Authors: Bobby Hutchinson
NURSING THE DOCTOR
More than anything in the world, physician Greg Brulotte loved a challenge.
He was a warrior of sorts, and St. Joe’s ER was his battle zone, he sometimes reflected with satisfaction and pride. After all, he and his staff were the last line of defense for those unfortunate souls who, due to accident or design, were hell-bent on eternity.
Greg was hell-bent on keeping them alive.
During his student days at Vancouver’s St. Joseph’s Medical Center, he’d realized that the emergency room was the most frequently used facility. Fascinated and challenged by the life-and-death struggles waged there, he chose the ER as his specialty.
Looking around on this Friday afternoon in late November, he concluded that the ER was running true to form.
One glance at the waiting area confirmed that every available orange plastic seat was occupied and that a number of people were standing or lying on stretchers, even crouching on the floor, waiting patiently and not so patiently to be seen. He knew that all of them had been expertly categorized by triage nurse Elizabeth Brownlee as to the severity of their needs, and each was being attended to in order.
It had been busy ever since he’d come on shift at two. It was now ten past four, and he noted that patients were still spilling through the ER doors, most of them soaked by the relentless rain that had been falling on Vancouver all week.
As he watched, an elderly Chinese man, bent nearly double and groaning, was helped through the sliding entrance doors supported by a small army of family members, all talking loudly in what Greg assumed was Cantonese.
Before the doors could close behind them, a city policeman shouldered his way in, half dragging a snarling prisoner in handcuffs. Blood oozed from a gash on the prisoner’s scalp, and directly behind them came Irene, pushing the shopping cart that contained all her worldly goods.
Greg knew Irene well; all the staff at St. Joe’s did. She was a street person, gentle and confused most of the time, an alcoholic suffering with sickle-cell anemia.
Greg had treated her yesterday afternoon when she came in complaining of pain in her stomach and back. Tonight, he knew she wasn’t actually in for treatment. On cold, wet nights like this she sought out the emergency room so she could sleep in a corner for a few hours, safe and dry.
After the initial check to be certain she had no new and immediate medical emergency, the staff would turn a blind eye to her presence, allowing her to rest for a while even though there were strict rules about loitering posted on the dull green walls.
“Dr. Brulotte, could you have a look at this, please?” Nurse Lily Sullivan stuck her head out of a curtained cubicle and beckoned to him before ducking back inside.
“Coming.” Greg headed toward her, but a short young man with thick glasses, a balding head and a white lab coat intercepted him.
“Greg, got a minute?”
He didn’t, but it was his job to be available for consults. “Yeah, Martin. What’s up?” He tried not to show how impatient he felt.
“I think a dissecting aneurysm, but I’d like you to have a look. Guy came in complaining of tearing pain, first in his abdomen, now in his back. BP 180 over 120. I’ve done a chest X ray and it was normal, but I wondered about a CAT scan....”
Dr. Martin Fabro went on explaining his troubling case in excruciating detail to Greg. Fabro was an intern doing a rotation in ER. He was smart and earnest, but Greg knew from the first day he’d never make an emergency room doctor.
He didn’t have the necessary ability to jump from one crisis to the next, one sick patient to one even sicker. He didn’t have the sense of raw adventure or the inborn ability to take risks that Greg considered necessary for those who spent their working life in the ER.
Emergency medicine was chaotic and disorganized. It demanded supreme self-confidence and total versatility from its physicians, and if they had a touch of arrogance, as well, Greg figured so much the better. It worked for him.
This was the field of medicine he’d been born to practice, and he had little patience with interns like Fabro who were cut out for office hours. With a faint trace of contempt, he thought of neat days sliced into twenty-minute segments, weekends off, hour long lunches and little need for adrenaline.
Curbing his impatience, he quickly assessed Fabro’s patient and agreed with his diagnosis. “Get radiology to do an angiogram. If that doesn’t prove anything, then order a CAT scan.”
He hurried out of the cubicle.
“Dr. Brulotte, I do need you over here.” Lily Sullivan, the nurse who’d summoned him before, came hurrying toward him, impatience evident in her voice and manner.
He grinned at her. Lily, now, she had what was needed for the ER. She even told him off when she figured he needed it. It infuriated him, but he admired her for standing up for her principles.
“Whaddya got, Lil?” Greg lengthened his stride to keep up with her. He knew it got under her skin when he called her Lil, which was why he did it.
Tall, slender and graceful, she moved with the controlled energy of a gymnast to a cubicle where a young Thai woman sat, left hand wrapped in a blood-soaked towel.
“The resident who was caring for her has disappeared, and she needs attention. Her name’s Mon Thong, she doesn’t speak any English and from what I can gather she works in a restaurant, where she sliced her finger with a meat cutter.
The owner of the restaurant sent her over by taxi with a note.”
Lily thrust a medical chart with the note clipped to it into Greg’s hand and moved a tray closer to the bed, murmuring assurances to the woman, who began to sob when Greg removed the bloodied towel.
“How d’ya do, Mon? I guess you’re not having the best day ever, huh?” His voice was friendly and deliberately reassuring. “I’m Dr. Brulotte. Doesn’t look as if there’s any nerve damage here. It’s deep but not life threatening.” He kept up the patter and the tiny woman relaxed a little bit.
