by J. G. Sumner
She stared at the note, then looked around to make sure he wasn’t lurking somewhere. “Jesus, is he some sort of stalker?” she said aloud. How the heck did he know where I live? He followed me!
Okay, slow down, she told herself. Maybe he was just being nice. He was a gentleman making sure I got home safely. But really?
Still shaking her head, she turned and closed the door behind her and then locked it. She picked up the items and juggled them in her arms with everything else she was carrying and walked to the garage.
She slid it all onto the top of her car while she carefully opened the car door and organized everything. Finally, she sat in the driver’s seat and rewarded herself by opening the coffee and pouring a heaping amount of sugar into it. She took a sip. Ahhh. Just what the doctor ordered. Laney giggled at the pun as she started up the car and pulled out of the garage, knowing that in about thirteen hours, she’d be off for four days.
Chapter 9
Laney opened the door to the break room and placed her lunch inside the fridge before heading to her locker. She shoved her purse inside and took out her stethoscope and some pens. Just as she was about to shut the door, Dinah came around the corner.
“Good morning, sunshine. How was your night?” Dinah gave her a coy smile.
Odd. “Fine. How was yours?”
“How was O’Sullivans? Did you run into any hot guys?” Again with that grin.
“What’s up? You’re acting weird.”
“Dr. Stone came by here last night looking for you. I ran into him in the hallway when I was leaving. I told him that you were already heading to O’Sullivans. Did he show up?”
“Ah that explains it.”
“Explains what?”
“Why he showed up last night.”
“Ha! So he did go! What did he want? Is there going to be a follow-up date?”
Laney shook her head. “First of all, there are no juicy details. Second, there was no date. In fact, I told him I just wanted to be alone. And third, I don’t know what he wanted. He didn’t say a heck of a lot. He pretty much told me I did a good job yesterday and offered to buy me dinner since, in his opinion, I was drinking too much. I kindly declined, excused myself, and went home.”
“What’s wrong with you? Did you ever think that maybe he was trying to get to know you and maybe wanted to ask you out?”
“Quite frankly, no. I was really just trying to process my day. I wasn’t looking to get any action. Besides, he totally caught me off guard.”
Now Dinah looked hurt. “I just really want to see you happy. I don’t like seeing you alone. I guess I stepped out of line. I’m sorry.”
“Don’t be. I appreciate the gesture. Any other time and it may have worked out differently.” She didn’t want to talk about the infamous doctor anymore. “Hey, what are you doing here today? I thought you had the day off.”
“We were short staffed, so they called and offered me double time. I couldn’t say no.”
“Awesome! They don’t offer double time very often. They must’ve been really desperate.”
Dinah seemed a little down, so Laney felt the need to lift her spirits a bit. “Want to hear a secret?” She leaned in so that no one else would be able to hear.
“He looked really hot. And he left me a bagel and coffee on my doorstep this morning.”
Dinah’s eyes opened wide. “See? I knew he liked you! And you said there were no juicy details. What are you going to do now?”
“I’m going to thank him for my breakfast and go on with my day.” She smiled and walked away before Dinah could say anything else. The morsel of information she had given Dinah would keep her going for the rest of the day.
***
Laney had received the report from the off-going nurse, checked the trauma room to make sure it was stocked, and made her usual loop around the department to make sure no one needed help. It was still early and the ER was pretty slow. Summer months were usually slower in the morning, since there weren’t as many patients coming in with colds and flu. Instead, they were replaced with traumas and injuries that people suffered from spending long hours outdoors.
She decided to go check on Skyler. Laney made her way to the ICU and found Peyton was again the nurse in charge. She was already busy in Skyler’s room, with Rebecca sleeping in a recliner in the corner.
Laney caught Peyton’s eye. She motioned for Peyton to come out of the room. “Hey, girl. How’s it going?”
“Pretty good, except for a headache.”
“How late did you stay out last night?”
