Miracles in the ER (4 page)

None of this was lost on the younger boy. His frustration turned to resentment toward his brother and ultimately to anger. Ted didn’t understand it and didn’t know how to deal with the animosity. His years in college created more space between the two brothers—a distance that grew and was never bridged.

Years passed. Then Ted became sick. Out of nowhere, his kidneys stopped working. The specialists had no clue and no answers. Multiple biopsies weren’t helpful and no treatments could stave off the inevitable. He was soon on dialysis, every other day. And then every day. Even
that was only temporizing. The only hope for Ted Bartlett was a kidney transplant.

The doctors turned first to any family members who might be a good match. His mother was quickly ruled out, and Ted’s father had died years earlier in an auto accident. That left Andrew, and he would have nothing to do with it. He said he was too busy, too much going on, and he couldn’t take the chance of getting sick.

Because of Ted’s age and previous good health, he was high up on the transplant list. But there were no good matches and without that, the chances were too great that an operation would fail. All the while he was getting sicker and weaker.

“It was finally his mother who talked some sense into Andrew.” Virginia shook her head and stared at the countertop. “To this day I don’t know what she told that boy, but something changed his mind. He lived in Charleston, so it wasn’t much of a trip to get here. When they tested him, he was a perfect match. I remember talking to one of the doctors, and he was amazed at how good it was. He thought they must have been identical twins.” She shook her head again and chuckled. “Far from that.”

The surgery had gone well, and both brothers quickly recovered. Ted was soon doing fine, off his dialysis, and only taking a couple of medications to keep his body from rejecting his brother’s kidney. Andrew was back in Charleston.

“That’s good to know, Ms. Granger.” I nodded at the nurse and was turning around when I felt her hand on my arm again.

“That’s not all, Dr. Lesslie.” Her voice was quiet, strained, and I faced her once again.

“A few weeks after the procedure, Andrew was getting some routine follow-up labs and his white count was elevated. Not bad, but enough to cause the doctors to repeat the study in a week. The
second
time it was sky-high—over 30,000—and within a few days he was diagnosed with acute leukemia. Funny how things work sometimes. He wasn’t one to go to the doctor very often, if at all. If Ted hadn’t needed a transplant and if Andrew…Anyway, he got sick real fast. You can guess what happened next.”

I shook my head and said, “He needed a bone-marrow transplant, and the best donor was going to be his brother, Ted.”

“The
only
donor,” Virginia said. “No other matches came close. They
were only a few months out from the kidney transplant and the doctors were reluctant to consider it. But Andrew was getting sicker, and Ted insisted.”

“You’d think with all the medications there might be some problems.” I rubbed my chin, trying to get my head around all this.

“That’s why the doctors were reluctant to do it. But Ted was insistent and determined. His brother had saved his life and now he had a chance to do the same for him. But you know, it worked. Ted never missed a beat—no setbacks or anything. And the bone-marrow transport was a complete take. As far as I know, Andrew’s been in remission ever since.”

“Wow, that’s some story.” I watched Virginia’s eyes, waiting. Was there something more she needed to tell me?

“Anything else?”

She sighed and pressed her starched, white uniform with the palms of her hands. Then she looked at me over her bifocals. “That’s not enough?”

The door to cardiac opened and Lori stepped into the hallway. Our eyes met, she nodded, then turned and walked away.

Andrew Bartlett was standing at the side of the stretcher, leaning over his brother and holding Ted’s hands in both of his own. I walked over and he looked up.

“You’re Dr. Lesslie?”

I nodded.

“Thanks for trying to help Ted. The nurse told me you worked with him a long time and that…” His voice broke and he turned away.

“We did everything we could. There was just too much going against him.”

We didn’t say anything for a moment.

“It was his time, I guess.” Andrew spoke quietly. “At least that’s what Momma would say. And she would probably be right.”

We were silent again, and then he looked up at me.

“The last couple of months, Ted and I talked a lot. It was just last week that he said…” His voice was breaking again but he cleared his throat and struggled to continue. “He said that his kidney failure was a gift—a miracle. If he hadn’t needed a transplant and if I hadn’t been the donor and had the follow-up blood work—who knows what would have happened? It might be
me
lying on this stretcher.”

Andrew looked down at the peaceful face of his brother, took a deep breath, and sighed.

“He said we should make the most of this. It was a chance for us to live our lives like we meant it, and to always remember it can be over in the blink of an eye. He said his kidney failure and my leukemia were a miracle. He said they were a gift.”

…he’s my brother.

Sometimes, You Just Know

Early October, and the weather had finally changed. The summer had been long and hot, but the past few days declared that fall was upon us. Crisp, cold nights and cool, pleasant days. The change in seasons usually brought a change in the types of complaints and problems we saw in the ER, and this year was no exception. The sunburns, cuts, and tick bites of summer were giving way to colds and coughs and a few cases of pneumonia.

Lori walked out of triage, leading a young man who apparently had not checked his calendar. He wore flip-flops, dirt-smudged bathing trunks, and a much-used Clemson T-shirt. Streaks of blood coursed down his forehead, drawing my eyes to the treble fishhook embedded firmly in his scalp. His sheepish grin was a combination of embarrassment and a significant number of adult libations.

