Miracles in the ER (30 page)

“Every year, our church choir goes Christmas caroling. We’d always stop at Jim Conyers’ house, somebody would knock on the door, and we’d sing a couple of songs. He never came out—never opened his door. One year he even turned off the porch lights while we were singing. Then a few years ago, my teenage granddaughters went caroling with me. They brought a friend, and that friend’s little brother had tagged along. He couldn’t have been more than six or seven, but he knew the words to all the songs and wasn’t shy about singing out. Not always in key, mind you. But he was having a grand time.

“It was getting late, about nine o’clock, and we found ourselves in front of Jim Conyers’ place. Somebody knocked on the door and we stood in the front yard and sang two or three songs. Nothing. The door never opened, but we could see him moving around inside.

“We turned around to head to the next house, and I’ll never forget what happened. We had started singing ‘Joy to the World’ and were almost to the street when my granddaughter’s friend realized her little brother was missing. She ran through the crowd, looking for him, calling out his name, but he wasn’t there. Then someone hollered out, ‘Look! Up on the porch!’

“We turned around and that child was standing all alone on Jim Conyers’ porch. He was knocking on the door, quiet as a lamb, but absolutely determined. He never stopped. We all sort of froze, and then his sister took off—but it was too late. The door opened and out stepped Jim Conyers himself. He glowered at us and didn’t move a muscle. I don’t know if the boy said something or moved a little, but Jim looked down at his face and just stared. All of a sudden, that boy reached out and grabbed Jim’s legs and just held on.

“Jim looked over at us and then at the boy. No one said a word. No one dared to. Finally, Jim’s hand slowly came up, and he put it on the boy’s head.”

Harriet stopped, her eyes moist and distant.

“And then?”

She cleared her throat and looked at me. “That was it. He patted the child’s head a couple of times and the boy let loose of his leg, turned around, and bounced down the steps. It wasn’t till he got out to where we were standing, under the streetlight, that I saw.”

“Saw what?” I was leaning on the counter now, not wanting to miss a single word.

“That child had the sweetest face—all smiles and happiness and love. He had Down syndrome, just like Manny.”

We stood there for a moment, looking at each other, and for an instant were removed from the chaos of the ER—we were somewhere else.

“What about Jim Conyers? Did he come out on his porch the next time you went caroling?”

“Oh no.” She chuckled again. “He never comes out and stands on his porch. He always meets us in the front yard with a plate of cookies.”

I glanced down the hallway, to the doorway of minor trauma.

“I need to go talk with this Jim Conyers.” His clipboard was still in my hand. I stood up straight and turned in his direction.

Harriet stopped me. “It’s Uncle Jim.”

Let every heart prepare him room.

T
HE
Miracle
OF
F
AITH

Now faith is confidence in what we hope for and assurance about what we do not see.

H
EBREWS
11:1

Faith is the bird that feels the light and sings when the dawn is still dark.

R
ABINDRANATH
T
AGORE
(1861–1941)

Blessed Assurance

“Yeah, Doc, right there. That’s where it hurts.”

My hand was pressing lightly into the pit of Clay Winston’s abdomen, just below the lower end of his sternum. I didn’t feel any masses or anything unusual. But this seemed to where his gnawing pain was originating.

Clay was a close friend of Harriet Gray, and she was waiting for me at the nurses’ station when I walked out of room 4.

“Well, what do you think, Dr. Lesslie?”

I dropped his chart onto the counter and scanned his vital signs again. No fever and normal blood pressure and pulse. His weight seemed a little low—162 pounds—and I circled it with my pen. He was six feet tall and might normally be slender, but I had no point of reference. I had never—

“He’s been losing weight.” Harriet tapped his chart with her index finger, right where I had just circled it. “I’ve never seen him this skinny, and he looks pale. What do you think’s going on?”

I scratched my head, trying to put all of this together. My first thought had been his gallbladder. He had been having intermittent belly pain for the past few weeks, usually brought on by eating. And there was always the possibility of reflux or even an ulcer. But the weight-loss thing bothered me. That opened up a whole different set of possibilities.

“I’m not sure, Harriet. We need to check some things while he’s here—some lab work and maybe an ultrasound. And I agree, he
does
look a little pale. We need to find out what’s causing all this.”

“I’ve known him since high school.” She glanced over at the curtained entrance of room 4. “He’s a great guy. I just hope he’s alright.”

Clay Winston was not “alright.” His lab work came back with elevated liver enzymes and evidence of a chronic anemia. But that wasn’t his real worry.

“Dr. Lesslie, this is Dr. Newton over in radiology.” Amy reached over the countertop and handed her phone to me. “He wants to talk to you about the ultrasound in room 4.”

I still had Clay’s lab slips in my hand, and dropped them before grabbing the receiver. A sudden uneasiness crept over me. It was unusual for the radiologist to call about an ultrasound report. Ordinarily we just got a faxed piece of paper with their impression scribbled on it.

“Bryan, this is Robert. What have you got there?”

