Authors: Carolyne Aarsen
I checked Tabitha's oxygen levels, her heart rate, put my hand to her cheek as I double-checked her physical appearance. “How
much more and how quickly did she drink it?” I pressed as soon as I got Tabitha hooked up. I caught another quick consultation
between Deke and Cassie and resisted the urge to grab the young girl by the shirt and shake the information out of her. My
niece lay on the bed between us, with who knows what kind of alcohol cocktail spinning through her veins, and these two were
trying to protect themselves.
But if I pushed too hard, they would clam up, and if Tabitha had taken drugs, this would be a whole different scenario. I
doubted it, based on her appearance, but it was too early to rule anything out.
Deke started. “She might have had a couple of coolers. I think.” Another quick “cover-for-me” glance to Cassie.
“And some Jack Daniel's,” Cassie added sullenly.
I heard Dr. John's welcome voice, then he whisked the curtain aside. He glanced at Tabitha, then at Cassie and Deke. Now that
the doctor was here, the atmosphere became more serious.
“How long has she been like this?” Dr. John asked, glancing at the chart, then stepping between Deke and the bed to have a
closer look at Tabitha. He took a moment to glance at me. Smile. I felt a flush of warmth, then pulled myself back.
I gave a succinct rundown of what I already knew and how Tabitha was responding, my voice clipped as I struggled with my anger
with these kids.
My niece reeked of alcohol and bodily fluids, and I wanted nothing more than to strip her down and wash her up. Clean away
the filth that dirtied her body and my image of her. But we had procedures to follow, and we still had to get what information
we could from these teenagers.
“Has Arlene contacted her parents yet?”
“I believe so.” How often had I wondered what kind of parents would let their kids go wild like this? Even after I met the
parents, their protestations of their child never having done something like this before would, at times, strike me as false
or naïve in the extreme.
But now I saw what kind of parents Tabitha had. I'm sure Gerrit and Gloria did their best. They probably didn't know every
detail of her life.
Dr. John examined her, then scribbled some orders on the chart. “I'd like to keep her overnight. I'm concerned about her alcohol
I adjusted Tabitha's shirt, pulling it up around her shoulder. Sweet, loving Tabitha who happily carted my kids around had
been hanging around with a guy who reeked of alcohol himself, sporting a ring in his eyebrow and a tattoo on his neck, gravity
fighting with his skinny hips for his baggy blue jeans, his T-shirt ripped and stained.
What would Gloria think?
I felt a flash of guilt and shame for her. Getting blindingly drunk with Deke and Cassie on a Friday night was hardly on Gloria's
wish list for her daughter.
“You kids should go,” Dr. John said as he signed off the orders on the chart. Then he caught Deke by the shoulder. “Don't
even think about driving, kiddo. You smell like you're way over the limit.”
“I only had a couple of beers…” His gaze flicked toward me, then back at Dr. John and held up his hands in surrender.
“Okay, okay. I'll get a cab.”
Dr. John sighed. “Fourteen. What possesses these kids to be so incredibly dumb?”
I wanted to defend Tabitha. To explain how sweet and sensible she could be.
“We'll keep her overnight.” He stripped off his gloves and glanced at Tabitha and sighed heavily. “I'm sure Gloria is not
going to be impressed.” I got a conspiratorial look and as he passed, a faint brush of his warm hand over my back, right between
my shoulder blades. “Thanks, Leslie,” he said quietly, his hand coming to rest on my shoulder. “I'm beat and I'm heading home.
Dr. Williams is on call the rest of the night.” He smiled at me, tightened his hand. “I'll see you tomorrow.”
I swallowed at the promise in his voice and couldn't help a quick glance over my shoulder as he left. He was looking at me
as well. A flush warmed my face as I turned back to the work at hand.
I got a basin of warm water and started cleaning what I could of Tabitha's face. Other than monitoring her vital signs and
keeping her hydrated to dilute the alcohol, there wasn't much else we could do. Arlene would notify one of the ward nurses
to come and get her, but for now I wanted to get her clean. To remove the mess that coagulated on her face. I didn't want
the ward nurses seeing my niece like this.
