“Sounds good,” Jake said. “But if those dudes are here, you should probably keep us away from each other.”
“I will take that under consideration,” she said. She pulled a thermometer out of a holder. “Under your tongue, please?”
She took his vital signs and wrote them down on the triage form. She added in his height and weight—allowing him to self-report the figures instead of actually measuring them—and then went over his medical history (he did not really have one), what prescription medications he was taking (none) and what medications he was allergic to (again, none). She then wrote out a brief summary of what had happened to Jake and where he was injured.
“All right,” she said. “I’m going to order an x-ray of your right hand. Go ahead and pop back out into the waiting room and someone will come get you and take you over to diagnostic imaging. Once the films are read, we’ll get you in a room and go from there.”
“Sounds good,” Jake said.
It took about thirty minutes for Jake to be x-rayed and placed in one of the rooms in the ER. A young male technician housed him and Laura in one of the enclosed rooms near the front of the department. It was one of the big rooms, with a cardiac monitor on the wall and all the bells and whistles as far as equipment went. Jake wondered if there was some reason they had put him in here instead of a smaller room. This looked like the room they dealt with serious shit in—heart attacks and CPRs and things like that. Was it just VIP treatment because he was Jake Kingsley, or was there another explanation?
They sat in the room for almost twenty minutes before the door opened and a tall, trim Asian featured woman of about Jake’s age came in. She wore grey scrubs and had the letters MD after her name on her name badge. She wore an expensive looking stethoscope around her neck. Her face was completely expressionless.
“Hi, I’m Doctor Wei,” she introduced, without a hint of accent. “What is your emergency tonight?”
“I got in a scuffle this morning and punched someone in the face with my right hand,” he said. “I think I broke something.”
“Yes, you did,” the doctor told him. “You have fractures to the third and fourth metacarpal bones of your hand. Those are the bones between your knuckles and your wrist. This is what is commonly known as a boxer’s fracture, although most of the time it is the fourth and fifth metacarpals that are fractured.”
If you already knew why I was here and that my bones were broken, why the hell did you ask? Jake wondered but did not say aloud. “How bad is it?” he did say.
“You did a pretty good job of it,” she said. “Both bones are displaced by more than eighty degrees. We’re going to have to put them back together and you’re going to have to be in a splint for some time. I’m not sure if surgery will be needed—it usually is not with this injury, although you did a better than average job of breaking them—so you’ll need to follow up with an orthopedist.”
“Okay,” Jake said. “What does putting them back together entail?”
“We’ll do what we call a procedural sedation,” she said. “The nurse will start an IV on you and we’ll give you propofol through it so you go to sleep for a bit. I’ll then reduce the fractures the best I can and we’ll put a splint on the hand to keep the bones immobilized.”
“Okay,” Jake said carefully. He had never had surgery or been anesthetized before and the thought of being put to sleep was a bit disconcerting. But he had to trust modern medicine, right? “What about functionality?”
“What about it?” she asked.
“I’m a musician,” he said. “I play guitar for a living. Will I still be able to do that?”
“Not until the injury heals,” she said, “but I do not see any reason why you should not be able to play guitar after that.”
Jake breathed a little sigh of relief. “That’s good,” he said. “I’m also a pilot. Will I be able to fly my plane with this splint on?”
Dr. Wei’s expression changed for the first time. It darkened. “You are a pilot?” she asked.
“That’s right,” he said. “My plane is currently parked at Henderson Airport here in Vegas and I was planning to fly it home to Los Angeles tomorrow. And then I need to fly to Oregon from there a few days later. Will I still be able to do that?”
“Uh ... well ... I’m not really sure,” she said. “If I make a good reduction and the splint is applied correctly, you will have some basic movement and function of the distal joints of your fingers, but no grasping ability. Will you be able to operate the controls of your plane under those circumstances?”
“I don’t know,” Jake said. “I guess we’ll find out.”
“I would strongly suggest that if you have any doubt whatsoever, that you refrain from flying until you have full use of the appendage again.”
“I understand, doc,” he said. “Trust me, if I don’t think it’s safe, I won’t do it.”
Dr. Wei looked a little dubious about this but said nothing. “Let me make an examination of the hand,” she said.
Jake showed it to her, and she seemed impressed. “It is extremely swollen,” she said. “This was just from one punch?”
“Well ... only one punch, but I probably did not help things by playing out my set after it happened.”
“Your set?” She was unfamiliar with this term.
“I was at the Tsunami Sound Festival,” he explained.
“Ahh yes,” she said. “We’ve had a number of people come in here from there this weekend. The nurses tell me that you were one of the musicians playing there tonight?”
“Yeah,” he said, realizing that the doctor had no idea who he was—even after being told. “Laura and I—Laura here is my wife, by the way—we both played last night and tonight. It was a sixty-five-minute set and on every number I played the guitar with this hurt hand. It started to hurt more and more as the night went on.”
This time her expression became something that almost looked like respect. “You played guitar for sixty-five minutes with his injury?” she asked incredulously.
“That’s right,” he said.
“We’re you taking any analgesic medications? Opioids, perhaps?”
He shook his head. “I wouldn’t even know where to get opioids. Wouldn’t want them even if I could get them. I just took Motrin and Tylenol,” he said. “That helped a little—at first anyway.”
“Wow,” she whispered as she palpated his hand gently. “That is probably how the fractures ended up so displaced. Going out to play after this injury was not a very good idea.”
“I had to,” Jake said.
“You had to?”
“The show must go on,” he said simply, the way she would have said ‘brain perfusion is life’.
“Even when it is detrimental to your health?” she asked.
“I didn’t know it was going to be that detrimental,” Jake said. “But even if I had, a whole bunch of people paid good money to see me there tonight and there would have been wide-reaching repercussions if I had not been able to play, not to mention that I would have been out more than half a million dollars.”
She raised her eyebrows a bit at this. “They paid you half a million dollars just to play your guitar?”
“And sing,” he said. “And it was actually six hundred thousand ... per show.”
“Per show?” She shook her head. “I think maybe I picked the wrong profession.”
“Trust me, doc, I paid some serious dues to get where I am. And besides, I don’t get to keep all the money. I have to pay my band members and my road crew and my sound people and, of course, the good old IRS and state franchise tax board.”
“Interesting,” she said, finally releasing his hand. “Are you injured anywhere else? I see you have that swelling on your face. Is that from the same incident?”
“Yeah,” he said. “I got tackled and punched by a guy who was about the size of a refrigerator/freezer combo you might have in your kitchen. He tagged me in the face and a couple of times in the ribs.”