Chapter Twelve Hailey
The ER at night is an animal of its own.
Daytime chaos that primarily consists of minor injuries and routine complaints trends toward the unpredictable and complex as the sun falls from the sky.
Sometimes, the department is eerily quiet; other times, it’s filled with the strangest cases of the week.
Tonight is somewhere in the middle. By nine p.m., I’ve treated an elderly woman with unexplained fainting spells, a college student with a pencil embedded in the palm of his hand (“I was trying to catch it,” he explained, as if that clarified anything), and a middle-aged man experiencing chest pain that turned out to be caused by anxiety rather than cardiac issues.
He’d been convinced he was dying ever since WebMD told him his headache was a brain tumor.
I gently suggested he stop consulting Dr. Google.
“Brigham, you’ve got incoming,” Marco calls from the charge nurse station. “Adult male, early thirties, severe genital pain, suspected foreign body, signs of systemic infection. Three minutes out.”
I freeze with a chart halfway to the printer. “Genital pain and systemic infection?”
“Patient’s febrile. Tachy. Girlfriend called 911 when she found out he was urinating blood and running a high fever.” Marco scrolls down the screen. “EMS is flagging possible Fournier’s risk. Says the patient’s been hiding it for days.”
Days. Fuck.
A chill rolls down my back, making my entire body shiver. Fournier’s gangrene is the kind of diagnosis that makes ER staff exchange the look. Necrotizing fasciitis of the genital and perineal area. Fast-moving, tissue-eating, life-threatening.
Basically, the dude might lose his dick.
“What’s the foreign body?”
“Unspecified.” Marco’s mouth twitches. “EMS said he wouldn’t tell them.”
Awesome.
I move toward the trauma bay and start prepping. Sonography. IV fluids. Antibiotics—broad spectrum, the heavy stuff, because if this is what they think it is, every minute counts. Dr. Chen joins me a moment later, already pulling on gloves.
“Urology’s been paged,” she says. “Dr. Gupta is en route.”
The ambulance bay doors slide open with a hydraulic hiss. The paramedics wheel in a white man who’s pale, sweating, and has his jaw clenched so tightly I can see the muscle ticking. He’s curled slightly to one side on the stretcher.
“Brandon Halverson, thirty-two,” the lead paramedic reports. “Severe lower urogenital pain, temperature 105.4, HR 174, BP 92/58. Reports dark-red urine. Localized swelling, erythema extending into the perineum. Patient confirms a foreign body but declined to specify on transport.”
Of course he did.
“Brandon, I’m Dr. Brigham.” I keep my voice low and even as we transfer him to the trauma bed. He won’t meet my eyes. “I know this is uncomfortable, but we need to know exactly what’s going on so we can help you. Whatever you tell us doesn’t leave this room.”
He squeezes his eyes shut. “I thought they would just… pass.”
“You thought what would pass?”
There’s a long pause. A very, very long pause.
“The…packets.”
I keep my face perfectly still. “Packets?”
“Ketchup packets.” His words are barely audible. “Empty ones. Like from a fast-food place. I rolled them up. Tight. Like…like little tubes.”
I do not look at Dr. Chen. I cannot look at Dr. Chen. If I look at her right now, I’m going to lose my poker face and this man is going to feel humiliated. Humiliated patients shut down, and shut-down patients lose body parts.
“Okay.” My voice doesn’t waver, which feels like a major win. “How many, Brandon?”
He makes me wait a few seconds before giving me an answer. “Six.”
Six.
“And how long ago was this?”
“Four days.”
Four fucking days.
Dr. Chen is typing rapidly on her laptop, not missing a single word. I focus on Brandon’s face, which has gone a shade of white worryingly similar to the skin tone of a corpse I worked on in med school.
“Did any of them come back out on their own?”
He shakes his head, a regretful tear sliding sideways into his hairline.
Dr. Chen steps forward, calm and professional as always.
“Brandon, I’m Dr. Chen, the attending doctor tonight.
We’re going to get some imaging and have urology come down here right away.
You’ve got a real risk of a tissue infection that can spread very fast, so we’re going to start IV antibiotics immediately. ”
He nods. “Okay. I understand.”
A nurse gets the IV in and starts antibiotics while Dr. Chen does the exam I’m grateful is not my job tonight.
As the transport team arrives to take him for imaging, I feel my phone vibrate in my pocket. Normally I wouldn’t check it unless it’s a slow night, but with Brandon out of my hands for a moment, I sneak a quick glance.
Cole: I just heard from Jack… Skydiving tomorrow after you wake up?
My heart does that odd little skip it always does when I think about seeing him.
It’s embarrassing, really. I’m a grown woman.
And a medical professional. I’ve held people’s intestines in my hands without flinching.