“Not long. I really didn’t feel like drinking. How was your big date?”
“It was all right. Nothing too exciting. We can talk about it over coffee.”
Peyton didn’t seem like she wanted to talk about it. “What’s with your hesitation?”
“I don’t know. There’s not a whole lot to talk about.”
Laney wanted to probe further into Peyton’s date, but knew her time was limited. “How was Skyler’s night?”
“Surprisingly, he did very well. He’s been pretty stable.”
“I assume he’s still in a medically induced coma?”
“Yeah, Dr. Stone did rounds early this morning and was pleased with his progress, but he wanted him to be in a coma for the next couple of days just to give him a little more time to heal.”
“That’s great! How’s his mom doing?”
“She’s doing well too. Ever since he responded to her singing, she’s been very optimistic. I’m going to try to get her to go home for a bit. We’ll see if she’ll do it.”
“Well, let me see what magic I can work. Is it okay if I come in?”
“Yeah, sure. I’m done with my assessment. Take as much time as you need.”
Laney pulled a chair up next to Rebecca and sat down. She gently touched Rebecca’s arm.
“Good morning. Did you get any rest last night?”
“I got a couple of hours here and there.” Rebecca smiled and wiped the sleep from her eyes. “How’s Skyler? Any changes?”
She put her hand on Rebecca’s. “From what I hear, he had a great night and seems to be stabilizing. We’re just going to have to wait for Dr. Stone to wake him up in a couple of days to see how he does cognitively.”
“Yeah. He said he’s off for the next few days and his partners would be covering. He said he would personally come in here if and when it was time to wake up Skyler.”
Laney was surprised. She didn’t know that Dr. Stone was on vacation for the next few days, nor could she believe he would come in on his day off to check on a patient when his partners could take care of it for him.
“Wow, that’s awesome!” she said. “It’s always better for the patient to have continuity of care.”
“He’s such an amazing doctor. We’re so lucky he’s the one taking care of Skyler.” Rebecca looked in Skyler’s direction. She had that concerned mom expression on her face.
“Since Skyler has stabilized somewhat, how about you go home for a while? You’ll definitely feel better and be more refreshed to hold vigil next to his bed.”
Rebecca forced a smile. “I know, but I just can’t bring myself to leave right now. Everyone keeps saying how the first twenty-four hours are the most critical. I just can’t bear to leave until that time is up. I know that something could go wrong at any time, but in my head, I have to and I want to be here until the twenty-four hours is up.”
Laney nodded. “I’d probably do the same thing if I were in your shoes. Just promise me that when they’re up, you’ll go home and take care of yourself even if it’s only for a couple of hours.”
“I promise as long as nothing happens with Skyler between now and then.” Rebecca sighed heavily as she peered at Skyler.
“Sounds good. Now, what are you doing about breakfast? Do you want me to walk you down to the cafeteria?”
“I appreciate the offer, but Emily is going to stop by this morning and bring me something to eat. And Offi
cer Miller said that he was going to come and see how things were going as well. He’s bringing some Starbucks.”
“Wow, really?” Laney felt a pang of jealousy. She had been pining for Stephen Miller for a while. It was her own fault she never said anything to him.
“That’s what he said. Not that I have a lot of experience with police officers.”
“He’s a really nice guy. We’ve run into each other a few times in the ER, and he has always been very patient. If he’s bringing you coffee, it’s with good intention.”
In her heart Laney wished well for Rebecca. But in her mind, she was sad another good one was getting away. She stood. “I have to get back to work but I’ll be around all day. If you need me for anything, just let Peyton know. Also, she’s one of my best friends and a great nurse. She can help you too.”
“Thank you for checking on me. I promise I’ll go home for a bit when we hit that milestone.”
Laney smiled as she made her way to Skyler’s bedside. She leaned over and whispered into his ear, “Skyler, you have the best mom in the world here. You need to fight for her and make it through this.” Laney patted his uninjured shoulder before leaving the room.
