Look Closely

by | Jun 2, 1999 | Death, Eternity, Grief, Heaven

Daniel Martin pulled his car into the ER parking lot and swung it into the space marked “Doctors Only”. As he turned off the engine, he let out a soft sigh and looked at the nearly empty patient lot and vacant ambulance bay. “Perhaps it will be a quiet night,” he hoped within his mind.

As he walked into the staff entrance, he met Doctor Nancy Covington, who had just finished her shift and was leaving. “So?” he asked her as she stopped and faced him.

“Sorry, Dan, quiet. You know what the means,” she said with fake sympathy.

He looked at her and raised one eyebrow. “Hopefully not. I’ve lucked out a couple of times and continued the trend.”

Nancy laughed and said, “I don’t think so, Doctor, they’re predicting a full moon tonight.”

“Thanks,” he responded and lightly squeezed her shoulder in his usual affectionate manner. He looked at his watch and realized it was almost 4 PM when his shift started.

“Try and have a good one,” Nancy said as she breezed through the automatic door into the cold autumn afternoon, where the New England sky was quickly turning dark.

Dan walked down the pungent antiseptic halls to the doctor’s lounge, went to his locker and absentmindedly twirled the combination lock, having done so many times. Placing his coat inside, he then grabbed at the pile of cleanly laundered scrubs stacked high on a utility metal shelf. Finding his size he quickly dressed, grabbed his name badge from the locker shelf and then reached into his coat pocket. He withdrew a gold plated stethoscope and slung it around his neck. He slammed the door and snapped the lock shut and twirled it once around.

The emergency room hallway he walked down was quiet as he headed to the front desk. Glancing at the wall board he noticed only two patients listed. He reached into his message box and saw that Lori had left him a message only minutes earlier. He absentmindedly touched the gold stethoscope she had lovingly given to him upon graduation. The note simply said that she would be at her parents that evening if he needed her. He smiled to himself, thinking of how considerate she was and tucked the paper into his pocket.

Just then the ambulance radio crackled and Amy, who Dan thought was one of the best ER nurses he had ever worked with, responded. “NNEH”.

“Yeah, Northern New England Hospital,” the EMT’s voice answered. “We’ve got an eighty one year old female, clammy and pale, complaining of shortness of breath.”

Amy looked over at Dan and then briefly glanced into the radiology room where Doctor Naylor was checking out some X-Rays to see if she should take the call or not. Dan nodded and said, “I’m going to get a cup of coffee. If it’s more than you think you can handle, just go and get Ray Naylor.” He then knocked on the glass partition between the radiology room and the front desk and Ray looked away from the X-Ray he was examining. Dan pointed to the radio and him and understanding, the other doctor nodded in acknowledgement.

He then strode down the opposite hall he had entered and took a sharp left into the little galley kitchen that the staff and, at times, patients or family members used. The stale odor of old, thick coffee greeted him. He proceeded to go through the cupboards and make a fresh pot. Waiting for it to brew, he pushed his wire-rimmed glasses up and rubbed his eyes. He knew this wasn’t going to be a good night because he was having those self-doubts again if he had chosen the right field of medicine. While he wanted the fast-paced, decision-making on a second’s notice, if even that, which made his adrenalin flow, the years had taken their toll. He had learned to deal with the mother who came in, her screaming child with a simple earache that should have been seen during the day by his pediatrician. Then there were the bloody cuts and bruises that had to be attended to by a physician, and were most certainly not life threatening. But the senseless, severe, car accidents, the sudden, deadly heart attacks, the unexpected medical emergency like the twenty-five year old woman last night that presented as a simple indigestion, or at best the stomach flu. It turned out to be a good catch for him. Having that familiar gut feeling, he ran her through a couple of tests and called in the hospital’s best gastro guy. Just as he was going off his shift, the physician came down and told him congratulations on his call. The woman would have died from a ruptured abdominal aneurysm had he not gone that extra step that he was known for. Those were the type of cases that got to him. The ones that made him question God, never mind himself. Why did some live, why did some go on despite his best efforts?

“I see you made the leaded stuff,” a voice broke through his thoughts. Dan turned and saw that the petite, young nurse named Beth, was standing next to him with an empty cup waiting. She looked into his steely blue eyes and saw the darkened circles under them. Doctor Martin was a handsome man, slender, with unnaturally white hair for his age, mixed with blond, and with a well defined, short beard to match. But more so, she found him to be the kindest, most compassionate of the physicians’ staff. After graduation, on her first day in ER, she was so nervous it seemed that everything she did was wrong. Yet he took the time to patiently talk to her and explain the various procedures. Yes, this doctor did not have the ego that many did and now that she had worked for a year with him, she was still grateful that he was there when she started.

