For Tuyet, Katrina, KaSandra, and Luc
my inspiration
"GABRIEL'S PROMISE"
San Pedro,
California, November 24, 2002
Bits of molten steel
spattered, spurt, and rained down all around me as I worked repairing some
minor hull damage to the “The Lavender
Mist." Registered out of Singapore
Dealing with his
bellyaching and non stop vomiting didn't bother me as much as the knot in my
own stomach that was telling me forebodingly I should be more concerned than I
was. Why’s this healthy child suddenly so sick anyway? The poor kid was miserable,
up all night, a peaceful sleep denied until the wee hours of the morning. Michelle
and I talked for an hour afterwards, racking our brains trying to self
diagnosis our son. Gabriel had always been healthy, fit as a fiddle, but lately
he seemed to be coming down with one bug after another. It was beginning to get
on my nerves. I had even called my Dad around 3am to pick his brain. But all my
sleepy father could offer was 'growing
pains'. "Leave him be son, he’ll be fine in a few days.” I was so
fatigued that I eagerly accepted that as plausible and went to bed hoping to
grab at least a couple hours sleep before going to work.
It wasn’t even noon and I
was already physically, mentally, and emotionally drained, not a good thing
given the type of work I do. I'd learned this craft during two hitches with the
United States Navy. It was a vocation I'd been prepped for from an early age by
my father the merchant seaman. Papa started planning my path after catching his
six-year old son driving sixteen-penny nails into Mama's dining room table with
a hammer in each hand, or so the story
goes anyway. I should mention that while this feat of natural ambidexterity
had impressed him to no end, Mama was not quite as pleased with my abilities.
In fact, that little stunt nearly cost me my chances to see the age of seven!
Suffice to say I learned some colorful new French words that day, the kind of
words that would earn me several soap sandwiches during my formative years.
My eyes followed the halo
surrounding the brilliant blue tip of the torch, as I put the finishing touches
on the seam attaching the half-inch thick steel patch to the freighter's
rusting hull. Patching this beast was like putting lipstick on a pig, but that
wasn't my call, so long as long as their check cleared. As soon as I reached
the end I gently pushed away from the mammoth vessel and closed the valve on
the torch head, shutting off the flow of oxyacetylene. The spattering debris
and cloud of bubbles disappeared quickly, and I was once again silently
treading water beneath the big freighter. I kicked at the water surrounding me,
my legs scissoring slowly and surveyed my handiwork with the critical eye of a master
craftsman, and then prepared to return to the surface. I reattached the torch
to my weight belt and reached up just below the faceplate of my dive helmet
depressing the squelch button on the communicator to contact my support crew
topside.
“Hey Sandy Sandy
“Dude, it’s about time, I was getting
ready to send Roundy down to check on ya…over,” came the reply.
“Now why would you send ‘bulkhead’ down here man?”
“Would you check on Michelangelo just
because he worked through lunch…over?”
“Har-dee-har-har,
very funny Rembrandt, I take it you welded yourself another masterpiece…over.”
“Roger that! I really should
autograph this stuff…over.”
“You’re
a piece of work Patzoid!”
“Come on, haul your gear and your ass topside before the old man
starts giving me shit cause you’re not here to give it to…over!”
“Don’t get your panties in a bunch Nancy
“No foolin Patrick, we got a rudder
to fix before quitting time.”
“And if I’m late for supper one more
time this week Laura will divorce me…over!”
“Alas, poor Yorick…”
“Shakespeare is wasted on me fool, I
never read any of that crap! Just start making your way to the surface before I
give the oxygen reel a spin and yank you up here myself, and I ain’t kidding
Pat, so move it…over!”
“Oh, one more thing, stop calling Roundy
‘bulkhead’, you know that just sets
him off…over.”
“Alright already, I’m coming, I’m
coming!”
“I’ll lay off Roundy too, happy…over?”
“Roger that goofball, I’m freaking
ecstatic, now shake a leg…over!”
“Seriously though, Roundy's head is the
size of a small planet, that thing should have its own moon, for real's…over!”
“Cut the comedy and make like a squid
and jet dude…over and out!” I didn’t
bother with a snappy reply, chuckling as I leisurely made for the surface.
