Angels on the Night Shift

by Robert D. Lesslie, M. D.

  She hesitated, but only briefly. Then she moved over beside me.

  “Where?” she scoffed. It was obvious she was becoming increasingly annoyed. Darren looked up at her and then over to me.

  “Put your hand right here,” I directed her, pointing to an area just above and to the right of his navel.

  “I don’t feel—” She stopped mid-sentence and her entire body tensed. Then she placed both hands on the man’s abdomen and began to examine him more carefully.

  She was feeling his aorta. It was enlarged, forcefully pulsating, and was about to burst, if it hadn’t already.

  It all came together. This man had an abdominal aortic aneurysm and it was getting ready to blow. This was causing his back pain, and not a kidney stone. And it explained his low blood pressure, the blood in his urine, and his determination to remain completely still. He needed to be in the OR, probably an hour ago.

  “Did you feel his belly when he first came in?” I asked her quietly.

  Across the stretcher, I saw Darren look up at Liz, waiting for her response. He had been in the room from the first moment Dan Perkins had come to the ER.

  “Of course I did,” she answered defensively. Darren shook his head and looked down at the patient.

  I studied her for a moment and then turned to Darren.

  “We need to get in touch with the vascular surgeon on call. And we’ll need another IV, some blood typed and crossed, and a portable chest X-ray. I’ll send Lori in to help.”

  Then stepping toward the entrance, I turned to Liz and said, “Come out here with me for just a second.”

  She followed me as we moved out of the room and to the back of the nurses’ station.

  Facing her and carefully considering my words, I said, “Liz, we all make mistakes. The key is to be sure we learn something from them. And—”

  “Look!” she exclaimed angrily, then pointed her finger at me, not more than an inch from my nose. “If you’re going to hand me that stuff again about making assumptions, you can just save your breath.”

  Over her shoulder, I could see Susan and Lori turn and stare at the two of us, their mouths hanging open.

  “Just calm down, Liz,” I said quietly, reaching up and slowly moving her hand from in front of my face.

  “I’m not the one who needs to calm down!” she yelled. “So I missed an aneurysm! What’s the big deal? You’ve never missed anything before?”

  She was quickly spinning out of control, her body shaking and her face a deep red.

  “Liz—”

  “Don’t Liz me!” Her hand went up again, this time with her palm in my face. “I’m outta here!”

  She turned, walked around the nurses’ station, and disappeared down the hallway.

  I was hot, and was about to follow her back to our office when I remembered Dan Perkins. Quickly stepping over to Susan and Lori, I told them what we needed. Within a few minutes, the surgeon was on his way to the ER and Mr. Perkins was almost ready for the operating room.

  “There, that should do it,” I told Lori, sliding the man’s chart over to her. “I’ll be right back.”

  She looked up at me but didn’t say anything as I headed down the hallway.

  I was still angry, still trying to get control of my emotions. Liz had really ticked me off, and I was wondering what in the world had flipped her switch.

  She was standing by one of our bookshelves when I walked into the office. Her head jerked in my direction, and she began fumbling with some of the heavy texts on one of the upper shelves.

  “What do you want?” she sputtered angrily, looking first at me and then back up at the bookshelf. She clumsily tried to straighten up the jumbled books but quickly gave up and turned to face me.

  “Look, if you’re going to try to lecture me, I don’t want to hear it!”

  Where has all of this anger come from?

  “Liz, why don’t you just hold on and have a seat for a few minutes,” I told her as calmly as I could. “We need to talk.”

  “There’s nothing to talk about!” she almost yelled. “I told you, I’m off duty and I’m getting out of here!”

  Then she backed away and reached down for her sweater, quickly putting it on. She must have just taken off her lab coat and tossed it onto one of the chairs in front of the desk.

  But I had seen it. And I stood there, looking into her eyes.

  She had seen my glance and now turned her head away from me, patting the sleeves of her sweater. She became more agitated and started looking around the office for something. When she finally spotted her shoulder bag, she walked over, grabbed it, and headed for the door.