“Yeah,” he chuckled seeing her bright, youthful eyes peering at him. “Told it just might be a busy night.”

“Well, it sure hasn’t been that way on my shift and I’m off in two hours so actually that would be fine with me. Helps the time to fly,” she said as she poured a cup of coffee for herself and one for him.

“That, my dear, is true,” he responded affectionately. “But at what toll,” he thought to himself, again slipping into that depression that blackened his soul at times like this.

Simultaneously they both left the galley kitchen and walked down the hall toward the front desk. From that vantage point they could make out the waiting room and it appeared to be filling up with people. Also, the ambulance call was just pulling in with the elderly woman’s case that Amy had taken care of. “Yup, it was going to be one of those nights,” he thought.

Fortunately, within three hours of his shift, Doctor Coates came on and with the increase in ER patients there was now three physicians and six nurses to handle the caseloads. Good thing because it was one patient after another, streaming in either with the virus that was sweeping through the town or a housewife who had burnt her hand while frying chicken for supper. Other than the elderly lady who turned out to be dehydrated because she had been abusing laxatives, as many of the elderly did who believed that to be “regular” they had to go every day, it was rather a humdrum evening so far. But without the help of an extra doctor, such as Coates, things could have gotten a bit stressed for the staff.

Dan looked at his watch and realized that he still had a long night ahead of him and decided now that there was a lull he would go grab another cup of coffee, hoping that one of the staff or patient’s family had made a fresh pot. He decided that he would take ten minutes to himself in the patient’s lounge to just quietly sit back. He always preferred to go there instead of the staff room because it was so soothingly decorated in soft pastels and a countryside theme. It was usually used for the physicians to discuss their patient’s problems with family members, or, at times to let them know of a loved one’s death. He jotted down on the board where he was and swiftly left.

After he had gotten his second cup of coffee of the night, he went to the dark lounge and noticed that the lights were out. “Good,” he thought to himself. “All mine if only for ten minutes.” Going inside he flipped on one of the lamps on an end table, instead of the bright overhead light and shut the door behind him. He sat on the couch but sprawled his long legs out and took a sip of his coffee. Trying to keep his mind blank, he put his cup down and closed his eyes.

Suddenly, through the silence, a voice spoke. “Hard night?”

Startled Dan’s eyes flew open and he saw a well-dressed man sitting in a wing backed easy chair across from him. He had on a plain, but well tailored, light tan suit, with a white starched shirt and wore shiny, dark brown loafers. He appeared to be about thirty and his neat, gold-colored, hair barely touched his shoulders in an outdated style.

“Sorry,” Dan said starting to stand up. “I didn’t know you were in here.”

The man put his hand up in a gesture to stop him and sit back down. “I could use the company, if you can,” the man said in a soft voice.

“Sure,” Dan said sitting back and once again taking his coffee cup in his hand and drank from it.

“So?” the man asked.

Puzzled Dan looked at him wordlessly.

“Hard night?” the man asked again.

“Oh, right, you did ask that didn’t you?”

The man nodded in agreement.

“Not really. Just your usual run of the mill stuff,” Dan answered.

“Sure about that?” the man asked with a slight smile flickering over his kind face.

“What do you mean?” Dan asked and leaned forward to the man, his elbows on his knees, and continued to sip at his coffee.

“Well, it seems to me that the look on your face means you might be having a tough time of it tonight. And I don’t mean the amount or severity of your patients problems.”

For some reason, Dan immediately felt connected to this man and answered him honestly. “I’ve been practicing emergency medicine for fifteen years now and it seems that for the last couple I’ve just been questioning lots of things I see around here.”

“Such as?” the man said raising an eyebrow, yet not changing the kind expression on his face other than that.

“Well,” he said taking a heavy sigh, “why some make it and some don’t. I’ll have what looks like a simple case of the flu that turns out to be congestive heart failure and the guy is one S.O.B. who could care less about the world, never mind the poor lab technician he just told off who didn’t draw his blood the way he thought she should have. We catch the CHF and after diuretics and the other protocol, he’s stabilized and on his way out the door without a thank you. Then across the room is a kid who just got his driver’s license and wasn’t doing a thing wrong. Just inexperienced. Along comes a drunk driver careening down the hill and flies right through the red light and broadsides him. He’s hanging on for dear life and we’re doing everything we can to keep that thread between life and death disconnected and he suddenly goes into heart failure and is gone. Where’s the justice?”

The man did not answer right away and there was dead silence in the room. Then his soft voice spoke. “God is not fair but he is just.”

“Meaning?” Dan asked in frustration.

“Just something you’re going have to find out in time yourself,” the man answered. “Some things you have to go on faith. Faith that He, and he lifted his eyes upward, “knows what He’s doing.”

