A VERY ODD COUPLE
Part IV
Previously on my ER
Following some manipulation by Randi
Dave moved in with Luka
While on his way home Dave was mugged at an ATM
He was brought to the ER and Elizabeth prepared to operate on him
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Luka was met by Kerry upon his return to the ER.
“Where were you?” said Kerry as she handed him a trauma gown. “I was just about to page you.”
“I was bringing a patient to the OR,” replied Luka. “It was…”
“Never mind,” interrupted Kerry. “We have incoming traumas. Cyclist versus motorist, I’ll take the cyclist.”
“How far away are they?”
“Just pulling up now.”
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Luka’s patient had minor facial lacerations, caused by the shattering of his windscreen from the impact of the cyclist. He was also suffering from seatbelt bruising and shock.
When Luka had dealt with him, he was kept busy with a string of minor injuries, and so was unable to inform Kerry about Dave. Finally there was a lull in the influx of patients. He decided to take a few minutes to compose himself before trying to contact Dave’s family.
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Kerry’s patient had not been as lucky
as Luka’s.
“Why do these people not wear helmets?” she asked
rhetorically as she surveyed the bloody mass that had once been a
man’s face. “Connie, get me a surgeon down here.
Let’s see if there’s anything we can do about this.”
By the time Peter arrived the patients x-rays were back.
“What’s the story?” asked Peter as he walked in the room.
“I think it’s a wasted journey,” replied Kerry. She indicated the skull films. “Take a look.”
Peter examined the x-rays “I see what you mean. Why are you still bagging him?”
“Chest film’s clear. We might be able to salvage his organs. The paramedics are checking their bus for his wallet. They think it fell out on the way.”
“Got it,” said Doris triumphantly as she walked through the door holding a wallet in her hand. “I knew I’d seen it on him.”
“Thanks Doris,” said Kerry as she started looking through it.
“Oh God,” she said and went white as a sheet.
“What wrong?” asked Peter.
With shaking hands, Kerry held out the driver’s license she had found in the wallet. On it Peter could see a picture of a familiar face and the words David Antonio Malucci MD.
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Kerry walked sadly towards the lounge. This wasn’t fair. Dave may have been a sloppy and irresponsible doctor, but he had been a warm and kind-hearted person. He deserved better than this.
Luka was already in the lounge when she walked in.
“Dr Kovac,” said Kerry. “Do you know how to get in touch with Malucci’s family?” She sighed wearily as she sat down on the couch.
“Yes. I have his sister’s phone number. What’s the matter?”
“I need to get in touch with his parents, to get their consent…” Kerry’s voice choked on the words.
“Kerry, what happened? What did Elizabeth say?”
“Peter was the surgeon on the case. There was nothing he could do.”
“But I handed him over to Elizabeth myself, she said she was going to operate immediately.”
Kerry looked at Luka in surprise and shock. “What are you talking about? I’ve just left him in Trauma one. He has massive head trauma from a bike accident.”
“You must be mistaken. I brought him upstairs to the OR a couple of hours ago. He was mugged.”
“You’re sure it was him?”
“No question about it.”
A wave of relief swept over Kerry. “How serious is his condition?” she asked.
“Dr. Corday seemed to think his chances were good. I was just about to phone his sister and tell her.”
“Why his sister? Why not his parents?”
“She’s a doctor in Milwaukee. Their parents live in New York. Dave said once, that if anything ever happened to him, that I should get in touch with her first.”
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A few hours later.
Luka completed his patient’s chart, and looked at his watch. If all had gone well, the surgery should have been completed by now. “Randi,” he said. “I’m just going upstairs. Page me if I’m needed.”
“Hang on a minute Dr Kovac,” replied Randi with the phone in her hand. She listened for a moment and then said, “There’s a Chris Malucci on the line looking for you.”
“That’s Dave’s sister,” said Luka as he took the phone.
“Doctor Malucci?” said Luka. “My name is Luka Kovac. I’m a friend of your brother.”
“I’ve heard Dave mention you. Your message said to call you immediately. What’s wrong?”
“I’m afraid that Dave was attacked, and admitted to the ER a couple of hours ago.”
“Oh God, how bad is it?”
“It’s serious, he’s currently undergoing surgery for a collapsed lung.” There was silence on the other end of the line. When Chris spoke again, Luka could hear a catch in her voice.“I’ll be on the next bus to Chicago. I should be there in about….”
Luka could hear rustling noises over the phone as Chris checked her bus timetable.
“three hours,” she continued.
“I will be here. Ask for me at reception.”
“Dr Kovac, if Dave, <when> Dave comes round, let him know I’m on my way.”
“Of course I will. Do you want me to inform your parents?”
“Oh God, Mum and Dad. No, I’ll phone them before I leave.”
“I will see you in a few hours then.”
“Please look after him until I get there.”
“Of course I will.”
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Luka was hovering outside the OR when Elizabeth came out.
“How is he?” he asked.
“He came through the operation all right, and he’s in recovery now.”
“Was there any internal injuries?”
“Nothing major. He’s been very lucky.”
“If you call being beaten unconscious, and puncturing a lung lucky.”
“It still could have been a lot worse. You might as well go back to the ER. He won’t regain consciousness for a few hours yet. I’ll keep a close eye on him.”
“As will I.”
“There’s no need. We have plenty of competent ICU nurses, and I’m sure you have other patients to see”
“I promised his sister I would.”
“As you wish.”
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A few hours later in the ICU
For the second time in a few hours, Dave regained consciousness without knowing where he was or how he had gotten there. This time the transition was less abrupt. His eyes focused on Luka standing by the bed, looking concerned. “What have I done now?” he thought as he tried to speak. The sensation of the tube in his throat brought back the memory of his earlier period of consciousness. His eyes flew open in shock as he remembered being brought to the OR. Again, he tried to pull the tube from his mouth, but the anesthetic had left him as weak as a kitten, and Luka was easily able to prevent him.
