Miracles in the ER (25 page)

“What is it?” Corley’s voice finally grumbled, sending warm and fuzzy feelings all through me.

I explained Mattie’s troubles and that she would need to be admitted to the hospital.

“I’ll
decide that issue.” Click.

Warm and fuzzy.

Thirty minutes later, I was standing in front of Amy, just outside room 5. Moments earlier, Bill Corley had snatched Mattie Caufman’s chart from the countertop and stomped into the room, snapping the curtain closed behind him.

“And just
why
are you in the ER today?” he demanded.

His voice carried through most of the department, and Amy looked up at me and shook her head.

“Why…I…” was the feeble reply.

“Speak up! I have other patients to attend. I repeat—why are you in the ER today?”

This went on for several minutes, time enough for me to put a stop to it. I turned, took a step, and was nearly bowled over when a red-faced Corley stormed out of the room. He never addressed me or looked in my direction, but walked over to the counter and flung the chart on Amy’s desk, narrowly missing her hand.

“Find a bed in the ICU and call me when she’s upstairs.”

Corley spun around and stalked down the hallway, his dark cloud straining to keep pace.

“One of these days…” Amy grumbled.

I pulled the curtain aside and stepped into room 5. Brenda Mayes was standing in the corner clutching the back of her neck, tears streaming down her reddened cheeks.

“Mrs. Mayes, Mattie, I’m sorry about—”

“Tsk, tsk,” Mattie clucked, smiling up at me. “You don’t have anything to be sorry about. But that Dr. Corley—he certainly is an angry young man, isn’t he?”

We talked for a while and I explained what would happen with Mattie in the ICU. I tried to calm Brenda, but she remained upset and angry. Mattie was fine.

“You know, Dr. Lesslie,” she whispered between difficult breaths. “Sometimes these things, just like chickens, come home to roost.” She paused and looked at the closed curtain. “I’m afraid your Dr. Corley is going to have to learn that lesson.”

Three weeks later, Dr. William Corley’s chickens came home to roost. Rich Aberman terminated his employment with the group, and Corley was gone. We never saw him again in the ER. Rich told me he was somewhere in Oklahoma but wasn’t practicing medicine.

Months later, Rich was seeing one of his patients in the ER and told me he had recently talked with Bill Corley.

“Robert, he sounded like a completely different person. He’s joined an internal-medicine group and seems to be completely happy. And he said something that almost knocked me down. He said he was really
enjoying
his patients. Can you believe that?”

I
could
believe it, after recently bumping into Brenda Mayes during a concert at Winthrop University. Mattie was at home recuperating from her pneumonia, and her daughter and I had a chance to talk about that Sunday morning in the ER.

“God bless Momma.” Brenda shook her head and glanced at the distant ceiling. “She just sat there and smiled while that doctor went on and on.
I
was the one getting upset—but I suppose you saw that. I couldn’t
speak, I was so mad. When he finally stopped yelling at us, Momma motioned for him to come close to her stretcher and she whispered something. I had to strain to hear, but I did. She told him that to walk with the Lord, to really get to know him, you have to be humble. A proud man has only himself for company, and that’s a long and lonely journey. Then she looked him right in the eye and said, ‘Doctor, I hope your journey isn’t lonely.’ He didn’t say another word—just walked out of the room.”

“
Enjoying
his patients,” Rich repeated. “Can you believe it? What do you suppose got into him?”

Yes, I
did
believe it. And it wasn’t
what—
it was
Who.

T
HE
Miracle
OF
…C
OINCIDENCE

Coincidence is the word we use when we can’t see the levers and pulleys.

E
MMA
B
ULL
(1954–)

Expect the Unexpected

There, right in front of me, was the answer. But it wasn’t what I expected.

Toby Meyers, a precocious, active three-year-old boy, had been brought to the ER by his mother. For the past week or so he had been coughing, running high temps, and occasionally wheezing. No history of asthma and no medical problems. Prior to this, he had been the picture of health and, I’m sure, quite a handful.

“We took him to a clinic down at the beach last weekend,” his mother had explained. “Same thing—cough, fever. They told us he had bronchitis and to take this.” She reached into her oversized purse and took out a bottle of liquid medicine with pink smears down its side. Amoxicillin. “He’s no better, and still coughs a lot. Mainly at night.”

Toby looked up at me, smiled, and coughed twice. “See?” he said, then coughed twice more.

His temperature was 102.2 and I heard noises on the right side of his chest. If he had had bronchitis last weekend, there was a good chance it was now pneumonia.

“We need to get an X-ray of his chest,” I told his mother. “Just to be sure it’s not pneumonia.”

“What’s ‘moanya’?” he asked, looking first at his mother and then at me.

“Don’t worry, Toby. I’m sure Dr. Lesslie is going to get you feeling better.”

Now, here before me on the view box, was the answer. Toby did in fact have a right-sided pneumonia. But there was something else on the X-ray. Somewhere in his right lower lobe was a small, round metallic object—the size of a BB. It was just above the pneumonia, and would explain why the infection had developed in a perfectly healthy child. This wouldn’t be a simple “change up the medicine and get well in a couple of days.” Whatever this was would need to come out.

