Recoveries... a KnightWATCH story

Chapter 8

         ”Charge it… set to 360… CLEAR!!!” An audible <<CRACK>> was heard as Dr. Swanson applied an electrical shock to the young accident victim in ICU 8. ”Come on honey, come back to us.” But it was not to be. Melissa Stark’s heart monitor screamed a single continuous tone, its video screen showing only a flat line.

         ”Time down, anyone?”

         ”37 minutes,” Dr. Jack Mitchum replied anxiously. An intern just starting his ICU rotation, it was his first Code Blue. Dr. Swanson sighed at hearing the amount of elapsed time.

         ”Okay, people, let’s call it.” Angie Swanson resignedly removed her gloves. ”Time of death, 9:43 a.m.” Dr. Swanson walked out towards the nurses’ station, pulling off a protective gown. Dr. Mitchum caught up to her as she threw the gown in a biohazard bin.

         ”How can you do that?” Mitchum half-demanded. He threw his own gown in the waste bin after Swanson’s. ”How can you just give up?”

         ”Just give up? Doctor, I know you’re new, so I won’t get angry over that comment. But I will ask you a question. Was there anything we didn’t do for her while trying to bring her back?”

         ”Well...” Mitchum started remembering the last 40 minutes. The silence stretched as he mentally ticked off every option he could think of. ”Honestly… no, ma’am, I can’t think of anything we could have done differently.”

         ”Neither can I. Jack, there’s something we all have to accept in this job, and you might as well start now. No matter the training and knowledge we have, the effort we give, there will always be patients we can’t save. Death is a natural part of life, even from unnatural causes. And for some, their ‘time’, as they say, comes sooner than anyone would like. The quicker you learn to accept these sad facts of medicine, the less you’ll tear yourself up over the years. Now… it’s time to learn something just as distasteful.”

         ”Breaking the news to the family?”

         ”Yes. Has to be the worst part of this business. It’s never easy; all you can do is be honest and respectful, and answer their questions as best you can.” Swanson and Mitchum started towards the waiting area, to deliver the news no family wants to hear.

         ”And one thing that makes it harder,” mused Mitchum, ”is that this could have been prevented.”

         ”Prevented? How, doctor?”

         ”Well, her injuries would have been a lot less serious if she had gotten here safely. After all, half her injuries came from her ambulance being in an accident --” Stopping just short of the door to the waiting area, Swanson grabbed Mitchum by the right arm and very roughly pulled him around to face her.

         ”What in the Hell,” Swanson hissed through clenched teeth, ”are you talking about, DOCTOR?” Until that moment, Jack Mitchum had never understood what it meant for someone to have “fire in their eyes.” Seeing the anger and emotion in Angie Swanson’s gave him a crystal-clear definition. It also made him realize he was in deep water and needed to tread very carefully. ”ANSWER ME!!!”

         ”Uh, ma’am,” Mitchum stammered, “she’d have had a better chance of survival if she’d gotten here right away. BUT, a careless ambulance driver wrecked on the way here, delaying her care.” Mitchum’s voice gained confidence as he proclaimed, “If he’d been paying attention to his job, the girl we just gave up on would still be alive.”

         ”Doctor, and I’m beginning to use that title rather loosely, I’m here to tell you that you are sorely misinformed.” She leaned against a counter, her head in her hands. Swanson then reached over the counter and grabbed the front section of the morning newspaper. ”Who, young man, is leading you so far astray?”

         ”Uh, ma’am, it was a private conversation. I’d rather not say.”

         ”Well, would you be willing to tell me what was discussed in this private conversation?”

         ”We, the other person and I, discussed this case. How the young girl you just quit on was severely injured in a combination of accidents. How she was further injured when by being thrown around the ambulance when the attendant wrecked. I have reason to believe my source, and no, I’m not going to tell you who it is.” Mitchum had gotten his ”information” while shooting pool the previous night at McGreevey’s Public House with Dr. Karl Marx. While he had no idea why Swanson was so incensed, he also had no desire to cross scalpels with the chief trauma surgeon. By the same token, Mitchum wasn’t going to hang his friend and college fraternity brother out to dry.

         ”Okay, Jack, come with me.” Swanson walked down to ICU 5, where David Longfellow was napping. ”Take a good, long look at that patient.” Mitchum saw a man near his age, hooked to a ventilator, with both legs in traction splints.

         “I take it,” Mitchum replied, “he had a major FDGB.”

         “Fall down go boom? Yeah, except he was lucky there wasn’t a real boom. He was in a major automotive accident yesterday. You can see the leg damage from here. And he’s on that respirator because of a seven-rib flail chest.”

         “Ouch… how’d that happen?”

         “The driver’s airbag on his ambulance didn’t deploy.” Swanson handed Mitchum the newspaper section she was holding. “The ambulance in that picture. The girl we just lost, whom you insist we ‘gave up on’, was his patient.” Swanson tapped the newspaper in the younger doctor’s hand. “Read this story, look at the pictures, and then decide if your ‘unimpeachable source’ still deserves protection.” Swanson read the indecision on Mitchum’s face before continuing. “Now, tell me something else. How is a patient supposed to be transported from a car accident?”

         ”Standard spinal package,” he replied, his exasperation at being quizzed creeping into his voice. “You stabilize the neck, then place them on a backboard. If you’ve got time, you use a KED device, or some other type of wraparound torso splint. Once you’ve got them on the board, you strap across the chest, then the pelvis, the legs, and you tape the head down last. Put them on an ambulance cot and transport. What’s so all-fired important about that?”

