Gnab

Gloria Brancusi had had days before when she really regretted having chosen nursing as a career, but this looked like it was going to top all of them. She swerved to a stop to avoid an oncoming wheelchair and glared at the gigantic leather-clad biker who was steering it. "Please, Mr. Hogg, you're going to have to wait in the corridor until we've got a chance to take a look at you."

"This foot hurts, lady," the hirsute giant growled impatiently. "When you gonna get me something for the pain?"

"A doctor has to see you first," she told him for the fifth time. "And all the doctors are busy with people who are hurt worse than you are."

"I been waitin' an hour," he roared. "And I don't want to wait no more, see?"

"Well, we'll just have to take a look then," a familiar voice said from behind her shoulder. Gloria gave a little sigh of relief; Jackpot Jackson was just the right person to get rid of Hogg.

"Mr. Hogg, this is Dr. Jackson. Maybe he can take a quick look at your foot while I get this place cleaned up." Gloria smiled appeasingly and started working.

Jackpot looked surprised at the mess in the treatment room; "Do you want us to move to another room, Gloria?"

"No, I've gotten the worst of it up," she said. "Just work on this side over here."

"What happened?" Jackpot asked as he helped Hogg up onto the gurney.

"Heart patient with a frantic family. Gonzo just took him up to CCU." Gloria told him.

Jackpot started to unwind the crude bandages on the man's ankle and realized that he had left his bandage scissors in the last treatment room. "Gloria, could you bring me some scissors?" he asked, as he started to palpate the swelling gently.

"Yes, Dr. Jackson," Gloria sighed again, this time with resignation. She'd finish cleaning up once she'd gotten rid of both of them. She pulled some scissors out of one of the drawers and brought it over.

"This doesn't look very bad," Jackpot said, bent over the ankle. "How did you hurt it?"

As soon as Gloria got within range, Hogg suddenly reached out and grabbed her, pulling her up against him with his left arm and producing a small gun in his right hand. Gloria made a surprised squeak, and Jackpot looked up, distracted by the movement and then froze when he saw the gun, dismayed.

"You listen Doc. That foot's bad. Real bad. You're going to go and get me three cases of morphine and some clean syringes, you got it? And you're not going to alert that cop in the corridor, or else this Barbie doll will be your next patient."

"Are you crazy?" Jackpot exclaimed.

"You heard me!" Hogg growled. Jackpot stood up, very carefully, and holding his hands where they could be seen. "You don't understand," he protested. "They won't give me that much morphine. It's against the rules."

"You're a doctor, they'll give you anything you ask for."

"I'm a resident," Jackpot said, his forehead lined with worry. "There's no way anyone's going to give me that much morphine. Residents are barely considered competent to take blood pressures."

"Shut up, and do as your told," the shout made Jackpot flinch, and Gloria, who was beginning to feel a little less shocked, thought maybe she should try to help.

"He's right," she started to say, and then gasped when Hogg hit her across the face with the gun.

"You shut up too," he ordered.

"Now just one minute," Jackpot said, stepping forward, and then pausing when the gun was trained on him.

Just then, the door opened and Stanley Riverside II walked in, frowning at a set of x-rays. "Jackpot, did you order an angiogram on Mrs. Horstedder?"

Hogg swung the gun up toward Stanley and tightened his finger on the trigger. Jackpot shouted, "No!" and leaped forward to try to grab the gun arm. There was a loud noise, and Gloria found herself jarred free when Hogg started to wrestle with Jackpot for control of the gun.

She was knocked to the ground, and scrambled for safety, toward Stanley, who was still looking a little stunned as he clung to the uncertain cover of the floor. "He's going to kill Jackpot!"

"Get security!" Stanley ordered, pulling himself up to a crouch. He grabbed the nearest thing to hand, an IV pole, and clubbed it like a baseball bat, but ducked when there was another shot.

