In history, there are two kinds of people. The kind of people who look for
history to find them. The kind who want to see their name in print and in
the history books, the kind who want to do more and better than everyone
else.
There's also the kind who would prefer that history simply pass them by. The kind who just want to do their job and go home everyday in the same shape that they left home in. And it's often those kind of people who end up doing more and better than anyone else and end up making more history than the other kind.
Chapter 1. My Semi-normal life.
The coffee was cold. And if you had ever had real hospital coffee, also affectionately known as the "lifeblood of an ER doc", you would know that it was palatable only when it was somewhat lukewarm.
Sarah glanced up at the clock and sighed, realizing that she had only another 13 hours left of her 36 hour shift. Her fingers pinched the bridge of her nose as she squeezed her eyes shut. Opening them again she felt somewhat refreshed, and picked up the chart she had finished reviewing. Slugging back the last bit of her cold coffee, she stood, ignoring the protesting ache in her feet and thighs. 13 more hours..13 more hours. Then back to my normal routine.
She had to admit that the normal routine for her was probably considered boring to most others. Her fellow residents relished in the nightlife and barhopping fun, where she preferred to jog and read. They preferred to flit between the beds of the women they dated, she was waiting for something special. Someone who could challenge her intellectually, captivate her emotions, help her dream..again. Someone like him.
Him. Even 10 years later she still thought of him. Memories of his wild hair and seductive eyes, of smiles and words promising passion and--
"Code blue, Emergency Room. 5 minutes." Blared the com unit in Sarah's office. Simultaneously, her beeper sounded, alerting her to the impending flurry of activity. Immediately, she felt her heart rate jump as she felt the surge of adrenalin signaling "game time".
She scooped up her stethoscope, and left the office with a swift stride. Rounding the corner to the corridor of the trauma bay, she was met by Dr. Diane Chapters the senior surgical resident, a feisty redhead who was frowning over the ambulance report.
Diane looked up and smiled grimly, "Hi Sarah. We have a young male coming in flat, with a stab wound to the stomach. They haven't been able to establish a line yet. The weapon is still in situ. " She stated worriedly. "I've called Ian down from anesthesia and the OR is on standby."
Sarah nodded her head as they walked into the trauma room. "Life in the big city." She muttered as she checked the open central venous access tray.
The nurses were hurriedly prepping the area. Checking the intubation equipment, filling the rapid volume fluid infuser with lactated ringers, and passing out protective equipment.
"They're here." Stated one of the nurses. All noise in the room stopped, replaced by the growing wail of the ambulance siren.
The automatic doors to the ambulance bay swished open as the gurney was rolled in by one of the attendants. The second EMT was straddling the gurney, doing compressions over the patient's sternum. He jumped down as the patient was transferred to the hospital stretcher. A young, well- muscled orderly resumed compressions as Ian slipped the endotrachial tube in place.
The EMT turned to Sarah and Diane to deliver his report, "We have a John Doe, mid 20's, found unconscious in the park with an apparent stab wound to the epigastric region of his stomach. Upon arrival, he was barely responding to command, and hypotensive. He crashed 7 minutes out. He is in v tach, no pulse or respirations. Pupils are dilated and responsive. We could not get a line in. Hell, we couldn't find a vein!" He finished, while wiping his forehead with his sleeve.
The team then launched into the choreographed dance of resuscitation. Smooth and seamless. Team A secured the tube and placed him on ventilatory support, while the second team cut his clothing away and placed warm blankets over his exposed body.
Simultaneously, Sarah donned her sterile gloves and prepped the man's neck for the central line placement. As she pierced the skin just above the clavicle with the introducer needle, she noticed that she obtained an immediate flash of blood in the collection chamber. Frowning and taking note of the shallow anatomy, Sarah guided the central line into place with ease. "O.K. Run the fluids in wide open! Get a liter of hespan up on the pressure infuser." As she passed the intravenous port to the medication nurse. The line was connected to the infusion port and began to whirr as the warmed fluids poured into the man's body, giving circulatory support. "Has the O neg arrived yet?" She asked as she sutured the line in place and dressed the wound.
"Lab said it's on it's way, Doc." hollered the recording nurse.
"40 mg of Vasopressin stat, then 1 mg of epi." she ordered. "Are we still in V tach?" she turned to the monitor next to the bead. The chaotic rhythm continued, indicating that the patient had no cardiac output. She was passed the syringe with the vasopressin, and injected it into the infusion line after swabbing the injector port with alcohol.
Immediately, Ian scooped up the paddles and charged them to 200 joules. "Clear!" he yelled, as he positioned the paddles on the man's chest. The patient's body jerked on the bed, spasming upwards as the electrical current spread through his body, contracting muscles and hopefully knocking out the errant cardiac rhythm.
