Miracles in the ER (27 page)

“Thank you.” She glanced down at the secretary and something on the countertop caught her eye. Her hand slowly moved toward the forceps Frank had left lying there. She picked it up and held the instrument a few inches from her face.

“Thank the Lord. He used this little bug to save my Maylee’s life.”

Any Port in a Storm

It started off simply enough, as most conundrums seem to do.

Mildred Jackson brought her eight-year-old boy, Benny, to the ER with chicken pox. That’s what she told me it was, and I agreed. He had developed a rash a few days earlier that started on his belly and spread all over his body. He was aggressively scratching the scattered blisters in spite of his mother’s strident directives to cease and desist. He didn’t have any fever, though, and that was a little odd for chicken pox. I checked his scalp to be sure there were some lesions hidden in his hair—in my experience a prerequisite for the diagnosis. Present and accounted for.

“Well, Mrs. Jackson, I think your boy
does
have chicken pox. Not much to do for it except take some Benadryl for the itching and Tylenol if he develops any fever. Just be sure to follow up with his pediatrician if he has any problems.”

She nodded and looked down at her boy. “It’s just a little peculiar. I thought he had a mild case when he was two or three. You can’t get it again, can you?”

“Not supposed to.” I stepped toward the entrance and pulled the curtain aside. “Just be sure to see his pediatrician if there’s a problem.”

The rash went away, and Benny did fine. Two weeks later, he was back in the ER with the same rash. This time he saw one of my partners.

“Robert, the kid had chicken pox, as sure as I’m standing here.”

Jay Barton had seen a lot of kids with the disease and was adamant about his diagnosis.

“But two weeks ago—”

“I know, I know,” he interrupted me. “I read your note. And I’ve never heard of a child getting chicken pox twice, but that has to be what he had. I’m going to check into it and see if this has ever been reported.”

We were standing at the nurses’ station, and I picked up the chart of the next patient to be seen. Something was bothering me. I looked over at Jay.

“If this
is
recurrent chicken pox, and at his age, he might have some kind of problem with his immune system.”

“I thought about that.” He put his hand to his chin and slowly stroked the side of his face. “We checked some basic labs, but everything was normal. No low or elevated white count, and his platelets were fine. He looks completely normal, except for that rash.”

“Hmm. I’m sure you sent him back to his pediatrician. Maybe he can figure something out. Maybe it will go away again and that will be that.”

“Let’s hope so.” Jay turned and headed toward the medicine room. “Let’s hope so.”

The rash
did
go away, again. But two weeks later, it came back, just like before. His pediatrician came up to me after a medical staff meeting and told me what had been going on with Benny Jackson.

“Darnedest thing I’ve ever seen.” Jim Matthews was a crusty, cantankerous seventy-year-old curmudgeon, but his patients and their parents loved him. He knew his stuff and didn’t waste words or time. “Just like you guys, I thought it was chicken pox the moment I saw him. But three times in a row? That ain’t gonna happen. Something else is going on here. He was in the office two weeks after Barton saw him in the ER. Scratching his skin off and making
me
itch. I thought it might be scabies, or some kind of skin mite. But no one in the family has any rash, and they haven’t been traveling anywhere. Mildred got a little offended when I mentioned scabies, but I asked her what
she
thought it was and she quieted down. I told her I just didn’t know. Never seen anything like it. She told me you boys checked some lab work and I got a copy of all of that. Completely normal. I told her if it didn’t go away or if it went away and came back again, we would send him to a dermatologist, or an infectious disease expert.”

“How has he done?” This was unusual, and I was really curious about the boy. “Did it go away?”

“Two weeks later, he was clean as a whistle. No bump or blister anywhere. Gone. Haven’t seen him since, but it’s only been another week or so. I’m just hoping we’re through.”

“I’m sure Mildred and Benny feel the same way.”

But they weren’t through. Four days after that meeting, Lori Davidson led Mildred and Benny into the department and down to minor trauma. It was seven in the evening and all of our private rooms were occupied. Mildred shook her head at me as they passed the nurses’ station. Benny didn’t look up. His eyes were squeezed shut and he was clawing at his trunk and legs.

I picked up the chart of another patient in minor trauma and glanced at the front sheet:

Danny Totherow. 42 yr old M. Bar fight—cut head.

“Looked like he got busted pretty good to me.” Amy nodded at the chart in my hand. “Gonna take awhile to put that one back together.”

I followed the drops of blood down the hallway and almost ran into Lori when I stepped into minor. She was headed back to triage and handed me Benny Jackson’s chart.

“Same thing,” she whispered. “He’s covered from head to foot.”

She slipped around me and disappeared up the hall.

Benny was on the first stretcher on the left, and Lori had pulled a curtain all the way around the bed. Just beyond him, in the back left corner of the room, was Danny Totherow. He was still fifteen feet away, but I could see Amy was right. His scalp was gaping open and still oozing blood. This was going to take awhile.