  “Liz,” I said quietly.

  Her hand was on the doorknob and she hesitated for just an instant.

  “I saw your arm.”

  She stood there, staring down at the handle, and her shoulders slumped. Then she sighed heavily and dropped her bag to the floor.

  She didn’t say anything. She didn’t have to. The needle tracks in her left elbow said it all.

  How have we missed this? Surely something should have tipped us off.

  Then I remembered some of the simple mistakes she had been making, and her lack of patience with some of our “regulars.” But this had escalated so quickly. It had not even been a couple of months since we had first noticed the missing Vistaril.

  It’s been Liz all along. But what about Amy? How could Liz have…

  The shock of all this was beginning to subside and now I was more than angry—I was livid. We had brought this young woman into our midst, into our family, and she had almost destroyed it. Maybe she had destroyed it.

  I wanted to walk over, grab her by her shoulders, and shake her until…

  When I looked at her again, she was still standing by the door with her head hanging on her chest. She had put her arms around herself and was slowly rocking from side to side.

  I turned back to the shelves and looked up at the toppled medical books. Reaching up, I moved them aside and felt behind them. When I turned around, Liz was looking at me, her eyes reddened and her lips trembling.

  I opened my hand and showed her four syringes. They were each filled with a clear liquid, the morphine intended for Dan Perkins.

  Liz Kennick collapsed into one of the chairs, her head in her hands, and she began to sob uncontrollably.

  I walked around behind the desk, picked up the phone, dialed the nurses’ station, and said, “Susan, would you ask Lori to come back to our office.”

  21

  Redemption

  A few days later, Virginia and I were in the medicine room, discussing the tumultuous events of the past few weeks.

  It had taken us several phone calls, but with the help of the state medical board we were able to locate a drug rehab center for Liz Kennick. She was on her way to a facility in Virginia that specialized in the treatment of professionals, and she had a tough road ahead and some hard work to do.

  She knew that, and she knew her medical license would be revoked. Whatever flaw in her character, whatever weakness that had allowed her to fall into this trap, it would have to be overcome if she was to continue a career in medicine. More important than that, it would need to be overcome if she was to regain control of her life.

  “I hope that young woman knows how lucky she is,” Virginia said, shuffling through some purchase orders. “The hospital had every right to press charges against her, and she might be looking at jail time in addition to losing her license. She has Bill Chalmers to thank for that.”

  “Still, she’s going to be paying a heavy price for what she’s done,” I told her.

  “Hmm,” Virginia grumbled. “She’s leaving some real damage behind her. And speaking of Bill Chalmers, he came by my office yesterday.”

  I was leaning against the counter, watching her do her paperwork.

  “What was that about?” I asked her.

  “It was interesting,” she said, putting her papers aside and looking up at me. “He wanted
to talk about Amy Connors. He had tried to call her a couple of times, after all of this happened, but never talked with her. He had left messages but she never returned his calls. So then he found out where she lives and went to see her.”

  “He what?” I exclaimed. “When was the last time—”

  “I know,” she interrupted. “When have you ever heard of that happening? And it may never happen again. But he was determined to talk with her, and that’s what he did. He drove out to her house.”

  “Wow. I never would have expected that. I hope Amy’s husband wasn’t at home. That would have been some fireworks!”

  “You’re right about that,” she laughed. “But Charlie wasn’t there. It was just Amy, and they talked for a good while. He apologized as best he could and asked her to come back to the hospital.”

  “I hope she knows how much it took for him to do that,” I said. “It was the right thing…but still, that surprises me. How did she respond?”

  “He told me he couldn’t be sure,” she explained. “She listened to him, and she accepted his apology. But she told him she’d have to think about ever coming back to the hospital and the ER. He didn’t sound too hopeful. Oh, and he told her about Walter Stevens.”

  “What about Stevens?” I asked. I hadn’t heard anything about the vice president and didn’t know what she was talking about.