All eyes swam to the monitor as the line flattened from the chaotic up and down to a flat line. "Come on...come on dammit.." Ian urged. "Abruptly, the line moved into a normal complex. Slow at first, but gradually, it picked up speed. "Yes! He's back! Sinus rhythm at 50. Check his pressure."
Sarah let out a deep breath and moved to assist the surgical team.
"Pressure is 72/40. Pupils are reacting and he's not liking the ET tube" yelled the nurse as she desperately fought to hold onto the airway that the patient was grasping. "BP 106/78, and we're going to loose this tube if we don't snow him out real soon folks." The patient had a death grip on the tube and was desperately trying to remove it.
Ian had moved up to assist the Nurse, and was slowly administering Ativan through the central line. Within seconds the patient's grip on the tube slackened and his hand slumped to his chest. "Little vitamin "A" always does the trick." He grinned.
Diane, Sarah and the charge nurse were examining the abdominal wound closely. The man's skin was a translucent white, like fine Italian marble over well developed but lean muscles. Delicate blue veins were visible under the skin. "Christ, He must have exanguinated most of his blood volume." Diane stated while bending closer to look at the abdominal wound. The hilt of a dagger protruded from the man's stomach, two inches above the umbilicus.
"Look at this. What the heck could have done this?" she said softly. The base of the wound appeared to be charred, the flesh melting and bubbling around the blade. Diane turned to the radiology technician, "Let's get several pictures of this abdomen and prep to get that knife out of there."
Minutes later the x-rays were being examined and puzzled looks were upon all faces. "I just don't understand" Sarah said pointing to the first film. "Where the hell are his liver and bowel?" Turning to look at Diane, Sarah noted that the momentary confusion on the senior residents face was suddenly replaced by recognition. "What's going on Diane?" Sarah whispered.
"Nothing. Probable pre-injury surgical history." She stated briskly, moving back to the patient. "Sarah, I'm going to remove the knife on the count of 3 and I want you to apply deep pressure to the wound." Diane handed a large bulky dressing to Sarah and placed her hand around the hilt of the knife.
"Shouldn't we get him up to the OR to do this?" Ian cautioned, "I think we'll risk doing more damage trying to get it controlled here Diane."
"If we don't get this thing out immediately, he won't make it to the OR." She replied sharply. As if on queue, the alarm sounded on the blood pressure monitor, indicating a sudden drop in Mr. Doe's pressure. "OK Sarah, on 3. One.Two...THREE!" The dagger slid out of the wound easily, and Sarah's hand firmly pressed the dressing deeply into the wound.
Diane briefly examined the dagger she'd placed on the abdominal tray then moved to place her gloved hand over Sarah's. "I've got it." As Sarah moved her hand away.
"His pressure is coming back up." Ian noted, and shot a questioning look to Diane. She glared meaningfully at him and glanced to Sarah briefly, while raising her eyebrows ever so slightly. Ian nodded slightly.
"Sarah, could you check the central line." He asked, replacing the ambu bag on the ET tube and ventilating the man manually. I think we should get him upstairs and check for internal damage."
She moved to the head of the bed and examined the line. Securing the line to his skin with 2 inch tape, she brushed the patient's long dark hair from his neck and shoulder. Stubborn strands fell back onto the dressing. "Let's just tuck this behind your ear." She carefully gathered the hair into her hand and moved it upwards and looked at the man for the first time.
His fine boned features were somewhat obscured by the ET tube and tube holder, but Sarah could see that he was quite handsome. On closer examination, she noticed that his eyebrows arched towards his temples, and felt a slowly growing sense of familiarity. She gently tucked the hair away, her hand trembling as she saw the elongated ear.
She stumbled back away from the gurney as it was moved out of the trauma bay by Ian and several nurses. Images of a maze, and piercing mismatched eyes flashed in her mind, as she stood numb and frightened.
Chapter 2.
Questions, questions, questions..
Jacket in hand, she slowly walked into the intensive care unit. Sarah was exhausted but needed answers to her growing list of questions.
Diane hadn't been much help. She couldn't explain the visible exterior oddities and when pressed to explain the radiology findings, Diane turned to her and said, "I have no idea Hon. Maybe he's had major retooling of his bowel. Guess we won't know much more until after sleeping beauty wakes up."
There was something about the mischievous glint in the red head's eyes that prompted Sarah to believe that she knew more than she was telling.
"Anatomy like that isn't something you see every day. Doesn't it strike you as bearing further investigation?" Diane stiffened. The question was abrupt, the tone all the more so.
Without looking up from the chart in her hand, Diane shook her head, "No Sarah. I don't. That chap has just come back from a rather nasty injury. I'm not sure he's even going to recover from this. He needs our best TLC and lots of rest. Nothing more."