“How did this happen, Danny?”

I rolled over to him on a stool and looked down at the suture tray Lori had set up. Everything was ready, and I snapped my surgical gloves in place.

Danny was lying on his back, with his bloody head toward the middle of the room. His hands were folded casually across his chest and a smile spread across his face.

“Well, Doc, it was like this.” He kept smiling, but didn’t open his eyes. His words were garbled and his sentences non-diagrammable, probably the result of cheap wine, the odor of which saturated his breath and permeated the room. From the few words I could make out, it seemed he had been on the losing end of a “broken bottle fight” and was now in need of repair.

“Okay, Danny, I just need you to be still and let me take care of you.”

He sighed heavily, nodded his head, and kept smiling.

The curtain behind me suddenly opened, its metal rings shrieking their objection as they were pulled aside.

“Dr. Lesslie, it’s me, Mildred Jackson. And Benny.”

I slowly spun around on the stool and smiled at her. “Hey, Ms. Jackson. I see Benny has his rash again. Let me take care of this gentleman and I’ll be with you as soon as I can. You might want to pull that—”

“You’re absolutely right.” She shook her head and looked down at Benny. “That rash is back, maybe worse this time. What are we going to do?”

There was no room for an answer. She took a deep breath, puffed it out, and proceeded to present Benny’s entire history of the mystery rash. Again.

She didn’t leave anything out, from his first visit to the ER up until this latest recurrence. She was especially descriptive of her visits with Dr. Matthews. All the while, Benny sat on the edge of the stretcher, dangling his legs and scratching his torso. I was a captive audience and kept on stitching Danny’s scalp.

“You know, my sister in Tennessee wonders if it might be smallpox. But I thought that was a real bad one.” She looked down at her son and grabbed his hands. “Stop that, Benny!”

I knew there were a few vials of the virulent smallpox virus locked away in some hidden vault somewhere, but the disease is now nonexistent. Yet it was an intriguing idea. Maybe this was some new and rare malady. One thing for sure: none of us had been able to come up with an answer.

“We’ve tried everything,” Mildred continued from her corner of the room. “Everyone in the house was treated for scabies—I
told
Dr. Matthews—and we washed all of Benny’s clothes and sheets. Even steamed them. And now it’s back.”

I leaned back and reached over to the surgical tray for another piece of suture. Danny Totherow rose up on one elbow and looked over at Benny. A blue surgical towel was draped over his head, but an eyehole allowed him to see the boy. He collapsed back onto the bed and once again folded his hands across his chest.

Benny sat wide-eyed, staring at the apparition across the room. For a brief instant he had stopped scratching. Then he was clawing away again.

“Got a hot tub?”

The muffled question came from under the blue towel.

“What was that?” I picked up an edge of the towel, trying to free his mouth.

“Got a hot tub?”

A lightning bolt had somehow penetrated the building and miraculously struck me. That was the long-sought-for answer.

Mildred Jackson stared at the hooded head of Danny Totherow. “No, we don’t have a hot tub. Why?”

Danny mumbled something incoherent, and I took over.

“No hot tub in the neighborhood? No friends or anything with one?”

Mildred shook her head. “No, we don’t have one and no one—wait, the Pottses have one in their backyard, Charlie’s one of Benny’s friends. But he’s not allowed to get in it. That’s the only one I know of. Why?”

“Uh-huh,” came the slurred response from Danny.

“Benny, you haven’t been in Charlie’s hot tub, have you?” Mildred was staring at her son and he dropped his head, shaking it slowly.

“Benny?” She dragged his name out, hanging it in the air.

With eloquent fluidity, just as a master conductor would direct his orchestra, Benny’s head-shaking morphed into a slow but definite nod.

“I’m sorry, Momma. Charlie said it would be okay, and his mother didn’t mind, as long as I didn’t have the rash when I got in.”

“Has Charlie ever gotten this rash, Benny?” I had turned around on the stool, my gloved hands upright in front of me.

“No, he never did. He never got in the tub. Said it was too dirty.”

“Uh-huh.” Danny again.

That was it—the answer—the resolution of our mystery.
Hot tub dermatitis,
usually caused by the pseudomonas bacterium. Its small blisters look very much like the lesions of chicken pox. The Pottses’ tub was a regular petri dish—and every time Benny’s rash cleared, he would dip himself in it again.

I explained all this to Mildred Jackson.

“Well, I’ll be. And that’s it?”

“That’s it. We shouldn’t be seeing him again with this rash.”

Case closed.

I spun around again and looked down at Danny Totherow’s covered head.

My seafaring grandfather’s words came back to me:
Any port in a storm.

The Cell Phone

“Sharon, what is it going to take to get through to you? How many times do I have to tell you about picking up hitchhikers?”

Mike Brothers had just walked into the house and was hanging up his jacket. His wife, Sharon, was standing in front of the kitchen sink, preparing chicken for the frying skillet.

She froze and stared out the window.
How had he known? Who told him?