Emergency Room

by Caroline B. Cooney

  The Attending frowned over the nineteen-year-old. “What’s this wound on the back of your neck, kid?” The boys had refused to identify themselves, so they could not be called anything except “kid.”

  “I dunno.”

  The doctor prodded gently. “Kid. Is this a knife wound up here?”

  “Could be.”

  “You got a knife wound and a gunshot wound? What kind of life you got here, kid?”

  The boy smiled with satisfaction. “Exciting.”

  “And possibly over with!” snapped the Attending. “Roll the fourteen-year-old back into the hall,” he said to Diana. “He’s hardly scratched; we can get to him anytime.”

  Diana shoved the stretcher. Stretchers were much heavier than you expected them to be, and much harder to maneuver. They didn’t like to roll in a straight line, but always aimed for IV poles and visitors’ legs. Panting, Diana got the stretcher into the hall and shoved it against a wall between two drunks.

  Two cops took over. “Who shot you?” they said to the kid. They were writing in very tiny notebooks. Diana didn’t have small enough handwriting to use anything that little. Maybe it was a special police skill. Writing in miniature.

  “Huh? Who shot me?” said the fourteen-year-old. “I dunno. I din’ see nothing.”

  “That guy in Bed Two shot you?”

  “Huh? I dunno. I jest walkin’ by.”

  “Kid, you got shot. You gotta tell us who did it.”

  “Can’t. Din’ see nothing.”

  “What was it about?”

  “I dunno. I jest walkin’ by.”

  “You dealing drugs?”

  “What you mean? Me? I still in junior high.”

  “Yeah, and are you dealing?”

  “Nah, man, I get straight A’s. I be home studyin’.” He couldn’t keep a straight face during this and giggled softly to himself. He tested his bonds and smiled happily because he was indeed securely fastened.

  Diana had absolutely no idea what on earth his thoughts might be.

  Mary walked up, as uninterested in the GSWs as if she saw them every day of the week. But then, of course, she did. Diana tried to imagine such a thing, and remembered in some confusion that she herself hoped to be a surgeon and see this kind of thing every day of the week.

  “Here,” said Mary, “come on, we’re swamped, do your share.”

  Diana took the sheet. How could life go on like this? Surely if there were three people shot, the rest of the world should slow down and give the hospital, and specially Diana, time to consider things. But the patients kept rolling in, and she kept having to find out their insurance status.

  Trauma Room doors closed and Diana felt shut out of all excitement and all possibilities. The only good thing was that old Seth wasn’t in there. He was probably off flirting with Miss Pretty Medical Student.

  Diana made a face and stared down at her assignment. A man with SOB. In an Emergency Room, this trio of letters meant shortness of breath. Very serious. People who weren’t getting enough air were people in danger of dying. They were never in the Waiting Room, always went straight to treatment.

  She checked the wallboard for the patient’s room number.

  The name on the sheet registered in her mind.

  Robert Searle.

  Her eyes glazed over. She could not think. Her mind went flat.

  No, she said to herself. No, it’s not the person I’m thinking of. Can’t be. Impossible. I’m going home now. I’m out of here. I can’t do this. She closed her eyes tightly, as if she could actually blot herself out of the ER.

  Robert Searle. She would have to look at him. Talk to him. Hear his voice.

  She remembered that she was eighteen and brilliant and she could handle things. She forced herself to open her eyes and look back down.

  Robert Searle.

  The name on the paper had not changed.

  Only her life had changed.

  Routes 14-A and I-95 6:42 p.m.

  ALEC’S OWN FACE WAS the brake that slowed him down.

  He did not lose consciousness.

  He knew exactly how long it took an ambulance to arrive.

  Nobody tried to move him, and the two women who first stopped to help were not strong enough to get the motorcycle off his legs anyway.

  The heat of the motorcycle exhaust pipe burned away his skin as he lay there. He could smell himself charring, even over the smell of gasoline and pavement and blood.

