Critical Condition

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Critical Condition Page 16

by Richard Mabry


  The conversation during the meal skipped from subject to subject, everyone avoiding the eight-hundred-pound gorilla in the room. Why had the family gathered? When her mom put an apple pie on the table, Shannon heard tension in her voice despite the smile on her face. “I have ice cream if anyone wants it.” There were no takers.

  Finally, with coffee cups and empty dessert plates before the four of them, Shannon’s dad carefully folded his napkin and looked around the table. “I’m glad you girls could be here tonight. I want to get your opinion on something.” He sipped his coffee, then gently put the cup back in the saucer. “I’m meeting with the elders tomorrow morning before church. And I need to decide what to do after that.”

  Shannon listened intently as her dad explained his situation: the diagnosis, the treatment Dr. Kim had outlined, and the outlook for the future. When he finished, he clasped his hands on the table before him and said, “So what do you think?”

  The question remained unasked, but Shannon had no doubt what her father wanted to know from his family. She figured that, as a physician, she was best qualified to render an opinion. “Dad, I don’t think you have to resign your position. From what Dr. Kim told me, you have an excellent chance of responding well to chemotherapy. And you may even be a candidate for a bone marrow transplant, which could lead to a cure, not just a remission. Leukemia is no longer an automatic death sentence. You have to remember that.”

  “I understand,” he said. “And I plan to go through with chemotherapy. But that will most likely mean periods of weakness, lack of energy, side effects like vomiting.” He forced a smile. “What if I lose my hair? What church wants a bald pastor? Of course, I can think of a few that already have a pastor who’s bald . . . from natural causes.”

  “Dad, I’m sure Dr. Kim told you this already, but let me remind you that hair loss isn’t a problem with the FCR regimen. You can put that out of your mind. One thing you will have to consider, though, is that chemotherapy makes you more vulnerable to infections.”

  “So no hugging the ladies of the congregation?” her dad said.

  “Not even handshakes,” Shannon said. “But you can still preach, and that’s important.”

  Megan said, “Dad, your congregation loves you. What makes you think they’d love you any less because of this diagnosis?”

  “Leukemia, or any other illness for that matter, doesn’t come because God has visited the disease on you due to your sins,” Shannon said. “You know that. You’ve preached about it. Now practice what you preach.”

  Her father looked at his wife. “What do you think?”

  Shannon had heard the reply so many times she could have given it for her mother. “Whatever you do, I’ll support you.”

  Both Megan and Shannon nodded silently. Their father rose from the table. “If you’ll excuse me for a few minutes, I want to be alone in my study. God already knows my decision. Now I need to find out from Him what it will be.”

  “YOU’RE SURE OF THAT?” WALT CROSLEY’S RASP WAS AS LOUD AS he could make it. The bullet in his throat might have made his voice rougher, and he could no longer yell, but he was still capable of putting enough menace into his words to instill fright in the listener.

  The man seated in front of the computer cowered as much as his frail frame would allow. He didn’t turn to look back at Walt, who stood with a hand on each of his shoulders, gripping them with enough pressure to bring pain. “I’m certain. First, I agree that these numbers could be GPS coordinates. But if we assume that, the ones you gave me are smack in the middle of the North Atlantic Ocean. The numbers must be wrong. Somebody made a mistake.”

  “Yeah, and I know who made it.” Crosley took one hand from the little man’s right shoulder long enough to rub his chin. “How about switching around some of the numbers? Can you do that?”

  “S-s-sure, Walt. Just gimme a minute.” He tapped a few keys. “How do you want me to do this? Are you looking for someplace in particular?”

  Once more, Crosley rubbed his chin, this time with his other hand. He felt the muscles of the man sitting at the keyboard relax, so he quickly resumed his grip. The little man needed some encouragement, and when administered by Crosley, that usually took the form of pain. “I’m looking for someplace local.” He hesitated, then decided there was no harm in giving the man more information. “I’m looking for someplace near here where you could hide . . . something.”

  It took thirty minutes, during which time Crosley kept up his painful grip on the shoulders of the computer operator. At last, the little man said, “Look here. Does this sound right?”