Sandy
Lucci was not someone to push too far into a corner, a lesson I'd learned the
hard way several years earlier. The two of us had met in Honolulu
where I had been stationed during my first hitch, working the dry docks in Pearl Harbor . Sandy Dallas class submarine landed him in Hawaii Sandy
It was a good thing that
my mom was 1200 miles and half an ocean away or Sandy
might have wound up sleeping with the fishes which is exactly where Sandy would have ended up if he had put that beating on me
in San Pedro instead of a strip club in Honolulu Sandy Sandy
County
Trauma Center… Los Angels, November 24, 2002…10am
Rounds
generally sucked whenever Dr. Wilhelm Doenitz, also known covertly amongst the
rank and file as ‘Dr. Villi’ or ‘the Commandant’, was presiding. Trying
to stay in the middle of the pack and remain as invisible a possible, Lizzie Andrews
clutched her notebook close to her chest and avoided making eye contact with the
pontificating internist. It would have worked too if she had not already
established herself as his favorite whipping girl. Somehow, in only two short
weeks, she had managed to discover every raw nerve the poor man had, and then proceeded
to stomp one or two of them at every opportunity.
“Dr. Andrews?”
“Please come forward young lady, I can hardly see you hunkering down like that,” Dr. Doenitz requested tiredly.
“Yes sir, sorry sir,” Lizzie replied as the small pack separated to let her pass through to the front of the group. She glanced at the others as she made her way forward, giving them the stink eye in retaliation to the sarcastic grins on their faces.
“Miss Andrews, my apologies, Dr. Andrews. Reluctantly I am required
to address you thusly since you managed to graduate from that social club the
State of California insists on calling a University,” began her tormentor, rudely
chopping her alma mater UCLA.
“So, DOCTOR Andrews, as we can all plainly see, this unfortunate young man’s left leg has compound fractures of both the tibia and fibula bones.”
“Of course as you can see our crack
team of paramedics, or EMT’s (emergency mayhem
technicians), have done their usual bang up job and managed to exacerbate
this poor lad’s woes by immobilizing the limb with a crude field splint,
thereby adding undue stress to the wound, and inhibiting a proper healing blood
flow.”
“In addition, an apparent over generous dose of morphine has rendered our patient unable to be of much assistance in ascertaining what other injuries he may have suffered in the process of breaking two of his favorite bones,” ranted the Commandant.
Doctor Doenitz flipped
back the sheet that covered the patient and pointed to the ghastly injury and made
a mental note of those who swooned when stepping in for a closer look. Those
weaklings would be the ones that he’d give the least attention to on future
rounds. He was not surprised to see Elizabeth Andrews was not among that group.
She was always the most curious and fearless. He had a good feeling about her
which was why he rode her harder than the others, she had rea potential. Lizzie
studied the protruding bones; she wasn’t affected much by the graphic display
of the meaty carnage. After all, she had made
her bones so to speak in the ER. This was nothing new, she had seen as much
and worse. Lizzie was more affected by her disgust with herself, for letting
this bald headed toad of a man continually get the best of her. She was
confident she knew the correct response to any question he was likely to ask,
but she also knew that the rat bastard would never give her the opportunity to
show him up in front of the group either! He'd cut her off in mid-sentence,
dismiss her nonchalantly, and call upon someone else. That just mashed Lizzie’s
beans every time! And each time it happened she'd swear it was the last time.
She was unconsciously daydreaming of marching up to Human Resources and the
Head of the Department to file a formal complaint.
“That would fix your wagon,” she muttered, as he prepared to cut her off.
“Well sir, if I had been out there I would have…”
“Miss Andrews, I did not ask for a fairy tale, just the facts if you please!”
“Yes sir, I was just saying that if…”
Dr. Doenitz sighed heavily and raised his arm to look at his wristwatch, “Nice try Miss Andrews, but we’re running late.”
“For the sake of expediency why don’t we ask someone who has an actual clue, shall we?” he said sarcastically, surveying the group for a suitable suck-up to complete today’s humiliation of Dr. “Wimpy” Andrews, would-be-physician at large.
Lizzie bit her tongue as
Dr. So & So rattled off a
textbook response to the Commandant's question, covering operational field
procedure, diagnosis, and suggested meds. Dr. Doenitz finished it off with a
classic retort.
