by Shana Festa
"Howdy, neighbor," a male voice called from next door. Our next-door neighbor, Neal, was waving from his driveway. A miraculous feat considering the amount of grocery bags he was juggling. We parked the bikes and walked over to socialize.
Neal was one of those neighbors who would come over and fix your mailbox when it fell over. I know this from first-hand experience, because my mailbox was a piece of junk and was always listing precariously to one side. Every time Jake commented that it was time to get a new one, it would be magically standing at attention the next time I pulled the car out of the driveway. Neal’s family is what I would call good people.
I exchanged a quick wave with his wife as she grabbed another load of bags from the trunk. Their daughter, Alicia, jogged down to the end of the driveway to join the conversation. Alicia was seventeen, and was hands down the brightest and most respectful teen I’d ever met. Like her dad, she was outgoing, always willing to lend a hand, and I couldn’t think back on a time when her lovely face wasn’t wearing a smile.
"Hey, guys. Whatcha up to?" she asked. Her arms kept swinging back and forth as she stood there; there was that smile again.
I smiled back; it was contagious. "Just coming back from the beach." I held out my arm to hers and compared tans. Jeez, I needed to get out more. Even after all day outside, my skin still looked like it belonged to a ghost next to her bronzed arm.
Alicia was enamored with Daphne. Her mom, Pat, was allergic to most animals so their home was pet free. If dogs could have big sisters, Alicia would be the equivalent. She was constantly knocking on the door to take her for a walk, play with her, or even give her a bath. That kid loved my dog, but then again how could anyone not love the little spitfire?
The sun got lost behind a puff of dark storm clouds and Neal made me laugh with his imitation of a country bumpkin. "Looks like there’s a storm a-comin’," he mimicked, pretending to spit a wad of chew on the driveway.
Alicia giggled and rolled her eyes at him. "God, Dad, you are such a dork."
We said our goodbyes and got the bikes into the garage just as the first drops of rain fell.
* * *
Settling on the over-sized sofa, we snuggled and watched a movie. Of course we bickered over the movie. Jake wanted to watch some slapstick comedy, but I won and we popped in a horror flick. The movie started off bad and went downhill from there. Jake tickled me as he laid down the law. "You no longer get the job of choosing movies. This is horrible."
"Maybe I knew it would suck." I laughed mischievously. "So your attention would be on me instead of the idiot box." Jake let out a laugh and leaned down to kiss me. He brushed my long bangs behind my ear and looked at me, his face mere inches away. I inhaled his musky scent and sighed with pleasure.
"What do you say we end the day with a bang?"
"Oh, that was just bad. I can’t believe you just said that." He chased me into the bedroom, and out with a bang we went.
* * *
Chapter 03
Squishy
I spent most of the next day studying for next week’s pharmacology exam. I decided enough was enough when I started falling asleep around two in the afternoon and decided to spend the rest of my day at the dog park with Daphne. Lord knows why I continued to take her there, considering she had zero interest in any of the other dogs and spent half the time scratching at my legs for me to pick her up. The other half was spent pissing over other yellowed spots on the grass, marking her territory.
Once home, I changed into my freshly-laundered nursing uniform and put my hair up. No matter how many times I washed those uniforms they always came out of the dryer like they were freshly starched. What I wouldn’t give to soften them up. Our instructors insisted on us wearing these thick white uniforms. So not only could I barely move, I looked like a giant marshmallow.
The sun was just setting when I pulled into the emergency room parking lot. Ollie was waiting by the door for me so we could head in to report together. "Dude, I still smell it. I can’t get the eau de shit out of my nostrils," she said as we walked through the automatic doors. Ollie, Kat, and I had become fast friends after meeting at orientation for the nursing program. All three of us were so different. Ollie was single and definitely the party girl of our little clan. I lived vicariously through her Facebook posts. Ollie also had an intense addiction to Red Bull and zipped around on a permanent caffeine high. Kat was the matronly presence in our little group, doting on us like children and always packing a cooler of snacks for us to pick at during class.
