That sounds reasonable to me, I thought. There was nothing unusual in what she was telling me. I reached down for the X-ray folder but Liz slammed her hand down again.
“Not so fast!” she corrected me. “You haven’t heard the rest of it.”
I stood back a little and teased her. “Is there a point to this story?”
She looked at me, doing her best imitation of Virginia Granger, and said, “Be patient. I’m getting to it.”
The she turned back to the view box and continued. “Chip was okay for about a day, but they never saw the magnet. And then he started getting sick. First he complained of some stomach pains, and then he started lying around and not moving much. They thought about going back to the ER but decided to come home and see their doctor. On the ride back, he started vomiting and running a fever, and they came straight here. He’s been vomiting what looks like bile, and his belly is rock hard.”
“Have you called a surgeon?” I asked her, becoming more concerned. She was describing a surgical abdomen, and it sounded like Chip needed to be in the operating room as quickly as possible.
“Dr. Scott has already been down and is going to take him to the OR as soon as they can get the crew ready,” she told me. “We’ve got two lines going and antibiotics. He’s ready to go.”
“Well, what does he have?” I asked her, puzzled. “You said the magnet was small and rounded and had made it through his stomach. That shouldn’t be the problem. Is it his appendix, and the magnet is a red herring?”
“Nope, it’s not his appendix,” she answered, picking up the X-ray folder and handing it to me. “And the magnet is not a red herring. Take a look.”
I opened the folder and put Chip’s X-ray on the view box. It was a “kiddie-gram,” one X-ray that showed most of his entire body. His whole chest and abdomen were in view, and right in the middle of his belly was the white outline of the magnet.
Just as Liz had described, it was rounded on both ends and was about the size of a small Tootsie Roll. Actually, it was smaller than that, and should easily pass through the rest of his GI tract. The critical thing was that it had cleared his esophagus and stomach, the narrowest points, and the places where foreign bodies can become lodged and cause problems. And I had seen stranger things passed without any trouble—coins of all sizes, pop-tops from soft-drink cans, paper clips, marbles, and even a drill bit from an electric drill.
I scanned the entire X-ray but didn’t see anything unusual. What was I missing?
“What do you think?” she asked, with a growing coyness that was starting to bug me. After all, who was the teacher here?
“Well, I think he should pass this magnet without any trouble and that his surgical belly is coming from something else.”
“What if I told you that one plus one equals one?” she asked cryptically.
“One plus one…What are you talking about?” I was getting a little frustrated.
“What if I told you that Chip swallowed two magnets and not one?”
I looked over again at the view box.
“I would say that he had already passed one on the way to the hospital at the beach,” struggling for an explanation for this new twist. “Or that he never swallowed it in the first place.” Maybe that was the errant assumption, that there were two magnets initially, but now only one. But if that was the case, where was the other one?
Liz stepped nearer to the X-ray. “Take a closer look.”
I didn’t know why, but I found myself leaning in toward the view box just as she had done. I studied the film again, and then focused on the magnet.
“Whoa!” I exclaimed. “Would you look at that!”
“That’s something, isn’t it?” she said, stepping back a little. “Chip’s mother told the ER doc that two magnets were missing, but he said the same thing you did. Either he passed one or never swallowed it in the first place.”
“But there it is,” I said, pointing to the spot on the X-ray. “Or there they are.”
When I had looked closer at the magnet, I thought I saw something unusual. And as I studied it more, I had suddenly realized what I was seeing. It wasn’t one magnet, but two. And they were almost perfectly overlapping each other. Almost. If you took the time to look closely, you could see two edges and not one.
So that was it. One plus one did equal one. They had become stuck together and wouldn’t move on down. But why the surgical abdomen? Had they caused some kind of perforation, or leaked some corrosive chemical?
“Mrs. Flanders and I tried to piece this together,” Liz began to explain. “It looks like Chip swallowed these magnets at two different times and they were moving through different parts of the small intestine. When they passed near each other, they stuck together, just like… Well, just like magnets. But there was the intestinal wall between them, and over a day or so they rubbed together and wore a hole and stuff started leaking out. And Chip got sick. Really sick.”
“Wow, you’re right,” I quietly uttered. “This is really interesting. I’ve never heard of anything like this happening. Great job, Liz. I’m glad you took the time to look at this film. The answer was right there all along. You know, you saved this boy’s life.”
Liz nodded her head and with a playful look in her eyes said, “Just remember, Robert—never make assumptions.”
She walked back over to the nurses’ station and I was about to follow, when Lori Davidson stepped out of the medicine room and called out to me.
“Dr. Lesslie, have you got a minute?”
The place was crazy, but I knew Lori had worked the day shift and should be gone by now. Something was up, and she needed to talk with me.
I headed for the medicine room and said, “Sure, Lori. What’s on your mind?”
She turned around and quickly moved back into the small room. I followed and stood facing her near the window, thankful for the relative quiet of this space.
“It’s been a little more than three weeks since Amy left the department,” she began. “And Virginia and I have been paying close attention to the narcotics cabinet. Nothing has been missing or tampered with.”
