The House of Hope and Fear by Audrey Young

Author:Audrey Young
Language: eng
Format: epub
Publisher: Sasquatch Books
Published: 2010-07-22T00:00:00+00:00

The following morning, Alice told me that Fred Wirth, the drinker with the gangrenous foot, was back.

“I’m bringing him in,” Alice said.

“How did he get here?”

“He walked. We can’t really stop patients from walking in.”

“He’s walking on that thing?”

“Yeah,” she said.

I knew Wirth from before, so I told Alice I would take him again. It was doubtful he’d get the definitive surgery he needed, given the pressure on beds. But he had a touch of congestive heart failure, a condition I could actually fix, at least temporarily. Wirth again had no memory of me; when I went to see him, he was just starting to come down off his buzz. I put on gloves and removed the shoes and tube socks that were sticking to his body. His black toe had begun melting away, but now he had a new, larger ulcer on his shin. I decided we’d talk about surgery later, when he was sobered up and might remember something.

Upstairs, Karen Chow was again breathing at twenty-four breaths per minute. Just a few family members were at her bedside today.

I said hello to everyone and then said, “Apparently, I can’t knock her off.” The family laughed.

“We all got some sleep,” the son said. “Finally. Thank you.”

Another relative said, “Maybe she’s gotten used to the morphine. Maybe it doesn’t affect her anymore?”

“That typically takes more than just a few days.”

“Well, she had a patch before.”

I put a hand to my forehead. I hadn’t gotten this part of the story before. “The fentanyl patch. She’s used to the really strong stuff.”

“She would have been a good drug addict!” one of the men joked, and everybody laughed again.

I told the family that I hadn’t seen a situation like this before, but it was possible that the IV fluid she was getting along with the morphine drip was flushing out her kidneys. I doubled her dose of morphine and said I’d double it again six hours later if she remained uncomfortable. I told them to call in the troops, because it was going to happen by the end of the day.

On Monday morning, Alice was standing on her toes in front of the Board with the air traffic control nurse, waiting for Scott. There could be forty-five open beds and perhaps more, owing to Karen Chow’s peaceful passing overnight; to the ambulance that was taking Montel Menino to the airport, where he would catch a direct flight home to Reno; and to Fred Wirth’s unannounced departure—his nurse discovered his abandoned hospital gown in his bed and the IV that he’d torn out of his arm, the tape with little hairs attached. Presumably, Wirth had headed back to the streets to drink because his chest felt marginally better, because he was starting to feel a little tremulous from his low blood alcohol level. A half hour later, air traffic control relinquished his bed.

Forty-five-plus discharges for the day meant the ED could begin to move hospital admissions to their various destinations, could go back to addressing medical emergencies.

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