“Hi, Robert. Listen, this Clay Winston, with the gallbladder ultrasound.” There was a pause, and my uneasiness grew. “His gallbladder is fine—no stones or signs of infection. But there’s something going on in his pancreas.” Another pause, and I waited. “There’s a mass in the head of the pancreas, and it looks like cancer. If that fits with what you’re seeing, we’ll need to get a CT scan.”

It
did
fit. I thanked him, handed the phone to Amy, and asked her to arrange for a CT of Clay’s abdomen. Then I walked over to room 4.

I pulled the curtain aside, and Harriet looked over at me. She and Clay had been laughing about something—both were still smiling. My eyes met the nurse’s and the smile froze on her face.

“Mr. Winston, we need to talk about your ultrasound and your lab work.”

I pulled up a stool and told him what we had found and what needed to be done. When I said the words “pancreatic cancer,” his eyes closed, but only for an instant. He looked over at Harriet and nodded.

“I knew something was wrong, and something more than just my gallbladder. But pancreatic cancer…Isn’t that a bad one, Dr. Lesslie?”

It
was
a bad one, and we talked about it. If it indeed was pancreatic cancer, the chances of his being alive a year from now were very small.

Clay accepted all of this with the same calm demeanor he had exhibited when he first arrived in the ER. He nodded a lot, and occasionally pursed his lips. But he was calm, almost resolved.

The curtain was drawn aside and Amy Connors stuck her head in the room.

“They’re ready for Mr. Winston in CT.”

A few minutes later, his stretcher disappeared around the corner in the back of the department. Harriet pulled me aside. “He’s only sixty years old and has always been healthy. I just don’t understand how something like
this can happen. Especially to someone like Clay. He’s one of the kindest people I’ve ever known—always there if you need him.” She stopped and looked down at the tiled floor. “I know it happens to all of us. It’s just that…This is going to be hard.”

The next six months
were
hard for Clay. The diagnosis of pancreatic cancer had been confirmed, and he had been to several leading cancer centers. The answer was always the same—there was nothing anyone could do. It was only a matter of time.

And time was running out. We saw him in the ER every few weeks, and on each visit he was paler, more emaciated. We were watching him pass from this life.

Yet his attitude, his spirit, remained undaunted. In spite of his pain, he was able to smile, ask about the staff members he had come to know, and apologize for “being a bother.”

On one of his final visits, I overheard Harriet talking with Lori Davidson in the medicine room.

“We go to the same church, you know,” the older woman was saying. “And everyone who knows Clay has been praying for him. But you know what he said last week? He told my husband and me that the Lord had already answered his prayers.”

I was standing just outside the room, eavesdropping. But I felt no guilt. I didn’t want to interrupt these two women. And I did want to hear what Harriet was saying.

“He told us he had always prayed for the Lord’s help to live his life well, and that now he was praying for the strength to die well. And that his prayer was being answered.”

Clay Winston
was
dying well. The last time I saw him alive was on a Tuesday morning in the middle of December. His skin was parchmentlike, his eyes sunken but still sparkling, still calm. And he still smiled.

“How does that happen?” Jeff Ryan whispered. We were standing at the nurses’ station, talking about Clay and whether we should try to have him admitted to the hospital. He was close to the end, and a better option would be to keep him in the ER for several hours, with people who knew and cared for him. That might be all the time he had left.

“You mean his attitude?” I turned and looked into Jeff’s eyes. Like the rest of us, he had come to know and respect Clay.

“Yeah, how does that happen?”

I looked past him to room 2, then put a hand on his shoulder. “Come on—let
him
tell you how this happens.”

We walked over to room 2, drew aside the curtain, and sat down beside Clay’s stretcher. He was awake and looked up as we entered.

“Gentlemen, I didn’t press the call button by mistake, did I?”

“No, we just wanted to talk a minute, if you feel up to it.”

His breathing was labored, but when I explained why we were in the room, he looked over at Jeff. His face suddenly brightened and his eyes began to dance.

“Jeff, this is the easy part. My battle is almost over, and I’m not facing it alone. I’m sure of that. That assurance means everything. You see, it comes down to faith, and that’s a gift from the Lord. When you experience the real presence of the Lord in your life, that faith becomes something else—something stronger, something rock solid. I would call it assurance. Blessed assurance.”

Clay glanced over at me and nodded.

He took a couple of deep breaths, turned back to Jeff, and smiled.

“That’s how it happens.”

I Have a Plan

“How many stitches, Doc?”

I had just numbed up Jeremy Draffin’s lacerated eyebrow and hadn’t started putting it back together yet. This was a frequent question with patients and I understood his concern, but I had no clue—and wouldn’t until we were finished.

There are a couple of ways to answer this. If my patient has been imbibing or is under the influence of some other mind-altering substance, I will sometimes answer, “Somewhere between fifty and sixty.” That usually evokes an interesting response, at which point I give them my best estimate. Jeremy was completely sober and had suffered this injury while practicing basketball at one of the local high schools. A friend’s elbow had been in the wrong place at the wrong time. I decided to give him my best estimate.