I also hadn’t heard anything, and had assumed that if something was going on, I would have been told. While that was good news, it made things look worse for Amy Connors.
Lori must have been having the same thought.
“Somebody this morning made a remark about that,” she told me. “And they were wondering if Amy in fact had been the one stealing the medicine, since it stopped when she left. I just can’t believe people sometimes,” she added with growing anger in her voice. “There is no way that Amy was responsible. It’s just that whoever is responsible must be pretty smart. They’re lying low right now, biding their time. Don’t you think?”
“No doubt they’re smart,” I agreed. “And I also think it’s just a matter of time. Something’s going to give, Lori. This kind of thing just doesn’t go away.”
I was wondering if this was what she had wanted to tell me. But the troubled look on her face told me there was something else, some other reason for her wanting to talk with me.
“I talked with Amy yesterday,” she said, and then fell silent.
When she didn’t say anything else, I asked, “How is she? Has she found a job yet?”
“Not yet,” Lori answered. “But she’s been looking. And Dr. Lesslie,” she added, pausing and looking away.
“Yes?” I prompted her.
She looked at me again and said, “She’s really hurt by all of this. At first she was angry, with the administration and Stevens and all. But then she started wondering why you and Ms. Granger hadn’t done more to help her. She asked me if you two thought she was guilty.”
“She what?” I exclaimed, astonished. And then I felt an uncomfortable guilt begin to steal over me. Had we done enough? Had we left this young woman, a friend, to fend for herself?
“I know,” Lori responded. “I tried to talk with her about that, but she’s still upset. It’ll tak
e some time, but she’ll understand that your hands were tied. There was nothing that either of you could do.”
It was what I had suspected and what I had feared. This was an empty, awful feeling, and I just stood there staring out the window into the ER parking lot.
“There is something you could do to help her,” Lori added. “If you would consider doing it.”
Quickly turning to face her, I said, “What? What kind of help does she need?”
“She won’t ask you in person,” Lori explained, shaking her head. “And please don’t try to contact her, not yet anyway. But she’s trying to find a job, and she’ll need a reference, a recommendation. She wanted to see if you and Ms. Granger would be willing to do it. She won’t ask anyone else here at the hospital, and she hasn’t worked anywhere else in a long time.”
“Of course I will,” I told her emphatically. “When does she need something? I’ll get it done tonight.”
Lori smiled up at me. “She’ll be glad to hear that. She was afraid that…” She stopped, obviously trying to choose her words carefully.
“Tell her I didn’t hesitate,” I said. “And I’ll have it ready in the morning. And tell her…you tell her…” I didn’t know what to say.
“I’ll tell her,” Lori said, smiling again, and heading back out into the department.
I stood there by myself in the medicine room for a few moments, wondering how we had gotten to this place.
“Doc, we’ve got a bad burn in major trauma!”
It was Darren Adler, and he almost knocked me down as I walked back to the nurses’ station.
“Dr. Nivens is in there now, and I’m gettin’ some morphine,” he told me, disappearing into the medicine room.
I could now hear the cries of a young child coming from just down the hall.
“Two-year-old girl,” Susan said as I passed her at the nurses’ station. “Looked like she was in a lot of pain when they brought her in.”
I hurried into major and found Ted Nivens standing beside the stretcher, looking down at a screaming toddler. Lori Davidson was the only other person in the room. He looked up at me as I approached the bed.
“Hot-water burns,” he said quietly. “Second degree, maybe even some third.”
The little girl looked up at me with wide, terrified eyes, and continued to scream. Every once in a while we could understand “Momma!” but the rest was unintelligible.
The left side of her body, from the neck down to her knee, was nothing but angry blisters and raw flesh. Miraculously, her face had been spared. But the burns covered at least 30 percent of her body, making this a very serious and possibly life-threatening injury.
I turned to Ted and asked, “How did this—”
“I’ll tell you how it happened!” Darren interrupted. He had just come back into the room and was standing right behind me.
“Here, Lori,” he said, handing her an opened vial of morphine. “I cracked the top off and it’s ready to go.”
She had just finished starting an IV and was going to push some of the pain medicine directly into the little girl’s vein.
“Her mother’s drunk and wasn’t payin’ any attention,” he explained, anger rising in his voice. He stepped around me and moved closer to the stretcher. “Cindy here was playin’ in the kitchen and her mother went outside to smoke a cigarette. She had somethin’ boilin’ on the stove and Cindy reached up and pulled it over on herself. I don’t know how in the world it missed her face, but the rest of her…”
He couldn’t say anything else and all of us stood there, looking down at Cindy, and knowing the terrible journey she had just begun. Her skin was peeling off in sheets, and what wasn’t peeling was forming gigantic fluid-filled blisters. She would spend the next few weeks in a burn center, undergoing multiple, painful skin grafts, and hopefully surviving. Then she would spend the rest of her life dealing with the scars.
“She doesn’t deserve this,” Darren muttered. “Her mother ought to be…”
I took him by the shoulder, gently turned him away from the stretcher, and led him toward the door.
“That’s not going to do Cindy any good,” I told him.
