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I had worked on the women's surgical floor for ten years and had helped many of my friends through those years. Today, however, was the first day I have ever felt as though one of my friends might die in my care.
While walking back from lunch with my Uncle Jerry who was also the Chief of Surgery at Danville Memorial, I heard a familiar voice call my name from the emergency room waiting area. Turning mid-laugh after Uncle Jerry had told me a funny story about a patient, I was stricken by the sight of Kelly Wilson.
She was as white as a ghost, and the minute our eyes locked, all life seemed to drain from her body as she collapsed onto the emergency room floor.
Running to where Kelly had fallen, I was thankful to see my Uncle Jerry in my periphery calling out orders and wanting to know what she had come into the hospital for.
Unfortunately, none of the regular staff seemed to know there was anyone left in the waiting room, nor why her registration entry was sitting incomplete in the queue waiting to be forwarded to the triage nurse for review.
"Who took this registration?" Jerry bellowed towards the office pods in the entry.
"It says here that Trish Samson took the entry, sir," squeaked a young registration rep.
"Get her out here now. I need to know exactly what the patient said when she came in," my uncle demanded while following the gurney into the nearest trauma room.
Within seconds Trish was rushing into the room to calm the situation and immediately stopped in shock when she saw a lifeless Kelly lying before her.
"Trish, we need to know why Kelly came into the ER today. The registration was never completed or forwarded to triage," I said, while my uncle ran his initial diagnostics.
Stuttering, Trish says, "Ssssshhh-she said it wa-was a UTI."
"What were her exact words, Trish?" I asked trying to stop myself from screaming at her incompetence. Saving Kelly at this point was more important.
"She said that she thought it was a UTI, but that the pain had increased so fast that she was worried about her appendix. I Th-th-thought she was trying to get attention." With her confession, she was finally exhibiting some shame at her apparent pettiness and incompetence.
At hearing the words UTI and Appendix, my uncle asked for the portable Ultrasound machine to determine where to send her next.
"There!" my uncle said with relief at knowing the diagnosis. "She has a tubal pregnancy that has burst, let's wheel her up to the women's surgical floor immediately."
"Wait, doctor!" said the technician. Something is showing in her uterus as well."
"Damn! It looks like a set of mono-di twins in her uterus. I'd estimate around 2-3 months along. Polly, call ahead, and I want the surgical team ready to go as soon as I get up there. And somebody, call her emergency contact!"
Within ten minutes of Kelly's collapse, my uncle was scrubbing his hands and asking me questions about Kelly. Unfortunately, all I could convey was that she was a new friend and that she was recently married last week to Tyler's school principal.
Knowing that my Uncle Jerry would be handling the surgery brought extreme peace of mind to the situation. Besides having one of the best track records in the state, he spent his first ten years after medical school as an OBGYN before transferring to general surgery.
The downside to this happening on a Friday was that we were stuck with Dr. Johnston.
Dr. Johnston was a reject from our sister hospital up north who was currently working at rebuilding his reputation after several patients overdosed on anesthesia. He rarely listened to his patients and made errors with total apathy. He also tended to leave the nurses to deal with the side effects.
Because of the severity of Kelly's situation, Jerry opted for an open surgery in case any complications were to arise.
"Now I want to take a moment to remind everyone here that this woman has just lost one baby, and has two more that are trying to survive. Let's make sure we give them their best chance."
Due to Uncle Jerry's expertise, he was able to have Kelly's right fallopian tube removed and the damage cleared within 20 minutes.
Wanting to use this as an opportunity to educate the resident standing by his side, he said. "If you see here," pointing towards the left tube. "The lips of her tubal clamps have broken on both sides. We're going to have to make sure we remove all of the debris and document the state we found her clamps. That way she'll have a thoroughly cataloged case to show the manufacturer, and the patient may be able to get most of her surgery covered by them."
After making quick work of the other clamp, Jerry's efforts to close were suddenly stopped when Kelly's heart monitor started to show that her heart wasn't pumping as fast as it should.
Unable to figure out the cause of the distress, my uncle had an intern pull Kelly's medical history and located the issue.
"Dr. Fredericks, it says that the patient has a history of overdosing on anesthesia and that in two out of the last three times has had issues with breathing during surgery," the intern said while glaring at Dr. Johnston.
We all knew he should lose his license, but so far we had no power to initiate it.
"Dr. Johnston, please lower her dosage and let’s see if that make a difference."
Walking over to where the intern still had Kelly's file up, I happened to notice that her last anesthesiologist was Dr. Johnston, who after the patient had clearly advised him of her history of extreme sensitivity to anesthesia, had still chosen to administer her doses according to the archaic chart he designed years ago.
"Dr. Lopez?" I asked softly to the intern reviewing her history in case of another complication. "Can you go ahead and forward a copy of the patient’s chart to Dr. Fredericks' email with a note that I need to talk to him regarding its contents." At least this way, I could lodge a formal complaint and maybe prevent a future malpractice suit.
Luckily, Kelly eventually stabilized enough for us to move her up to ICU where she would be for at least the next 24 hours.
It was during her transport, that one of the assistants walked up to me to say that Mr. Wilson and Kelly's mother were currently waiting down the hall for an update.