I fell somewhere in the middle.
The one thing we all had in common was a kooky sense of humor. Some nights in class something would strike us as funny. One of us would end up leaving the room because we’d be laughing too hard to contain ourselves. We frequently disrupted the classroom and garnered disapproving looks from our instructors.
Ollie grabbed my arm, pulling me back to the present and laughed, "I ran into Kat while I was waiting for your ass," she giggled again. "She pulled Ortho tonight." We laughed all the way into the conference room.
* * *
Five hours into the shift, and seven Foley catheters later, and an elderly female patient was brought back to the emergency room from triage. She held her left arm close to her body, blood spattered her shirt, and she had a blood-soaked towel wrapped around her forearm. The triage nurse directed her into one of my assigned rooms and I went in to do an initial assessment.
"Hi, Mary, my name is Emma Rossi. I’m a nursing student with Jackson State College, and I will be assisting your nurse with your care today." I put on a pair of gloves and removed the towel from her arm. The first thing I noticed was the odor. It was a pungent, almost rotten smell, and it was strong enough to make me lean backwards away from her arm. "Can you tell me what happened to your arm?"
Mary winced as I moved her arm to better examine the wound. "I was in the drive-thru at McDonalds on my way home from Joanne Fabrics and had my window down waiting for my turn to place my order. I reached over to the passenger seat to get my wallet from my purse, and when I came back up there was a man reaching his head through my window."
I could feel Mary trembling as she recounted the attack. Her fear-filled eyes were wide and stood out against her pale skin. I gave her hand a little squeeze for support and smiled compassionately back at her.
"He scared the bejesus out of me, and I threw up my hands in defense. The next thing I knew, he was grabbing at my arm and bit me." She stopped talking and closed her eyes, looking frail. Sucking in a ragged breath, she continued. "I panicked and just started hitting him over the head with my wallet until he let go. He was crazy. I screamed for help and begged him to stop. He didn’t even react. Then I sped off and came straight here." I looked over to the bedside table and saw her wallet. This thing looked more like a brick then any wallet I had ever seen. Mary caught me eying her weapon of destruction. "I have a lot of coupons, so I need a big wallet."
I covered Mary’s arm with some saline drenched four by fours and began charting.
My nursing instructor came into the room and snatched the chart out of my hands. "Tell me about your patient," she snapped at me. What was it about those old-school nurses? Did something strip away their humanity over the years? She always gave off this air of annoyance, like we were putting her out by forcing her to do her job.
"Mary Jennings, sixty-seven-year-old female presenting with a malodorous circular laceration to her left forearm, approximately six centimeters in diameter and one centimeter deep. The wound is not actively bleeding but is oozing purulent discharge. Patient is alert and oriented to person, place, and time. Complains of ten out of ten throbbing pain in her arm and a severe headache." I relayed the clinical information as I’d been instructed. It always felt cold and somewhat condescending to talk about a patient like that in front of them.
My instructor stood at the foot of the bed going over the chart, nodding while she listened. "What assumptions can you make from your initial assessm
ent?"
"Patient has been bitten," I said at first, not believing that someone could do such a thing, but then I caught up with my instructor’s meaning. "Patient is ambulatory but complaining of dizziness and fatigue. Skin color is pale, heart rate elevated, respirations are increased, and she is hypotensive. I suspect she may be in hypovolemic shock and will require electrolyte replacement. There is a potential for transfusion, depending on her hemoglobin levels once labs are returned." I looked at my instructor for feedback and was rewarded with a curt nod as she put down the chart and promptly left the room.
"The physician will be in to see you shortly, Mary. I’ll go check to see if your labs are back. Lay back and try to relax." I assisted Mary to lay back, covered her with a blanket, and left the room to check on her labs. On the way to call the lab, my assigned nurse caught up with me and informed me she had already called them. Results wouldn’t be back for about thirty minutes so she suggested it was a good time for me to take a dinner break. I promptly texted Kat to meet me in the cafeteria.
