Chapter 5 Nate
five
nate
"Listen to me," I said quietly but firmly to the nervous-looking volunteer EMT clutching his clipboard. "You cannot spring these things on us."
The volunteer rescue squads often had these problems. This particular one was largely staffed by pre-med and medical students from the local college, kids with grand visions of doctorhood who thought volunteering as an EMT would be the perfect stepping stone for their careers.
I understood how important it was to train these folks—they might well be taking care of me someday, a thought that made me shudder—but it didn't make it any easier to deal with the constant cycle of "How hard could this really be?
" becoming "Oh God, I don't know what the fuck I'm doing" as students rotated through the squad.
"If you're bringing me a severely hypothermic patient with active GI bleeding and systolic pressure in the 60s, I need that information before they roll through our doors," I continued, keeping my voice measured despite the frustration coiling inside me.
"What did you chart her temperature at when you first assessed her? "
The young man glanced down at his clipboard. "Um, we didn't actually... I mean, the nursing home staff told us her vitals were stable this morning, so we just—"
"Stop right there." I cut him off, unable to hide my incredulity. "You took the nursing home's word for it? Without checking yourself?"
He shifted uncomfortably. "They're—I mean—"
"Let me explain something that will serve you well if you ever make it to med school," I said, leaning in slightly and putting an edge of drill instructor sharpness into my tone.
"Rule number one in emergency medicine: Never, ever trust what a nursing home tells you about a patient's condition.
Not because they're bad people, but because they're understaffed, undertrained, and overwhelmed.
Half the time, the person who called you hasn't even seen the patient themselves. "
His face fell as I continued, "That 'feeling a little weak today' could mean anything from fatigue to full septic shock.
That 'hasn't eaten much' could mean they haven't taken food or fluids in three days.
And 'seemed fine this morning' often translates to 'nobody's checked on them since yesterday afternoon. '"
I gestured toward the trauma bay where the patient was now surrounded by staff working frantically.
"That woman has probably been deteriorating for days.
Her core temperature is 89.9. That doesn't happen in an hour.
She's been bleeding internally long enough to drop her pressure to critical levels.
And now instead of coming in as the critical patient she is with resources ready, she rolled in as a 'weak elderly woman' and we're playing catch-up. "
The young man swallowed hard. "I didn't realize—"
"This is what separates the people who should be in medicine from those who shouldn't," I said, my voice quieter but no less intense.
"It's not about the fancy degrees or memorizing the Krebs cycle.
It's about developing the healthy skepticism and critical thinking that keeps patients alive.
Always. Check. Vitals. Yourself. Always question what you're told.
Assume the worst until proven otherwise. "
I took a deep breath. "Look, I'm not trying to crush your spirit. But that woman deserved better, and so will every patient you encounter. This job isn't a line on your med school application. It's people's lives."
The terrified young man—who I'd probably be calling "doctor" in less than a decade, sigh—nodded frantically before scurrying off. I closed my eyes, took a deep breath, and exhaled slowly.
"Looks pretty rough," Maria remarked as I walked back to the charge desk.
"Yeah," I admitted, shaking my head. "She doesn't look good. Good chance she gets admitted to the 7th floor."
Maria winced and nodded. There was no 7th floor; our hospital stopped at six. The 7th floor was above the hospital.
Well. I thought it was a better euphemism than "the basement room” or “being discharged to JC.”
"What techs do we have free right now?" I asked aloud, mostly to myself. "Maria, would you ask Arushi and Kevin to help Deonna get that patient stabilized?" That would leave my triage nurse without assistance, but I didn't see much other choice.
"You got it," Maria confirmed.
Acting as charge nurse during Sophia's absence was like juggling chainsaws while reciting the periodic table.
This is why I preferred triage and loathed being in charge.
Triage was mechanical: assess, decide, move.
This was like conducting an orchestra playing in a burning semi traveling 75mph down the road.
Sophia was infinitely better at this than I was.
But she was off gallivanting around New Zealand with that Kiwi paramedic boyfriend of hers, and I'd agreed to pick up a couple of her shifts.
Sigh. To be fair, I did owe her—not just for helping out with Paige, but for so many things I'd lost count of over the past few years.
My phone vibrated in my pocket. Normally, I'd ignore it until a break, but the school's number flashed on the screen. My heartbeat accelerated immediately.
"This is Nate Crawford."
"Mr. Crawford, this is Ms. Wilson from Riverdale Elementary." The assistant principal's voice held that careful neutrality school administrators perfect, the one that says 'don't panic yet, but something's wrong.'
