It was the week before and....

Magical Times of Christmas

It was one week before Christmas when I stepped through the ambulance bay doors into the ER for the night shift. The room was decorated in that sort of tacky ER Christmas style. Someone had blown up some rubber gloves and painted on them with markers to fashion them into a group of malformed reindeer. Ribbons and garland were draped across things that really should not be decorated, such as the shelf that holds the emesis basins, urinals and bedpans…not really festive thoughts come to mind with those items. Yet it brought a warm feeling of love for my coworkers and made me merry and bright!

After a couple of steps into the room, just before I reached the door to the break room, I heard a scream. While it is not unusual to hear screams in the ER, this one startled me. One of our male nurses was wheeling in a patient who had blood running down his face and pouring onto his bright green elf costume. His hair was dark in color but I could see immediately it was matted heavily in blood. The scream had come from his lady friend who accompanied him and stood, wringing her hands, at his bedside the entire time he was there. We offered her a chair but the big wings she was wearing presented a problem when she sat in the straight chairs we had available and she seemed opposed to removing them. It was sad to see someone dressed as an angel, looking beautiful but weeping and fearful. Though her angel costume was very sexy looking, not too angelic, she was a sight to behold.

I have to admit, at this time the elf looked like something out of a horror movie.

It turns out they had been at a festive party with people from all walks of like, including local politicians. I am a believer in live and let live. I do observe things though and I have seen over the years that some people cannot just have a glass of wine or a drink. Some go overboard to the point they lose control;  reaching a place of no return and then misbehaving. This elf was one of them. Some people just should not drink. Everyone knows at least one person who fits that description, I know several. I did not know this elf nor his lovely friend. He admitted his temper goes out of control when he drinks. He said and he did some things at the party he should not have and another person hit him over the head with a beer bottle. It was quite a crack that had been created right across the very top of his head and it gaped open revealing a bloody mess that oozed out in every direction. It was a sobering experience for him.

The blinking lights on the sad, sparse, bent up Christmas tree in the center of our workstation somehow kept reminding me it was a joyous time of the year. I love Christmas like a child loves candy.

The elf had a concussion and required many stitches to close that wound. I hope the next morning when everything was clearer to him, he realized drinking is not his niche in life. Sobriety should be his choice in the future, but who knows what he will decide. I must say the elf costume that he wore was wonderful, even down to the green turned up toes on his elf shoes. There was a bell sewn on the turned up toe of each shoe and every time he moved, the bell would ding.

It made me think of the Christmas movie “It’s a Wonderful Life”…”Every time a bell rings an angel gets his wings”. So all night I would smile each time he moved his elf foot and I heard the bell ring. In my mind many many angels got their wings that night. I just love elves, even drunk ones with busted heads.

There was an elderly male patient who lay on a nearby gurney. He was on oxygen as he lay only a few feet away from our elf patient. He seemed annoyed at first with all the ruckus and noise. But after he saw things were going to be ok, it seemed to relax him and he began to smile. I could tell he probably had not seen many grown men dressed as elves and was very amused by it all. He could not seem to take his eyes off that elf. 

As the night passed, I came to realize, it was not the elf he was looking at but the sexy angel with her bare legs and ample cleavage. She stood next to the elf, between his gurney and the one the old man occupied.  She was standing very close to this elderly patient and would occasionally turn and smile at him. The wings she wore were beautiful.

To this day I am not sure if the elderly patient was ogling a beautiful woman dressed as a sexy angel or if he perhaps thought this angel had come from heaven to get him. Either way he was in a zen moment for hours, dozing off now and then. When his eyes popped open he was once again a happy man staring at this angel.

The moment I realized what he was staring at and why he was smiling so big, my eyes and the old man’s eyes locked up and he and I smiled a knowing smile that was priceless. He was busted but quite happy with his care in the ER!

Christmas, it is a wonderful, magical time…even in the Emergency Room. 

Merry Christmas!

Why I love Christmas...

A tiny, sparsely decorated tree stood in the corner near the door. It had a slight lean like a ship that was listing at sea, not sure whether to remain afloat or give up the fight and go under. The first time I laid eyes on that tree when I came into work that night I knew that I had finally seen a real Charlie Brown tree. Also, someone had strung silver shiny garland around the work station and up the poles that support the ceiling just above it. It was officially Christmastime in the ER.