But one text from a cute guy and suddenly I’m a fourteen-year-old girl at a boy-band concert.
And skydiving? Tomorrow? I’m suddenly giddy. I’d jump up and down if I were anywhere else.
Hailey: TOMORROW??? I’d love that. I’ll text you in the morning when I get off and we can figure out a more exact time.
His reply comes instantly.
Cole: Can’t wait. Have a great shift, gorgeous.
Gorgeous. I stare at the word for probably too long, like a moony-eyed teenager. Get it together, Hailey.
I shove my phone back in my pocket just as Marco appears in the doorway with a serious expression.
“Hailey, got a minute?”
I step out with him. “What’s up?”
“Just got a strange call asking about you specifically,” he says, lowering his voice. “Guy wouldn’t give his name, just asked what time your shift ends. I told him we don’t provide staff information to callers.”
A chill runs through me, making my spine straighten. “What else did he say?”
“Nothing. He hung up when I asked who was calling. Probably nothing—could be family trying to reach you—but I thought you should know given the Winters thing last week. They didn’t stay on the phone long enough for me to place his voice.”
Great. I’ve got options now. Potentially multiple creeps to worry about.
“Thanks for the heads-up,” I say, fighting to keep my expression neutral despite the sick feeling settling in my gut. I’ve only told Rachel about the note and my car being keyed. “Hopefully it’s just my dad trying to make a surprise visit or something.”
Marco doesn’t look totally convinced, but he nods and circles back to the charge desk. I take a moment to compose myself before returning my attention to the floor.
Dr. Gupta, the urologist, arrives within a few minutes. She’s a small woman with kind eyes and zero capacity for being shocked by anything. She reviews Brandon’s imaging, examines him, then comes to find Dr. Chen and me at the desk.
“He’s going to the OR,” she says. “We need to get the foreign material out and debride the infected tissue. I won’t know how much I can save until I’m in there.”
As the transport team wheels him out, I exhale slowly. Whatever decisions led him here, this man is a person. A scared, embarrassed, possibly very unlucky person. And, I suspect, a person in need of mental health support.
But also—six ketchup packets. Six.
By midnight, the ER has settled into its quieter phase—the initial evening rush subsided, the late-night emergencies not yet arrived. I take the opportunity to chart thoroughly, but my mind keeps slipping back to Cole.
Rachel finds me in the break room and drops into the chair across from me with a container of pasta that smells aggressively of garlic.
Seeing her is like a cool wash of aloe gel on an emotional sunburn.
We found out the other day that she got hired part-time at a physical therapy clinic on the other side of town, which means she’ll be able to reduce her hours at Fort Collins Memorial.
I’m obviously thrilled for my friend, but I can’t deny how empty this place will feel when her presence doesn’t ring through the hallways quite as much.
“You look like you’ve had a night,” she says, stabbing a forkful of leftovers. “Spill.”
“Where do I even start?” I take a long sip of my coffee. “Brandon Halverson.”
“Don’t know him.”
“You will. He’s in the OR right now with Dr. Gupta.”
“Trauma?”
“Foreign body.”
Rachel pauses, fork halfway to her mouth. She knows that tone. We’ve had a lot of foreign-body conversations over our two-year friendship.
“How bad?”
“Possible Fournier’s. He came in septic.”
“Oh no.” She winces. “What was the FB?”
I take another long sip of coffee, savoring this. My compassion for Brandon doesn’t preclude me from acknowledging the humor of the situation. Penises are funny on a good day. Penises filled with condiments? Comedy gold. “Six rolled-up ketchup packets. In his urethra. For four days.”
Rachel sets her fork down very slowly.
“I’m sorry?”
“You heard me.”
“I need you to repeat that for the record.”
“Six. Rolled-up. Ketchup packets.”
“In his—”
“In his urethra.”
“For—”
“Four days.”
Rachel stares at me, and I stare back, unblinking. The microwave hums in the background. Somewhere down the hall, a call bell rings.
“Wait.” Her brow furrows. “Ketchup packets? Wouldn’t you think—”
“Mayo.”
“—mayo?”
We say it at exactly the same time, which is when we absolutely lose it. Real, undignified, head-back, snort-laughing. I have to put down my coffee because I’m going to spill it. Rachel is wheezing.
“It’s the lubrication,” she gasps. “It’s literally—”
“It’s the texture—”
“Mayo would glide—”
“Rachel!”
“Why ketchup? Was it a flavor thing?”
“Don’t—” I’m crying laughing now. “Don’t make me think about it as a flavor thing.”
“There has to be a thought process. Somewhere in his brain there was a moment when he thought, I should grab the ketchup.”
We’re full-on cackling now, probably drawing the attention of people in the hallway.