by J. G. Sumner
“The report I received from the medics was that Skyler was thrown from his bike going off a jump. Based on that account, I have no alternative but to believe when he hit the ground, he hit hard. That’s the only explanation I can come up with as the cause of the aortic tear.”
“I see. Is there anything else that could have caused that?”
“Well, I suppose there could’ve been some sort of congenital defect that could’ve caused his aorta to tear and then caused him to crash his bike. However, the fact is that he is young and it hadn’t been detected up until now, so I’m inclined to believe the accident was the cause of the tear.”
“Thank you for your honesty. How often have you seen this type of injury?”
“Quite honestly, this is only the fifth one I’ve seen. The other ones were all on elderly people who suffered a trauma and had poor vascular health or from severe car accidents. I’ve never seen this happen to a healthy child. My suspicion is the impact he suffered was significant.”
The policeman jotted down everything he said.
“I see. Thank you for your input. This helps a lot.”
“If you don’t mind, I have some questions for you.”
“Sure, go ahead.”
Josh and Miller rounded the corner and pushed the button to call the elevator. “I’m guessing that since you’re investigating this, you’re concerned this may not have been an accident.”
“I think it’s still too early to make that assumption. However, from what information I’ve received about this accident, there’s definitely the possibility that foul play was involved.”
“If you have some details you could share about the accident, I’d love to hear them. Knowing the mechanism of injury helps me anticipate things that might go wrong with the patient.”
The elevator doors popped open and both men stepped inside. Josh pressed the number five button and the doors shut.
“I haven’t had the opportunity to interview all of the witnesses. My partner is back at the scene right now doing that. However, I’ve been able to ascertain that Skyler had performed pre-race checks on his bike. And he had a reputation for being very thorough with his checks.”
The doors slid open. Both men stepped out on the fifth floor and made a right toward the ICU.
“Skyler started the race. He was in the lead. He’d gone off several small jumps and landed them perfectly. He came upon the largest jump on the track. While he was in the air, the front tire flew off. It appeared he tried to recover by landing on the back wheel. However, he was in the midst of doing some sort of stunt and was unable to make the landing. As a result, he took the brunt of the fall on his left side, with the bike landing on top of him. Not that I’m a medical expert, but it seems to me that would be the reason why he has all of the injuries on his left side.”
When they came to the doors of the ICU, Josh turned and looked at the officer. “That certainly does explain a lot, and it reinforces my theory about the shearing force causing the tear. Any idea what may have caused the tire to come off the bike?”
“Not yet. We’ve confiscated the bike for investigation. Hopefully, we’ll find out sooner than later.” Miller gestured toward the door of the ICU. “Do you mind if I follow you in and get a look at Skyler? I’d like to see for myself how he looks for my report.”
“Sure, but I’m going to ask that you remain quiet and not touch him. He’s in critical condition and needs the least amount of stimulation possible.” Josh swiped his badge to enter the unit.
“On a professional level, do you think he’s going to make it?”
Josh paused and sighed. “I don’t know. If he does, it would be because there’s a higher power looking out for this kid. It’s unlikely, though.”
***
Laney
When Laney and Rebecca headed out of the family waiting room, Rebecca looked fragile and weak, as though she could collapse at any minute. Laney’s need to comfort Rebecca was strong. That desire was what drove her into nursing. Even as a child, she would try to mend sick animals and always stick up for the kids who got picked on.
“Have you had anything to eat or drink since you’ve been here?”
Visibly shaken, Rebecca bit her lip and shook her head.
“It’s going to be a few minutes before you’re allowed back with Skyler. How about we go to the cafeteria and get you some coffee and something to eat? You need to take care of yourself so that you can take care of Skyler.”
Rebecca cleared her throat. “Thank you, but I don’t think I can stomach anything right now. It’s in knots.”
“How about we get you something to drink at least? Perhaps we can find some food to go for later.”
They entered the elevator where Laney pressed the button for the first floor. As the doors closed, she looked at Rebecca.
“Are you okay?” she asked. The other woman was trembling. “Maybe we should look into getting that friend here for you.”
“I’m fine. I think the magnitude of everything has just hit me. The fact that Skyler would be dead right now if it weren’t for you and Dr. Stone saving him, the thought that there is an investigation into his accident, and me just hoping and praying that Skyler gets through this—it’s a little much to handle right now.”
The elevator doors opened and Laney directed Rebecca toward the cafeteria.
“I understand what you’re going through. You need someone to help you through this. I can call a chaplain to come and pray with you if you’d like. But I really think you should have someone else with you.”
As they headed into the cafeteria, Laney directed Rebecca to the coffee machine.
“How do you take yours?”
“Black. Thank you.”
Laney handed her a cup. Rebecca still looked lost in her thoughts, so Laney guided her toward the ready-made sandwiches.
“Is turkey okay?”
“Yes, that’ll be fine.” Rebecca looked up at Laney. “I have a friend named Emily, and I know she’ll come. Would you help me call her? I don’t know if I can get the words out.”
“Absolutely! Let’s get you back upstairs to the ICU. We can use one of the phones up there to call her.”