I walked back into his room and held up the X-ray for his mother to see.

“What is that?” she asked, immediately pointing to the round object.

“It looks like a BB to me,” I explained. “Any chance he could have been playing with some and gotten them into his mouth?”

“A BB?” She spun around and stared at her son. “Toby, have you been playing with some BBs? Did you swallow one?”

Toby’s face flushed and he looked at his mother and then at me. “No, I didn’t play with any BBs,” he muttered. His head dropped to his chest and his eyes found the floor. “Johnny, he made me do it. He dared me to eat some of them, and I…I’m sorry, Momma.”

It turned out that Johnny was Toby’s older brother. Mystery solved. I explained to their mother what would need to happen and walked out of the room and over to the nurses’ station. Jason Wood, the other ER doc on duty with me that day, was standing there writing on a chart.

He glanced over as I dropped Toby’s X-ray onto the countertop.

“What you got there?” He picked up the film and held it up to a ceiling light. “Wow, what do you think that is, other than a pneumonia?”

“Looks like a BB to me.” Amy Connors was sitting behind the counter, straining her neck to see the film. She leaned back in her chair and looked at me. “Whatcha think? Did the kid aspirate a BB? Or did he get shot?”

“A BB!” Jason pointed at the foreign body. “You’re right, Amy. That’s what it looks like.”

I told them Toby’s story, and of my surprise when I saw the X-ray.

“You just never know, Robert,” Jason said. “It’s like Amy always says, you gotta expect the unexpected in the ER.”

He dropped the X-ray back on the counter and slid his chart back in front of him. With pen poised in midair he looked over at me and said, “That reminds me of a patient I saw during my residency.”

“Oh boy, here we go.” Amy shook her head and shuffled the stack of papers on her desk. “Another one of your tall tales I bet.” Jason was known to tell some stories, all of which he swore were true. “And I bet it’s gonna start with ‘It was a dark and stormy night…’ ”

Jason looked down at the secretary and smiled. “As a matter of fact, it
was
a dark and stormy night. I was a resident at Charlotte Memorial, and Dirk Trueblood—I’ll never forget his name—came walking into the ER.”

It was a little after midnight, and the triage nurse led the twenty-eight-year-old Dirk into one of the treatment rooms. She walked over to the nurses’ station and handed the chart to Jason. “Fell over a chair and thinks he cracked some ribs. Pretty sore, but he looks okay.”

Jason walked into the exam room and pulled up a chair. “So, you think you might have broken some ribs. Tell me what happened.”

Dirk Trueblood proceeded to explain the reason for his late-night visit to the ER. He was putting his young boy to bed, flipped off the light, slipped on a carpet, and fell over a wooden chair. The chair back had caught him on his right chest and knocked the breath out of him. His lungs sounded okay, but he was really tender over his right ribs and was already starting to bruise. Jason sent him around to radiology for some X-rays of his chest.

It was an hour later when the tech brought Dirk back to the department. Without a word, she dropped his films on the counter and disappeared.

“Would you look at that,” Jason muttered to himself, peering closely at the X-rays now on the view box. “How in the world…”

Dirk didn’t have any obvious fractured ribs, and his underlying lung looked okay. But there was something else there. Something unexpected.

Jason walked back into the exam room and over to Mr. Trueblood. “Have you ever had any chest problems before, or been in some kind of altercation?”

“Altercation? What do you mean?”

“A fight, or some kind of assault.”

Dirk scratched his chin and stared at the tiled floor. He shook his head, then suddenly dropped his hand and looked up at Jason. “About five years ago, I was brought in here with a cut on my arm.” He rolled up his right arm sleeve, revealing a jagged ten-inch scar. “Somebody here stitched me up, but I don’t remember very much. I had been at a friend’s and probably had too much to drink. It was the next morning, when I sobered up, that I realized what had happened.” He rolled his sleeve down and shook his head. “I was a little wilder back then.”

“Anything else happen that night? Or have you had any other occasions when you…had too much to drink and got hurt?”

“No, that was it. Why?”

“Well, something is showing up on your X-ray, and—Have you had any neck problems? Any pain or maybe some numbness in your arm or hand?”

Dirk reached up and rubbed the back of his neck. “No. No neck pain. But now that you mention it, I’ve had some numbness in these two fingers for a couple of weeks.” He held up his left hand and pointed to his long and ring fingers. “Seems to be getting worse. But what does that have to do with my neck?”

Jason walked around behind him and examined the back of his neck, just below his hairline.

There it was. A faint, thin scar, about three quarters of an inch long. He pressed down on the scar and the area around it. “Does that hurt, Mr. Trueblood?”

“No, it doesn’t hurt, Doc. But when you press down, I can feel that numbness in my fingers. Weird.” He shook his hand a couple of times then looked up at Jason. “What does that mean?”

“Let’s go look at your X-rays.”