Jackpot was still fighting for the gun, but Hogg had managed to get it between them. Jackpot stepped on the man's bare foot, and tried to defend himself with elbows, but he needed both hands to try to keep the gun from pointing at him, and Hogg was using his right hand to try to get a grip on Jackpot's throat. "Somebody help!" Jackpot yelled. He saw movement on the other side of the room and tugged the gun away from that direction. "Gloria! Get away! Get Security!"

Stanley had to wait for a moment when the combatants had turned. He didn't want to risk hitting Jackpot, and part of him couldn't believe he was going to hit anyone. But he couldn't think of a better plan. Time wasn't moving at the right speed. The gun went off again, and the bullet spanged off of the cabinets. Stanley flinched, but moved closer, still hearing the burring of the bullet in his imagination. He could see the fear on Jackpot's face, and the murderous rage on the gunman's, as the two men staggered into trays and carts, knocking things down, and knew he couldn't wait for the security teams to arrive. The wheeled end of the IV pole gleamed as it came down on the broad hairy head, and Stanley could hear the crack of bone blend into the bang of the gun going off one last time. Hogg went down, and Jackpot staggered back against the wall, his face almost comic with surprise and dismay.

Stanley tried to catch his breath as time began to snap back into normal sequence. He looked down at the man he'd hit and wondered if he'd killed him. That would be a hell of a thing for an emergency medical man to have done. "Oh, dear. Jackson, what were you treating this man for?" There was no response.

"Jackpot?" Stanley looked up just in time to see Jackpot start to slide down the wall, leaving a broad smear of blood behind him. He forgot about the patient. Forgot about the gun. Forgot about everything except catching Jackpot and getting him onto the treatment table. The door burst open and a security cop stuck his head in, gun ready. Behind the cop, Stanley could see Ernie, holding Gloria in the curve of her arm. "Shoop!" he yelled, so loud his vocal cords hurt. "Get McIntyre! And I want two trauma teams in here. Now! Jackpot's been shot!"

"Shot?" Jackpot whispered, staring at Stanley with bewilderment as the older man tried to get him to move his hands from the wound. "Is that why I can't breathe?" He was pallid from shock and beginning to tremble, and his pulse flickered wildly under Stanley's fingertips. "Easy, Jackpot, I've got you." Stanley tried to get his voice to come down to its normal register, but his own heart was pounding and his head was beginning to hurt as much as if he had been the one who had been hit with an IV pole. "Try not to talk."

"You're hurt," Jackpot said, a little more clearly, and made a weak effort to sit up.

Stanley gave up on trying to hook the oxygen tank closer with his foot and concentrated on trying to get a look at the wound. "I'm not hurt, you're hurt. Hold still!"

"I've got you, Jackpot," Ernie said, materializing at the head of the table.

"Oxygen!" Stanley ordered. "And I want six units of blood up here stat!"

There was too much blood, too much! A trickle of it was falling off of the table already, and it had hardly been two minutes! Stanley knew he had to control the bleeding, or Jackpot wouldn't stand a chance.

Near Stanley's feet, the security cop, who had retrieved the gun, was looking green. "Hey, Doc, I think this guy's starting to choke!"

Stanley s wore. He couldn't take the time to look. Jackpot was bleeding to death. Ernie had gotten the oxygen mask into place, but Jackpot's color was only getting worse.

"Here, help me turn him over," Stanley said. "There's got to be a major bleeder in there." They flipped Jackpot as quickly as they could and Stanley reached into the gore of the exit wound and found the source of the bright spurting blood -- an artery. Not severed, thank god, but nicked. He held the break closed with his fingers. "Hemostat!"

"I'm looking!" Ernie said, ignoring the scattered equipment in favor of the drawers. "I can't find one!" "Bring a suture kit and a trauma tray!" Trapper John ordered someone as he came in from the hall, trailing nurses. "What have you got, Stanley?"

"The aorta," Stanley said. "I've ordered six units of blood."

"Hey! This guy's dying!" the security cop insisted.

"Anderson, take a look at him! Someone get Titus in here and where the hell is Gates?"

"Cardiac care," Gloria said. "I'll get him."