Rebecca wrapped her arm around Laney’s. “Thank you again for all that you’ve done for us. I don’t know where I’d be without your support right now.”
“You’re very welcome. I’ll be here as long as I can. But right now, let’s see how Skyler is doing and call your friend.”
Chapter 6
As they arrived in the family waiting room, Laney gave Rebecca a tour of what to expect.
“This is where you’ll come each time you visit Skyler. You’ll need to check in here with the volunteer. She’ll call the nurse to see if it’s a good time to see him. If the volunteer is not here, you’ll need to pick up this phone.” Laney pointed to a red phone on the wall. “This phone will ring directly to the nurses’ station, and they’ll be able to help you. There’s a little conference room right around the corner that I want to take you to first.”
They headed out of the waiting room and turned down the hall about a hundred feet before they got to a sign that said ‘Family Conference Room.’
“What do they use this for?” Rebecca’s voice was shaky.
“It’s used by the staff and family of a patient when there are updates to be given, or families need a private place to talk to the doctors.”
Laney opened the door and motioned for Rebecca to enter. The automatic lights flickered on as soon as they entered. Laney took a seat next to the phone on the conference table.
“Do you want to start by calling her or would you like me to?” Laney asked.
“I think I should start. I know she’ll have questions and I probably won’t be able to answer them. I’m sure I’ll turn into a blubbering mess as soon as I hear her voice. Maybe you could take over at that point?”
Rebecca proceeded to dial. Laney could hear the phone ringing and a woman’s voice answer.
“Rebecca, how’s it going? How did Skyler’s race go? Did he win?” Rebecca looked to Laney who motioned for her to continue.
“That’s what I was calling you about.”
“Is there something wrong? Are you okay?”
“It’s Skyler. He’s been in an accident.” Rebecca began to sob. “I don’t know if he’s going to…make it.”
“What happened?”
Rebecca nodded to Laney.
Laney took the phone off speaker and began speaking in the headset. “Emily? Hi, my name is Laney, and I’m a nurse. Rebecca has asked me to talk to you and ask that you come here to be with her. She could really use your support right now.”
“Of course! What happened to Skyler?”
Laney had to calm her down. The last thing the world needed was a hysterical driver on the road. “I need you to stay calm. I need you to be okay to drive.”
“I’m sorry. Of course. Can you please just tell me what happened?”
Laney proceeded to give a status update on Skyler, and where Emily should go before she hung up.
“She’ll be here shortly.”
Rebecca looked down at her hands. “I guess I shouldn’t have waited so long to call her.”
“Don’t start beating yourself up. Skyler needs your attention right now. In fact, let me go check and see if they are ready for you to come back and see him. You stay right here and I’ll come back to get you.” Laney got up and went to the door. As she opened it, she turned back. “Everything is going to be okay. I’ll be back in a jiffy.” She gave her best reassuring smile.
As Laney walked into the ICU, she was greeted by Peyton, her best friend and coworker. Peyton was gathering supplies for a patient. “Hey, Laney! I bet I can guess why you’re here.”
Laney smiled. Peyton was one of the smartest nurses in the ICU. On top of being smart, she was one of the most beautiful people Laney had ever met—inside and out. Her petite frame, blond hair, blue eyes, and a body most women would kill for left many thinking she was conceited and vain. But Peyton was the opposite; she had to be one of the kindest people on the face of the earth.
“I’m looking for the trauma that should have rolled up here in the last few minutes.”
“How did I know? He’s in five forty-seven.” Peyton gestured at a room a couple of doors down. “You have the pleasure of talking to his fabulous nurse.” She curtsied.
Laney laughed. “How’s he doing?”
“Dr. Stone is in there with him right now. He seems stable for the moment. Rumor has it you were on top of the gurney doing CPR all the way into the OR.”
Laney blushed. “Geez, that got around quick.”
“You know us, always looking for a little excitement. You had to know that story was going to spread like wildfire.” Peyton winked.
“I guess I did. I was hoping it wouldn’t.”
Laney changed the subject. “I have his mom in the conference room. Any chance she could come back now?”
“Back to business. I was just going to bring these things to Dr. Stone. Let’s see if he needs anything else before we let her come back. I’d prefer not to get on his bad side today.”
Laney scoffed. “I haven’t known him to not have a bad side. I think he’s rather impersonal, don’t you?”
“Who, Mr. Personality?” They both laughed. “Seriously, he is probably one of the best trauma surgeons around. And when his patients are doing well, he lightens up. He’s amazing with the patients and their families. He’s really patient with them and makes sure they understand everything. There’s no one I’d rather have taking care of me.”
Laney nodded. “I know. But he can be such an ass sometimes.”
“You’ve got to play the game, Laney. You can’t take it personally when the doctors act up.”
“Code blue to room five forty-seven. Code blue to room five forty-seven.”
“Holy crap!” shouted Peyton. Both nurses ran toward Skyler’s room and found Dr. Stone performing CPR on Skyler.
“While you were out there lollygagging getting my supplies, Skyler went into PEA,” Stone said shortly. “He has a heart rhythm but no pulse.”