  “You need to pay more attention to the hospital grapevine,” she said knowingly. “Stevens has been given a sideways promotion—actually it’s a demotion, and everyone knows it. Bill relieved him of his duties and put him in charge of facilities management.”

  “You mean housekeeping and making sure the grass is mowed?” I chuckled.

  “It’s a little more than that, but yes,” she replied. “Bill’s idea is to give him some time to mature a little, to gain more management experience.”

  “You mean, in a place where he’s not going to mess up so badly?” I asked.

  “That’s the general idea,” Virginia said, picking up her paperwork once more. “And I think it’s a good one.”

  There was a tapping on the door and both of us looked over.

  It was Darren Adler, and he was standing there in his street clothes.

  “Ms. Granger, Dr. Lesslie. Good morning,” he said politely.

  “Good morning, Darren,” Virginia said. I detected a sadness in her voice, or maybe it was resignation.

  “You haven’t changed your mind, have you?” I asked him.

  “No, I haven’t done that,” he answered.

  I studied him for a moment, hoping for a different response. But none was offered.

  Reaching into one of my lab-coat pockets, I took out a sealed envelope and handed it to him.

  “Here you go,” I said quietly. “And if you need anything else, just let me know.”

  It was a letter of recommendation. Darren was applying for a job in one of the ERs in Charlotte and had asked me for this a few days ago.

  He was leaving Rock Hill General, determined to move on from all that had happened. In spite of everything Virginia and I could say, and in spite of our apologies, he didn’t think he could get past the thought of our having lost faith in him. But I knew it was more than that. He had lost faith in us.

  “Maybe someday,” he had said when Virginia told him he would always have a place in our ER.

  Here was another casualty of Liz Kennick’s terrible wrongdoing.

  “Thanks, Dr. Lesslie,” he said, taking the envelope from my hand. “I’m sure I’ll be seeing you guys around.”

  Without another word, he turned and walked out of the department and out of the hospital.

  Virginia sighed and looked at me, slowly shaking her head. Then I saw her look down at her watch and step over to the window overlooking the parking lot. She was scanning the area, looking for something.

  “Well, would you look at that?” she said quietly in exaggerated surprise.

  I stepped over behind her and looked out the window.

  “What are you talking about?” I asked her, not noticing anything unusual.

  “Over there,” she answered, pointing to the employee parking area.

  It was a big silver truck, and it had just come to a stop in one of the parking spaces.

  “I know what you’re thinking,” I told her, turning back around, determined not to be disappointed once again. “And it’s not who you think it is.”

  “Oh yeah?”

  There was something in her voice that made me turn around one more time and move closer to the window. The truck door was opening, and out stepped…Amy Connors!

  “What!” I exclaimed. “Did you know about this?”

  Virginia winked at me and said, “Aren’t you supposed to be somewhere?”

  I looked at the window and then back at Virginia. Then I muttered something that didn’t make any sense and headed for the door.

  Amy had just walked through the ambulance entrance and was headed straight for the nurses’ station. I hurried over, intercepting her before she got there.

  “Amy!” I said. Then I hugged her. I had always respected and loved this woman, but never more than in this one moment. It had taken a lot of courage and faith for her to walk through those doors. And a lot of forgiveness.

  We just stood there, with every eye in the department focused on the two of us.

  Then smiling up at me she said, “Get on with yourself.”

  She stepped back from me, and suddenly the department erupted in applause. Standing in the triage doorway was Jeff Ryan, hootin’ and hollerin’. Clara Adams was clapping loudly while tears rolled down her cheeks. And Virginia Granger stood in the doorway of the medicine room, feet apart, arms crossed, and nodding her head.

  Amy looked over at the nurses’ station and at Lori Davidson, sitting behind it.

  “And Lori, you need to get out of my chair. We’ve got work to do!”

  22

  Phoenix Rising

  11:15 a.m.—6 months later. “Amy, we’re going to need an ultrasound on the woman in 5. ‘Right upper quadrant pain—gallbladder disease.’ ”

  “Got it,” she replied, reaching up for the chart. “Anything else?”