Leaning back, Dan put down the now finished coffee cup and folded his arms over his chest. “Well, I don’t get it, even after all these years. Just too many questions.”

“Questions are alright, they mean we care. And if you don’t get it, as you say, we’re not always meant to at that moment. But then again sometimes if you look closely, you’ll see the answer in the unknown. It may only be a glimmer of truth, a symbolic cast iron frying pan that comes up and hits you on the side of the head or even a solution that won’t be answered until you leave this world. But there’s always a just answer. Just keep your eyes and your heart open and you’ll know what to do.” Leaning close to Dan, he looked directly into his eyes and softly added, “and remember, Dan, you’re meant to be a part of someone’s life, an integral part. You may not know it at that moment. Be it briefly as you walk by a patient who belongs to Dr. Coates and simply give him a quick smile of reassurance, or are with a patient for five hours attempting to enable him to continue to live and be back with his family. Each and every second in your life does affect someone else.” With that the man wordlessly got up and walked out of the room and shut the door behind him.

Taking in what the man said, Dan realized that he had called him by name and wondered how he knew. Then, realizing, he had his name tag on, he answered his own question. Still, it was as if he really knew who he was, not just a tired, confused ER doctor.

Just then there was a soft knock on the door and Marilyn, the front desk receptionist who had been with the hospital for years, opened the door. “They’re asking for you out front, Dr. Martin,” she said. “There’s a patient the ambulance just brought in that you’ve seen before and it appears he may be critical. The other docs are swamped.”

Dan immediately got up and walked out into the hall. He looked in both directions but the man was gone. ”Did you see that guy who was with me just leave,” he asked the older woman.

“What guy?” she asked looking surprised.

“Right before you knocked on the door, a man in a light tan suit stepped out of the room,” he said incredulously.

“Sorry, but I didn’t’ see a soul,” Marilyn answered, worrying that perhaps it was time for Doctor Martin to take a vacation. After all it had been months since she had remembered him doing so. “This always gets to the good ones,” she mused as she turned away.

Dan shrugged his shoulders and quickly went down the hall and checked in at the desk.

Betsy, a nurse who had come down from Canada, walked up to him and with her heavy, French accent attempted to fill him in on the patient. “Dan, it’s John Hunt again.”

Dan immediately felt a stab in the pit of his stomach. A seemingly robust middle-aged man, he had just seen John the weekend before for problems, unrelated to the cancer he was valiantly fighting and appeared to be winning, until of late. Turned out that the problem was related to extremely low blood sugars which were unusual because he was a Type II diabetic. Leafing through the notes, as he rushed to the trauma area, he saw symptoms that made him more concerned.

This patient was one of those special ones. He had a wonderful sense of humor and despite the war he was waging always seemed concerned as to the feelings of the medical staff who were there to help him. He once asked Dan about the gold stethoscope and when Dan had told him that Lori had given it to him as a gift, John proudly told him of his great love that he and his wife had for each other. He would tell anyone who cared to listen, “We’ve got twenty-eight years together. Can you believe it? I love her more with every passing day.”

John’s wife, Laura, would just smile, squeeze his hand and almost always gently kiss him on the lips with a sweet, “I love you”. It was apparent in every conversation that Dan had with John that not only were these two people one of the rare couples who were still madly in love after many years of marriage, they were both good, caring people who gave to the world and did not take.

“What’s going on Buddy?” he now asked with grave concern, but attempting not to show it to John. The man kept asking for his wife and Dan quickly looked to the nurses for an answer. “She’s following the ambulance in their car and should be here any second. She said she had to get him some clothes to go home in since he just has his briefs on.”

Looking up to the monitor, he heard the alarm that showed it could not register a blood pressure and the team immediately began working on John as Dan gave out orders.

Within minutes the intake nurse came up and said that the wife had arrived and they had her waiting in the reception area. “For crying out loud, get her in here,” Dan said softly.

Having been through these emergencies so often in the past couple of weeks, Laura immediately sat down in a chair near the scene and shaken, watched Dan give orders and then waited for an appropriate medical reaction from John. When a side of the stretcher was empty from any personnel she got up and walked up to her husband. He was seemingly in and out consciousness. She gently kissed his lips and whispered, “I love you.” John kissed her ever so softly twice and was barely able to respond but managed a caring, “I love you too”. Then he closed his eyes and seemed to be incoherent once again.