“Well done Dr. So & So, perhaps
you can spare a few moments to tutor our less prepared young doctors? I’m certain
Dr. Andrews would appreciate the support.”
That was just the cherry
on the cake of Lizzie’s day! For a split second she wrestled with either
socking Doenitz in the beezer or running to the bathroom to cry! She knew which
solution her Dad would suggest, but she still had a year on this rotation and
she had to keep her eyes on the prize. Instead she resolved to just let it
slide like water off a ducks back. She was going to have a good day, she'd
promised herself that earlier this morning. If neighbor Bill, couldn’t send her
to ‘tears-ville’ than neither would
this jackass! Lizzie just stared him down until he flinched, caught off guard
by her sudden moxie. Dr. Doenitz cleared his throat then pushed through the small
group heading to the next victim/patient. Lizzie smiled as he walked by her, shamefully
proud of herself, and enjoyed her little victory in their battle of wills, then
followed after him. She glanced at the clock over the nurse's station, it read
12:30pm, and rounds were nearly over. She would relax; maybe grab a sandwich
with Yvonne and Denise from the ‘preemie’ unit. That was where she
wanted to end up after her third year.
She had spent some time
there as an RN and was hooked the first time she held one of the little ‘joeys’.
That was the term everyone on the ward used for the tiny prematurely born
infants, because they just reminded you of kangaroo babies. Not that the
preemie’s looked like kangaroos, but because they seemed to exhibit the same
strength, spirit, and determination to survive, so small in a world so big. The
row of incubators sort of protected the preemies from the big bad world much
like mother kangaroo did with her pouch. Lizzie marveled at the way the mothers
watched over their babies, cooing and humming to them, reading to them, talking
to them as if they could understand each and every word.
“Alright ladies and gentlemen, that’s all I can take for today. Let’s break for lunch and get on with the rest of the day,” announced Dr. Doenitz as he dismissed the group and returned his brand new Parker ballpoint pen to his smock pocket. The small group disbanded as quickly as a jailbreak, everyone headed in different directions.
“Hey Lizzie, want to run over to
“Thanks guys, but I’m going to stay
in and study, maybe eat my sandwich in the cafeteria,” Lizzie replied
apologetically.
“Suit yourself! I hope we don’t wind up reading your chart on tomorrow’s rounds!” Danielle hollered from over her shoulder as she took Jeff’s arm and walked down the hall toward the exit. Lizzie waved as they disappeared down the corridor and turned to head for the hospital cafeteria. She nearly collided with a woman rushing into the ER carrying a whimpering child. There was blood all over the front of the woman’s blouse; the child’s face was buried in her bosom.
“WHOA!” Lizzie yelped, side stepping
the hard charging woman, nearly tripping over her own big feet in the process.
Recovering quickly, she grabbed onto the woman’s arm as she attempted to pass
her and gave it a gentle tug.
“Hold on a minute, what seems to be the problem?” she asked calmly, trying to make eye contact with the woman and reduce the level of panic on her face. The young woman lifted the child slightly, readjusting her grip. As she did so, the child’s face rolled away from her chest and Lizzie could see that the little boy had quite a nosebleed going.
“My son’s nose won’t stop bleeding! I’ve tried everything, direct pressure, ice, I even held him upside down for a while, none of that helped, it wouldn’t stop! What’s wrong with him? Help me!” the woman pleaded hysterically.
“Take it easy, take it easy, you’re in the right place, we’ll fix him up, just calm down, OK,” Lizzie replied, trying her best to sound confidently reassuring.
“Ernesto, bring that gurney over here and help me get this kid onto it. Then take them to trauma 3, rapido dude, rapido!” Lizzie shouted to a nearby orderly. The young man hustled over with the bed on wheels and helped Lizzie and the mother place the little boy onto it. Lizzie slid up the rail on one side while Ernesto did likewise with the other and then the two of them wheeled the gurney swiftly into trauma 3, closing the curtain around them. The curtain slid open again immediately as an ER nurse popped in to see what was happening.
“You’ll need an attending before you
do anything Lizzie, you know that right?” Nurse Haley asked rhetorically,
unsure of Lizzie’s intent.
