Chapter Seventeen
Holly
“Dr. Carrington, we have a critical hemoglobin that came back for room nine.”
“Dr. Carrington, the detoxer in three is refusing his lorazepam, but also refuses to leave, what should we do?”
“Dr. Carrington, abnormal EKG for the ninety-year-old here for sepsis.” An EKG graph is shoved in my face, and I flinch, grabbing the paper from the tech’s hand to confirm any abnormalities.
I scan the rhythm, noticing a slight bundle branch block, which could be chronic, or an effect of the sepsis.
“Chest pain?” I ask the tech, and she shakes her head.
“No chest pain, pretty limited cardiac history from what I can see. Vitals suck, though.” She points to the monitor desk, and the blinking red numbers scream low blood pressure.
“Have the fluids been administered?”
She nods. “Finishing the last bag per sepsis protocol right now.”
I rub my fist into the meaty part of my eyes, wishing I had slept more than a handful of hours last night.
No amount of essential oils, comfortable pillows, or night shades could’ve helped me prepare for my first day back in the ER.
The only thing that might have been helpful was sharing a bed with a certain country boy, but there’s no way I could’ve made the drive back this morning without wasting hours in traffic.
I’ve been up since four in the morning, even though I didn’t have to be at the hospital until seven.
We’re twenty patients deep in the waiting room, which doesn’t include the ten that we just triaged.
I hand the EKG back to the tech and reach for a computer chair.
“I’ll place orders for vasopressors. Call and get her a bed in the ICU please, and tell the family she will be admitted. ”
Before I can log into the computer to get meds ordered, my name is shouted, and the door to trauma bay three is swung open.
“Dr. Carrington! I need you in three, all hands on deck!”
I’m up and racing around the nurses’ station, following the train of staff into room three.
Our detoxer arrived an hour ago via ambulance after being found lying in the street by a concerned citizen.
The ambulance had placed an IV, which he promptly ripped out once he came to.
He’s refused all of my attempts at help and has been shouting obscenities at the female staff as they try to work.
Most of the staff has been grumbling under their breath at him, and I’ve had to remind them more than once that he’s not in his right mind.
Underneath all the pain and drugs, he’s still a person that deserves our help.
His body is convulsing in a full tonic-clonic seizure, and it shakes the gurney, rattling the sides as staff surround him. I begin shouting orders, and the staff moves in fluid symmetry, placing a new IV, lowering the head of the bed, and rolling him onto his side so he doesn’t aspirate.
I keep one eye on the clock, timing the length of his seizure as another nurse comes close to place an oxygen mask over his face. He’s trembling so badly she struggles to get the strap of the mask around his face, and we work in tandem to lift his head so the strap can slide behind it.
Once the IV is placed, I have staff grab lorazepam from the med machine. “Let’s start with two milligrams.” As soon as her back is turned, I shout after her, “Grab the zofran, too!” There is a good chance he may vomit, if not now, at some point when he wakes up.
My heart rate kicks up, the adrenaline from the situation at hand breaking me out of my groggy haze.
The lorazepam is pushed through his IV, and we wait, watching the clock to countdown the seconds until he hopefully settles.
Thirty seconds turns into a minute, and one minute into two.
I’m about to tell her to administer another dose, when his jerking motions start to relax, and the convulsions stop.
His eyes flutter shut as his head relaxes, and once he’s still, the blood pressure cuff inflates.
I hold my breath as the machine springs to life, and his vitals crossing the screen are somewhat stable given what he just went through.
I release the death grip I had on the sides of his bed and take a step back.
The seizure wasn’t pretty, but I’m thankful that we can start to get him the medications that’ll hopefully get him on the road to recovery.
“Sandy,” I call out to one of the newer nurses.
“Let’s get labs from him while we can. Get him on tele; we’ll monitor him here until we can get a bed in ICU. ”
She nods at my request, and I stare at him for another minute.
He’s younger, in his early twenties. Close to Harper and Piper’s age.
Even though an hour ago he was a stranger, and some would argue that he still is, it breaks my heart to see him lying there with his body fighting for stability.
I wish he’d talk to me, tell me what he’s going through and what led him down a path that has him lying in my ER in the early afternoon.
I strip off my gloves, tossing them in the trash bin and reaching for the hand sanitizer.
I gently wipe the gel between my palms, moving back to the computers to enter orders for pressors on my poor septic ninety-year-old.
“Dr. Carrington, what did you want to do about that critical hemoglobin?”
Shit. I curse quietly under my breath, logging into the computer before giving my full attention to the tech standing to my left.
“I’m sorry,” I tell her sheepishly. “Who is this on again?” My mind is officially complete mush.
I thought I was ready to be back. I thought my days working in clinics and urgent care centers with a handful of providers was enough to calm my nerves, to ground me.
To have me so bored that I was ready for this fast paced, constant stream of questions that the ER brings, but if anything, I’m feeling even more like a failure.
“It’s for the elderly man in room nine, the one who came in with his daughter. She reported he fell this morning and is complaining of dizziness.”
I nod, recalling now which patient we’re talking about. His initial hemoglobin was a six, and we transfused two units which should have brought it up to an eight at the least. “He’s still low?”
She nods, showing me the Post-it note from whoever took the call from the lab. “Only at seven point one.”
The hospital has a stiff policy where we technically shouldn’t transfuse if a hemoglobin is above seven, but given his symptoms and fragility, I’m tempted to transfuse another unit. “How long has it been since the last bag was transfused?"
“About two hours.”
I rub at my temples with both hands, thinking over my options.
“Let’s wait on another unit. I know he wants to go home, but let’s get him a bed on the floor.
I’ll put in orders to check his hemoglobin in four hours, and if it’s still low, then the hospitalist can manage it.
” The tech nods, and I stand to head down the hall to talk to the patient and break the news that he isn’t discharging home, when my phone vibrates in my pocket.
I pull it out, and a smile immediately forms on my face when I see it’s from Grayson. I pause, leaning against the wall as I open the message, and a giggle bubbles in my chest when I see the picture he sent.
He must be working on something, one of the tractors or a piece of machinery, because his face is covered with a layer of dirt and grime.
A thick black smudge of grease runs across his forehead, and my body immediately flushes, imagining him bending me over one of those pieces of equipment and railing into me, sweaty shirt, grease stains, and all.
But then I take a good look at the picture, and I crack up, noticing one of the goats is standing right by him with its head resting atop his shoulder, peering into the camera as if it’s his sidekick, and smiling wildly as he takes a selfie.
The caption reads: “Prancer decided to help me change the oil today.”
I pull my bottom lip between my teeth, the movement failing to hide my smile.
Once again, I’m jealous of the time the goats get to spend with you.
Grayson: Three more days. I’ll be counting down the minutes, baby.