"No, stay here and help me get these clothes out of the way," Ernie said, spotting a candy striper in the doorway. "Darlene, get Dr. Gates!"

"Yes, Mrs. Shoop!"

"Get a MAST suit in here!" Trapper ordered. "And where's that suture kit?"

"Here Doctor," one of the orderlies said, pushing in a cart full of sterile packs, "There's one on here."

"Blood pressure 40 over Doppler!" One of the nurses warned.

Trapper grabbed the rubber gloves Ernie had taken from the cart. "Clamp first, Ernie, and then four-oh silk on a curved needle. Stanley, don't move your fingers until I tell you to."

"Right," Stanley said, "His pulse is getting irregular, John."

"Somebody tell OR that we're coming! Have we got the blood yet?" Trapper yelled over his shoulder and then bent to the wound. "I'm going to suture the artery here, Ernie, and then we'll get him to OR for the rest of it. Tell x-ray we're going to need a fast chest shot, and I don't want to wait. Get security to clear a path." Even as he was talking, he was suturing, and Stanley could feel the needle tightening the hole under his fingers. "Okay, Stanley, ease up." Trapper did the last couple of stitches as quickly as he could, but still got blood sprayed on his glasses.

Gloria had cut away Jackpot's lab coat and shirt, and was helping get the MAST trousers on but it was awkward, because she had to step over the injured biker who was being examined by Dr. Titus. Her face was starting to hurt, and her stomach churned at the sight of Hogg, even unconscious, but she bit her lip and made herself concentrate on what she was doing. Titus was shouting orders, Trapper and Stanley were shouting orders, nurses were reporting vital signs and the security cop was trying to explain what had happened to Arnold Slocum and clear a path through the doorway at the same time. Someone brought in the blood and started a unit. Someone else had hooked Jackpot up to the EKG machine. She got the MAST trousers in place and started the pressure system.

"Yeah, Trapper," Gonzo Gates blew in through the door. "Where do you want me?"

"Go scrub, we'll be right behind you," Trapper ordered. "Stanley, get your head taken care of. Make a hole, everybody we're coming out!"

Gurney, IV rack, monitors and all, Trapper and Ernie and the orderlies headed out the door as fast as they could safely go. Gloria trailed along for a few feet, and found herself standing next to Stanley in the hallway. They stared after the gurney until it turned the corner to radiology and then turned, startled, when someone wailed with pain in the crowded corridor behind them.

Arnold was there, wringing his hands.

"This is terrible!" the administrator said. "Riverside, what happened?"

"I'm not sure," Stanley said, uncertainly, trying to look past him to see who was crying. It was the little girl who had come in with stomach pains. He tried to remember her name and couldn't. "The patient had a gun."

"He was holding me hostage," Gloria said. "And when Dr. Riverside came in he tried to kill him, but Jackpot grabbed his gun arm."

Stanley heard her with half an ear. He had stepped past Arnold to get a clearer view of the patients in the corridor. Half of them looked ready to run away, and the other half looked like they had tried to vanish into the walls. Only the little girl with the stomach pains was still wrapped up in the cocoon of her own pain. Stanley knew he was still a mess, but no one seemed to be paying attention to the patients, so he took a deep breath and tried to look calm. "The danger is over," he announced. "The gunman has been subdued, and it will just take us a few minutes to get everything cleaned up. I know several of you have had to wait a long time, and that this was a shock, but try to relax, and we'll get to you as soon as possible."

The stares he got were incredulous, but he could see shoulders dropping back to their normal position, and hands unclenching, so he figured it had helped a little. He turned back to Arnold. "Arnold, has anyone called the police yet?"

"Yes, yes, I think so. They should be on their way."

"Good." Stanley tried to think through the headache that was dancing on his skull. "We'll need some replacement doctors down here -- call anyone you can reach. And find out if any of the interns are upstairs. I know they're tired, but we'll need the bodies. Miss Brancusi?" Stanley turned to Gloria, who was leaning against the wall and nursing her swelling face. "Miss Brancusi, would you please take a minute to escort the patient in room three down to x-ray? And have them run a skull series on you, too. I'd like to make sure that you haven't got any serious damage there. Have you got an icepack?"