* * *
"I so hate you right now," she said while we waited in line to pay for our food. "I wish I was in the ER. I hate Ortho. It’s total poop patrol!"
After paying, we walked our trays to a table in the corner and I chuckled, glad someone else felt my misery from the night before.
"I’m loving life right now," I gloated. "I have a wicked cool wound that I get to dress when I get back, and I may get to hang blood if her hemoglobin and hematocrit levels are low enough." We both sat down with an audible sigh, grateful to be off our feet for the first time all night, and ate dinner while chatting about all the new and exciting things we were learning.
After half an hour of gabbing, we headed back to our respective units to finish out the last part of the night. Halfway back I heard, "Code Blue, Emergency Room," come through the loudspeaker and hastily made my way back.
The ER was in chaos. As I got closer, I realized it was coming from my patient’s room and started running. Ollie came out of a nearby room, jogging by my side as we burst into Mary’s room to find it packed with people and Mary lying flat on the bed with a nurse already performing chest compressions. The physician pointed at Ollie, "You! Do you know how to find a femoral pulse?"
Ollie nodded her head in affirmation and was instructed to switch places with another nurse and keep checking. Every thirty compressions, the nurse stopped and the physician asked Ollie if she felt anything. She gave a negative response each time.
He turned to me and barked, "You’re on compressions, switch out."
My nervous system’s flight or fight response kicked in, increasing my heart rate and flooding me with adrenaline. My stomach turned to ice when I noticed everyone’s gaze focused on me, and I began compressions. The first thing I felt was squish. I remember reading that it was common to break ribs while performing CPR, but I had never imagined the mushy feeling I experienced.
I was singing the Bee Gee’s song "Stayin’ Alive" in my head to keep the right pace, or so I thought. I looked up for a millisecond and caught the look on Ollie’s face. Oh. My. God. I was singing out loud.
After five minutes, the physician called it, "Time of Death, twenty-three, forty-seven." The statement was so powerful; one could almost hear the capitalization of his words.
He came over as the nurses and aides cleaned up the patient and surroundings. I jumped when he spoke to me, too caught up in what was going on around me to notice he had even moved. "That was your first time, wasn’t it?"
"Yes." I looked at Mary. Her skin was grey, lips blue, and eyes vacantly open, staring at nothing.
"You did fine. I had you jump in because I knew it was over. We had been at it for fifteen minutes, but I wanted you to gain some experience."
I looked down at my hands, mind racing. A woman’s life just ended right beneath my hands. I killed someone tonight. Someone that I had been having a normal conversation with a half hour ago was now dead. That’s the experience he wanted me to have? I mumbled something akin to thank you and left the room.
Our instructor sent us home for the night. We only had ten minutes left, so no big deal if we skipped out a bit early. I felt like I was in a fog. I couldn’t put words to what I felt in those moments following Mary’s death. Walking out, I vaguely remembered saying goodnight to Ollie and got into my car drenched from the rain. I didn’t see Kat, but I assumed she was still upstairs on the Ortho floor.
There was a weight to me when I slumped into the seat. My brain felt numb. I didn’t cry, but I mourned for Mary Jennings as I sat in the parking lot for what seemed an eternity. What happened? This woman with a wound on her arm was now dead. Even though I knew it wasn’t my fault, I felt like I let her down, like I had been the one who failed to save her.
* * *
Chapter 04
Snow Day
I drove home in silence and ruminated over the events of the night. The rain came down so heavy I could barely see out of the windshield. Tropical Storm Ike made its way up the Florida coastline and closer to my little town. Looking at myself in the rearview mirror at the last stoplight before home, I realized this was a gut-check moment and pulled myself out of the stupor. "Nut up, bitch. Grow a set and stop acting like a pussy," I said out loud.