“Yeah, yeah, I know Marjorie, who
hasn’t gone to lunch already?”“Umm, Dr. Wallace right next door looking over that compound fracture in T1. I think he’s waiting for the new orthopedic guy, what’s his name, Phillips maybe, to come down stairs,” Marjorie replied quickly. There was a short pregnant pause and then, “You want me to go get him?” she added.
“Duh…yeah!”
“I’ll just go and get Dr. Wallace now,” Marjorie said meekly, slowly backing away, closing the curtain behind her.
“Thanks Marjorie, you’re a peach!” Lizzie shouted after her.
Placing
her hand underneath the boy’s neck, Lizzie gently rolled his head back forcing
the chin up in an effort to slow the rate at which the blood was flowing. She
reached over to the cart beside the gurney and grabbed a sterile towel from the
top drawer and pressed it to the boy’s face, pinching his nostrils shut and
applying pressure as gently as possible. “It’s OK honey, I won’t hurt you,” she
said softly and soothingly to the frightened child.
“I told you I already tried that,”
the mother said in frustration.“You mean just this time or when did he start having nose bleed all together?”
“Let’s keep it manageable for now. How long has he been bleeding at this rate today?” Lizzie asked rolling her eyes, grateful that her back was to the woman.
“It was only a little drip about an hour ago, just a drop or two really. I sat beside him at the kitchen table with a warm washcloth while I made him a peanut butter and banana sandwich, his favorite. It stopped for a few minutes while he ate, but when he went to take a drink of cold milk he choked and then there was blood everywhere!” the mother exclaimed, her voice rising sharply as she finished her sentence.
“What do you mean he choked? Did the blood come from his mouth or his nose? Lizzie asked.
“Has that ever happened before?” Lizzie pressed.
“Not the coughing up blood part, but yes, he’s had problem nose bleeds before.”
“How many times, roughly?”
“I don’t know, ten, maybe twelve in the last month or so.”
“Why, is that important?”
”Has he been seen by a doctor?”
“Of course he has!” the mother replied defensively.
“No offense ma’am, I was only asking,” Lizzie replied apologetically. She looked over her shoulder, partly to see if Dr. Wallace was coming and partly to make sure Dr. Willie wasn’t within earshot to witness her botching the bedside manner drill.
“What exactly did the doctor say when he treated your son for the other nose bleeds? I mean did he give you any sort of diagnosis?” Lizzie asked, changing hands on the towel to relieve the cramping in her fingers.
“He said it could be a number of things, that’s why they took so much blood and ran so many tests. He said it would be a few days before we knew anything specific,” the mother answered, chewing on her thumbnail as she watched Lizzie work.
“Actually, my husband and I were up with Gabriel most of the night. He was complaining his tummy hurt, as well as his legs and eyes? We were kind of hoping that Patrick’s father was right about it just being growing pains,” she added with a weak smile.
She
hoped that Lizzie might agree and send them home with a sucker and nothing to
worry about. She watched Lizzie gently examine her son, and she was grateful
that she had run into a female doctor this time. The male doctors Gabriel had
seen so far were all too clinical, they made Gabriel nervous, and he cried with
each of them. Michelle noticed that Gabriel held onto this doctor’s hand as she
pressed the towel to his face. She actually felt this young woman’s
concentration and calmness. There were no tears running down Gabby's cheeks, he
was quiet as a church mouse. His breathing was slow and even, he might just as
well have been resting in her own arms, Michelle was very grateful for that.
Lizzie was about to speak when the curtain slid open again and Dr. Adam Wallace
walked in briskly. The tall, dark haired attending resident looked on for a
moment before speaking, respecting Lizzie’s position as having arrived on the
scene first.
“So, what have we here?” he asked
politely, his tone firm, yet soft and soothing at the same time.“He’s six, Gabriel turned six years-old July 27th,” the mother offered up, sensing that Lizzie could use a little help.
“Right, uh, thank you,” Lizzie replied, giving Michelle a thank you smile.
“OK, male, age six years,” said Dr. Wallace.
“Arrived approximately fifteen minutes ago, bleeding profusely from each nostril.”
“The mother says that he has been bleeding at this rate for approximately forty to forty-five minutes.”