"My point exactly." Sarah said, "But how can we give him the best degree of care possible if we don't fully understand his physiology?" She pressed
"Sarah. You are one of my best friends." Diane sighed, looking up at her friend. "Please don't make me pull rank on this one. The universe loves wondrous variety. Let's leave it at that" She placed a hand on her shoulder, and gave Sarah a small smile. Nodding, Sarah went back to work.
Now, here she was, 12 hours later, Jacket in hand, standing by his bed. The nurses had bathed John Doe upon his arrival to the ICU and he looked better for their care.
He was still unconscious and appeared to be resting comfortably. Sarah gently smoothed his soft black hair back from his forehead. His skin was still very pale, but was now warm to touch. She touched the pinnia of his ear, tracing the firm cartilaginous ridge to it's pointed tip.
She heard the soft whisper, "Sarah." a voice she recognized as deeply familiar stirred her soul.
"How are you tonight Dr. Williams?" a nurse asked, starting Sarah out of her trance, as she checked the ventilator settings.
"Tired and a bit confused by our young guest." Sarah admitted, "but, I wanted to check on him before I left for home." They moved to the nurse's station several meters away.
Sarah glanced at the nurse's name tag. "How is he Catherine?"
"Holding his own. Vital signs are stable and we don't see any evidence of infection. He hasn't roused yet." She shrugged. "Do we know anything more about him? Family or next of kin?" The nurse asked as she sipped a steaming mug of coffee.
"Nothing yet. However, police and social services are checking on their respective ends." Sarah replied, looking back at the young man. "How bad was the abdominal wound?" she asked.
Catherine chuckled, "Not bad enough to merit an exploratory laparotomy. He came straight to us from Cat Scan Doc." She looked up at Sarah with puzzlement. "You would think that a stab wound, severe enough to cause a code, would have done some degree of internal damage, right?"
"Makes sense to me. Drugs perhaps? Did we run a toxicology screen with his trauma panel?" Sarah asked picking up Mr. Doe's hospital chart.
"Yup. Clean as a whistle. Nothing on board that shouldn't have been there." Catherine said with a tight smile. "What's your take on this guy?"
"I'm not really sure Catherine." Sarah admitted. Flipping through the chart to the lab work, she scanned the labs, her brows knitting together. John's electrolytes were all elevated above normal limits. Muscle contractility, cardiac and renal output would be altered due to these values. "Did Dr. Chapters see these values?" she asked turning the page to the hematology panel. Her eyes widened in surprise.
His hemoglobin and hematocrit, the oxygen carrying component of the blood, were below the critical values. His tissues wouldn't be oxygenated and would eventually start to die off. She turned the page.
Arterial blood gasses were normal however. Her brow furrowed deeper. This just didn't make any sense at all.
"We called her with the results. But she felt that he was doing well, and didn't want to upset the apple cart." The nurse replied. "Ordered us to let him rest. So we've been letting him rest." Catherine was obviously displeased with Diane's lack of response to the abnormal lab values. Sarah grinned at her and wondered if Diane had pulled rank on them, as the ICU nurses had reputations of arguing patient care to death. She had to admit however, that if she were critically ill, she would want her nurse advocating for the best care.
"Would you give me a hand examining him Catherine?" She asked, picking up a stethoscope and neuro light from the desk.
"His renal output has been normal, and I can't explain why he's reading perfect oxygen saturation on the monitor with his hemoglobin level as low as it is. We tried 3 different machines, and had the same results each time." Catherine reported as they reached his bed side.
Sarah leaned over him and gently touched his face. "Can you hear me? I'm Sarah Williams, one of the doctors at the hospital. Can you open your eyes Sir?" No response.
She turned the over bed light off and smiled her thanks as Catherine handed her the flashlight. She noted that his pupil reacted briskly to the application of light. "Blue eyes." the nurse murmured.
Sarah nodded and moved to check his other eye. Gently she moved the lid away, exposing his eye. She froze as the light illuminated the quick contraction of his pupil and increased the visible portion of his soft brown iris.
"That's something you don't see every day, doc. One blue and one brown." Sarah wasn't listening. She already out of the unit, walking as fast as her feet would carry her.
There's also the kind who would prefer that history simply pass them by. The kind who just want to do their job and go home everyday in the same shape that they left home in. And it's often those kind of people who end up doing more and better than anyone else and end up making more history than the other kind.
Chapter 1. My Semi-normal life.
The coffee was cold. And if you had ever had real hospital coffee, also affectionately known as the "lifeblood of an ER doc", you would know that it was palatable only when it was somewhat lukewarm.
Sarah glanced up at the clock and sighed, realizing that she had only another 13 hours left of her 36 hour shift. Her fingers pinched the bridge of her nose as she squeezed her eyes shut. Opening them again she felt somewhat refreshed, and picked up the chart she had finished reviewing. Slugging back the last bit of her cold coffee, she stood, ignoring the protesting ache in her feet and thighs. 13 more hours..13 more hours. Then back to my normal routine.
