Angels in the ER (16 page)

Within minutes, he had been intubated and a respiratory therapist was carefully forcing air into his lungs with an ambu bag. Lori had an IV going and was making sure he was not too chilled. His oxygen saturation had improved with the ventilation of his lungs, as had his heart rate and cardiac output.

With a sigh of relief, I stood up straight and looked around the room for the delivering paramedic. Things were stable for the moment and I needed a better idea of what was going on here.

I located him at the foot of the stretcher and I asked, “Denton, what’s this about a head injury? Do you have any idea what happened?”

Denton was making notes on the EMS clipboard. He looked up and said, “We got a call to Jones Avenue, about a child having trouble breathing. When we got there, well, it was absolute chaos. There must have been ten or twelve people in the house and they were all screamin’
and hollerin’. Someone said he fell and hit his head. Couldn’t get any sense out of any of them. I think they were all drunk. Anyway, his parents were behind us in a truck and should be here any minute.”

He stopped and resumed writing up his report. Looking up again he added, “Oh, and Doc, the parents are drunk too.”

We would need a CT scan of the child’s head, and Lori was going to the nurses’ station to get it ordered. As she opened the door, three people bowled their way into the room, pushing her back against the counter.

“Where’s my baby? Where’s JJ?” This came from one of the two women. Denton was right. She was clearly intoxicated. She staggered as she made her way to the side of the stretcher.

“How is my baby?” she asked, struggling to focus her blurred vision on the small body lying before her. She was barefooted, as were her two companions. Like them, she wore cut-off blue jeans and a dirty T-shirt. “Is he gonna be alright?”

Lori had called for the CT scan from the open doorway and now came back to the stretcher. She was trying to calm these visitors and restore order. I tried to explain the situation in terms they would understand, and tell them what our immediate plans were.

The mother’s name was Maylees, and it turned out the other woman, Jenny, was Maylees’s sister and JJ’s aunt. The man was in his mid-twenties. His name was Bubba, and he was Maylees’s common-law husband. We assumed he was also the father of the baby.

Jenny had walked over and wrapped her arms around her sister, though this didn’t provide much support. They listed to one side and had to take a quick step to right themselves. Bubba stood back from the stretcher, leaning against the wall. His eyelids were half closed and his head was bobbing. He was also obviously drunk. I wondered who had driven the truck.

“Maylees, can you tell me what happened to your son?” I asked.

She glanced in Bubba’s direction and then said, “Yeah, we had some friends over this afternoon, and JJ was in the kitchen and must have tripped and fell and hit his head.”

“Yeah, that’s right,” Jenny slurred in agreement.

I was distracted by a movement in the corner of the room and looked over to Bubba. In spite of his alcohol content, he was really quick. A cigarette was dangling from the corner of his mouth and before I could say anything, he had taken his lighter from his pants pocket and was clicking it. A small flame appeared at the tip of the lighter, and he was leaning forward, his hands cupping the cigarette.

“Hold on there, Bubba,” I called out. “You can’t smoke that thing in here. Put that lighter out.”

Responding to his name, he looked up. “Huh? Oh, okay,” he said sluggishly. He extinguished the lighter, took the cigarette out of his mouth, and carefully placed it behind his right ear.

Now, what had Maylees just told me? She had been telling me how JJ had hurt his head.

“He tripped and fell in the kitchen?” I asked, resuming my questioning.

Lori looked over at me, a doubtful expression on her face. Why that look? Wait a minute…JJ was seven-and-a-half months of age, still an infant. Unless he was a prodigy, he probably wasn’t walking. This answer didn’t make sense. Something else was going on here. I nodded to Lori.

Before I could ask another question, two radiology techs came into the room.

“We’re ready for him in CT,” one of them reported.

“You can all wait in here if you want,” I told the three. “This should not take long, and as soon as we know something, I’ll let you know.”

Maylees and Jenny backed away from the stretcher, making room for the techs. “You take care of him, now,” Maylees told them.

“Yeah, take care of him,” Jenny echoed.

Forty minutes later we had our answer. I had walked around to the Radiology Department and was reviewing the child’s head scan with the radiologist.

“Here is a skull fracture,” he pointed, indicating a starburst
pattern on the back of JJ’s skull. That indicated a significant and direct blow. “And here’s a good bit of blood in his head. See how everything’s shifted over?”

The findings were obvious. “Yeah, but that should be able to be drained, don’t you think?”

“Should be, but that’s not the real problem,” he continued. “Look right here.”