Christmas is so close I could reach out and touch it! This story is of a time when I worked in the Emergency Room of a local hospital and the people and cases that walked, or were rolled through those doors.

One thing I learned when I worked my first Christmas season in the emergency room was that it is NOT a joyous time in everyone’s lives. From patients and from fellow employees I realized that for some it is a deeply lonely and sad time. For them Christmas brings back horrendous memories of great pain and emptiness. 

Thankfully for most it is a time of great memories.

I remember a little girl about 4 years old that was brought in a couple days before Christmas. She was in a Christmas Pageant at her church and she wore a beautiful green satin dress with lace and a peter-pan collar. It had a huge bow that tied in the back and a matching bow was attached to her beautiful black hair; though at this point it had loosened its grip and was about to let go and slide right out of her hair. We learned that her brother, who was 6, had accidentally slammed the car door on her hand as she entered their car to head home after her performance. She looked to be in great pain, yet she forced a sweet little smile when I looked at her. As I approached her bed she said, “Brent didn’t mean to do it, it was an accident!” I thought it was sweet that she felt the need to exonerate her brother of any blame. She had a small laceration and a cracked bone in one of her fingers, some bruising too. It was overall a good outcome. As they carried her out she turned to me and said, “Merry Christmas!”

This was a brave and compassionate child.

Later a man came through our doors, led by a nurse and screaming obscenities. He was very intoxicated. He exclaimed he hated Christmas and everything about it. “The only way to make it through all of the Christmas Bull-S*#t, is to stay drunk!” he said. I watched as he was rude to all those around him and continued to push everyone away.  A police officer had accompanied him to the ER and now stood by the gurney where he sat. I could see blood oozing through a wrapping on his hand. He was a perfect example to show people not to play with your gun while you are drinking alcohol. Somehow he was not aware his gun was loaded and accidentally shot off one of his fingers, then fought with his family when they tried to get him in for medical care. He was a mess; his clothes had spatters of blood and his face even had a spot or two. The more everyone worked to calm him, the more combative he became.

It was a busy night and my attention strayed from him as I worked on my computer. The night slowed by 2:00am and I thought about the angry, drunk man, who was now in recovery. Surgery had cleaned up the nub where his finger had been and stopped the bleeding. A friend of mine worked in recovery and around 6 she came by as she was heading home. I asked about the man with the finger and she stopped to talk about him. Somehow when he sobered, he turned into a decent guy. She talked to him at length about Christmas and learned that he had terrible memories as a child, especially at Christmas when others were joyous and opening presents and being visited by Santa. He yearned for those things as a child. I suppose his pain had turned to anger and to drinking. She told me she believes he is a good guy with a good heart but he hides that part of himself this time of year.

It is so true that we do not know what others around us have in their hearts or what they have walked through in life. Since that time when I see someone angry, drunk or unreasonable I tell myself they are hurting. I envision a child who is hurt or mistreated as I look at them and my view is kinder. I am aware there are people who are just plain mean without anything to blame, but this man was not one of those people.

We are complicated creatures and we each handle disappointment in our own way. I don't think it is our place to judge others. The older I get the more I understand why I love Christmas so much!

She said "Dern, I'm dead!"

The day had been rough and I was scheduled for the night shift at the ER, and I knew there would be no opportunity for me to nap. I also knew there would be lots of coffee drinking that night as I managed to stay awake all day dealing with problems and then working all night in a busy ER on what is normally the busiest of all nights.

I walked in feeling great, my inner voice encouraging my outer spirit that it was going to be a piece of cake.

It wasn’t bad at all. We had some horrendous cases come in, so there was rushed times and then some people who came with silly little issues, one man even came because he cut himself shaving. It hardly even required a bandaid. 

Things settled down and there came a lull unlike any I had witnessed since I started working in the ER. We were down to only 3 patients and they were all settled in for the night. So one of the male nurses who is computer savvy pulled up a program that was created by experts in the medical and psychiatric fields. This program was a predictor of sorts, it predicted a person's death date. It required truthful answers to a series of questions about things like, your age, weight, family status, any illnesses you experienced and it even questioned your attitude towards things. The attitude part was just to determine whether we were more positive or negative when it came to life in general. After about 30 minutes, most of us had taken the test and received our answer.

Once this nurse typed our data and hit the enter key, it would calculate it all, then come back with our Date Of Death.

It was pretty daunting and downright creepy but all of us were so into it and we would laugh at the dates. Overall, so far, we were all pleased with our dates. 