Normally I wouldn't know the kids who came in like this at night. Normally I would clean up and when I got home, tell Dan
how incredibly stupid some kids would be.
Could I tell him about tonight?
I did what I could, then stayed by her side, doing my charting while I waited for the ward nurses. I didn't want to leave
her alone, and so far no one else needed my help.
Then a sound of hurrying feet and I heard someone call out, “Where's my girl? Where's Tabitha?”
I stepped outside of the cubicle and came face-to-face with Gloria. She blanched, stared at me a moment, then rushed past
me to her daughter.
I decided to give them a few moments' peace and returned to my desk. I felt surreal as I made notations I'd made countless
times before. But the person I wrote the information on wasn't an unknown person I could create my own scenarios around. This
was a sweet young girl who sang in church, who had a cute smile and a cheerful attitude. This was my niece.
“Leslie,” Arlene popped her head over my desk, her face flushed. “Got a lady here with chest pain.”
I ran to the reception area in time to see a young woman supporting an older woman who had her hand pressed against her chest.
“It's my mother. She's been complaining about her chest,” the younger woman said, her frantic gaze flickering from me to Arlene.
I felt an uptick of adrenaline.
Possible heart attack?
“I'll need you to answer some questions,” the clerk said to the younger woman, pulling her aside to the admissions desk. I
grabbed a wheelchair and put the older woman in it. I recognized her as the woman who had the auction.
“Dr. Williams is on call now. Get him right away,” I said to Arlene. “Then get the lab. I'll need an ECG stat and a cardiacworkup.”
I left Arlene still asking some questions of the younger woman.
As I wheeled toward the trauma room, the usual questions came back to me like riding a bike.
“When did the pain start, Mrs.—”
“Harris. Margaret Harris. I was, well…” She hesitated as I helped her into bed.
“Were you working? Resting?”
“I was getting up to get some coffee.”
“How did it feel?”
“Like a cow landed on my chest.” She stopped. Breathed again, as if making sure she still could. “I couldn't get any air.
My left arm tingled. I thought I was going to throw up.” Another grimace of pain flitted over her face.
Sounded like classic cardiac symptoms. While I went through the automatic questions about her allergies and medical and family
history, my mind scrambled.
The acronym I'd memorized long ago beat an insistent rhythm in my mind as I put her in bed and elevated her to a semi-seated
position. I slipped on the O
mask, high flow, attached her to the vital-signs monitor and cardiac monitor from the crash cart. Too much to do, not enough
hands, I thought as I pulled in a breath, slowing myself down.
Intravenous. Where was Dr. Williams?
Focus, Leslie, focus.
I slipped the cannula in.
Nice and smooth,
taped it down and adjusted the flow. My mind ticked over my list again.
Oxygen. Check. Intravenous. Check. Leads. Check and check.
I scribbled a few quick notes on a clipboard on the crash cart as a lab tech came. I turned my attention back to Mrs. Harris.
“On a scale of one to ten, ten being the worst pain you ever had and one being a little discomfort, how would you rate your
pain?” I asked, my gaze flicking over the information pulsing at me from the vital-signs monitor as the lab tech worked on
the other side, drawing blood.
“It's about an eight,” she gasped.
Her b.p. wasn't bad, but I gave her a shot of nitro, made a quick note, and glanced at my watch. I felt slightly outside of
myself, watching myself going through the routine that so easily came back to me. In charge. In control.
A clatter of wheels announced another lab tech with the ECG machine. And right at that moment the daughter appeared by the
bed. She didn't even ask, just went straight to her mother's side. It was getting crowded in here and Dr. Williams still hadn't
shown up. I could use his help.
“I'm sorry, ma'am, you'll have to move,” the lab tech snapped as he pulled out the leads for the ECG machine.
“I have to be here,” she said firmly.
“You can move to the head of the bed,” I said. “You won't be in the way there.”
She gave me a thankful glance.
I checked the cardiac monitor. Classic wave form of an acute heart attack.
Arlene ran in. “I can't get ahold of Dr. Williams.”