He pointed to the base of the skull where it sat upon the atlas, the first cervical vertebra. The atlas was displaced a good two and a half centimeters posteriorly. His spinal cord had been severed.

“This kid’s dead, or soon will be,” he said matter-of-factly.

He was right, of course. There was nothing anyone could do for JJ. I just stood there a few minutes, looking at the films.

As I walked back to the department, I considered my options in dealing with this child’s parents. They would need to know the full extent of his injuries and the inevitable outcome. First though, I needed to know what really happened to JJ.

When I reached the nurses’ station, I asked Lori to come with me to major trauma. JJ would be following us in a few minutes.

I opened the door, and we found Maylees and Jenny sitting on the stretcher, their legs hanging over the edge. Bubba was sitting on the floor in the corner of the room. His legs were splayed in front of him and his head drooped on his chest.

“How’s JJ?” Jenny asked.

“He’s about the same,” I answered. “And they should be on their way back here with him now. But there’s something on his scan that doesn’t make sense,” I told them.

Maylees and Jenny looked at each other and then at me.

“You told us he tripped and fell in the kitchen,” I continued. “But what doesn’t make sense is that his head injury is mainly on the back. When kids trip, they usually fall forward.”

I paused and studied their faces, waiting for a response. They looked at each other again and then back at me. Bubba just stared at the floor.

“So, tell me. Does JJ really walk? And if he doesn’t, then tell us what really happened.”

They were silent for a moment and then Jenny spoke up. “No, JJ doesn’t walk. And he didn’t trip, or anything. Bubba…” she said, nodding at the slumping figure in the corner, “Bubba had him out on the concrete patio and was throwin’ him up in the air and catchin’ him. JJ was screaming, scared to death. And everyone was laughin’. So Bubba just kept throwin’ him up, and then…then…he dropped him. And his head hit the concrete. And he was just layin’ there. That’s how it happened.”

Maylees was nodding her head in agreement.

Lori had closed her eyes upon hearing this. My knees became weak for an instant as I thought of my own children. And then I became angry.

The opening of the door drew my attention, and I watched as Lori walked out toward the nurses’ station. She would be calling the police.

Wine is indeed a mocker. And too often a murderer.

 8 

It
Must
Have Been a
Miracle

You are the God who performs miracles; you display
your power among the peoples.

—P
SALM 77:14

Y
eah, Doc. I had this spot on my lungs a year or so ago and now it’s gone. A miracle, don’t you think?”

A miracle.
I have never personally witnessed anything I would call a miracle of healing, nor have any of my colleagues—at least that they have told me about. And I have never read of any such occurrence documented in the medical literature.

This is not to say that wondrous things don’t happen every day in the medical field. I think it’s pretty amazing that a broken wrist, if properly immobilized and left alone, will heal in three or four weeks. Or that a lacerated forehead, with appropriate attention, will heal itself in a matter of days. What cardiac surgeons are able to do borders on the miraculous: stop a beating heart, reroute and restore a compromised blood supply, and start the heart beating again.

But even though I have no personal testimony concerning a verified miracle of healing, I continue to be impressed by everyday encounters that come close.

For instance, an impressive clinical encounter is the handling of a diabetic who has taken too much insulin. Your blood sugar starts to drop, and at dangerously low levels, you lose consciousness. Most diabetics recognize the symptoms leading up to this and know to get some sugar into their systems. A new diabetic, or one who takes poor care of himself, will come to the ER unconscious or comatose. The
history will usually give us the correct diagnosis. A quickly given load of IV glucose will rapidly resolve this condition. The comatose patient sits up and asks, “What’s going on?” It’s like turning on a light. Not exactly a miracle, to be certain, but surely something special.

And so, while miracles are not necessary or essential to my faith, I continue to be open to the miraculous. In fact, a few years ago I thought I had happened upon just such a case.

Christmas Eve.
I was unlucky enough to have drawn the short straw and was working the night shift. You would think the ER wouldn’t be busy on this pre-holiday night. To the contrary, most holidays are among our busiest times. All of the doctor’s offices in town are closed, there is usually a liberal amount of alcohol flowing, and people just seem to get lonely.

It was 9:30 p.m. and I was standing at the nurses’ station, talking with our ward secretary, Marcella James.

“Any big plans for tomorrow?” I asked her. She was a young woman, early twenties, and I knew she had two small children.

“Nope, gonna be workin’ here,” she answered. “The hospital’s paying a big bonus and I couldn’t pass it up. I do get a chance to be home in the morning with the children, though. That’ll be good.”