  I slid the clipboard across the counter and said, “Nope. That should do it.”

  The door to triage opened and Lori Davidson and I turned around.

  Patsy Wilson was pushing a wheelchair into the department and stopped right in front of us.

  “This is Sarah Alpert,” she told us. “It seems that she slipped on her carpet this morning and might have broken her wrist.”

  I glanced down and noticed the temporary splint on her left wrist. It was already swollen and bruised, and it looked like Patsy was going to be right.

  The elderly woman in the chair looked up at me and said, “Dr. Lesslie, is that you?”

  Looking closer, I now recognized her. She had been one of the matriarchs of our church when we first moved to Rock Hill, a great lady and a great teacher. She had broken a hip several years ago and was having a hard time getting around. I hadn’t seen her in a while.

  “Yes, it’s me, Mrs. Alpert,” I answered, reaching down and taking her uninjured hand in mine.

  “Well, I’m mighty glad you’re here this morning to take care of me,” she said, smiling.

  “You know this guy and you’re still glad to see him?” Patsy said in mock surprise.

  “Why of course I am,” Sarah said, squeezing my hand. “He’s always been such a fine young man.”

  “Are you sure we’re talking about the same person?” Patsy persisted, making faces at me from behind Mrs. Alpert.

  “Honey, don’t make me get out of this chair. I’ve still got one good arm,” she said laughing, still quick-witted and still lighthearted.

  “It’s okay, Mrs. Alpert,” I told her. “I’ll take care of Patsy. Let’s get you back to ortho and get an X-ray of that wrist.”

  “Thank you, Dr. Lesslie,” she replied, settling back in the wheelchair and point
ing down the hallway.

  “Okay, Mrs. Alpert,” Patsy said to her patient. “Let’s rock and roll.”

  When they were out of hearing, Lori said, “It’s great having Patsy back. Almost like old times.”

  “You’re right about that,” I agreed, chuckling quietly.

  The phone rang, and Amy picked it up.

  “Rock Hill General ER. This is Amy Connors.”

  Lori and I were writing on a couple of charts and weren’t paying any attention to Amy and her phone call. Not until she said, “Hello, Dr. Kennick.”

  We each stopped what we were doing and stared across the counter at her.

  She sank back into her chair and twirled a pencil between her right index finger and thumb.

  “That will be fine,” she said into the receiver.

  She sat there, listening and occasionally nodding her head. “Charlie gets off about 5 or 5:30, so 6 ought to be about right.”

  More silence, and then, “Okay, we’ll see you then. Yeah, here he is.” She sat forward in her chair and held the receiver out to me.

  “It’s for you,” she told me. “Dr. Kennick.”

  I looked at the receiver, then over to Lori. She seemed as confused as I was, but when I just stood there, she poked me in the side with her elbow and motioned for me to take the phone.

  “Here,” Amy whispered, thrusting the receiver at me.

  I took it from her, covered the mouthpiece, and made a silent gesture with my head for them to give me some privacy. They just smiled, obviously not going anywhere.

  I gave up and put the phone to my ear.

  “Liz, this is Robert,” I said, not knowing what to say next.

  She immediately jumped in and said, “Robert, I know you’re busy, but I just need to say a couple of things.”

  I hadn’t talked with her since she’d left the ER and was admitted into rehab. We had heard a few things here and there, and that she seemed to be doing okay, but nothing concrete. This phone call was coming out of the clear blue.

  “Sure, Liz,” I told her. “It’s not too busy right now. What’s on your mind?”

  “I just want you to know what’s going on with me,” she began, her voice calm and sure. “But first, I want to apologize, and tell you how sorry I am for what happened in the ER, with the drugs. I let you down, and I let myself down. And I still can’t believe I would ever put a patient at risk. Most of all though, I let Amy Connors down. I let her take the fall for me, and I knew what I was doing. With everything I’ve had to deal with, that has been the hardest part.”