***
“Full trauma team to the emergency department, stat. Full trauma team to the emergency department, stat!”
Laney finished taping the IV she had just started and hurried toward the trauma room. She already knew what she was getting because Dinah had called her a few minutes before.
She got there the same time that the surgeon arrived. At over six feet with thinning white hair, Dr. Milken was the most senior trauma doctor. He was at the age where people began to wonder when he would finally retire, but he seemed to love what he did so much that many felt he never would.
“Dr. Milken, how are you today?” she asked as he was donning his surgical gloves.
“I’m just dandy. And you?”
“Great! I’m looking forward to the end of the shift because I have four days off.”
“Do you have anything fun planned?”
“No, I think I’m going to hang out by the beach and maybe watch a sunset or two. I’m definitely going to relax and not think about work.”
“Very healthy for the psyche. By any chance are you headed to Del Mar?”
“Should I?”
Dr. Milken smiled. “Definitely. I know this great restaurant called Jake’s. It overlooks the ocean and is perfect to watch the sunset or even just to sit at the bar. Plus, their food is out of this world.”
“Thanks for the tip. I’ll have to check it out sometime.” Laney glanced up to find the Vista View medics rolling in with the patient.
“What have we got here, boys?” Dr. Milken asked.
“This is a thirty-two-year-old male who’s been on a bender for the last three days,” the head medic explained as they rolled the gurney up to the trauma bed and began transferring the patient over while giving their report.
“He states today alone he’s had a twelve-pack of beer and a fifth of whiskey. He was near a liquor store when he got into an altercation with another male. Apparently, the other guy’s friends got involved, and they beat the crap out of this guy. He was found unconscious in the parking lot but has been in and out of consciousness with us. He has a deformed left humerus, and it appears from the angulation of his right leg that he may have some sort of hip or pelvic fracture.
“As you can see, he has multiple abrasions and lacerations to his face, arms, and legs. We noticed there were a couple of teeth on the ground next to him and we confirmed that he’s missing his front two teeth. His vital signs have been relatively stable. His blood pressure is one ten over sixty-six, heart rate is one fifteen, respirations twelve, and oxygen saturations at ninety-four percent. We threw on a few liters of oxygen by mask because of the low sats. There’s a 16-gauge IV in his right antecubital. We’ve given him a liter of fluids so far. We also placed him in spinal precautions, immobilized his left arm, and his left leg. Do you have any questions?”
“Any family around?”
“No, sir. None that we heard about.”
Dr. Milken looked up from the patient and made eye contact with the medic. “What about a name?”
“We only got the first name of Larry.”
“All right, thank you for the report. Nice job. I’ll take it from here.” Dr. Milken stood by the patient’s head and began palpating around his head and neck.
“Larry, can you open your eyes?”
Larry failed to respond.
Dr. Milken curled his hand into a fist and rubbed the center of Larry’s chest as hard as he could with his knuckles.
“Larry, open your eyes.”
“Huh? Where am I?” Larry opened his eyes for a second and went back to sleep.
“It looks like we’re going to have to intubate our friend to protect his airway. Laney, could you get me fifty milligrams of etomidate and ten milligrams of succinylcholine? And respiratory, please get me a seven point five endotracheal tube and prepare to tube him.”
Laney rushed to the Pyxis machine and pulled out the medications Dr. Milken ordered.
“Are you ready for the etomidate?” she asked.
“Yes, go ahead. Respiratory, please continue to hyperventilate him.”
Laney drew up the medication into a syringe, attached it to the IV tubing, and began pushing the medication in.
“Etomidate in.” She grabbed the succinylcholine and drew it up into a syringe. She tapped the side of the syringe to get the air bubbles out and attached it to the IV tubing as she had done before and began slowly pushing the medication in.
“Succs is in,” she said, taking her used syringes and putting them into the sharps container on the wall behind her.