  He wanted to scream but his mouth was full. He did not know how he was able to breathe. He was aware of more than he wanted to be: of how the elderly ladies were crying, of how somebody would have to notify his mother, of how his cousin was going to react about the bike. Did he have a face left? What was filling up his mouth and making it impossible to talk?

  The siren was an oddly terrifying sound.

  It sounded like arrest and rage, like police and prison.

  He tried to think of it as his own rescue, but couldn’t.

  Along with the pain came a rush of fear so strong it was like the wind that had lifted his hair.

  He could not move.

  Was it the weight of the bike?

  …or had he hurt his spinal cord?

  The Waiting Room 6:45 p.m.

  ANNA MARIA WAS FEELING secure. Half an hour in the Waiting Room and she felt as if she knew everybody there. She was no longer afraid of them, and nobody had asked why she and José and Yasmin were sitting at the coloring table. Nobody ever would, either. As for the police, they were there to stop trouble, not start it.

  For a few minutes a girl whose name tag read Diana had sat at the low table and colored with them. Anna Maria loved that. Diana was so pretty and had such a nice pink jacket on. It made Anna Maria feel special to have Diana sit next to her. “Let’s make get-well cards,” Diana had said cheerfully. “Who is sick? Your mother? We’ll make a card so she’ll feel better.”

  Anna Maria smiled and pretended not to speak English.

  Diana drew a garden of yellow flowers and put a big red castle behind it, with orange towers and a blue dragon. Anna Maria and Yasmin were awestruck by this artwork and struggled to copy it. José leaned forward in his stroller to watch. Then he sucked on his bottle some more.

  When Diana left to run an errand, Anna Maria carefully slipped the three best crayons into her pocket. When they got home, they would each have a crayon.

  Behind Anna Maria sat perhaps a dozen patients waiting to be seen. With them were family members or neighbors who had driven them over, or followed the ambulance. Lots of people took the ambulance even if they weren’t hurt very much. They didn’t have taxi money, and anybody knew that the doctors saw you faster if you came by ambulance.

  Although tonight that did not seem to be the case.

  Half the patients waiting had come by ambulance and nobody was calling them back for treatment.

  “Hey! Nurse!” yelled a man on Anna Maria’s left. “How long I gotta wait here? I been waiting here an hour.” His voice lurched a little. He was drunk. Anna Maria managed to scope him out without actually looking in his direction. Unshaven, clothes needing a wash, he had the look of street drunks — angry, confused, potentially dangerous.

  “It’s busy,” the nurse told him. “There are no beds back there.”

  “I don’t care about beds!” The man did not swear, but only because the security guard had straightened up and was staring at him. “They can see me in the hall. Get me in there! Stop screwing around!”

  The security guard wandered over.

  Anna Maria looked hard at her little sister, and Yasmin obediently changed sides of the table, farther away from the drunk.

  The nurse was bored. She had to say this a dozen times a night. “I’m sorry, sir, this is an Emergency Room. We don’t see patients in the order they arrive. We see them according to how dangerous their situation is.”

  “My ankle hurts!’ the man bellowed. “You been lettin’ people in there all night but you ain’t lettin�
� me in. I gotta die before you look at me?”

  The security guard leaned against the wall, right where Yasmin had been sitting. Anna Maria rolled José’s stroller closer to the table.

  “Since when is a twisted ankle life threatening?” said the nurse. “We’ve got a motorcycle accident coming in. They will be seen first.”

  “So how long you tellin’ me I gotta wait?” The man left his seat and staggered toward the nurse. He bumped hard against Anna Maria’s seat. “Huh? How long? Don’t tell me no lies. How long?”

  The security guard walked next to the guy.

  The two fat gossiping women one row away said to Anna Maria, “Little girl, where’s yo’ mama at? Who you here with?”

  Anna Maria smiled widely and pretended not to speak English.

  She knew the fat women were worried about her, but this was not the time for somebody to get involved. This was the time to be invisible.

  A burst of laughter rattled out of the television on the wall, and the fat women were distracted.

  Anna Maria sneaked a look around to make sure nobody else was wondering where her mama was at.

  Nobody was.

  Routes 14-A and I-95 6:50 p.m.

