At the ED receiving bay, a group of doctors, nurses, and orderlies, all in full personal protective gear and face shields, were waiting, including a rugged-looking, slim, white-haired man and the ranking emergency physician on the shift, Dr. Theodore Hard. By the time Brian had quickly climbed out of the ambulance’s cab, Emma was already on her way inside with the Lucas apparatus pumping and Alice still respiring her with the ambu breathing bag. Brian had to run to catch up. He knew he probably wasn’t supposed to follow, but he did anyway, and in the commotion, no one questioned his presence despite the fact that he was the only person without an impermeable protective gown and face shield.
The entire group raced into one of the Level 1 trauma rooms, where Emma was transferred from the ambulance gurney to the table. Brian stayed in the background while Dr. Hard yelled orders to set up an ECG, place an oximeter, and start an intravenous even though the tibial cannula was still in place. The oximeter gave a reading of 95 percent, suggesting that the CPR had been effective. The moment the electrocardiogram blip appeared, tracing across the monitor, everyone could see there was electrical activity, but it was obviously not normal. It was also quickly determined that when the Lucas was switched off, there was no pulse and no blood pressure. Instantly they reinstated CPR with manual compressions while Alice, who had not stopped using the ambu bag, quickly summarized for Dr. Hard what had happened in the victim’s home and in the ambulance, listing the medications that had been given and the approximate duration of the initial seizure. She made a point of emphasizing how cyanotic the patient had been, and then described how surprised she was to be confronted with pulseless electrical activity after the second seizure and what she thought it meant.
“I think you are probably correct,” Dr. Hard said. He’d been nodding as Alice had related what they’d done. After Alice finished her rapid synopsis, he took a small penlight from his pocket, bent over, and checked Emma’s pupils. “Uh-oh! No reaction whatsoever,” he stated as he straightened upright. “That’s not encouraging, to say the least. It suggests no brain stem reflexes. Okay! Let’s get the neuro guys down here and do an emergency electroencephalogram. Meanwhile, continue the CPR and draw blood for electrolytes, glucose, and troponin just to be sure.”
As the only person in normal street clothes, Brian felt that he stood out like a sore thumb and was expecting to be asked to leave at any moment. Taking advantage of a new flurry of activity, enacting Dr. Hard’s latest orders, Brian glanced around the trauma room, quickly spotting a long, white doctor’s coat hanging on the back of a door. Trying not to garner attention, he walked over, lifted the coat from its hook, and slipped it on. It was unreasonably snug, but he couldn’t be choosy. He was aware there was a name tag, but he couldn’t make it out upside down. So attired, he felt considerably less out of place and only hoped no one asked him any difficult medical question, which would surely expose him as an outsider.
A few minutes later Alice and George informed Dr. Hard they had to call in their home base and be available for their next run. After they’d gathered their belongings and said goodbye to all, George recognized Brian despite the white coat and approached.
“Wait a minute, are you a doctor?” George asked, momentarily confused. He leaned forward and read the name tag on Brian’s doctor’s coat. “Dr. Janice Walton? I don’t think so. I’m sorry, but you really shouldn’t be in here.”
Brian started to desperately explain that he needed to be with his wife.
“Sorry,” George repeated. “I can only imagine how wrenching this must be for you, but you aren’t allowed back here.” He called out to one of the ED nurses named Tamara Reyes, who came over immediately. George explained that Brian was Mr. Murphy, the patient’s husband.
“Good lord! Have you been watching all this?” Tamara said, eyeing him as he struggled out of the doctor’s coat and returned it to its hook. “You poor, poor man. How did you get in here? Oh, never mind. Follow me! I’ll take you out to the lobby. You should have gone out there to sign in your wife.”
Resigned to having been discovered and mildly surprised he’d managed to stay undetected as long as he had, Brian followed Tamara. Out in the lobby there was a line of people waiting to check in, but Tamara ignored them and called out to one of the clerks. She introduced Brian as Mr. Murphy, the husband of the CPR victim, and told her to get all the info and a signed release pronto.
For the next fifteen minutes he gave all the usual information, including the Peerless policy number. As he did so, he wondered how Peerless might try to evade covering this emergency visit since Emma certainly hadn’t walked in. He also wondered if the hospital computer would immediately spit out that he owed the institution almost two hundred thousand dollars when the clerk entered his name. If it had, the clerk didn’t let on. After Brian signed what he needed to sign, he was free to find a place to sit. He chose a spot at the far end of the room, as far as possible from any other people.
Time dragged. Minutes seemed like hours. At one point he took out his phone to call home, more just to connect than anything else since he didn’t have anything yet to report. As he held his phone, he noticed his hand was trembling. Try as he might, he couldn’t stop it, and he realized it was because every muscle in his body was contracted. Changing his mind about calling anyone, he used his phone to check his email, but he did so with unseeing eyes. He couldn’t concentrate. What he was really attempting to do was occupy his mind so as not to think about what was going on back in the trauma room, yet it was impossible. In his mind’s eye he kept seeing the horrifying image of Emma being given CPR. From his EMT training and experience as a police officer, he knew all too well what that could mean if the patient didn’t respond immediately.
In an attempt to avoid thinking the worst, Brian let his eyes wander around the ED waiting room. It was moderately busy as per usual. In contrast to him, no one seemed to be in an agitated state, which only made him feel worse. Then he suddenly saw Dr. Hard, who had just materialized from the depths of the Emergency Department. The doctor paused, and after a moment surveying the room, his eyes locked on to Brian’s. He then immediately headed in his direction with a determined stride.
Assuming the man was coming to see him, Brian quickly rose to his feet. As the doctor approached, Brian’s mind, which was trying desperately to divert his attention away from reality, decided that without his protective gown and with his lean and lanky body the man looked more like a cowboy hero in an old Western movie than a doctor in a New York City Emergency Department. Yet, unfortunately, he didn’t appear as if he was coming to save the day. With his mask covering most of his face, Brian couldn’t see the man’s expression, but the way he was walking suggested a disturbing gravity. Fearing the worst, he tried to steel himself.
Dr. Hard stopped six feet away. “Are you Brian Murphy, husband of Emma Murphy?” he asked. He spoke with an aura of seriousness and empathy that cut to the chase.
“I am,” Brian managed. His throat had gone bone dry.
“I’m afraid I have very bad news for you,” Dr. Hard said. “Would you please come with me?”
Book 2
Chapter 15
August 31
Squinting his eyes, Brian walked out of the MMH Inwood Emergency Department into the glare of the late summer sun and then hesitated on the sidewalk. He was overwhelmed and had never felt so much in a daze in his whole life. Was he locked in a terrifying dream with no escape? If it was reality, was he depressed or furious? It was difficult to decide as his mind flipped back and forth from one extreme to the other.