"I can get one," she said, and looked up at him. "Do you know you're bleeding?"

"I am?" Stanley said, but his fingertips found the sore place near his temple without hesitation. He looked at his hands and could barely tell where his own fresh blood left off and the gore from Jackson began. "Oh, dear. I'd better clean up after I call Mrs. Jackson. I can't examine patients in this state."

"You're going to keep working? With poor Jackpot in surgery?" Her eyes were wide with surprise as well as pain, and there were tearstains on her face.

Stanley looked around at the chaos of the corridor. "I have to, Miss Brancusi," he said, looking back to her. "There are people in pain, and no one else is available." He tried to think of something inspirational to say, something that would help her regain her professional composure. "I'm sorry."

She looked into his eyes as if she were seeing something there that she had never noticed before, and then took a deep breath. "Don't be sorry. You're right. We're needed." She gave him a crooked smile. "Patient in room three to radiology. Which series?"

"Lower abdominal," Stanley said. "And then take a minute to wash up, all right?"

"Right."

"Thank you, Miss Brancusi." Stanley turned to see where Arnold was, but the administrator had moved off to deal with the arriving cops. Good enough. Stanley went into treatment room one and washed up at the sink. He stuck a gauze patch over the graze on his head as best he could and then went to the linen closet to snag a clean labcoat before he went back to his office. There was a clean shirt in the closet and an unspattered tie in the drawer, and he put them on his desk before he went to dig out Jackson's emergency notification card. He pulled off the bloodstained coat and shirt and tie and put on the clean one before he sat down to dial. It was a Los Angeles number. Stanley buttoned up his shirt as he listened to the phone ring on the distant end. Maybe she wasn't...

"Hello?"

Now that he needed to talk, his throat closed on something like a sob.

"Is anyone there?" the voice at the other end said impatiently.

Stanley swallowed. "Umm, Uh. Is this Mrs. Jackson?"

"Yes, that's right." He could hear the question in her voice, but there was no fear or dismay yet. This was the worst part of Emergency medicine: blindsiding relations with news of disaster. Stanley had never gotten entirely used to it, but he knew he usually managed better than this.

"Ah... I'm... My name is Stanley Riverside the second. I'm Chief of Emergency Services at San Francisco Memorial Hospital," he said, taking refuge in ritual. "Oh, Dr. Riverside," she said, still unsuspecting. "JJ's mentioned you. What's up? He didn't try to pull a scam on you, did he? I swear, that boy's got more get-rich-quick schemes than anyone I know." Sometimes all Stanley had to do was say who he was, and the person on the other end would know, but some people, like Mrs. Jackson, needed to be told everything. On the whole, Stanley decided, he preferred clairvoyance.

"No, nothing like that," he said. "Not lately anyway. Mrs. Jackson, I'm sorry, but I'm calling to tell you that Jackpot's been seriously injured. He's in surgery." Get it out and get it over with, and hope she wouldn't faint.

"Injured?" she repeated, in a stunned voice. "JJ's been injured? Was it that car of his?"

"No, no, it wasn't a car accident. Do you have anyone who can drive you up here?"

"It's that bad? Oh, Lord, is he dying?" Stanley could hear her trying to keep herself in control.

"It's too soon to say," Stanley said. "But two of the best surgeons in the world are working on him as we speak. Listen, my wife has a lot of friends in Los Angeles, maybe one of them can drive you here."

"No, that's not necessary. I've got a neighbor who can drive. Thomas lives right next door. But it will take hours."

"So will the surgery," Stanley didn't know if it was tactful to say that or not. "Mrs. Jackson, your son was shot by a deranged patient, right here in our ER. We were able to get him into the operating room within fifteen minutes of the time it happened. That gives him an improved chance of surviving. You'd be astonished at what the human body can put up with and keep going."

"Do _you_ think that he's going to survive, Dr. Riverside?"