There was a nurse who worked that shift and I had worked many shifts with her before. I would say that she was probably the most negative thinking person I had ever met. She would even complain when the pharmaceutical reps would cater in wonderful meals for our shift. I even heard her say one time, “That was just too much food, the whole catering thing is ridiculous!” Who complains about free food? Especially from an excellent restaurant that seasons their food to perfection. One night we spoke of her and no one could ever remember hearing her say anything nice or upbeat.

Well this nurse had watched and listened as we gave our truthful answers to the nurse in charge that was inputting our data. Yet she had not participated. Some in the group began working on her and encouraging her to join in the fun. I did not think that she would ever agree but after some strong persuasion, she did. 

As we all gathered around that computer screen, I was just certain that she would never admit to being so negative about everything. But she surprised us all as she saw herself exactly the same as we saw her.

All of the data was input and we stood there silent and anxious waiting for the computer to process this and tell us how long this very negative person would live. I remember standing there hoping the ambulance phone would not ring, and no other disturbances would interfere with our fun before we got this answer.

“Bing”, the answer came up and we all stood there stone faced and shocked! Then all of us began laughing uncontrollably. According to this computer program, she was already dead! It gave a date that had passed 6 months before!

She laughed and we laughed. Then we all laughed again.

She regained her composure, stood up,  then said “I told y'all that I felt like I was dead and a zombie most days…well there’s your proof!” She walked off muttering, “Dern, I’m dead”…

For me it was a great shift and I was happy to be alive!

Poor Choices

It was shocking to see all of that blood. I know it was the ER but still some sights are hard to take and harder to forget. This man’s hair was matted with blood and one eye looked like it had been ripped from the socket. He had blood coming out of one ear and his clothing was covered.

Sometimes things are not nearly as serious as they appear, but I had a feeling that was not the case with this guy. For the sake of this story I will call him Jim.

As Jim's nurse and a couple of others rushed to his side, and Dr. S seemed unsure where to start (which never happens), I knew this would be a case I would remember forever. I noticed a beautiful lady near his bed who had fear covering her face. She seemed lost. I decided she was this patient’s girlfriend. I got her settled into a more private waiting room (we often called it the grief room); I notified the doctor where she was in case they needed to speak to her.

As I stepped into the the Emergency Room that night I could sense the tension in the room. Some shifts are like that. A lot of that has to do with which doctors are on duty and the rest of the staff as well. The patients that walk in or are rolled in, also play a big factor in the tension. All shifts have an ebb and flow about them so I knew that things would relax and then build again as the night progressed. This case was the center of our focus for quite a while.

Meanwhile, a large lady dressed in a big moo-moo type outfit was wheeled in by her daughter. She had fallen on the steps that led to her porch and twisted her ankle. It did look very swollen and some bruising was already visible. Once she was settled into her bed and the doctor saw her, she was whisked off to our radiology department for some X-rays. The daughter remained next to her bed in a small chair. Her eyes darted around the room in amazement. We had many patients at that time and most of them seemed to need attention. Once things slowed a bit, and while her mother was still in X-ray, this lady asked me what happened to the man with all the blood. She had been in the waiting room when he was wheeled in there. I explained that we can’t discuss our patients out of respect for privacy. She said she knows the girl who wheeled him in; they went to high school together. She added, “I doubt she would remember me, but she was a cheerleader and very popular so I remember her well, her name is Jessica, and that is her brother, Jim. He was always in trouble and had even gotten kicked out of school.”

I just gave an awkward smile and said, her mom would be back soon from X-ray. She grabbed my left wrist when I turned to walk away and said that someone in the waiting room, that came with them, said Jim had been seeing a married woman and the husband caught them and beat Jim up. He managed to get away and called his sister who picked him up. I wriggled my wrist free, smiled, said “thanks” and walked over to an elderly lady who was standing at the desk with a lost look on her face.

So, I made an assumption that she was his  girlfriend, when in fact, she was a sister to our bloody, brooding patient. He had a couple of gashes in his head that had to be sewn up, they were so large that all of his hair had to be shaved to gain access to the wounds. He had a severe concussion. Two of his fingers were broken, along with 3 ribs. He had lots of bruising on his face and his upper lip was swollen so much that it distorted his face. Jim had to be admitted to the hospital and his sister remained at his side.

Much later in the shift, Dr. S said that Jim would only say he fell. Knowing that these injuries looked more like a beating, he was questioned further; but that was his story and he was sticking to it.

