The ER Department was crazy. Not in the psychological sense, per se, but John Carter decided to stage a walk-out with a large portion of my staff following him out. His reason being: safety and security concerns. However, there were safety concerns of a different sort in here. Only myself, Dr. Susan Lewis, the new med student Erin Harkins, and a small handful of nurses were left to handle ten semi-critical to critical patients along with about a dozen patients in the waiting area. That, in my books, was an unsafe situation. If any of these patients were to die while the walkout continued, it would not be only my responsibility as Chief of Emergency Medicine, but also that of the physicians and nurses in charge of those patients.
I understood his concerns. I'd been working like crazy for the last two years with the hospital corporation and the security company to provide more security in the emergency department. I know that he feels this deeply, particularly in light of his assault and Lucy's death two years ago. So do I. I really liked Lucy and I felt she could do so much with her life, not only in medicine but with her life in general. He didn't know that it was Romano and I who cleaned her up after she died, or that I spent the most of that night vomiting just from the sheer violence of the situation. I can't forget the blood - so much. Too much. Lucy knew she was dying and by the time we knew that a pulmonary embolus had occurred, no amount of anti-embolic meds would have worked. I cried so much that night. I'd also been sickened when Mark had been attacked in our own bathroom years previous.
Yes, the ER has had its share of violent attacks. However, there was only so much I could do. At the moment, I was doing two jobs, since Romano was on light duty as Chief of Staff until he recovered from his injury. It's not like I asked for it. I'd made pleas to the hospital board for funding for security for the emergency department, but I was being stalled. The state government had yet again slashed the hospital department's operating budget. It didn't help that we were operating at almost 150% since two other area hospitals had closed due to budget cuts and reductions. John Carter was not making my job any easier. I actually liked him and thought he had reasonable leadership potential. This job walkout was just not the way to go about doing it.
I just stuck my head into the women's washroom for the third time since I got here this morning, hoping to get a quick break from the madness. But it wasn't long before I found myself in one of the stalls bent over the porcelain tank, brought up mostly bile - since I was sure I had nothing resembling food left in there. I'm sure that I'm pregnant. And the only appointment I could get with my gynecologist was cancelled. Sandy and I had talked about that for weeks. At first it was a bone of contention with her - not of planning a pregnancy itself, that was pretty much a go, she was excited. Her concern was that it would be too hard on me. Carrying a child to term and the effects on my hip. On more than one occasion, she'd had to massage the cramps out of my back, hip and legs after a difficult shift. And thered been more than one occasion that I thanked whatever gods are out there that she didn't up and leave - permanently, several months ago. I don't think I could have gone through that again. When we were first dating it took a while before I stopped comparing her with Kim Legaspi, my first female partner. I wasn't entirely sure what got into me when I asked Sandy out that first time. But I was glad she accepted. It wasn't like we hadn't had our rough spots, we had. And things had been going quite good since the spring. I fell in love - something I didn't think would happen again.
I thought about having kids before, several times actually. I'd always been good with children. Perhaps because of their innocence and desire to learn, their willingness to accept things, more so than adults. That desire for children culminated more in the past year. Perhaps it was seeing Mark and Elizabeth with their young daughter, Ella. Perhaps finally learning that my birth mother did not wish to have any contact strengthened a resolve to have a child of my own. But perhaps more telling was something Mark said to me on his last shift - "Don't let work become your life, Kerry." I'd gone home that night and curled up on the couch and cried. I was still in that same position when Sandy got home after her shift. And she held me and let me cry - again. She gently carried me up to our room and lay me on the bed. Silently we had gone through our nightly ablutions and climbed into bed. Sandy curled up behind me, and again held me. When Mark died, Sandy became an anchor of support for me, especially since work had become more and more strained. There were more than a few nights when I thought I'd lost everyone I'd ever loved. And Sandy just held me. Never once asking for anything more than I could give. I never thought I would miss Mark as much as I did. For all our disagreements in the last couple years, we had been colleagues, and perhaps even friends. During the summer time, we discussed having children. How we would do it, what planning we had to do, sperm donor clinics, and in vitro fertilization. We'd finally come to the agreement that I would carry the child, and she would donate the egg.