“I was about to order CBC, match type and cross match when you walked in, this kid is definitely a quart or two low,” Lizzie said, rattling off the facts like she had been taught, except for the harmless quip at the end of course.
“Yes sir, Elizabeth Andrews, first year.”
“Nice to meet you Liz, here, let’s have a look,” said Dr. Wallace, stepping in to join the exam from the opposite side of the gurney.
“How ya doin champ?” he asked softly, gently wiping a new tear from the boy’s face.
“You must be a baseball player, right? You look like a baseball player to me. Bet you want to be a Dodger when you grow up!” Dr. Wallace said, making small talk while he moved Gabriel’s hair away from his face and shined a pen light back and forth across his eyes, checking the pupil’s reaction and dilation.
“No way, I wanna be a Yankee,” Gabriel said weakly, speaking for the first time since arriving at the hospital.
“Really, like Derek Jeter I bet!” Dr. Wallace replied, returning the pen light to his coat pocket. He observed the pallor of the child’s skin while an RN prepared to draw blood for the tests Lizzie had ordered.
“Yes sir, Derek Jeter, he’s the captain and he’s my Daddy’s favorite player too!” Gabriel added, a grin spreading across his blood stained face.
“I KNOW, ME TOO!” DR. Wallace exclaimed, smiling and winking down at Gabriel.
“OK sport, nurse Marjorie here is going to get a little blood from your arm so we can test it and see what’s going on with all of these nose bleeds you’ve been getting." "Don’t worry though, I’m going to stand right here beside you and make sure she does it right! Here, you can go ahead and pinch me as hard as you want if she hurts you at all, OK? But I know a big guy like you isn’t afraid of any old needle, right!”
Gabriel
nodded, his grin fading slightly at the prospect of a needle prick. But Dr.
Wallace had happened upon just the right tactic to gain his confidence, the
very same approach that his Dad used at home. As nurse Marjorie inserted the
needle Gabriel pinched down on the good doctor’s forearm as hard as he could.
Dr. Wallace winced slightly and looked over at the little boy’s mother.
“Quite a grip on the little guy,” he
said, winking at everyone around the gurney. Lizzie put her hand up to her
mouth, stifling a giggle.
Doctor
Wallace slapped a cold pack onto the counter behind him and the wrapped it in a
clean sterile towel from the top drawer from the cart beside him. He leaned
over and placed it across the bridge
of Gabriel
“OK Gabe, just keep your head back
and breathe through your mouth while this ice pack does its job, OK?”“Ok.”
“Try not to sniffle or breathe through your nose at all.”
“If you feel some fluid gather in your throat just swallow.”
“This will be over in a just few minutes, I promise.”
“I’m going to go talk to your Mom for a couple of minutes, okay? Dr. Andrews will stay here with you, won't you doctor?”
“Of course, Gabriel and me are pals now,” answered Lizzie.
Dr.
Wallace took the mother by the arm and led her a few feet away, just out of hearing
range. Lizzie took Gabriel’s hand in
hers and gently stroked the back of it. She looked down at the little boy, only
his eyes and chin were visible from under the big towel resting on his face,
but the gleam in his eyes indicated to her that he was smiling. She was glad
for that, because she sensed this was only the beginning of a long ordeal.
Gabriel's symptoms supported a small list of possible diagnosis, and none of
them were trivial. She peered over at Michelle and Dr. Wallace. The woman’s
back was to her, but Lizzie could see that Dr. Wallace was likely telling her
exactly what Lizzie was thinking, and by the mother’s sudden change in posture
it was registering. She knew it for sure when Dr. Wallace glanced her way, it
was written all over his face.
Lizzie
looked away; suddenly sorry she had passed on that taco lunch with Danielle and
Jeff. Sometimes this job puffed you up like a helium balloon, especially when
you dealt with life’s high water marks, like the birth of a baby, or rescuing
someone from death’s door. And sometimes it left you empty, especially when you
dealt with life’s disappointments, this being one of them. By her count in her
short career, the lows are leading the highs. Sometimes she wondered what led
her down this road. She looked down at Gabriel who he staring up at her, his
eyes full of trust and hope.
“This is why,” she muttered, combing the
boy’s damp hair with her fingers.“This is why…”
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