  Crosley leaned forward and squinted at the screen. The map showed a teardrop-shaped pointer off Hall Street in downtown Dallas. The marker was within an area shaded in gray. “What is it?”

  “Greenwood Cemetery. It hasn’t been active for years, but it’s still sort of a tourist attraction. Lots of graves and monuments going back to the time of the Civil War.”

  “Yeah,” Crosley said. “That would probably be the kind of place he’d choose.” He squeezed the man’s shoulders even harder. “Thanks, you did well.”

  “And you know I’m not going to tell anyone,” the man squeaked. “My lips are sealed.”

  “I know they are,” Crosley said. He cupped the computer operator’s head with one hand on top, one beneath the chin. A quick twisting motion, and the man slumped over his keyboard. Crosley nodded in satisfaction. “I know they are.”

  SEVENTEEN

  WHEN THE ELDERS OF THE MOUNT HERMON BIBLE CHURCH CONVENED, there was generally a certain amount of talking among them before the meeting came to order. But whether it was because of the early Sunday morning hour or the unusual circumstances of a called meeting, the twelve men gathered on folding chairs in the pastor’s study that morning were quiet.

  Promptly at 8:00 a.m., the chairman, Herb Freeman, stood and turned to face the group. Herb was middle-aged, tall and lean, and dressed like a funeral director, which wasn’t surprising since that was his profession. He called the group to order and led an opening prayer. Then he inclined his head toward the pastor, who was seated in one of the chairs in the front row. “Pastor Frasier, I believe you have some things you want to say.”

  Robert Frasier stood and faced the group. This is it. Lord, give me the words. “I have some news to share with you. After you’ve heard it, I will answer any questions you may have. Finally, I need your prayers and support for what follows.”

  In a quiet voice, he told them how he’d been diagnosed with leukemia. He laid out the treatment plan his doctor had proposed. Then he came to the heart of his presentation. “Obviously, I will accept the program the doctor has suggested. That will involve chemotherapy, with all the potential side effects and possible complications that go with it. Unfortunately, there’s no way to predict how it will affect my ability to function.”

  He scanned the faces before him, but they gave no clue of the men’s thoughts. Robert swallowed twice. “I will announce this news to the congregation this morning, but I wanted you to hear it first.” Several men started to speak, but he silenced them with an upraised hand. “This change in my status raises a question. I’ve spent a great deal of time in prayer over this decision.” He took a deep breath. “I hope to continue my role as pastor of this church so long as I am able. If I reach the point where I can no longer function, I will offer my resignation.”

  Dr. Ralph Gutekind rose and moved to stand beside Robert. He looked directly at him and said, “You have been my pastor and my friend, and I have been your physician, for over twenty years. I was devastated by news of this diagnosis, yet encouraged by the possibility of a prolonged remission, perhaps even a cure.” He turned to face the assembled elders. “I hope you will join me in pledging our unanimous support of and prayers for Pastor Frasier, affirming his decision to continue as pastor, preaching as his condition allows, with the church staff and the elders shouldering as much of the load as necessary.”

  One by one,
the elders joined in with similar words. Robert touched the corners of his eyes, hoping to wipe away the tears forming there before anyone noticed.

  NORMALLY, SHANNON PREFERRED THE BACK OF THE CHURCH. SHE figured Megan’s preference was to be at home, asleep. But today they both sat on the second row, flanking their mother, as Pastor Robert Frasier delivered his sermon to the congregation of the Mount Hermon Bible Church.

  To her right, Shannon saw her mom’s head bowed in silent prayer, her hands clasped together so tightly the knuckles were white. Megan sat impassive on the other side of her mother, her emotions impossible to read. Shannon turned her eyes back to the pulpit, recognizing that the sermon was coming to a close.

  “I challenge those of you who have not yet made Jesus Lord of your life to do so now. Those who have already placed your trust in Him, I ask you a question. Do you believe God can do anything? If so, will you trust Him to choose what that anything is . . . even if it’s something you don’t want?”

  As the congregation bowed for a closing prayer, Mark, sitting on Shannon’s left, slid his hand over hers and squeezed. “I’m glad you’re here with me,” she whispered.