So, five and a half weeks later, there I was, stuck in a stall with morning sickness - never mind that it was 1600hrs. Whoever created that moniker, must either have not ever been pregnant, or had such an easy pregnancy that they were never sick morning, noon and night. Once the current set of heaves had passed, I pressed my head against the coolness of the stall walls. Gradually, I pick my crutch off the floor where it had fallen when the first of the nausea hit. The bathroom door opened and I could hear someone enter. I wished I could have stayed there in the stall and none would be the wiser, but the person had obviously come to look for me.
"Kerry, I need a hand. There's a MVA coming in, in a few minutes. Three casualties. One male with multiple head lacs and dislocated shoulder with possible abdominal injury, a female with broken ribs and possible pneumothorax, and a 10 month old child, non injured," Dr. Lewis called out. After not hearing anything for a moment, Susan inquired, "Kerry, are you all right?"
"Not particularly." I really loathed having to ask for assistance from my staff - at least with personal matters but that time, either I got assistance standing up - hoping that the nausea didn't make a repeat performance - or she wouldn't get a hand with the trauma. "I need a hand to stand up." I got a proper hold on the crutch, and with Susan's help managed to stand. After a few moments with no nausea, I nodded and walk over to the sink to splash some water on my face. I'd have to wait until I got to my locker to brush my teeth.
"Do you need a few more minutes?" Susan asked with her head slightly cocked to the side.
"Thanks, but I'm coming now." I settled my lab coat around me and headed out after Susan. "Have Dr. Corday come down for a surgical consult on the two injured. I want to know what we're in for. Also, what nurses are still in here?"
"Malik, Chuny, Yosh, Kathy, and Haleh."
Susan and I walked to the ambulance bay awaiting the arrival of our MVA patients. There were now four doctors out there and one med student and five RNs. Frustrating. I wished that I could get John to understand that the money for increased security had to come from somewhere - it didn't just exist ready to pull whenever it's needed. However, there wasn't much time to ruminate about the situation as the ambulance bus pulled up.
"What have we got here?" I asked.
Doris pulled out one stretcher first, with her partner bringing out the second after. "MVA. 33 year old male with mild head lacerations, likely dislocated shoulder and abdominal tenderness right upper quadrant. BP 130/90, Pulse 98, Resp 20. 28 year old female with at least a couple broken ribs and right pneumothorax. Left lung resp at 24 with increasing pain. O2 at 3L. BP 110/70, Pulse 88. And 10 month old daughter with slight redness where harness crossed over chest but not giving any sign of being sore - she was well belted into car seat." I sighed a little with relief that the child was not injured any worse. That was always the hardest - when children were injured.
As the stretchers made their way into the ER and into Trauma 1, I hadn't seen the porters bringing another patient down the hallway. Apparently they hadn't seen me either, so I got pinned between the two for a brief moment. But it was enough to cause me to go down to the floor in agony. The crutch slid back against a supply cart and I wasn't sure but my head may have hit the floor when I landed. *Damnit!*
As soon as the stretchers were into the Trauma room and Susan began working on the patients, two nurses in the ER had gotten me up onto a stretcher, despite my assurance that I would have been fine. It was a lie, but one I wanted to hold on to. My right hip hurt like hell, pelvic bones badly jarred, and abdomen was quite sore. Before I knew what had happened, Robert Romano had appeared out of nowhere and assessed me. If there had ever been a time to make an inappropriate comment it would have been then, but I didn't even have it in me to do that. I winced as he ran his good hand up my right hip and over the pelvic bones.
"Kerry, what have we got here?"
"I'm hurting like hell, Robert. But I'll be fine. I just need to stay put. Need some heat. And an ultrasound."
"No. I can't."
"And why not, Kerry. Your pelvis may well have broken."
"I'm pregnant, Robert."
"Great, a lesbian with a turkey baster, just what the world needs."
"Save the smart-ass remarks. I don't need them at the moment. And besides, they need some direction in Trauma 1 & 2. Get some of your medical staff down here to help."
"Where's Carter, Kovac and the rest of your staff?"
"Lewis is in Trauma 1. And one of our med students is in with her. Carter's staged a walkout since he's pissed at having decreased security measures in the ER, and half my staff are out there."
"You should fire the lot of them, Carter in particular."
"I can't afford to lose any more doctors; we're short on staff as it is. But I will make sure that he's disciplined. Now go."