“Then try Dr. John,” I snapped, torn between concern for this woman and pity for Dr. John being called back to the hospital
after a full day on call. “He's probably still in the hospital.”
“How is your pain?” I asked Mrs. Harris again as the tech pasted the leads to her chest.
“About a seven,” she said, giving her daughter a weak smile. “It's going down, Linda.”
Linda stroked her mother's hair. “That's good, Mom. You hang in there. We still need you around.”
“Shouldn't have sold the farm.”
“If you had kept it, you might be lying on the kitchen floor all alone right now.”
“Maybe. But maybe I'd feel like I had a purpose.”
“You have a purpose, Mom. That's to be with us yet.” Their conversation registered in one part of my mind and I felt my heart
tremble with yearning. I thought of my own mother and for a fleeting moment wondered where she was.
“Hello again.” Dr. John was behind me, slipping on latex gloves. He gave me a tired smile that told me he would be okay. “What
do we have here?” he asked as the ECG readout rolled off the machine. He pulled the paper, glanced at the patient then at
I drew it up and gave Mrs. Harris a small amount of morphine through the IV, my eyes constantly monitoring her blood pressure,
oxygen saturation levels, and heart rate. I didn't have time to grab the chart and quickly scribbled what I could on the back
of my hand.
“How is your pain, Mrs. Harris?” I asked again.
“Going down,” she said, reaching up to catch her daughter's hand.
The lab tech came back with the results. Dr. John scanned them before looking up from the paper at the patient. “Looks like
you're having a heart attack, or what we call a myocardial infarction. We're going to give you a drug to break up the clot
in your heart that's causing this, but before we do, we need to ask you a few more questions.”
Linda gasped. “Heart attack.”
“Thankfully we caught things in time,” Dr. John said.
As Dr. John went over the screening questions, I saw a faint track of moisture drift down Mrs. Harris's cheek. She pressed
her lips together but made no move to wipe her tears away.
had such a deadly connotation for the average person. Such strong terminology striking at, well, the very heart of a person.
I sympathized, but as I injected the clot buster, I glanced at the clock and couldn't help but feel a flush of accomplishment. Twenty-two
minutes from the time Mrs. Harris came into the hospital until we injected the clot buster. Not bad.
Dr. John must have caught my look, because he gave me a quick wink of understanding. I hoped the Harrises didn't catch it. This
quick rush of adrenaline was what emergency-room nurses lived for. It was our drug of choice, and every time we handled an
emergency smoothly or cheated death, the charge came. The more complicated the situation, the stronger the rush.
I tried to explain this to Dan once but I may as well have been speaking Urdu. Sometimes when a bad case had gone well, when
once again I had helped snatch a patient from greedy death, I wished he could see so he could share my thrill, understand
why I needed to be here as much as with him and my children at home.
For now I had John, and as he surreptitiously squeezed my hand, I felt a connection I never had with my own husband.
Mrs. Harris was stable for now and her daughter held her hand. Their eyes were closed, and Linda's lips were moving. “Thank
you, Lord,” she whispered over and over again, smiling as she did so.
Whatever gives her comfort,
I thought, though at the same time I felt a flash of envy. She at least had someone to talk to when all was said and done. Well,
she could keep talking to God—I still kept my eyes on the vital-signs monitor.
John laid his hand on my shoulder. “And again, nice work. Glad you're on my team.”
I was still coming down from my adrenaline rush. “Thanks,” I said, adding a smile. As he returned it, his eyes singing into
mine, I heard a faint niggling voice.
He's coming on to you. Keep your distance.
I chanced a sidelong glance, surprised to see his eyes holding mine. A little too intensely. I knew I should listen. My rational
self told me to be careful. But the lonely self, the one whose self-esteem had been battered by the woman who had held my
husband's attention, and now by his family, who seemed to be drawing him away from me, not only continued to hold his gaze
but lifted her hand up, covered John's hand with hers, and gave it an extra squeeze.
It's innocent. Means nothing.
He should be watching Mrs. Harris. So should I.
Confusion and professionalism fought with the basic need of any woman to know that she's attractive to a man.
So why do I have to remind myself of that? And why is this man so appealing?