Laney grabbed an ambu bag and began assisting with Skyler’s breathing while Peyton ran to the numerous IV pumps. “If it’s okay with you, I’m going to open his fluids wide open. Do you want me to hang an additional bag?” Peyton asked.
“Yeah, he needs to be tanked up with more volume. Get those going, stat!” Peyton got the IV fluids going as the rest of the code team arrived. The two respiratory therapists took over chest compressions from Dr. Stone and ventilations from Laney.
“I’m going to grab some more lactated ringers for you.”
“Thanks,” Peyton called from over her shoulder.
“All right. Can we hold CPR for a minute? We need a pulse check.” Dr. Stone felt next to Skyler’s groin. “No pulse, keep going. He is still in PEA.”
Laney came back with several bags of IV solutions and began assisting Peyton with getting them going.
“Where’s Skyler’s mom?” Dr. Stone barked.
“She’s in the family conference room,” Laney answered.
“Get her in here!”
Laney turned to look at him. “I don’t think that’s a good idea. She’s pretty fragile right now. I don’t know how much more she can take.”
“You can’t protect her from this. This may be the last time she sees him. She has to know we’ve done everything in our power to save him. If he were your son, you’d want to be here too.”
“Her friend should be here shortly,” Laney said. “Maybe we should wait until she gets here.”
Dr. Stone didn’t answer immediately. Instead, he grabbed her shoulders and looked her in the eyes.
“Go get her. Now.”
Laney turned to get Rebecca. On her way out, she took one last look at Skyler, seeing his chest being pounded on and the breathing tube helping him breathe.
She took her own deep breath and went toward the family conference room.
***
“I need you to come with me.”
Rebecca looked up to find Laney staring in her direction but not at her eyes. The expression on Laney’s face was as clear as day. Rebecca’s stomach twisted.
“What happened?”
“Skyler lost his pulse, and they are doing CPR on him again. Dr. Stone asked you be in the room with him.”
“Oh my God. I don’t know that I can watch that.”
Laney shifted. “The reality is this might be the last time you see him. Skyler needs you there with him and you need to see that we’ve done everything in our power to help him.”
The tears began flowing. Rebecca grabbed her coffee with both hands as though it would provide her strength. “Take me to him.”
Rebecca stood up and Laney reached out to assist her. Rebecca took her hand and squeezed.
As Laney led her down the hall, Rebecca glanced at Laney and saw tears trickling from the nurse’s eyes. If the nurse was crying, it couldn’t be a good sign.
Laney stopped when they had arrived at room 547.
“Give him another round of epi,” Dr. Stone instructed. He turned and acknowledged Rebecca and Laney standing in the doorway.
“Epi in,” called Peyton.
“Continue CPR.” Dr. Stone walked toward Rebecca. He took her hand.
“Ms. Smith, Skyler isn’t doing well right now. I was in here evaluating him to make sure he had enough IV access for all of the medications that he needed. That’s when I noticed a change in his heart rhythm. I felt for a pulse and found he did not have one. We immediately began CPR. When this happens, it’s called PEA or pulseless electrical activity. It means his heart is firing off electrical currents but it’s not producing a contraction that can get blood flowing through his body. We’re giving him medications to help get his heart beating for him. We’re also doing CPR to keep the blood flow going for him since his heart cannot d
o it. Unfortunately, if his heart does not start beating on its own soon, there will be nothing left for us to do.”
Rebecca stood there watching them push on Skyler’s chest as though they were kneading bread.
It almost didn’t look like her baby lying there in that bed. He looked like a stranger, covered with bandages, his face and arms swollen.
“Can I touch him? Can I just touch my baby?” Rebecca blurted out stifled by her sobs.
“As you can see, there are a lot of people working on him right now. There’s not a lot of room to get you in there. But you can stand on this side.” Dr. Stone motioned to the side the ventilator was on. “You can hold his hand, but I need you to stay right there and not move.”
“Can I talk to him?”
“Yes, please. Say whatever you need to say to him.” Dr. Stone guided Rebecca to the spot.
“Dr. Stone, it’s been three minutes. Do you want to give another amp of epi?” Peyton asked.
“Yes, and we’ve been performing CPR for about twenty minutes. Give him an amp of bicarb too.”
Rebecca took Skyler’s hand.
“Baby, Mom is with you now. You’re the most perfect son a mom could ask for. I love you so much. I need you to fight for me. I need you to hang in there. I can’t imagine a day without you in my life, a day I can’t see that smile and the twinkle in your eyes. Skyler, please come back to me. Please, son, fight.”
The nurses and staff grew quiet as Rebecca talked and talked. She looked around and saw they all had tears in their eyes.
They must have known what Rebecca was praying for wasn’t going to come true. Skyler wasn’t going to make it.
Rebecca took a deep breath and slowly began singing. “The itsy-bitsy spider crawled up the water spout. Down came the rain and washed the spider out. Out came the sun and dried up all the water. The itsy-bitsy spider crawled up the spout again.” She put her head down on Skyler’s arm and began sobbing.
“Is that epi and bicarb in?” Dr. Stone’s voice cracked.
“Yes, Doctor,” Peyton answered.
“All right, hold CPR and let’s check for a pulse.”