Stanley took a moment to think about it. This was too important for equivocation.

"Mrs. Jackson, I think that he _can_ survive. But I can't promise you that he _will_ survive. He was alive when he left ER and at that point it's out of my hands. But Dr. McIntyre and Dr. Gates can do wonders. I've seen them bring back patients with injuries that were far worse."

Nurse Andrews leaned in the door. "Doctor, we've got critical cases coming in."

"Mrs. Jackson, I have to go. Please, have your friend drive carefully. Bye."

"Goodbye," he heard her say as he hung up the phone.

"What is it, Miss Andrews?"

"Burns," she said shortly.

"Are they here yet?"

"On the way. I've notified the burn ward."

"Thank you." Stanley put his tie on and checked to make sure that he had transferred his stethoscope and otoscope to this labcoat. He had. Time to get his mind on the job at hand.

It was going to be hard to give each patient the time and attention they deserved. ER had been busy all night, with the fog causing accidents all over town, and the usual assortment of minor crises and hypochondriacs in attendance as well. And now he'd lost three of the five doctors who had been working -- four really, since Titus was still caught up with the gunman. Stanley sent a candystriper up to roust out any of the interns who might have crashed in the intern's lounge or the on-call room. He knew they were coming off of 18-hour shifts, but they were warm bodies. He'd lost treatment room two to the police investigation team, and that didn't help.

Neither did the undisguised jumpiness of the ER staff that remained.

From somewhere that Stanley had barely known existed, he found the right words to get Lee to straighten his shoulders, the right smile to reassure Brancusi when she came back with the x-rays, the right tone to take with the sleepy interns and the distraught relations. He saw how Andrews' steadiness worked on the other nurses, and he did his best to emulate it.

And something clicked.

Against all expectation or reason, it became one of the rare times when Stanley _knew_ beyond all doubt that he was where he was meant to be. It had happened before; there had been one glorious night during his internship; and there had been flashes of inspiration since, although the feeling had seldom persisted beyond a patient or two. And he had never had words to describe the thrill of diagnosis, or the pleasure of alleviating the pain and the fear. His father certainly didn't understand what had drawn him to Emergency work. He wasn't sure that EJ understood either, although she knew something of the satisfaction of healing. But most times Stanley knew that he saw his patients through filters of other concerns; the supply order, the work schedule, bad news from his stockbroker, or worries about the hospital's image or funding. He couldn't fathom why his attention wasn't divided now. But minor things had fallen away. He concentrated on each patient and made each diagnosis into a kind of a prayer for Jackson.

And then, suddenly, the corridor was clear of new patients. Stanley looked along it and saw nurses and orderlies blinking at each other as they came out of the whirl of work and found themselves bereft of the occupation that had saved them most of the night. Gloria Brancusi was at the desk, leaning on an ice pack. He remembered the hairline fracture of her cheekbone and went over.

"How do you feel?"

"I hurt," she answered with a shrug. "But it could be a lot worse. How is your head?"

Stanley hadn't thought about it much, but the reminder sent a fresh wave of pain through his skull. "It hurts," he said. "But it could be worse. Shouldn't you go home?" "Not until we hear about Jackpot." Gloria stacked up some charts. "It's better to stay busy."

"It was," Stanley agreed propping himself against the counter to ward off the exhaustion that he hadn't had time to notice before. "Didn't I see Fergusen here a little while ago?"

"Yes. Mr. Slocum called him." Gloria looked guilty. "That reminds me -- the police want us to meet with them in Mr. Slocum's office as soon as it's feasible."

"The police?" Stanley felt a knot growing in his throat. "What do they want with us?"

Gloria shrugged and made a face. "We were the only ones in the room with Jackpot and Hogg," she pointed out. Other staff people were drifting towards the desk now, their curiosity as plain as their worry. Stanley felt their eyes on his back.

"Hogg?" He knew his voice had gone up half an octave, but he couldn't help it -- the memory of the horrible sound of the IV pole hitting a man's skull had come back to him as clearly as if he were hearing it again. "Was that his name? Is he...I mean, how badly... uh..." Stanley couldn't put it into words for fear of making the worst of all possibilities real.