“I know, Doc,” he mumbled, looking down at the floor. “But I’ve got a little boy her age, and I can’t imagine him goin’ through somethin’ like this, and me knowin’ that it didn’t need to happen. She didn’t ask for this. It’s her mother. I talked with her out in triage and she’s dead drunk! She can barely stand up!” His face was beet-red, and I could understand why. But I had meant it when I said it wasn’t doing Cindy any good. And it wasn’t doing Darren any good either.
“Come on out to the nurses’ station,” I told him, pushing the door open and guiding him in that direction. “You can help Susan get in touch with the burn center in Augusta. We need to get Cindy down there as quickly as we can. And why don’t you call DSS. They need to know about this.”
Darren went straight to the counter and picked up one of the phones. I heard him ask Susan for our directory, and I was glad he had something to do now. Maybe this would give him a chance to cool off.
“Anything I can do?” I asked Ted. Cindy was quieter now, feeling the effects of the morphine. She had two IVs going, and Lori had placed an oxygen mask on her face.
“We’ll need to talk with her mother and let her know what’s going on,” Ted answered. “Then we need to get in touch with the burn center.”
“Darren’s working on that now,” I told him. “Why don’t you stay in here, and I’ll go find Cindy’s mother. Or hopefully someone sober enough for me to talk to.”
“That would be great, Robert,” Ted said. “I’m not sure I want to deal with any of the family just yet. I’m sorta feeling like Darren right now.”
I understood what he was saying, and the anger they were both feeling. I had been there before, a lot of times. But I had seen anger turn excellent ER doctors and nurses into cynical, burned-out, and ineffective people. I struggled not to follow that path.
Sometimes it was harder than others, like the night I saw Missy Jones.
February 1978. 11:45 p.m. I was working in the ER in Greenville and it was the dead of winter. The forecasters were predicting a heavy snowstorm in another day or two and that news must have kept people at home and in bed. We were strangely quiet, and I was sitting in the nursing area with some of the staff and one of the police officers who provided security for the emergency department.
“Doc, have you guys seen any of the ‘Red Devil specials’?” the officer asked me.
I wasn’t sure what he was talking about and was about to ask, when one of the nurses said, “We had one the other night.”
“Yeah, and two last week,” another nurse joined in.
“What are you talking about?” I asked, confused.
“Well, Doc,” the officer began, leaning forward in his chair. “We started seeing a lot of this a month or so ago. I guess the word got out that it was an effective means of self-protection, and a bunch of people—mainly women—started using it. They buy a bottle of Red Devil lye and pour it into a Mason jar and keep it by their bedside at night. If someone breaks into the house, they throw that stuff right in the face of the guy. Works better than a gun, and it’s a lot cheaper.”
“You’re kidding!” I exclaimed, imagining the damage caused by this caustic chemical.
“The one we had a few nights ago had to go to the OR,” the nurse explained. “He must have swallowed some, and it burned his mouth and esophagus. They’re not sure he’s going to live.”
“The other two were burns of the face and neck,” the other nurse added. “They weren’t life-threatening, but that stuff causes some bad damage.”
I had been off for a couple of days and hadn’t heard anything about this.
“We’re trying to put a stop to it,” the officer told us. “But the stuff is easy to buy, and we’ve been seeing a lot of break-ins lately for some reason. People are scared. I’m sure it’s just a matter of
time before you see your first one,” he added, looking over at me.
To this day, I don’t know how he knew, but the door leading out to the triage area burst open and the triage nurse ran into the department carrying a young child in her arms.
“Dr. Lesslie! Get over here quick!” she called out to me, heading to the nearest empty room and carefully putting the child down on the stretcher.
We all jumped up from our chairs and headed over to the screaming little girl. The police officer darted toward the triage entrance, his hand on the butt of his firearm. We had heard loud yells, and there was no telling what was going on outside those doors.
“What happened?” I asked the triage nurse, looking down at the girl. She was clawing at her face and eyes and her horrifying cries were becoming garbled. Foam was coming out of her mouth, and she started gurgling.
“Her name’s Missy—Missy Jones,” the nurse said breathlessly. “And it’s lye burns!”
“Lye burns?” I echoed, not believing what I was hearing.
“Red Devil lye!” the nurse clarified.
We sprang into action—one nurse starting an IV, another restraining Missy’s flailing arms while another was suctioning the ever-increasing foam from the little girl’s mouth and throat. One of the techs was getting the supplies together to start irrigating her face, eyes, and upper body.
I was preparing to secure her airway and turned to the triage nurse.
“Do we know what happened?”
“I couldn’t get much from the mother,” she began to explain, catching her breath and calming down a little. “But the boyfriend told me she keeps a glass of Red Devil lye on her bedside table, and Missy came in while the mother was asleep and must have pulled it over on herself.”
“That’s not the way it happened,” the police officer said, walking into the treatment bay. “When Missy walked into the bedroom, it startled her mother, and without thinking she threw the lye in her girl’s face.”
One of the nurses gasped.
My heart sank as I looked down on Missy’s destroyed face. The cornea of one eye was completely clouded over, gone. And the other was bright red and steamy. The skin of her left eyelid and the left side of her face had disappeared, eaten away by the lye.
Angels on the Night Shift Page 17