Lily gave her a tissue to blot her eyes and nose.
Greg went on talking. “I don’t allow any of this life threatening stuff in my Emerg anyhow, right, Lil?” He winked at Lily, and she smiled. “Now, Mon, we’re gonna just give you a shot so you don’t develop anything nasty from this, and then I’ll suture your hand up.”
He knew the woman couldn’t understand a word he said, but he figured his cheerful tone and his confidence would come through. Gently and swiftly, he administered the tetanus-typhoid injection and then the xylocaine to numb the site.
Greg began the suturing.
Lily stayed, assisting him and comforting the patient, and Greg was acutely aware of the nurse close beside him. She handed him a needle and he felt the accidental brush of her skin against his. One quick glance noted the sheen of her short silver blond hair as she bent forward over the tray. Her long, narrow fingers with their unpolished nails were competent and quick as she held out a length of synthetic nylon.
He could have done sutures in his sleep. He found himself thinking of the woman at his side instead of the job, wondering why this particular nurse irritated and intrigued the hell out of him.
He was a bachelor, and six months ago, when green eyed Lily Sullivan first arrived in the ER, he’d made it his business to find out that she was thirty two and unattached. Greg figured she was also breathtakingly sexy with her dramatically short, pale hair, tawny skin and long, shapely legs, and of course he’d asked her out.
Twice. First to a party he and Ben were giving at their house, and the second time to dinner.
It was a shock when she coolly refused both invitations. He hardly ever struck out. She’d offered no excuses, made no apologies. A smile, a courteous and gracious thanks but no thanks, and that was it. It was a blow to his ego and a challenge, and he couldn’t resist pursuing it.
“You involved with somebody, Lil?”
She’d raised one delicate eyebrow and given him a censuring look from those cool green eyes. “The name’s Lily, and let’s just say I don’t consider it smart to mix personal and professional relationships, Doctor.”
That was a crock; everybody did it all the time. So he’d figured she was involved with somebody, maybe a married staff member. A woman who looked like Lily had to have something going on.
For a while he’d paid more attention than usual to the hospital grapevine to find out who it was, but apparently he was wrong. She wasn’t seeing anybody from the hospital. As far as anybody knew, she wasn’t seeing anyone at all, which convinced Greg she must have hang ups of some sort, probably over sex.
It was too bad, he’d concluded. Really too bad. A terrible waste of a lovely woman, but there were plenty of other lovely women around, willing and eager to have a good time. So he’d scratched Lily off his list of possibles and got on with the absolutes; however, at times like this, when they were on shift together, he couldn’t help but wonder about her all over again.
The loudspeaker crackled to life just as he clipped the final suture.
“Multiple trauma, ETA six minutes.” Paramedics were arriving with more than one seriously injured patient.
“We’re done here.” Greg patted Mon’s shoulder and turned her over to an aide. “Let’s go where the action is, Lil.” He snapped off his gloves and, with Lily at his side, hurried over to the triage nurse, aware of the heightened activity throughout the ER.
Portable X-ray machines were being moved out of the way, and available staff members were congregating in front of the trauma slots, anticipating the arrival of ambulances.
“MVA on the freeway,” Elizabeth related. “One adult female, two kids.” She rattled off the details the paramedics had called in, adding, “We’re setting up in two, three and four.”
“Get that thing the hell out of the way,” Greg barked at an aide who was sauntering past pushing an empty gurney. She and the gurney were gone in an instant. Everyone knew Dr. Brulotte wasn’t long on patience when it came to the way he figured things should be done.
He donned protective clothing, sterile gloves and glasses, and he felt the familiar rush of adrenaline flooding his veins, the anticipation and the soul-deep exhilaration he always experienced at moments like this.
He winked at Lily again, nearly unrecognizable in her blue smock, headgear and glasses. A battle was about to begin, and it pleased him that they were in the front lines together.
In the staff washroom an hour later, Lily stripped off her bloodstained smock and dropped it into a laundry bag. She washed her face and hands and fluffed her hair with her fingers, aware of the lingering tension in her shoulders and back.
She didn’t feel tired, though. She felt exhilarated; a twenty-four-year-old mother was going to recover because of the efforts of the Emergency team, and hopefully a little boy would have the use of his right arm.
She made her way into the kitchen. Two senior nurses, Mary Giles and Patricia Zanik, were also on their breaks, eating yogurt and exchanging war stories. They smiled at Lily as she plugged in the kettle.
“Hey, Lily,” Patricia said. “What happened with that little kid from the MVA? I was working on a cardiac patient when they came in. Someone said the kid’s arm was almost severed.”
“Yeah, it was.” Lily nodded, opening the fridge door to retrieve her lunch. “The mother was driving along the freeway and another car tried to pass her, lost control and broadsided her. Jason, her three-year-old, was sitting on the seat beside her, no car seat, no seat belt. The impact smashed the side window and he went flying out. Miraculously, he landed on the grass at the side of the road, but the glass cut his arm. Doc Brulotte sent for Dr. Halsey, and he’s working on Jason now. Brulotte says there’s a good chance they’ll save the arm. Halsey’s the best there is when it comes to microsurgery.”