  WITH DIFFICULTY, THE AMBULANCE crew hauled the bike off the teenage boy and exchanged glances. Nothing would be said in front of the patient, but this was a “lock and load.” No fancy stuff. They had to get this kid in the ambulance and reach the hospital fast.

  They turned the boy over, slid him onto a backboard, and then set the backboard on the narrow stretcher. Heavy cervical collars were put around the boy’s neck, to prevent movement. Lifting the stretcher up into the ambulance, the men grunted at the weight, but braced themselves and held steady, trying not to tilt the boy, which would just scare him more. His heart was already racing like a house afire.

  The stretcher slid into place and the floor locks automatically snapped onto the stretcher wheels, so it wouldn’t roll during the drive — which was not going to be leisurely.

  Police waited for the EMTs to signal; they would block traffic so the ambulance could make a U-turn, take the other turnpike entrance, and begin the nine-mile trek to the hospital.

  The boy had to be flat on his back, neck unmoving, in case he had injured his spinal cord, but there was also danger of compromising his airway now that he was no longer facedown. The instant that the stretcher was in the ambulance, one EMT sat in the CPR seat and began suction. “It’s okay, son,” he said soothingly, although it was not.

  “What’s in his mouth?’ asked the second EMT.

  “Gravel. Teeth. Blood.”

  A clear plastic tube, exactly like the suction tube the dentist uses for saliva, but much larger, sucked up the debris that filled Alec’s mouth and deposited it in a container that looked exactly like a Mr. Coffee pot.

  Alec could feel the suction. It not only took the junk out of his mouth, it took the air. His lungs were being deflated.

  The ambulance doors slammed.

  The siren began.

  Alec convulsed at the two sudden huge noises and the EMT said, “Not to worry, kiddo. Everything’s, going fine.”

  Alec could not talk with the thing in his mouth. He could see, though. Blurry faces leaned over, while huge hands crossed his vision like expanded sign language.

  He felt movement as the ambulance turned around, and it was not like a car’s turn at all, but like an amusement park ride. A whipping dizziness.

  They were cutting off his clothes.

  Scissors cut through his jeans and underpants.

  He was going to be naked in front of these strangers. One of whom was a woman.

  He wanted to tell them to stop, that his legs were fine, that he didn’t want them to take his jeans off, please, no!

  There seemed to be nothing left of the T-shirt. Road burn had reduced his shirt, his chest, and right arm to one big scrape.

  “Jeans held up pretty well,” said the EMT. “What brand are these?”

  “Sneakers didn’t make it,” said the other one, cutting off what was left of Alec’s high tops.

  A cold slimy slab covered the agonizing burn where the exhaust pipe had cooked off his skin. Alec moaned slightly and the EMT said, “It’s Jell-pac, son. It’ll cool off the burn and keep it nice and clean for the doctors to look at.”

  A tiny clear plastic bag covered his face now, and an explosion of clarity fireworked in his head.

  “How much oxygen are you giving him?” said one.

  “Fifteen liters. You think that’s too high?”

  “Nope. That’s what I’d do.” This EMT said gently, “We’re going to pour water over you, son. Get the worst of the junk off your skin. You got sand and pebbles and tar stuck to you. Hang on, this won’t feel good.”

  It didn’t.

  “You’re gonna feel a little stab,” said the woman EMT. “I’m starting an IV on your left hand.”

  He wanted to watch but could see only her moving shoulders and arms. She was braced against the shiny built-in cupboards that lined the interior of the ambulance. He felt nothing when she claimed to be putting in the needle. That scared him more than if he had felt everything.

  “He’s got a wallet,” said the man who had cut off his jeans. “Driver’s license says this is Alexander Whitman. Age seventeen.”

  Distinctly, over everything else, Alec heard a pencil scrawling on paper. They are filling in forms for me, he thought.

  He wondered if there were carbons to give to the morgue.

  “Taking a corner!” yelled a voice from the front.

  He had forgotten about the driver, forgotten how fast they were going.