We all make bad decisions in this life, some worse than others. As I drove home that night, I thought of the sister who was so concerned and I figured that was probably not her first time to be worried about her brother. I thought of the brother and how his decisions had brought him so much pain. I thought of the wife that had been caught with him and wondered was she safe or maybe at another hospital or perhaps no longer alive. My  mind was bouncing around in the mess that was caused by this man and the price he was paying along with the misery he had caused for others involved. I hope he healed well and learned his lesson. We all make mistakes but lessons should be learned to avoid the same pitfalls returning. I was happy he had survived, mostly for his sister’s sake, I could see the pain and frustration in her face.

My shift was over and I was headed home thinking of how we all are free to live our lives as we choose and we sometimes make poor choices.

She had Lovely Bones

She came in screaming in pain, and from the large bandage on her hand, blood fiercely dripped; it was like something out of a horror movie. Of course I had heard screaming often at work and I had seen blood, spit, vomit, urine, fecal matter, anything you could imagine over the years. This time it was unique to me because this woman’s voice touched every nerve in my body and made me want to turn and run with all the strength I had left.

Once she was settled into the gurney in the laceration area of our ER, you would have thought her extreme anxiety would subside or at least diminish. It did not. There was no calming her down.  She was in her early twenties, but it was hard to tell her age; due to the sheer anguish, her face was so squished up from pain that I would have guessed much older. When the bandage was removed and I saw her hand, I was amazed. I knew from the amount of blood loss that it would be rough, but never expected the depth of her injury.

As the story unfolded we learned that she was a bit head-strong and independent minded. Her father nor brother were available to help her with this project she wanted and she had grown impatient about it. Both of the males in her family that had always been there for her in the past, were tied up with work projects and other responsibilities. So she decided, “I will do it myself”.  She had watched them work with this giant table saw in her daddy’s shop, so she had a really good idea about how it worked. 

She took out her tape measure and made the marks where she needed it cut. Then she lifted the wood up and positioned it. Now the blade was turning and she was in business. She started her wood through the blade, everything was going great. Her confidence was through the roof. 

Moments later she was screaming in agony as her hand got into the blade and that blade made a deep tearing slice into her beautiful hand. 

Her mother got her hand wrapped and they headed our way. They only lived a few minutes from our hospital.

She was taken to surgery for repair of her injury. The saw blade had made its way through two of the metacarpal bones in her left hand and scraped on the third.  I could see the pain on her father’s face as he watched his little girl suffer and felt bad that he had not been home to help her.

The bottom line is that she turned out fine. The surgery went well. There was healing and then physical therapy for a long period of time after that, but she was fine.

The lesson from her experience: Patience is Virtue

She had no patience and she paid a big price for it.

I too have been impatient at times and stubbornly took matters into my own hands as this patient had done. I took the chance and things went well, her results turned out differently. This is the chance we take when we take risks without thinking the situation through thoroughly. In the long run I do believe she learned a valuable lesson and that makes it all worthwhile in my book.

                                                                                            

Sometimes you must FIGHT for your life...

I remember that day when I first saw Evelyn. She looked so afraid of everything around her, those blue eyes of hers were darting around like a lamb surrounded by a pack of hungry wolves. I had just walked up to the computer to clock in for the night shift in the ER and something caught my eye…there she was staring at me, then scanning the entire room, then back at me. It was a bit creepy. Once I had a couple of conversations with her, I felt so much pain just oozing from her that she took a piece of my heart and she still holds it today. The pain ran much deeper than physical, though that was enormous, the emotional scarring was devastating.

Evelyn was a young woman who was repeatedly beaten badly by her husband. She returned to our ER several more times when I happened to be on duty and each time my heart was touched by her sad and lonely soul. Evelyn lived in fear and had virtually no one to protect her, not even herself. She lived deep in the back roads of Wilmer and it was miles from a neighbor or paved road. She knew she would be returning to that hell on earth when she left our facility, so she claimed she took another bad fall. According to her, she was a klutz beyond any klutz I had ever known before or since. She, “fell out the door” or “fell down the concrete steps outside”, “tripped over the dog”, “turned too fast and hit her head on the cabinet door”…..it seems that falling was a part of her routine. 