Jake was watching the same Vince Vaughn movie when I got home. I repeated my strip down from the night before and decompressed with a long, hot shower. When I got out, my phone beeped with a new text message. It was my mother-in-law asking where I was. I messaged her back, let her know I was home, and asked why she was texting me at one o’clock in the morning. Every time she sent a late night text, another one of Jake’s grandparents’ had passed away. I braced myself for bad news and was surprised when her text instructed me to turn on Channel 4 right away.
I went into the living room and dug the TV remote out of the sofa cushion, sat down next to Jake and changed the channel. "Hey, I was watching that!"
"It’s not like you can’t quote that stupid movie word for word. Your mother just told us to put on the…what the fuck?"
Splashed across the bottom of the screen was a breaking news banner reading four dead in hospital attack. A reporter stood in front of the camera. "For those of you just tuning in, we’re coming to you live from St. Vincent’s Hospital where just moments ago police shot and killed a female attacker. Eyewitnesses report that a female patient began attacking other patients and staff in the Emergency Department shortly after midnight.
"Authorities have yet to disclose the identity of the attacker, or the three victims brutally slain in the violent assault. The scene is in chaos, and we have received reports that the attacker was mistakenly pronounced dead just minutes before, regained consciousness, and began attacking staff. We will continue to bring you real-time coverage as information is released. We take you now to chief meteorologist Ken Aspesi for more on Tropical Storm Ike."
The scene flicked back to the studio, "Thanks, Jim. Tropical Storm Ike has just been upgraded to a category three Hurricane. Southwest Floridians can expect to see some severe weather in the next twenty-four hours. Tune in to Channel four for continuous coverage as Ike progresses."
"Oh, my God, Jake. I was just there. I…I think I know the patient that did this. I mean, I lost someone tonight, right before midnight. I did CPR on her and they pronounced her dead. But she was dead. Really dead. I saw it with my own eyes. It couldn’t be her."
I was floored by what I had just seen and reality crashed down on me. I realized Kat was still at the hospital. What if she had come down to say goodnight after her shift? Leaping from the sofa like a madwoman I caught my shin on the corner of the coffee table. "God damn son-of-a-whore!" I made a weird hobble to the kitchen table and found my phone.
At this point, in near hysterics, I was close to hyperventilating. With each ring of the phone that went by with no answer, I became more frazzled. Tears sprang to my eyes as I heard Kat’s voice mail pick up. I disconnected the call and redialed. The phone
connected after the third ring and I collapsed into the chair.
"Thank fucking Christ you’re okay. Did you see it?" I cried into the phone.
"I was so scared that something happened to you," she replied. "You never answered my text when I got done so I just went home. I had no idea what was happening down there until I got home and Sam met me in the garage. There is no way I’m sleeping tonight. I’m wired."
Her kids could be heard in the background fighting with Sam about going back to bed. Kat sighed. She had the perfect family, the kind you would see in a packaged picture frame. Her husband, Sam, was a corporate big-wig, and they had two of the most adorable little girls I’d ever seen. They were the perfect age, too, five and seven. Old enough to be more independent and carry on a good conversation, but still young enough that you could shower them with hugs and kisses.
"Grr. They won’t go back to bed for hours now. Would it make me a bad parent if I did a little late night grocery shopping and brought them? I am so not prepared for this stupid hurricane."
"Meh," I said. "Go for it. It’s probably better to get it out of the way now than wait ‘til the morning. You just know there’s going to be a frenzy." A grin spread over my face as I thought of my fully stocked house. I utterly hated the grocery store, so when I reached the point that I could no longer sustain life on what stocked my pantry, I made a very expensive trip to Costco and was safe again for two months.
"Ugh, you’re totally right," she groaned. "Girls, go get dressed, it’s fieldtrip time!"
I remembered what my patient had told me about the man attacking her at McDonald's. It was less than a quarter mile away from the grocery store. "Hey, Kat," I blurted before she hung up the phone, "be careful. I admitted a patient tonight that got attacked near there by some crazy dude."