Dr. Milken used his fist again to rub Larry’s chest. “Larry, open your eyes.”
This time, Larry didn’t move a muscle. “Okay, people, I think we’re ready to go. Someone please hand me the laryngoscope.”
One of the respiratory therapists handed the scope to Dr. Milken, and the other therapists pulled the ambu bag away from Larry’s face. Dr. Milken stood behind the patient’s head and pulled his head back to open his airway. Then the senior trauma doctor pulled the man’s mouth open and stuck the laryngoscope down his throat in order to visualize the airway.
“I see it. Tube, please.” The respiratory therapist handed Dr. Milken the endotracheal tube, and then he proceeded to guide it down Larry’s throat and into the airway.
“I think I have it.” He pulled the guide wire and the laryngoscope out. The therapist attached the ambu bag to the endotracheal tube and began squeezing to ventilate the patient. Dr. Milken listened to Larry’s lungs to ensure the air was moving in and out.
“It sounds like it’s in. Let’s get a chest X-ray to confirm placement. Laney, hang propofol to keep him sedated; start it at thirty micrograms per kilogram per minute. And we need to get him to CT. I want his full body scanned to see the extent of his injuries. I wouldn’t be surprised if he has some internal bleeding in his abdomen.”
Laney grabbed the medication she needed while the therapist hooked Larry up to the ventilator. She would have to start another IV to get this medication going since the other one was already getting fluids in it.
She was able to get the second IV quickly and infused the sedation medication into Larry. “Are you guys ready to go to CT?”
“Yeah. Let me just hook up this ventilator real quick.” The therapist grabbed the portable ventilator and put in on top of the gurney. “Okay, let’s go.”
Laney unlocked the gurney and began pulling it through the doors of the trauma room. Once they arrived at the CT scanner, Dr. Milken was already inside waiting.
Laney, the therapist, and the CT tech moved Larry onto the machine. Once he was safely secured, everybody went inside the small office to avoid being radiated. She watched him through the glass to make sure he was okay. The CT tech started the scanner.
“This guy has a huge br
ain bleed,” Dr. Milken pointed out. “His entire left hemisphere is knocked out as well as a good portion of his right. This guy isn’t going to make it regardless of what other injuries he has. Jesus, those idiots did a number on this poor guy.”
When the scan reached Larry’s abdomen, Dr. Milken spoke again. “He also has a grade three liver laceration and a ruptured spleen. He’s going to need to go to OR for that or he’s going to bleed out. We’d better call a neurosurgeon to look at his head for a consult. And we need to get the social worker to find his family. Even if I do take him to the OR to fix his abdominal issues, he probably won’t live to see tomorrow. Let’s get him back to the trauma room. I’ll see you there.” Dr. Milken explained before leaving the room.
Laney’s heart sank as she moved to get Larry back onto his gurney. As they were moving down the hallway, the monitor let out a very long beep. Laney looked at the screen and saw that Larry’s heart had stopped. Without a word, she started chest compressions while the therapist continued to push the moving bed toward the trauma room.
“Can I get some help?” Laney yelled out. “He’s coding. Someone get Dr. Milken. Let’s get him in the trauma room and get him some epi.”
Once they got Larry back to the trauma room, they hooked him up to the permanent monitor. A therapist came and took over chest compressions and another nurse was pulling up epi to push into Larry’s IV.
Dr. Milken hurried into the room. “What happened?”
Laney always hated explaining this part to the doctors. “As we were leaving CT, he went asystole. We’ve been coding him since. It’s been about five minutes.”
Dr. Milken rubbed his chin. “Has he had any epi?”
“Yes, one dose.”
“Is there any pulse?”
“No, we haven’t been able to locate one.”
“All right, folks, with that brain injury, this guy isn’t going to make it through this. But I want to at least feel like we exhausted all avenues. Continue with CPR and give another dose of epi. If we don’t get a pulse or a rhythm in the next five minutes, we’re going to have to call it.”