  “I’m here every Sunday,” he whispered back.

  “I mean today especially,” Shannon murmured. Actually, she wasn’t sure she could have made it through the past few days without him. There was no doubt in her mind. She loved Mark. But she still couldn’t fully accept the thought of marrying him. Soon, she hoped. Soon.

  After the amen, there were no swelling chords from the organ in the usual postlude. When the congregation looked up, they saw Pastor Frasier still standing beside the pulpit. Herb Freeman slowly rose from his seat and made his way to the platform, adjusted the microphone, and made a patting gesture. “Please be seated. I’d like to call the church into a special business meeting.” A gentle murmur went up. “I don’t think this will take long.” He turned to the pastor. “Pastor, I believe you have an announcement to make.”

  A buzz went through the crowd. Behind her, Shannon heard a woman whisper, “He’s going to another church.” Her husband whispered back, “I doubt that. Maybe he’s retiring.”

  The pastor cleared his throat. “I shared with the elders this morning some news I’ve recently received. I’ve been diagnosed with leukemia.” A ripple of whispers swept across the room but quieted quickly. “I’m due to begin chemotherapy soon. The outlook is good, but I wanted to advise you of this occurrence as soon as the diagnosis was confirmed. At this time, after a great deal of prayer, it is my desire to remain as your pastor, unless you ask me to do otherwise.” In the stunned silence that followed, he picked up his Bible from the pulpit and walked slowly down the stairs to a vacant seat in the front row.

  Freeman moved to the microphone again. “I’d like one of our elders, Dr. Ralph Gutekind, to report to you our reaction when we heard the news this morning, and our unanimous recommendation to the church.”

  The doctor climbed slowly to the platform, leaned on the pulpit, and looked out at the congregation. “To put it simply,” Gutekind said, “the elders pledged our prayers and support to Pastor Frasier and affirmed his decision to remain as our pastor. I trust you will do the same.”

  It took perhaps ten minutes for those assembled to overwhelmingly voice their support for Pastor Frasier, most of that time given over to glowing tributes from various members. When the business meeting came to an end, the organ struck up a triumphant tune, and the congregation rose as one and applause thundered through the sanctuary.

  Shannon hugged her mom, then moved forward with the rest of the family to enfold her dad in a bear hug. “I never doubted how the church would react,” she said.

  “I prepared for the worst, hoped for the best, and left it to God,” he said.

  “I’ll call later this afternoon,” Shannon said. “Mark is taking Megan and me to lunch.” She turned to look for her sister and found her deep in conversation with Steve Alston. Oh, I don’t need this. She moved until she was in Megan’s line of sight. “We need to go now.”

  Megan smiled. “You go ahead. Steve invited me to lunch.”

  “Actually, I’d hoped you both would join me,” Alston said.

  “Sorry, my sister must have forgotten. My boyfriend is taking us to lunch,” she said, bearing down perhaps a little too hard on the word boyfriend.

  Alston held up his hands, palms out. “Didn’t mean to start a family fight. I’m happy your father is staying on as pastor here. If I can do anything to help . . .” He left the words dangling, smiled, and turned away.

  As Alston was walking away, Mark came up to Shannon and asked, “What was that?”

  She shrugged. I wish I knew. Actually, Shannon was pretty sure she did know—but it wasn’t something she wanted to discuss with Mark right now. Right now, all she wanted was a chance to relax.

  Her cell phone vibrated, and when she pulled it from her purse, her face fell. “It’s the hospital. I’m on call. I have to go.”

  A SURGERY RESIDENT AND THE ER DOCTOR FLANKED THE GURNEY on which the man lay. IVs ran into both his arms, one delivering blood, the other a clear fluid. Oxygen flowed into a mask placed loosely over his face.

  “What do we have?” Shannon asked, slipping on a pair of exam gloves.

  The resident held out his stethoscope. “Gary Hermanson was the driver in a head-on crash. The other driver was going the wrong way on Central Expressway. He and his passenger were dead at the scene.”