Romano, with charts in hand, spun towards the trauma rooms. Meanwhile I lay on that damned stretcher while Haleh brought me a hot pack and placed it against my hip. I knew I wasn't going to be much use in my own ER, so I got Haleh to put me in one of the observation rooms and bring me in some charts and paperwork. If I could concentrate on it, it would be a miracle but I was going to try anyway. Maybe I could find a way to squeeze some more funds out of the ER operations budget for increased security. I also got Haleh to bring me in some Ibuprofen for the pain.
After half an hour of unsuccessfully trying to concentrate on charts, I decided that I could as much sit at home and do nothing as I could here. Now if only I could get someone in here to run the ultrasound so I can get out of here. I'd do it myself, except the ultrasound machine is in the next room, I was sore as hell and would probably land on my rear end. Not exactly something that would look good for the Chief of Emergency Medicine in her own department. Thankfully, Lydia walked by the room and I managed to get her attention.
"Lydia, could you see if there's anyone available to take an ultrasound on my pelvis - or at least bring in the machine. I'd like to get out of here. I'm not going to be much help around here anyway. I can see about straightening out the security concerns as easily enough from home."
"Dr. Weaver, is there anyone going to be home to help you?"
"Lydia, I'm a doctor, I can handle being at home on my own."
"With all due respect, Dr. Weaver, while you are a doctor, you are injured. Last time I heard, you have several steps to walk up to even get into your place. Why don't I bring in the machine and set it up and give you a hand. Then we're getting Doris to take you home by ambulance." Lydia gave me a look that I would have been fool to ignore, particularly on the last issue. Getting home on my own was not going to be pleasant at all, no matter how you looked at it. And I'd already checked at the fire station. Sandy was out on assignment. I'd left a message for her to check in as soon as she was able.
"Fine. Thank you." I lay my head back on the pillow and closed my eyes.
No broken bones in the pelvis but they were going to be seriously inflamed for quite some time. There were torn ligaments surrounding the hip joint. And there was no bleeding from the uterus. I released a breath I hadn't realised I was holding until I saw that the foetus was fine. Lydia discreetly left for a few moments and came back with a chart for me to sign-off on before Doris came around to take me home.
Two hours later, I was lying on the couch, with my back propped up against the armrest. I was trying to figure out the best possible way to figure out how to pay for increased security measures. It was going to cost a lot of money that we really didn't have to spare. Budget projections were spread out on my lap and started to give me a headache. There were few options to be had. Even if I took a cut in pay, there'd still be thousands of dollars to cover. Finally I decided that since John Carter wanted this bad enough to stage a walkout and looking for more leadership experience, I would give him that opportunity. Let him review the budget and make some decision on where to get the money for increased security measures. Give him a few options and give him that decision. I would still have to review that decision but it would be his to make. After another twenty minutes had passed, the headache had not gotten any better and I needed to take something more for the pain.
Gingerly I stood and winced as the pain ran up and down my leg from my hip. My crutch in hand, I walked toward the kitchen where I kept a supply of Ibuprofen. Stinky was attached at the side since he got back. One of the kids from the neighborhood came by a couple times a day to walk the dog. Several months since Stinky adopted me and I still hadn't changed his name. Perhaps it had just grown on me as much as he had. Sandy sure liked him. Played with him for hours on the floor just throwing balls down the hardwood floor. It had become a routine for both of them when she got off shift. If she pulled a double or was stuck at work late, he just sat by the front door and whined.
Thankfully the Ibuprofen was on the counter but the glasses were still in the cabinet. In reaching for a glass, I lost my balance and started to fall. Unfortunately for me, I misjudged my distance from the counter and hit the side of my head against the edge of it as I went down. That was the last thing I remembered until I woke up sometime later with a very worried ex-girlfriend standing over me and holding a compress to my head. I tried to sit up and I got really dizzy.
"Wow, Kerry. Just stay where you are. The ambulance is coming in a few minutes."
"What happened?" I tried to get my bearings but my focus was a bit off. Straight blonde hair. "Kim? What are you doing here? Why are you here?"
"First off, I think you fell. There's a broken glass over there, so I'm betting you were probably reaching for that when you went down. You hit your head. There was a fair bit of blood on the floor. Probably nicked a vein. Doesn't feel like there's any skull fracture but you're going to the ER to have it checked out and to have that cut sutured. There's an ambulance that should be here shortly. Secondly, as for what I'm doing here - I was in Chicago for a Psych Conference. I decided to bring back some stuff of yours that I still had. Closure, I think. I really didn't think you'd be home, Kerry. I still had your key. Needed to bring that back, too. When did you get a dog, Kerry?"