“It’s all right Dave,” said Luka soothingly. “Don’t struggle, and we’ll extubate you as soon as Dr. Corday gets here.”
Dave was reassured by Luka’s comforting tone, but he still wanted to know what was going on? How badly was he injured? Was he going to be ok? He gestured at the pen in Luka’s pocket.
Luka realized what Dave was trying to do. “You want to write something?”
Dave nodded, relieved that he could still communicate.
Luka found a pad, and carefully placed the pen in Dave’s hand. Laboriously he scrawled the words ‘how am I’ on the pad, and then dropped the pen, exhausted by even this slight effort.
Luka considered Dave’s question. Earlier in the ER, he had deliberately concealed from Dave the severity of his injuries. He had believed that the knowledge would only serve to agitate him at a time when he needed to be kept calm. Now the situation was different, Dave was hopefully through the worst of his ordeal, and there was no reason to lie to him. He picked up Dave’s chart and carefully detailed his condition.
Luka was just finishing up by describing Dave’s broken left radius and ulna when Elizabeth joined them.
“Dr Kovac, may I have a word with you,” she said icily.
“I’ll be right back,” promised Luka following Elizabeth out of the ICU.
“What do you think you’re doing?” asked Elizabeth.
“Dave asked about the extent of his injuries. I was telling him.”
“Do you always tell critically ill patients how serious their condition is?”
“I do not lie to my patients.”
“Well Malucci is <my> patient now, not yours.”
“I do not lie to my friends either. Dave is a doctor. He asked how he was, and I told him. I know that you don’t have a lot of time for him as a doctor. I can only hope that you do not allow your personal feelings to interfere with your treatment of him.”
“How dare you,” said Elizabeth, outraged. “From what I hear, you’re the one that lets your personal feelings influence your treatment of patients.”
“It’s not the same thing,” said Luka angrily. “That man’s lifestyle made him an unsuitable transplant candidate. He’s probably back on dialysis by now.”
“Actually I was referring to your refusal to transport a seriously injured patient by helicopter. A refusal I might add which <may> have cost the man his life.”
“You seriously expect me to have given priority to a man who was shooting at children?”
Luka was almost shouting by now.
“Keep your voice down,” ordered Elizabeth. “Look, I treat all my patients to the best of my ability, regardless of my personal feelings. Malucci will be no different.”
“And how many of your other patients were told by you that they were sloppy, irresponsible and in the wrong profession?”
“I never said that Malucci was in the wrong profession. If I thought <that> I wouldn’t have bothered saying what I said to him. I would have simply informed Dr Weaver of the incident and recommended that his position as resident be terminated.”
“But you said that he wasn’t much of a doctor?”
“He isn’t, at least not now. But if he got his act together he might, just might make a halfway decent ER doctor in the future. That’s why I said what I said to him. It wasn’t out of malice or vindictiveness, it was simply to shake him up and make him take a long hard look at himself.”
Luka was taken aback by this revelation.
“I had no idea.”
“Of course not. You only heard it from Malucci’s perspective, and naturally you took his side. You both saw me as this ‘hard assed bitch’ who delights in hurting people.”
“Actually,” thought Luka. “Dave saw you as a demon bitch from hell.” He wisely refrained from mentioning this.
“Look,” continued Elizabeth. “Believe me when I say that I have no personal animosity towards Malucci, and my treatment of him will reflect that.”
“I do believe you, and I apologize for my earlier insinuations.”
They looked at each other in silence.
Finally Elizabeth spoke, “I’m going to extubate him now. I presume that you want to be there.”
“Of course.”
Silently they went back into the ICU.
Dave watched them return to his side. He could remember Luka reassuring him in the ER and keeping him calm in the elevator. He could also remember Dr Corday reassuring him in the OR, or maybe he’d dreamt that part.
“Okay Dave,” said Elizabeth. “You know the drill, I want you to breathe out as I remove the tube. On the count of three, one, two, three.” She deftly removed the tube from his throat, and then quickly reached for a basin as Dave started retching.
Luka supported Dave as he leaned over the basin, hoping that Dave would not displace his chest tube, or cause any further damage. Finally Dave stopped retching and Luka carefully lowered him back to the bed.
“How do you feel?” asked Elizabeth handing him a glass of water. “Take small sips,” she instructed.
Dave sipped the water gratefully. “I’ve felt better,” he whispered hoarsely. He cleared his throat and tried again. “Thank you,” he said. “Both of you.”
“Your throat will be sore for a few days, but then so will the rest of you.”
Dave managed a wry smile. “Looks like I did a good job of wrecking myself,” he said.
Luka and Elizabeth exchanged glances.
“What’s the last thing you remember?” asked Elizabeth.
“I remember riding home from work, trying to decide what video’s to rent,” said Dave hesitantly. “Next thing I’m staring at the ceiling in the ER. Guess I must have come off my bike or something.”
“It wasn’t a bike accident,” said Luka. “According to the police, you were found near an ATM. They believe that you were mugged.”
“Don’t worry about it for now,” said Elizabeth. “The memories will probably come back of their own accord. Now I’ll be back to check on you in a few hours. Try and get some rest. And you,” she said looking at Luka, “You can have five more minutes with him, and that’s it.” She scribbled something on Dave’s chart and left the pair together.
“She’s right you know. It’s time you got some rest.”
“Yeah, I guess so. Did anyone call my family?” asked Dave.
“I got in touch with your sister Chris. She said she’d be here in a few hours.”
“Good old Dr Chris,” murmured Dave sleepily.
“Rest now.”
Luka waited until he was sure that Dave was sleeping and then returned to the ER.
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To be continued