         “Then tell me how someone in full spinal immobilization, belted to a secure cot, is going to be ‘thrown around’ the back of an ambulance.” Mitchum stood there for several seconds, staring intently at the ICU’s tile floor, trying to come up with an answer.

         “How do we know,” he finally retorted, “they were using full spinal precautions?”

         Swanson opened the paper to an inside page. “Look at that picture and tell me what you see.” Mitchum saw two pictures. In the first, a girl was being removed from a wrecked car on a long spine board. The second was of firefighters removing a patient, strapped to a backboard, from the wrecked ambulance through the door on the side of the patient compartment. The caption said the patient in both pictures was the same person, unidentified.

         ”The patient in these pictures. You’re saying that was the girl in ICU 8? The one we just lost?”

         ”Yes,” Swanson sighed, thinking she had already made this clear. “Dr. Charbaneaux and his team operated on her for several hours. Now, read the first few paragraphs.” Mitchum flipped back to the front page and started reading. He learned a car had crossed the grassy median of Interstate 47, running head-on into an ambulance transporting a critical patient from a fatality car wreck.

         All of this was news to Dr. Jack Mitchum. All he had heard from Marx was blame for Melissa Stark’s injuries, laid at the feet of a supposedly bumbling EMT. Karl Marx had ‘forgotten’ to mention that the driver of the car and the paramedic treating the patient were in stable to fair condition at St. Vincent’s Hospital. Marx had also not said that the EMT he was deriding was a patient in Carrolton’s ICU. Though he wasn’t yet ready to say so, Mitchum was starting to have doubts about Marx’s version of events.

         “Ma’am, I still can’t say who my source is. I’m going to have to do some thinking and some questioning.” A lot of questioning, Mitchum said to himself.

         “Okay, Jack. I can’t ask much more. And I’m sorry about jumping down your throat. It’s been a rough morning, and I guess you were the first convenient vent. But you ARE badly misinformed about the ambulance accident. I’d suggest you do some serious research into what really happened.” Swanson shook her head, as though clearing out cobwebs. “This sparring isn’t doing us any good. It won’t bring Melissa Stark back.” Mitchum was shocked yet again; he hadn’t known the patient’s name. “We still have to talk to the family. I’m sure they know about the ambulance accident. But, despite what we may hear from ‘unimpeachable sources’, we have no proof that the accident contributed to that poor girl’s death.”

         “Yes, ma’am.” Swanson took a few more minutes to calm down, then started walking towards the ICU waiting area. On the way, she looked into ICU 8. The nurses and techs had finished cleaning up the attempts to resuscitate Melissa Stark, including removing airway tubes and IVs. She was ready for her family to say good-bye.

         In the waiting area, a couple in their mid-fifties stood up as soon as Swanson and Mitchum entered, along with a short, overweight man wearing a cassock and holding a rosary. Father Jeremy Crenshaw, SJ, had been doing his best to provide spiritual support to Alvin and Elizabeth Stark. The Starks had been praying for some sort of deliverance for the last 22 hours. Father Crenshaw had been with them most of that time, having learned of the accident just before performing the Sunday Evening Mass. As an Army chaplain in Vietnam, Crenshaw had seen much death in his life. He’d realized then that God’s Plan could never be fully understood by mortal men, even Jesuit priests. He had tried his best to counsel the Starks on this while providing hope and comfort, never promising miracles, and praying the torment would soon be over for this family, one way or another.

         Crenshaw had seen differing reactions on the faces of the Starks. Elizabeth had accepted his words while denying them, believing her daughter would recover. Crenshaw knew that was the only thing she prayed for, and feared any other news would seriously damage the 52-year-old mother of three and recently-new grandmother.

         Alvin Stark was a different matter. A 55-year-old retired marine, he had served two tours in Vietnam as part of a long and varied career. He’d been a line grunt, an MP, a Drill Sergeant, an Embassy Marine and a Sea Marine. As an MP, he’d seen numerous car wrecks at the bases where he had served and raised his family.

         By blind fate or bad luck, he had happened upon the accident just minutes after David Longfellow and Jim Hollis had left the scene with his daughter. Recognizing the car, Stark pulled over and ran to the accident that had put his youngest child in the ICU, and killed her best friend. He’d seen the damage, and knew that a long painful recovery would be a curse to the whole family. Because of this, Alvin Stark prayed for either a quick recovery or a quick death for his 28-year-old daughter. He was the first to address the approaching doctors.

         “I’m Alvin Stark, my daughter is in ICU 8 –“

         “Yes sir, I’m Doctor Angie Swanson. This is Doctor Jack Mitchum. I’m afraid we have some bad news.”

         “Doc, please,” Alvin Stark said, holding his wife as she joined him. “No fancy language. Is my daughter still alive?”

         “I’m sorry, sir--”

         “NO!! MY BABY!!” Elizabeth Stark shrieked at the top of her lungs. “Not my baby!! She’s alive, she has to be!!” She started to collapse, and was helped to a chair by her husband and Father Crenshaw. Elizabeth Stark continued to cry, ”she’s alive... my daughter has to be alive... my daughter’s alive...” Alvin Stark held his wife as she sobbed. Father Crenshaw came over to the doctors.