Still the same old Kim - could change topics in a blink of an eye. But I was actually glad to see her. Not for reasons some might expect. I held no notions that we would ever get back together, and had long since abandoned those notions. At the most I thought we might mend some fences and work towards being friends, again. As Kim said, gain some closure.
"Long story short - Stinky adopted me."
"He came in to the ER one day with his owner, an elderly, diabetic blind man. He stuck around Dr. Gallant, one of our med students - who happened to be allergic to him - for most of the shift. When the patient passed away during that shift, I was going to take him to the animal shelter when I left. I ended up taking him back here. He's stayed and made himself at home."
"Why's he whining at the front door?"
"He's waiting for Sandy to come home."
I was kind of hoping to ignore this bit of conversation. Actually, I hadn't even expected that I ever would have this conversation with Kim, after she left. "She's my partner."
"Oh." There was kind of a crest-fallen expression on Kim's face. "How long?"
"Almost a year, give or take. There was a few weeks where we'd split up, but we got back together." I smirked a little. Kim looked at me questioningly. Not really sure why I had told her that then, but small talk was never really one of my strong suits, and silence was overwhelmingly awkward. "Would you believe I asked her out, while I was suturing up her hand? We'd been out in the field during a storm. There were two ambulances out there and the fire department. There'd been a car accident - pregnant woman whose placenta had ruptured. En route, one of the ambulances was hit by a fallen electric pole and was hot. Sandy was the ranking firefighter at the scene. She kept telling me not to go anywhere near that ambulance until the power crews could cut power to the area. But the woman was bleeding badly, and the EMTs for that ambulance were injured and out of the rig. Someone had to help. That was me. So when she was attending to something else, I ran towards the rig and jumped in. Sandy was so furious with me that night. The next day she came by a couple times through the shift on paramedic duty. Finally she let me suture her hand up properly. And I asked her out." I finally stopped talking, realising that I had been babbling and that Kim probably didn't want to hear it.
"She smiled and agreed. Gods, I was so nervous. I helped save the woman's life and delivered the baby by emergency C-Section in the rig. The OR did the remainder of the repair once back at the hospital, but she and the baby would have died if I hadn't done something."
I suppose I was rather fortunate that the ambulance crew showed up at that moment. I ran out of things to say that would be comfortable for either of us. Perhaps sometime in the future. Doris opened the door and came in with a stretcher. I was about to argue that I was fine and could walk out before I remembered that I was in the predicament that I was, because my balance was off with walking since the accident earlier.
"Hey, Doctor Weaver. Long time, no see," Doris quipped. She also nodded at Kim.
"Funny, Doris. Just get me up on this damn thing."
Doris and her partner got me up on the stretcher and secured on there. Kim followed behind and got Stinky out of the way. She gave him a few doggy biscuits from the package on the kitchen counter. Once everyone had been settled in the ambulance and I gave Doris the rundown about what happened, Doris checked the wound, and applied a new bandage replacing the bloodied one. Vitals were checked after that and they ran through their checklist on the way to the emergency department. The call was radioed into the ER. The ambulance bay doors opened and we were ushered through. Abby and Susan met us at the door.
"Kerry? What happened?" Susan asked.
"Kim?" Abby asked. "What are you doing here?"
"I lost my balance in the kitchen and fell, hitting my head on the counter on the way down to the floor. Kim came by to drop off some things and found me there."
"I heard about what happened earlier with your hip. You okay?" Susan asked, concerned.
"Do I look okay?" I was kind of harsh. "Sorry. I'm sore and I'm tired. You didn't need that. Could you just get me some Ibuprofen. I was going for that when I fell."
"You don't want anything stronger? I'm sure you're probably in a lot more pain than you're alluding to." Abby noted the few grimaces I had made since I arrived. She didn't realise that half of the grimacing was due to the nausea I've felt. Though at this point, I wasn't sure if the nausea was due to the concussion or from the pregnancy. Quite likely from both.
"I shouldn't have anything stronger at the moment. Could you also get me an emesis basin, please?" My arm went over my stomach as a few more waves of nausea ran through me.
"Kerry?" Susan gently questioned my comment about the strength of medication.