“Minor trauma.” Lori shook her head and continued down the hallway.

As I tossed the chart of the asthmatic in room 3 into the discharge basket, the EMS phone squawked to life.

“ER, this is EMS 1!”

It was Denton Roberts, and the voice of the usually calm and collected paramedic was high-pitched and strained. Amy Connors glanced up at me. She rolled her chair over to the phone and flipped the receiver onto speaker mode.

“This is the ER, EMS 1. Go ahead.”

The phone crackled loudly and Amy flinched, moving her head away.

“Is the doctor nearby?”

Amy looked up at me again. “Dr. Lesslie is standing right here. Go ahead.”

“Dr. Lesslie, this is Denton Roberts. We’re about ten minutes out with a three-year-old boy drowning…or
near
drowning.”

Amy’s eyes widened. Lori Davidson had walked up behind me. She slid the chart of our fishhook patient onto the countertop, then turned and headed into cardiac.

“What have you got, Denton?” I was leaning over the counter and staring down at the receiver.

“A three-year-old, like I said, Doc. His babysitter found him in the deep end of the swimming pool. The kid was at the bottom, and it took her a while to get him out. Don’t know how long he was in the water. When we got there, he didn’t have a pulse, but she was doing chest compressions and we took over.”

There was mumbling in the background and Denton was hollering to someone, maybe his partner.

“Sorry, Doc, it’s crazy here. A bunch of neighbors came over, and the parents just arrived. Anyway, we’re loaded and pulling out of the driveway now. He’s intubated but we’re not going to be able to get a line started.”

“Is he breathing? Any pulse?”

“Nothin’.”

The word hung in the air, and I glanced over at Amy. Her youngest boy was three, maybe four. She looked away.

“Cardiac when you get here. We’ll get things ready.”

“Roger that. Cardiac on arrival. And Doc, he’s been down a long time.”

The receiver fell silent and I headed across the hall.

“Respiratory therapy is on the way down,” Amy called after me. “Lab and X-ray too.”

“Thanks.”

Lori had her back to the door and stood beside the stretcher, readying equipment and supplies on the counter.

“Doesn’t sound very promising,” I told her.

She turned and stood up straight. There was a deep sigh and then, “Three years old, right?”

“That’s what Denton said.”

She stood there for a moment, looking down at the syringes in her hand. “He’s going to make it.”

We always tried to be optimistic, to hope for the best, but there was something in her voice that made me look at her.

“What do you—”

The pneumatic hissing of the ambulance-entrance doors announced
the arrival of EMS 1 and I didn’t finish my question. Within a minute they were rolling into the room and the quiet calm exploded into chaotic but organized activity.

“Still no pulse.” Denton’s face was beet-red and dripping with sweat. He was hunched over the limp, lifeless body of the little boy. The paramedic continued his chest compressions, not missing a beat as we moved the child to our bed.

Denton had intubated him as soon as he arrived at the scene and I checked to confirm the clear, plastic airway was in the right place. Water continued to gurgle up into the tube and was suctioned away as soon as it appeared.

“He was full, Doc. We’ve tried to clear him out the best we could.”

“Has he ever had any sign of life?” I looked over at the paramedic and then down at the boy.

“No, nothing. His color’s been okay, but no effort at breathing or any cardiac activity.”

The door opened and an X-ray tech wheeled a portable machine into the room.

“Chest X-ray?” She maneuvered the awkward equipment to the edge of the stretcher. Before I could answer, a young man and woman burst into the room.

“BJ! Is he alive?”

Lori looked over at me, her eyes wide. I nodded and turned to the couple.

The man froze halfway to the bed. His previously flushed face now drained of all color as he looked down at the little boy. His wild eyes scanned the room and his hands began to tremble.

I got the attention of Denton’s partner and motioned with my head to a chair in the corner. He immediately went over to the father, took him by the shoulders, and guided him away from the bed.

“Let’s have a seat over here, sir. You need to get off your feet and take some deep breaths.”

The young woman had rushed to the stretcher and flung herself across the body of her son.

“BJ!” she wailed. “BJ!”

Lori put a hand gently on the woman’s shoulder. “Ma’am, step over here with me. We need to be able to work on your son.”

The mother slowly stood, one of her hands slowly trailing across the boy’s shoulder and down his right arm.

Denton had somehow managed to continue his chest compressions. He looked up at me, wet hair matted to his forehead, and then glanced at the cardiac monitor.

“What’s that?”

I followed his gaze to the small, green screen. Nothing. Just an undulating lifeless line.

“I don’t see—”

There it was. One small blip on the monitor, and then another.

“Has he had any of that before?”

“No,” Denton shook his head. “He’s been flatline the whole time.”

There were a few more erratic blips, spaced between painfully long pauses. Then they became more frequent, almost organized.

“Any pulse with that?” I continued bagging the child, making sure his chest was rising with each squeeze.

Denton stopped compressing BJ’s chest. He placed one hand over the boy’s heart and two fingers over his left carotid artery.

A hushed silence fell over the room as we all looked first at Denton, then at the monitor, and then back to Denton.

His eyes were closed, squeezed shut as stood over the boy. Slowly he began to nod his head.