Lynne Marshall

A &E Affairs


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      “You ride off into the night on a Harley with a hunk, and don’t have anything to report? You’re more messed up than I thought.”

      “Knock it off. It was just a ride home. You deserted me, and I was stuck with Beck. That’s all.”

      Carmen stopped, arms akimbo. She let out an exasperated sigh. “What flaw did you find this time?”

      Jan nailed her with a glare. “He rides a chopper.”

      Carmen rolled her eyes. “Oh, great. So here we go with another lame excuse from the queen of brush-offs. What was wrong with the last guy you went out with? Oh, yeah, his teeth were too white.” She shook her head in a slow, wide swing.

      “That guy’s teeth were practically fluorescent, Carmen. I couldn’t look him in the face without needing sunglasses.”

      Carmen worked to conceal the crack of a smile. She moved closer and lowered her voice. “Beck is different. You’ve got to admit, he’s a real find. A keeper,” she sang. “Why not give him a chance?”

      Jan drew a deep breath and adjusted her glasses. “Look. I admit he’s a hunk, but let’s face it. He’s out of my league.” She gave a pleading puppy-dog glance. “You don’t want to be responsible for my broken heart, do you?”

      Carmen slumped her shoulders. “You’re impossible. Someday you’re going to realize what you’ve missed out on and regret it.” Carmen couldn’t possibly know what a home run she’d hit with that bit of wisdom. She raised her hands in defeat. “OK. I give up. I’ll butt out.”

      Knowing Carmen as she did, Jan knew the woman had no intention of butting out. At least Jan had bought herself some time to figure out a strategy of her own on how to deal with the Beck situation.

      She spun around and headed toward the triage station. Thankfully tonight it was her turn to assess patients and assign their priority in order of their illness’s severity instead of at what time they showed up at the ER. If she played things right, she could possibly avoid Beck the entire shift.

      Before she reached her station, Beck appeared at the front desk. Her heart rocked with an unwanted reaction. He looked clean-shaven, and if it were possible, his hair was even shorter. He wore his dark police uniform like a new-age knight, a tall, broad-shouldered, noble public servant. To protect and serve.

      Not fair.

      When he noticed Jan and quickly looked away, she almost wished things could be normal between them instead of strained. Then she made a beeline for the triage door.

      Patients arrived in clumps. Eight different maladies rushed the front desk within five minutes of each other, and Jan worked her way through the problems in order of severity. The chest pain first, the child with the asthma attack next, the skateboard accident with a potential fracture third. The frequent-flyer migraine and the infected lip piercing would have to wait a bit longer. The rectal pain, “microscopic bugs under the skin,” and the new-onset fever and cough would most likely have a two-to three-hour wait before seeing an emergency doctor tonight.

      Three hours into the busy Sunday evening shift, a car sped into the red zone directly in front of the emergency entrance. A skinny teenage boy frantically rushed inside.

      “I need help,” he called to the desk clerk. “My girlfriend just had a seizure.”

      Jan heard him and rushed to the wheelchair storage area, thankful their stock hadn’t been depleted, grabbed one and wheeled it to the curb. A lethargic redhaired girl drowsily lifted her head from the front seat of the car.

      “You’re going to be OK. You’re at the hospital now,” Jan reassured her as she assisted the doe-eyed, freckle-faced girl into the wheelchair.

      “What happened?” Jan asked as they re-entered the hospital.

      The boy jumped in. “We were, like, just talking, and she got this strange look on her face and then, dude, she started shaking. She even foamed at the mouth.”

      Sluggish, but coming round, the girl was able to give her name, Cassie, and answer the question of where she thought she was. She was a bit foggy on what time it was. While Jan settled her, she asked more questions. Cassie knew the day’s date and her birthday. She was only sixteen. Her parents would need to be contacted as her condition wasn’t life-threatening.

      “Have you had any physical trauma lately? A fall? Bump your head?”

      Cassie shook her head. Her vital signs, including her temperature, were normal, with the exception of a rapid heartbeat.

      “Take any drugs recently?”

      The boyfriend stepped back and got quiet.

      “No,” Cassie stated.

      “Any alcohol today?”

      Again she shook her head. Jan hadn’t smelled anything obvious either.

      “Been sick lately? Have you been getting enough sleep?”

      “No and yeah.”

      “Show how many fingers I’m holding up.”

      The girl mimicked three digits. A quick head and face exam proved to be normal. A tap test of reflexes in all four extremities was also unremarkable.

      “Tell me what happened.”

      “I dunno. I, like, had this weird feeling and then I was like…here.”

      “We’ll admit you to the emergency ward for a thorough neurological examination, but your parents need to consent before we can do anything.”

      The attending boy’s eyebrows rose and he edged closer to the triage room door.

      Cassie lazily nodded her head. “OK,” she said.

      Jan didn’t want to risk putting Cassie back in the waiting room where she’d go unobserved, so she called the ED ward clerk and secured a bed. She also initiated standard protocol orders for the patient—monitor, IV and oxygen—prior to being examined by a doctor.

      Jan wheeled Cassie to the ER entry, tapped in the code and waited for the doors to open.

      “Look,” the boy said, with a skittish glance. “I gotta go. Cass, I’ll call you later, OK?”

      For the first time during her ER visit Cassie looked alert. “Why?”

      “I just gotta. Your parents are coming and all, so that’s cool. Look. I’ll call ya. OK?” He squeezed her shoulder and took off.

      Cassie got sullen and slumped in the wheelchair. “Whatever,” she said under her breath.

      As Jan rolled the girl past the doctor and nurses’station, Carmen indicated room five was vacant. Jan nodded and proceeded toward the room, but on her way made a stop at the linen cart for a few extra bath blankets.

      When they arrived in the room, she handed Cassie a hospital gown and pulled the curtain for privacy. The tall teen turned her back to Jan and removed baggy jeans and a loose shirt. Jan padded the bedside rails with the extra blankets as part of the seizure protocol for patient safety. When Cassie had changed, she assisted her into the bed, applied oxygen, blood pressure and oxygen sat monitor and secured the bedrail.

      “Was that guy your boyfriend?” Jan asked casually, pretending to be busy with putting the girl’s belongings into a large plastic ER patient bag.

      Cassie harrumphed. “Used to be.” She folded her arms across her chest and stared at the ceiling.

      Before starting an IV, Jan placed the personal items bag under the gurney. About to ask if Cassie was sexually active, she noticed the bed shaking. She glanced up to find Cassie rigid, staring at the ceiling with her jaw locked and hands fisted, her legs stiff and straight. The tonic phase of a seizure.

      “I need help in room five,” she called out, not leaving the bedside.

      Cassie had moved