Miracles in the ER (3 page)

“It was like I said, Doc. I was trying to pick up my speed, close strong, and then I felt a snap. Heard it too. And I went down.”

We had given him something for the pain and he was lying comfortably on the trauma-room stretcher. His mother stood beside him, gently stroking his forehead, her own forehead furrowed. She was chewing one corner of her lip and didn’t take her eyes off her boy.

The door to trauma burst open and a middle-aged man took two steps into the room, glanced around, then walked quickly over to the stretcher.

“Ben, are you alright?”

The man looked down at the boy, then over to his mother, and finally at me.

“Is he okay? What happened? Is he going to need surgery? What about—”

“It’s okay, Dad—I’m going to be fine.” Ben reached out a hand to his father. “Just a broken bone. Nothing serious.”

John Stevens took his son’s hand in both of his own and looked over at me again. “How did this happen? I thought he was at a track meet.”

I told him what I knew, and Ben filled in the rest. While we were talking, two lab technicians came into the room and prepared to draw some blood. He would be going to the OR and we would need some basic lab work.

“Type and cross for four,” I told them. A fractured femur can bleed a lot and he was going to need some blood.

Amy Connors stuck her head into the room. “They’re ready for him in X-ray, and the orthopedist on call is on the way down.”

Ben’s femur was obviously fractured and I had made sure he didn’t have tenderness anywhere else.

“Just the femur, right?” Amy called out again, raising her eyebrows at me.

“Yeah, that’s all we need.”

Ben coughed a couple of times and the rattling caused me to spin around.

“When did that start? The coughing?”

He looked up at me and shook his head. “I’m not sure. It’s just a cough.”

“I noticed it a couple of days ago.” His mother stopped stroking his forehead and looked over at me. “Nothing bad, or anything. Just an occasional cough, mainly at night.”

“Any chills or fever?” I looked at her and then at Ben.

He shook his head. “No, I’ve been fine.”

I turned and faced Amy. “Let’s get a chest X-ray too, PA and lateral.”

“Got it.” The door closed behind her and she was gone.

“Ben, have you had any broken bones before?”

“No, not that I can remember.” He looked over at his mother, and she shook her head.

“How about your index finger?” His father interjected. “When you fell out of the tree house. Remember?”

“Oh yeah.” Ben smiled and nodded his head. “That was nothing, just a little crack.” He held up his left hand and pointed to the ceiling. “See. Fine.”

“No medical problems or any medications?” I was still struggling to understand why this had happened.

“No, nothing like that.” His mother put a finger to the side of her face. “We
did
take him to his pediatrician a month or so ago. He was having some leg pain.” She paused and looked down at her son’s splinted right leg. “I think it was this one, wasn’t it?”

Ben put a hand on his injured thigh and nodded.

“He told us it was just ‘growing pains,’ and nothing to worry about.”

“It was getting better, wasn’t it, son?” His father leaned closer to the stretcher. “You haven’t said anything about it lately.”

Ben was silent, and his hand remained on his thigh. He took a deep breath and sighed.

“It was getting better, right?” his father repeated.

The door opened and two radiology techs walked into the room.

“Ready to go to X-ray? This shouldn’t take very long.”

Twenty minutes later, the same two techs rolled Ben back into the trauma room. His labs had just been returned and I was studying them. He was a little anemic, but it looked chronic, not something that had happened this afternoon.

One of the techs snapped the X-ray of his femur onto the view box, then laid three or four other films on the counter. She glanced at me and when I looked in her direction, her gaze quickly shifted to the floor. She locked the wheels of Ben’s stretcher and the two disappeared.

I was ten feet from the view box but could clearly see the mid-shaft fracture, angulated and shortened. It was what I expected.

As I walked closer, my heart flew into my throat and the blood drained from my face.

“What’s the matter, Dr. Lesslie?” It was Ben’s mother, and I didn’t respond. I just stared at the X-ray. The femur was fractured, but the break was through bone that was irregular, haphazardly layered like…like onion rings. It was bone cancer, probably a sarcoma, and it looked aggressive and deadly.

The cough! I walked over to the view box, took down the X-ray of Ben’s femur, and replaced it with the film of his chest.

I couldn’t stifle a loud sigh, and his mother repeated, “Dr. Lesslie,
what
is the matter?”

I turned around and faced the three of them.

“Ben’s femur is broken, just like we thought. But it broke through an area of what looks like bone cancer. And if it
is
cancer, it’s already spread to his lungs.”

I was with the family when the orthopedist confirmed my fears and explained what needed to be done. There would be no surgical repair of the fracture, no rodding of the broken femur. His leg was going to come off. And then there would be chemotherapy and maybe radiation. He was in a battle to save his life.

John Stevens stood beside his son’s stretcher, head hanging down, silent. Ben’s mother looked at the orthopedist and then at me, all the while gently patting her boy’s shoulder.

“He’s in the Lord’s hands,” she said quietly. “He’s always been in the Lord’s hands.”

I saw Ben in the ER three months later. His parents brought him in with fever, chills, aches, and a persistent cough. He looked like he felt terrible—pale, sweating, shivering. Yet he managed a smile when he saw me.

“Hey, Doc. I’m not feelin’ so good.”