I only got a quick glimpse of her husband as he dropped her off at the ER door each time and left. Though she told of her latest accident in great detail, everyone at her bedside knew it was not true. The physicians had all tried to council her on the availability of help for women in her situation. I could see that she wanted to reach out for help but she was far too afraid. Survival was what she clung to, the pain had become a part of her.

The first time I saw her, she had a black eye, multiple bruises, and a couple of cracked ribs that made breathing painful and labored. It always hurt me to see her as she ducked her head and stared at the floor in defeat. How can you help someone who does not want help and stubbornly denies your offers of help? Evelyn would not even admit help was needed.

I just wanted to grab her and shake some sense into her, but I knew that would not be appropriate nor effective.

In all I saw her 4 times in the ER, but my co-workers said she came in quite a few more times when I was not on duty. Evelyn abruptly quit coming in; this made us all wonder about her and her safety.  One night when things slowed down and we grabbed a cup of coffee, and began to talk; someone brought up her name. We all came to the realization that we had not seen her for several months. We thought perhaps they moved away, or she ran away. Perhaps he killed her and buried her in the yard. All sorts of possible scenarios were bounced back and forth in our conversation. None were a good ending to a bad situation. I hope that Evelyn escaped and is safe and happy somewhere that he can’t find her. Yet my gut tells me that is not the case. 

We all face adversities in life, some greater than others. Evelyn was beaten down by a man, she was beaten down by fear and heartbreak and she did not possess the strength to fight, so she chose to do nothing and hope for survival. Oh how I wish I could have convinced her that this was not the best tactic and she deserved so much more from life. Oh how I wish I could have convinced her to FIGHT for her life.

Joe Cain Day in the ER

It was a Sunday evening and I had just arrived in the ER to begin my shift when I heard the commotion out in the waiting room. It was Joe Cain Day during the Mardi Gras season in Mobile and some people tend to celebrate a little too much. A group of these partiers, who were having a great time a few hours earlier had arrived at our ER for help and they were now sobering a little bit while becoming disagreeable a whole bunch.

Joe Cain Day is known as the “The day for the common man” during Mardi Gras. People of all walks of life enter floats and sign up to march in groups and they form their own version of Mardi Gras. It is often one of the most exciting days of the celebration and is always scheduled on the Sunday just prior to Fat Tuesday. It turns out that a group of brothers and their friends made themselves a fabulous float and after working on it for half of a year they were ready to party like there was no tomorrow. Their partying and drinking began early that morning, so by the time they were loading onto this wonderful float, some could hardly stand up, life had become one big blur for them.  They had music blaring loud from the speakers on their float and things began with smiles and great anticipation of being in their very first parade!

Off they went, the crowds were waving and screaming “Throw me something!” “Moonpies mister!” So two of the brothers, Jack and Ian got into an argument over a bag of throws that lay at their feet between them. Both believed the bag was theirs and there was just no compromising to be had. After about a mile along the parade route, the verbal fight began, by the 2nd mile they could no longer contain themselves and the punches began to fly. They both ended up falling completely off the float onto the street below.

A couple of friends in the crowd loaded them up and came straight to our ER. They passed two other hospitals along the way but they preferred our facility. Neither had life-threatening injuries. Jack looked to be in the worst shape of the two. He had a large gash on his face and a broken right elbow. He ended up with 15 stitches in his face and surgery to repair the elbow. Ian was badly bruised in several places and he broke his left foot and a couple of toes, it was believed by him that their float’s back wheel had run over his foot. He too went to surgery.

When their wives arrived at the hospital they looked very concerned, yet they were extremely angry at the guys for being so foolish.

We received several Mardi Gras victims that evening but most were there due to extreme over drinking. They drank to the point of possible serious consequences. They had to be charcoaled to reduce the effects to their body. The charcoal grabs the alcohol or drugs that are not yet digested and carries it out of the body quickly to avoid any additional harmful effects. They were all very sick, retching and crying. Possibly they were questioning the decision to over drink? Who knows.

I wonder if the next day any of these partiers said,”Man, we had a great time!” Every single one of them at some point in time while they were there said they had no idea of what happened or how they  arrived at the hospital. They had large blank spots in their memory of the events that took place.

Is memory loss the new definition of…having a great time?

I enjoy the parades and festivities of Mardi Gras but I can see the dangers of over drinking to the point that you have no control and no memory, how could that be fun? I am happy to report that all of our Mardi Gras patients survived to enjoy another day. There is nothing wrong with having fun and everyone must decide what that means to them.