Deciding they needed a chest X-Ray because John was extremely short breathed, a portable machine had been called for. It promptly arrived and Dan went to John and asked him if he could sit up. Once again he opened his eyes and obeying, John attempted to do so, but quickly collapsed backwards. It was then that once again, that quick thinking was called for and Dan decided instead to put him in the cat scan. Quickly the team of nurses began setting up the stretcher to transport him and they practically flew down the hall and toward the cat scan room. Laura stood outside the door and a nurse glanced back at her, her heart skipping a beat in compassion as she saw the worried expression on the tired woman’s face. “You’ll have to stay out here.”

“OK,” the woman barely audibly said. “I’ll take this time to use the rest room and be right back. Is there enough time?”

“Yes,” the nurse said as she shut the door behind her.

Dan was at the front desk, pouring over the medical notes on John, his mind quickly running through possible scenarios and diagnoses when he heard the Code Blue alarm go off and Amy came running up to him.

“John Hunt appears to have arrested,” she stated and they both took off in a run to the cat scan room.

John was laid flat on the cat scan table which had been pulled out from the machine and his eyes were open and pupils fixed. Soon there were medical personnel not only from the ER but other departments nearby who had heard the Code Blue and had come to assist. They pulled John onto the stretcher and immediately began working, attempting to revive him. As he began CPR, Dan did not see John’s wife quietly enter the room and stand back as the staff swiftly moved all around the stretcher, each working in synchronism.

Knowing that she could not get near her husband, without endangering him because someone may need to be next to him working to pull him through this, she slipped back out of the room.

Oblivious only to his work, Dan looked at the clock and said, “How long?” meaning how much time had occurred since they had begun to attempt to revive John. A voice called out fifteen minutes. He then asked for the shock paddles and asked, “Where’s his wife?” knowing how important it was that this man’s soul mate be here at this time. Again the same voice said, “She’s standing outside.”

Indeed, Laura calmly stood in the hall and the attending doctor from the oncologist’s office, Anne Hadden, put her arms around her shoulders, sharing in the scene before them. Soon the wife broke away and pointing said matter of factly, “No one can stand at the end of his bed! That’s where his angel who is waiting for him belongs.” Laura recognized a woman as having been the head floor nurse from the time John had been in her ward for emergency surgery recovery the summer last year. The nurse went to her side and held her as Doctor Hadden had.

Anne Hadden immediately went to the stretcher and said, as she calmly took a nurse by the arm and moved her aside. “No one can stand at the end of John’s bed, because that is where his angel is waiting for him.” She said it loudly enough for everyone to hear. Satisfied that all had heard, she went back to John’s wife.

Just then Dan applied the first attempt with the life-saving paddles. His eyes darted from the monitor, hoping for a reaction when he saw out of the corner of his eye someone standing in front of the open door and at the end of John’s stretcher. In but a brief moment of time, he realized it was the same man who had spoken to him when he was in the patient’s lounge. Not having the time to dwell on what he was doing there, he quickly applied the paddles again.

Laura watched as John’s body jumped in reaction to the electricity pulsating through him and grabbed at Dr. Hadden, who again stood by her. “Enough!” she said. “Give him some dignity. Some respect.”

With compassion, Anne answered, “Let them try to intubate him. If that doesn’t work, I will end it.”

The wife nodded in understanding.

“Within minutes, everyone stood back and stopped what they were doing. Dan looked at the clock and announced the time which a nurse jotted down in the records.

Instinctively the wife went to her husband. His eyes were now cold and black. She begged for someone to please close them and a hand slipped over and did as she requested. Then she bent down to his lips and ever so wistfully kissed him and whispered, “I know you’re not here anymore, Johnny, but I want you to know how much I do love you. Just be there at the gate, waiting to greet me when I come home,” she said. She slowly took in his face and lightly caressed his cheek then turned and walked from the room.

Dan watched, his heart breaking with the loss he felt not only for the loving wife but John who had tried so very hard to battle his fight between life and death. He looked up just in time to see the man in the tan suit standing next to a vision of John, his arm around his shoulders, kindly turning him away and as quickly as Dan saw him, they disappeared.

Realizing how exhausted he was, he didn’t react and instead looked up to again see Laura leaning against the wall, seemingly commanding every part of her being to hold herself together. As he dejectedly passed her, he heard her say, “It’s OK,” comforting the doctor and nurse near her. “He’s with our Lord now and he’s happy.”

Somehow Dan could not imagine how this woman, who had given so many years of her life to this man in deep, loving commitment, could be so strong in her statement. Then he remembered, the words, told to him by the stranger he now knew, “Each and every second of your life does affect someone else … Some things you have to go on faith.” Dan realized that this was the beginning of what he had been told. Look closely not only with his eyes and his heart and he would see. Importantly, from now on he would ensure that the end of every bed or stretcher would have no one standing there with the patient. No one that could be seen…

Laura M. Boldosser Jballsta1@aol.com


Look Closely