His parents filled me in on what had transpired since he fractured his leg. The amputation had gone well and he was already able to get around some, much better than any of his physicians—of which there were many—had thought possible.

“He’s determined.” His father nodded, looking down at Ben and smiling.

“He’s hardheaded,” Mrs. Stevens spoke up. “Just like his father.”

Ben had lost some weight since that first visit. That was to be expected. I had talked with one of his oncologists shortly after the surgery about his outlook, and he had used the word “months” instead of “years.” It was a bad cancer. There were the three aggressive tumors that I had seen in his lungs, and there was little hope that chemo would be able to stop them. Except for his chest, though, all of his other scans had been clear.

“We tried the chemotherapy,” his mother explained when I asked about his treatment. “He just got so sick, and they stopped it after the second one. They haven’t decided on what’s next.”

She grew quiet, and I focused on today’s new problem. I was afraid he had pneumonia and that his lung cancers had spread.

“We’ll need to get another chest X-ray and check that out. I want to be sure he doesn’t have any infection there.”

Ben’s father looked sharply at me, then turned away.

“And since it’s January, I’m going to get a flu test. We’re seeing a lot of it now, and that might be a possibility.”

No one said anything, and I walked to the door and called out to Amy, telling her what we needed.

Ben was rolled back into the department and over to room 4. His parents followed, along with one of the X-ray techs. She handed me his films, then helped him onto the stretcher.

I walked over to the view box, knowing what I was going to find and not wanting to look.

“Doc, the boy in 4 is positive for the flu. Type A.”

I looked over at Amy Connors. She held a lab slip in her hand and waved it at me. That would explain the fever and aches and the cough. After all, even though he had metastatic bone cancer, he could still get the same things everyone else did. In fact, it was more likely. And the flu was no exception.

The X-ray of his chest snapped into place on the view box and I flipped on the bright light. I had to force myself to look up and—

His chest showed completely clear! There was no pneumonia and there was no cancer! I compared this X-ray with the one we had made three months earlier, carefully searching the areas where the tumors had been.

Gone! His lung cancers were gone! He just had the old-fashioned, run-of-the-mill flu!

I almost ran over to room 4, jerked the curtain aside, and told Ben and his parents the news.

Ben nodded and smiled calmly. His father stared at me, eyes wide and mouth open.

His mother gasped. Her hands flew to her mouth and tears flowed freely down her cheeks.

Gone
.

He Ain’t Heavy…

“Still no pulse.”

Jeff Ryan had his fingers on the man’s left carotid artery. He glanced up at the clock on the wall. “It’s been over forty minutes.”

I looked at the cardiac monitor for the fiftieth time—flatline. Nothing.

Virginia Granger stepped into cardiac and walked up behind me. She put on a hand on my shoulder and said, “Time to call this one, Dr. Lesslie.”

She was right, and I knew it.

“Okay, that’s it.” I glanced around the room at the nurses and techs surrounding the bed. “Thanks for your help.”

“7:52 p.m.,” Virginia announced. She made a note on Ted’s chart and headed out of the room.

I stood at the head of the stretcher and watched as the staff slowly and quietly drifted through the doorway. One moment the room had been frenetic, charged with the energy of our efforts to save this man’s life. And the next—it was as if the very walls uttered a whispered and final sigh.

He was only forty-two years old, and that made it even harder. I had seen him in the ER a couple of weeks earlier with a low-grade fever and what seemed like a simple virus. All of his labs had been okay, and there was nothing on his chest X-ray. He was a kidney-transplant patient, only six or seven months out from his surgery, and we needed to be especially careful with him. His family doctor had put him in the hospital for a few days and when everything had seemed fine, Ted Bartlett had been sent home.

Now he was on a stretcher in the cardiac room—dead. His lab work looked as if his kidneys had suddenly shut down, and he had an overwhelming infection due to the immune system suppressants he was taking. That was the probable explanation for his death, but it didn’t make anything easier.

Lori Davidson cleared her throat and I looked over at her. We were alone in the room.

“I’ll take care of things and see if he has any family members in the waiting room.” She didn’t look up from the pile of papers and rhythm strips scattered on the countertop.

Virginia was standing at the nurses’ station and I walked up beside her.

“His mother and I were good friends—
are
good friends,” she corrected herself. “She developed dementia a couple of years ago and it’s gotten a lot worse lately. She’s in a long-term care facility now and isn’t able to communicate.”

I nodded in the direction of the cardiac room. “Does he have any other family in town or nearby?”

“Just
that
man.” Virginia was looking over my shoulder and I twisted around. “His brother.”

Lori was leading a slender, middle-aged man down the hallway and into cardiac.

“Good. I’ll go—”

“Hold on just a second.” The head nurse laid her hand on my forearm, and I turned to face her. “There are a few things you need to know about Andrew Bartlett.”

Andrew was four years younger than his brother and had always walked in Ted’s shadow, or at least he thought so. Ted was a three-letter athlete at the local high school and had won the state track championship in the half-mile. Everything seemed to come easy for Ted—sports, friends, girls, studies. It was just the opposite for Andrew. He tried out for the football team but didn’t make the first cut. The coaches voiced their surprise and disappointment, given the successes of his older brother.