  He felt the engine back off, saw the woman grab a ceiling rod like a subway bar for balance. He felt every degree of the turn the ambulance took. The vehicle whirled. He felt like a vegetable in a blender.

  Vegetable.

  A picture of himself — unspeaking, unmoving, naked and helpless — appeared in Alec’s mind.

  Vegetable.

  Please, no. Please don’t let me be a vegetable.

  Emergency Room 6:55 p.m.

  SETH WAS COMING BACK from the Blood Lab, two buildings away. Newly built hospitals would have delivery systems with pneumatic tubes, like drive-up windows of banks, but this hospital was too old and had too many buildings for a straight shoot. Seth loved going to the Blood Lab, not because he got to do anything or talk to anybody, but because the route involved an underground tunnel not accessible to the public.

  It was one of the few things he would do tonight where he felt part of the system. Somebody who knew what was going on; a grownup. He loved that tunnel.

  Fat yellow tiles covered the walls and floor of this sub-basement tunnel, but the ceiling, which contained everything that let the hospital exist, was not enclosed. Spookily low over Seth’s head stretched armloads of exposed wiring, huge square air-conditioning ducts, and black plastic water mains. This allowed the maintenance crew to reach everything easily, but if you really wanted to disable the hospital, it wouldn’t take long from here.

  Seth dodged several large carts of dirty laundry being hauled behind a small electric truck. He found the right stairs (elevators were too slow) and walked swiftly back to the ER. (Real doctors did not take their time; they rushed; Seth loved rushing.)

  The doors to the Trauma Room were closed and the halls were mobbed by police and ambulance personnel. Something big went down, thought Seth, and I missed it!

  Perhaps there had been a drug war or a race riot or a multiple car crash! Seth wedged between the phalanx of cops and reached out for the silvery handle of the Trauma Room door. A cop blocked his way. “Run along, kid.”

  Run along, kid? The cop was dull looking. Beefy, beer-bellied, in need of a shave. How could this person push Seth around? Seth glared at him, ready to argue, but the cop never even glanced at Seth, never had looked at him to start with; Seth was nothing but a pink jacket taking up valuable space.

  The cops passed him like a
plate in a restaurant down the hall and out of the way. Oh, well, he thought, diverting himself by looking for the really pretty medical student. He searched the main halls and then poked around through the minor halls that led to X-ray and storage and conference rooms. On his second pass Meggie said, “They’re in the Family Room.”

  “Who?” said Seth.

  “The medical students. You think I didn’t see you pretending to be one? You want to catch up, they’re in the Family Room.”

  There was a glint in Meggie’s eye that Seth could not decipher. He debated his strategy. Should he acknowledge that he had his eye on the pretty doctor? Or did this have nothing to do with flirting? And was there something terrific going on in the Family Room that he should get in on? What was Meggie’s motive here? Was she making a gift to him or setting him up?

  “You’re gonna make a good doctor,” Meggie said. “I can see the calculating going on behind your eyes.”

  I hate women, thought Seth. They spend all their time trying to look inside men. Analyzing us. Trespassing on our thoughts.

  Meggie laughed. “Not a bad night for a future doctor. You got three women making eyes at you.”

  Three? That would have to include Diana. Seth, although busy hating women, found that he was still very interested in them. Playing for time and hoping for clues, he said, “So what’s happening in the Family Room?”

  “Patient is brain-dead but not body dead. Doctors are telling the family. They got to decide whether to donate the organs and pull the plug or what. Medical students are down there listening to see what kinds of things you say and what kinds of reactions you get.”

  Seth almost gagged. The family of some half-dead person had to have this terrible announcement made in the company of medical students taking notes on their clipboards?

  “This is a teaching hospital,” said Meggie. She sounded as if she were quoting a news release. “So anything that happens, you have to expect it to be a teaching event.” Meggie adjusted everything on her person. She adjusted her hair, her eyeglasses, her bra straps and the contents of her bra. If Seth did that much adjusting to his person, somebody would arrest him. “Go on down there,” Meggie added. “You might learn the really good stuff if you go down there.” There was such a taunt in her voice that Seth knew it was some kind of test.