"Is Paige hurt!?" I asked, a pang of adrenaline shooting through my heart.
"Not hurt, no. But there's a... situation. Paige has locked herself in the bathroom and refuses to come out. She's been in there for almost forty minutes. We've tried talking to her, but she just says she wants to go home."
A dozen scenarios flashed through my mind, none good. Bullying. Illness she was hiding. Anxiety attack.
"Has something happened? Was there an incident with another student?"
"Not that we're aware of. She seemed fine during morning classes. Her teacher said she asked to use the restroom during math, and that's when this started. We wouldn't normally call for a bathroom issue, but she sounds quite upset, and she specifically asked for you."
I glanced around the ER, dubiously, trying to do mental arithmetic that kept coming back with an impossible answer.
"Mr. Crawford? Are you able to come to the school?"
The hard reality settled over me. I couldn't leave. There wasn’t a single other “charge trained” nurse on the schedule, and we were barely holding things together as it was.
"I'm in the middle of an emergency situation at the hospital." The words felt like ash in my mouth. "I can't leave right now."
Ms. Wilson's sigh carried through the phone. "I understand, but Paige is quite distressed. Our school nurse would normally handle this, but she's only here Mondays and Wednesdays due to budget cuts."
"Is there anyone there who can stay with her until I can get free? Maybe Coach Lynn?" Paige liked her gym teacher, one of the few adults at school she talked about.
"Coach Lynn is on a field trip with the fourth grade. Mr. Crawford, we're doing our best, but we can't leave her in there indefinitely, and if she won't come out—"
"I understand." My mind raced, searching for a solution. Mrs. Swanson was visiting her daughter in Chicago. My list of emergency contacts was woefully short. "Let me see if I can find someone to come. Can you give me ten minutes?"
"Of course. We'll keep trying to talk to her."
I hung up, frustration and helplessness warring within me.
Who could I call? The question pounded in my head as I quickly documented vitals.
Paige's world was small—my parents had both passed away, and I didn't have any close family, both by emotion and geography, and that meant our support system was equally limited.
Then an unexpected face flashed in my mind: Tasha.
Tasha, who'd watched Paige during my babysitter crisis. Tasha, who'd bonded with her over books and tongue depressor butterflies. Tasha, who was off duty today.
Tasha, who had no real reason to help me again.
But I was out of options.
I grabbed our contact list of staff phone numbers, stepped into the medication room, pulled out my phone, and dialed.
The phone rang four times. I was about to hang up when her voice came through, immediately defensive.
"Look, Crawford, I'm already in overtime this week, so unless you're offering double call pay, there's no way I'm getting off this couch—"
"No, no, it's not that. I—" I faltered. This was unprofessional, inappropriate, probably crossing a dozen boundaries. "I'm sorry to call on your day off."
"Yet here we are." Her tone was dry, but the defensiveness had vanished. "What can I do for you? Everything okay?"
"No." The single syllable felt like defeat. "I need a favor. A big one."
There was a pause, then a rustle of movement. "I'm listening."
"It's about Paige. She's having some kind of... issue at school. She's locked herself in the bathroom and won't come out. We're slammed, Sophia's on the other side of the world, there isn't another charge-trained nurse available. I can't leave."
"Is she hurt?"
"They don't think so. They don't know what's wrong. I just—" I inhaled sharply, hating the weakness in my voice. "I don't have anyone else to call."
Another pause. I could almost hear her weighing her options, calculating the imposition.
"What's the school?" Tasha asked finally.
Relief washed over me so intensely my knees almost buckled. "Riverdale Elementary. You'd need to talk to Ms. Wilson in the front office, I'll call and tell them you're coming, and that you're authorized to pick her up and take her to our house if necessary." I rattled off the address.
"I'll be there in twenty. And Crawford?"
"Yeah?"
"Breathe. Kids have emergencies. It happens."
"Thank you, Tasha. I—" What could I possibly say? "I owe you. Again."
"Start a tab," she replied, but there was a lightness in her voice that hadn't been there before. "I'll text you when I have her."
I hung up, immediately calling the school back. "Ms. Wilson? I'm sending Tasha Williams, she's a colleague and an emergency department nurse. Paige knows her. She has my permission to help however necessary and to take Paige home if needed."
The weight on my chest lightened incrementally. Tasha was capable, smart, and she'd been surprisingly good with Paige before. Whatever was happening, she could handle it.
I just hoped Paige would let her.