"I'm going to be sick." I really didn't want Kim to find out right now about the pregnancy, and I saw that she wasn't particularly going to go anywhere until she knew I was going to be all right. An emesis basin was brought over and after a couple minutes of retching and nothing but fluid coming back, I lay back. That time, the grimacing was from pain. Next to me, Susan was setting up a suture tray.
"Do you think the nausea has abated for a bit? I'll give you an injection of Gravol if you'd like, then get you a couple Naprosyn," Susan queried.
"Kerry, have you had anything to eat at all this evening?" Abby asked, since there was nothing really of any substance brought up in the emesis.
"A sandwich and coffee several hours ago. All right. Gravol's fine."
"Okay. Abby will you get me 75mg of Gravol, and 500mg Naprosyn?" Susan had everything set up and cleaned, then placed the sterile suture sheet placed on my head. She'd put in the anaesthetic to numb the skin and was finally suturing. 12 stitches later, she was throwing out the disposable items, needle in the sharps container and placing the needle driver and scissors in the basin for sterilization. Some steri-strips were applied over the suturing and a couple of gauze bandages. During this, Kim had followed Abby out into the corridor. I couldn't tell what was happening out there.
Once I sat up, I could just see a few people in the hallway. One of which was barrelling her way towards the Observation room that I was in. Short stature, long, curly dark brown hair tied back. Firefighter's coat. Yep. Sandy had obviously found out what had happened. The door to the room opened up. In came Sandy, followed by Kim and Abby. Abby handed Susan the medication.
"Hey, Sandy. I'm glad you're here."
"Kerry, what happened?" She came up by the head of the bed, and gave me a kiss, not really caring that there were three other women in the room. For that matter, I couldn't have cared either. She was here. I had, however, heard a slight gasp from someone, fairly easily guessing it was Kim.
"You heard." Not really a question but she nodded slightly. "My Captain said you'd called earlier. Something about an accident. You injured your hip. When I got here tonight, I found out that you'd gone home, had a fall and hit your head. Did you have a concussion?"
"Essentially, yes, to all of that."
"I wish I could have been here sooner. Stuck at a fire across town in an abandoned building. We�d finally gotten things under control an hour ago. Our crew left after the next crew came in to finish the firefighting and check for any flare-ups. I came right over after hearing from the Cap. Who found you?"
"That would be me. Dr. Kim Legaspi."
"You're Kim?" Sandy looked at her and gritted her teeth a little, but not saying anything further.
"Yes. I came to drop off some things for Kerry and found her on the kitchen floor unconscious. Checked her out and called EMS."
"Thank you," Sandy replied.
"Kerry, do you want that Gravol now?" Susan asked, as she caught another grimace of nausea.
"Yes, please. Everyone but Susan and Sandy please get out. I prefer not bearing my rear end to a room full of people."
An injection of Gravol, and some Naprosyn later, I'm rather tired and quite ready to fall asleep. Susan wants to keep me overnight for observation, though I'm hesitant.
"Kerry, perhaps it's for the best. I've got tomorrow off. I'll go home and check on Stinky and take him for his walk then I'll be back." She gives me another kiss and looks down the hall. "So that's Kim Legaspi, your ex?"
"Yeah. That's her."
"Kinda cute, but not my type," Sandy quips. Susan just about choked behind us, obviously not expecting that. And actually I'd kind of had forgotten she was still in here.
"Oh hush. You know you've got me. Now are you really okay - everything?"
"Well, except for this whole morning sickness thing. The ultrasound showed that everything was okay.� I could feel my eyelids heavy with sleep, so Sandy gave me one final kiss before she mentioned she'd be back soon. When she opened the door to the room, I caught just a bare snippet of conversation from the hall.
"Well, well, well. If it isn't the lesbian psych doc returned from the great beyond. Heard you were out west somewhere. Your ex has got a new girl now...from my point of view, a lot hotter too." I could just imagine Romano posturing there in the hallway, trying to goad Kim.
Only to be followed by a rather succinct pause and then a low rumbling voice of Kim Legaspi. A sure-fire sign that she was pissed. "The only thing keeping me from ripping off your wad and shoving it down your throat is the knowledge that the male species is on its way to being extinct.'
Quiet. Followed by a very familiar laugh. The last words I heard from Sandy before I fell asleep were, "I think I actually like her."