  Shannon took the proffered instrument and listened to the man’s chest and abdomen. She ran her hands over the injured man’s extremities. She shined a light into his eyes. Without looking up, she asked, “What do you think?”

  “Fractured right femur, minimally displaced. No suggestion of significant head or neck trauma. He has marked ecchymoses along his torso, about where the seat belt would restrain him. That bruising plus significant hypotension made me think of a ruptured viscus—probably stomach.”

  “Think he’s got enough blood sequestered around his leg fracture to explain the drop in blood pressure?”

  “Not really,” the resident said.

  Shannon nodded in agreement. She, too, had noticed the evidence of severe pressure from the seat belt. The distention of the man’s abdomen and absence of bowel sounds further pointed to the rupture of a hollow internal organ. “X-rays?”

  “Confirmed free air in the abdominal cavity. I think we need to do an exploratory lap right now.”

  “Agreed,” Shannon said. She flipped off the gloves and washed her hands. “Is the family here?”

  “We’re working on notifying next of kin,” the ER doctor said. “I’ll sign off with you on an op permit for abdominal exploration as an emergency.”

  Thirty minutes later, Shannon stepped away from the scrub sink and asked her chief surgical resident, “Tim, ready to do this one?”

  “Sure,” he said.

  In a matter of minutes, the two surgeons stood under the bright operating lights, looking down at the rectangle of skin tinted orange by antiseptic solution and outlined by sterile green sheets. Tim looked to the head of the table. “Everything okay up there?”

  The anesthesiologist reported, “Pressure’s continuing to drop. He’s asleep enough for you to make the incision, but it’s going to take a few more minutes to get good muscle relaxation.”

  “Can’t wait for it,” Tim said. “We’ll have to pull harder on the retractors for now. Let’s go.”

  It took the operating team twelve minutes of intense activity to enter the abdomen and explore the contents. Just as they suspected, there was a small rent in the man’s stomach, spilling its contents into the peritoneal cavity. In addition, they found tears through the outer capsule of the spleen and liver, with bleeding into the abdomen from both organs.

  “What’s your game plan?” Shannon asked. So far Tim’s performance was good, and she had no doubt he’d have the right answers.

  “Stomach contents in the peritoneal cavity, so make sure pro
phylactic antibiotics are running in his IV.” He looked at the anesthesiologist.

  “Started in the ER.”

  “Close the hole in the stomach with a purse-string suture, then wash out the abdominal cavity thoroughly. Sew up the lacerations of the liver and spleen.”

  “Consider a splenectomy?” Shannon asked.

  Tim kept his gaze on the abdomen but shook his head. “The laceration isn’t bad enough to warrant that.”

  “Closure?”

  “Close the incision with staples, leave drains in for a few days.”

  “And . . .”

  “Get orthopedics to check on that femur.”

  “Good,” Shannon said.

  In the recovery room, a nurse approached Shannon. “The patient’s wife is in the waiting room now.”

  “We’ll talk with her,” Shannon said. She turned to Tim. “Want to do that before you dictate the operative note?”

  “Sure.”

  In the waiting room, it wasn’t hard to pick out the patient’s wife from the few people sitting there. The others were talking among themselves, some watching TV, some reading. These were family members waiting to enter the surgical ICU for their allowed visitation time. This woman sat alone, staring into space, her lips moving in silent prayer.

  Shannon and Tim walked to where the woman sat. “Mrs. Hermanson?” Shannon asked.

  “Yes?” The woman looked up at them. “Is Gary . . . is he . . .”

  “He’s okay,” Shannon said. She took the chair next to Mrs. Hermanson. “He sustained quite a few injuries—a hole in his stomach, some other internal injuries. He may need another operation for a broken leg, but he came through this one just fine.”

  The woman’s face relaxed a bit. “Oh, thank you. I’ve been praying for him . . . and for you all.”

  Shannon felt her throat closing. She knew a bit about what this woman felt right now.

  Tim had taken the chair on the other side of Mrs. Hermanson, and he spoke now. “Thank you. The nurses will let you know when you can see your husband. I’ll be by tonight to check on him, and I’ll talk with you then.”

 

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