Gloria, who had been there, met his eyes sympathetically, but before she could frame the news into words, one of the candy stripers announced it, with the innocent relish of excitement in her voice. "He's in ICU, but I heard Dr. Titus say that he was as good as dead already."

Stanley fainted. **

Gloria saw the color flee from Stanley's face and tried to get up and around the counter, but she couldn't move fast enough. Not that any of the others caught him on the way down. They were still making surprised exclamations when she pushed her way through and crouched down to loosen Stanley's tie. The flutter of returning consciousness was there already, but he was still so pale he nearly matched his labcoat. He'd hit his head against the floor and dislodged the gauze pad, and she saw fresh red coming from the bullet graze. "Lee," she looked over to the nearest orderly, "go get a doctor. Darlene, get a basin. Has anyone got a blood pressure cuff?"

Someone produced one, and a stethoscope as well, as she worked off the labcoat. Stanley was starting to try to curl up into an unhappy ball, but Gloria kept going, talking to him to try to get past the shock. "Easy, Dr. Riverside. Easy. It's all right. I've got you."

He pushed away from her, protesting, "I feel sick," and only just managed to get to his knees before he started to throw up. She held his shoulders, and found herself unaccountably glad when some of the rubberneckers had to leap back to avoid getting their shoes soiled. Serve 'em right. But most of her concentration was on Stanley, who finished losing his supper and then leaned back against her, shaking so hard he had to hold on to her to keep from falling. "I'm sorry, Gloria. I'm sorry."

"It's all right," she told him again. "I don't mind." She smiled at him, trying to distract him a little. "Maybe you should have gotten a set of head films from x-ray too."

He shook all the harder. "That's not..." he began, but she interrupted him to look up at the lingering crowd.

"Come on, give us some room. You've all seen someone with a concussion before, haven't you?" She saw gratefully that Dr. Fergusen was coming down the corridor. With any luck, she could get Stanley into one of the examining rooms before he fell apart in front of the entire staff.

Fergusen knelt by Stanley and took a quick look before ordering a couple of the orderlies to get Stanley up onto the nearest gurney. "Is room one open?" he asked.

"It should be," Gloria said, getting a grip on Stanley's hand again as she started the gurney in the right direction. "Lee..."

The curly headed orderly nodded and helped push Stan into the examination room. Stanley didn't protest. He was shaking too hard to talk anyway, and the diagnostic part of his brain was forced to admit that his symptomology could very well indicate a mild concussion. Except for the horrible guilt. He closed his eyes against the tears that wouldn't stop, opening them only to let Fergusen check his pupil dilation; and made vague answers to the questions he was asked over the repetitive crunching of bone inside his head. Fergusen recommended a skull series, and a CAT scan, and told Gloria to get Stanley a room on the fourth floor for overnight observation. That penetrated through the misery when nothing else had. "No," Stanley said, opening his eyes to protest. "Please. I want to go home. I want EJ."

"I don't think you should try to drive, Stanley," Fergusen said, his forehead wrinkled with concern. "It wouldn't be fair to the other drivers."

"I'll call EJ," Gloria promised. "She can come here."

"But the baby..." Stanley saw the difficulty, even though he didn't want to.

"We'll grab a cot from pediatrics. No problem." Gloria gave him an understanding smile. "You wouldn't send someone else home with your symptoms, would you?"

"I guess not," Stanley admitted, and let Fergusen chivvy him into signing the release form. The first burst of miserable energy was past him now, and he submitted to being x-rayed and put to bed in a sort of daze.

Gloria stayed with him, except while he was in the CAT scanner, when she ducked into the next room to call EJ, and check with ICU. She wasn't any happier with the forlorn obedience than she had been with the fainting, but there wasn't a whole lot she could do except stand between Stanley and his would-be questioners long enough to give him a chance to regain his composure. back to my home page

This page hosted by Get your own Free Home Page