more coffee, the phone rang. “I’ll get it,” he said.
“It’s me,” Rachel said. “I just pulled into your driveway. If you could bring my daughter out, I’d appreciate it.”
“I can do that. Sit tight,” he said and hung up. He squatted to face Julia. “Okey dokey. Your mom’s outside so say good-bye to Dakota. You’ll see him again later today.”
Mary went to the bag and pulled out Julia’s outerwear. Looking into Julia’s eyes, she tucked the little girl’s fine dark-blonde hair into a woolen hat, helped her with her jacket, and gave her a kiss.
Casey took Julia’s hand and led her down the hallway. “Bye, Julia. See you later,” Nancy yelled.
“You stay here, boy,” Casey said to Dakota as he opened the front door. In the double driveway to the left stood Rachel, leaning against her Miata.
Julia let go of Casey’s hand and skipped over. “Hi, my love,” Rachel said. She stooped down, hugged her, then walked to the passenger seat where she strapped her in. Casey followed and stood there with the bag.
“We love you, Julia,” Casey said before Rachel closed the door.
Rachel spun around and stared at him. No one would have known about her previous facial trauma, Casey thought, as the surgeon did a great job. He waited for her to speak again as it still amazed him that such a seductive voice - which could probably narrate every romance novel to be a best-selling audio book – could belong to someone that Nancy had labeled a ‘witch.’
“You just said ‘We love you,’” Rachel said to him, “but no one loves her like her mother.” She took the bag from Casey’s grip and marched in front of the car to the driver’s side. She wore a butternut-colored pullover with a matching cap and, below her velvet pants, low western-style boots which clicked against the asphalt.
As Rachel got into the car, Casey stooped low and waved to Julia.
“I’ll be back promptly at five o’clock to drop her off,” Rachel said through the open window. “I have to be somewhere after that. I’ll be in a hurry then … like I am now.”
“We look forward to it.” Casey smiled. He turned and walked briskly to the door.
Rachel turned the ignition key but, to her surprise, the car didn’t respond; she turned the key forward again and her Miata just growled. “Damn thing,” she mumbled. “Crappy timing.” She tried again but the car wouldn’t spring to life.
Casey glanced back the second time she cranked the motor. With displeasure registering on his face, he wondered if the sporty little car ever had regular maintenance.
Rachel opened the door halfway, put one leg on the ground, and leaned over the open window. “Do you think you could be a gentleman and help us out?” she asked with a more appealing tone than a minute ago.
Casey shoved his hands into his pockets and walked back to the car.
“I really have to get home,” she said with urgency.
“Okay, open the hood.”
The front end popped open. Casey propped it up and leaned to the side. “Don’t start the engine,” he shouted.
Scanning under the hood, the battery and parts looked clean and intact so nothing struck him as being amiss. He leaned in a bit closer; he especially took a closer look at the belts, what he thought of as the workhorses of a car.
As he arched further in, he moved his left hand onto the alternator belt. To his astonishment, he heard the engine crank on which made him jump with surprise. But his reaction was too late.
With a snap, his middle finger was amputated from the second knuckle.
-----
“Crap,” Casey said, his left finger gushing blood like a severed artery. When he took a fast step backwards, he yelled loudly. “I told you not to start the engine!”
Rachel turned off the switch. “What happened?”
“This is what happened,” he said, holding up his left hand. “I’ve lost most of my finger.”
“I have to get going.”
Casey heard her comment as he stepped back to look for his chopped-off finger in the bowels of the engine. Spotting it, he let go of the open wound, retrieved it and stuck it into his right palm, pressing it there with his three end fingers; he then used a pincer grip to tourniquet the blood flow on the other hand. As the pain intensified, he hurried into the house leaving Rachel with a frustrated look on her face and Julia sitting clueless in her car seat.
-----
Danny finished making morning rounds for his colleague, Matthew, hoping he would place in the top few runners of his mini-marathon.
He draped his white coat over a chair in the doctor’s lounge, grabbed a juice and a pastry, and sat down with a section of the newspaper. He finished reading the local news when his iPhone dinged with a text message from Mary.
If you’re still in the hospital, don’t leave. Meet Casey and I in the ER.
His heart thumped and he frowned; the message brought back memories of his daughter Melissa in the ER when she’d make emergency visits with Sara for asthmatic attacks. Glad that the text didn’t say anything about his other girls, he pushed back from the table and headed down the stairs to the ER. What could be the problem and was it Mary or Casey who needed help?
Passing the patients’ board over the desk, Danny immediately spotted Casey Hamilton’s name and he swallowed his worry as he rounded the corner into Room 2.