She had to admit that the normal routine for her was probably considered boring to most others. Her fellow residents relished in the nightlife and barhopping fun, where she preferred to jog and read. They preferred to flit between the beds of the women they dated, she was waiting for something special. Someone who could challenge her intellectually, captivate her emotions, help her dream..again. Someone like him.
Him. Even 10 years later she still thought of him. Memories of his wild hair and seductive eyes, of smiles and words promising passion and--
"Code blue, Emergency Room. 5 minutes." Blared the com unit in Sarah's office. Simultaneously, her beeper sounded, alerting her to the impending flurry of activity. Immediately, she felt her heart rate jump as she felt the surge of adrenalin signaling "game time".
She scooped up her stethoscope, and left the office with a swift stride. Rounding the corner to the corridor of the trauma bay, she was met by Dr. Diane Chapters the senior surgical resident, a feisty redhead who was frowning over the ambulance report.
Diane looked up and smiled grimly, "Hi Sarah. We have a young male coming in flat, with a stab wound to the stomach. They haven't been able to establish a line yet. The weapon is still in situ. " She stated worriedly. "I've called Ian down from anesthesia and the OR is on standby."
Sarah nodded her head as they walked into the trauma room. "Life in the big city." She muttered as she checked the open central venous access tray.
The nurses were hurriedly prepping the area. Checking the intubation equipment, filling the rapid volume fluid infuser with lactated ringers, and passing out protective equipment.
"They're here." Stated one of the nurses. All noise in the room stopped, replaced by the growing wail of the ambulance siren.
The automatic doors to the ambulance bay swished open as the gurney was rolled in by one of the attendants. The second EMT was straddling the gurney, doing compressions over the patient's sternum. He jumped down as the patient was transferred to the hospital stretcher. A young, well- muscled orderly resumed compressions as Ian slipped the endotrachial tube in place.
The EMT turned to Sarah and Diane to deliver his report, "We have a John Doe, mid 20's, found unconscious in the park with an apparent stab wound to the epigastric region of his stomach. Upon arrival, he was barely responding to command, and hypotensive. He crashed 7 minutes out. He is in v tach, no pulse or respirations. Pupils are dilated and responsive. We could not get a line in. Hell, we couldn't find a vein!" He finished, while wiping his forehead with his sleeve.
The team then launched into the choreographed dance of resuscitation. Smooth and seamless. Team A secured the tube and placed him on ventilatory support, while the second team cut his clothing away and placed warm blankets over his exposed body.
Simultaneously, Sarah donned her sterile gloves and prepped the man's neck for the central line placement. As she pierced the skin just above the clavicle with the introducer needle, she noticed that she obtained an immediate flash of blood in the collection chamber. Frowning and taking note of the shallow anatomy, Sarah guided the central line into place with ease. "O.K. Run the fluids in wide open! Get a liter of hespan up on the pressure infuser." As she passed the intravenous port to the medication nurse. The line was connected to the infusion port and began to whirr as the warmed fluids poured into the man's body, giving circulatory support. "Has the O neg arrived yet?" She asked as she sutured the line in place and dressed the wound.
"Lab said it's on it's way, Doc." hollered the recording nurse.
"40 mg of Vasopressin stat, then 1 mg of epi." she ordered. "Are we still in V tach?" she turned to the monitor next to the bead. The chaotic rhythm continued, indicating that the patient had no cardiac output. She was passed the syringe with the vasopressin, and injected it into the infusion line after swabbing the injector port with alcohol.
Immediately, Ian scooped up the paddles and charged them to 200 joules. "Clear!" he yelled, as he positioned the paddles on the man's chest. The patient's body jerked on the bed, spasming upwards as the electrical current spread through his body, contracting muscles and hopefully knocking out the errant cardiac rhythm.
All eyes swam to the monitor as the line flattened from the chaotic up and down to a flat line. "Come on...come on dammit.." Ian urged. "Abruptly, the line moved into a normal complex. Slow at first, but gradually, it picked up speed. "Yes! He's back! Sinus rhythm at 50. Check his pressure."
Sarah let out a deep breath and moved to assist the surgical team.
"Pressure is 72/40. Pupils are reacting and he's not liking the ET tube" yelled the nurse as she desperately fought to hold onto the airway that the patient was grasping. "BP 106/78, and we're going to loose this tube if we don't snow him out real soon folks." The patient had a death grip on the tube and was desperately trying to remove it.
Ian had moved up to assist the Nurse, and was slowly administering Ativan through the central line. Within seconds the patient's grip on the tube slackened and his hand slumped to his chest. "Little vitamin "A" always does the trick." He grinned.
Diane, Sarah and the charge nurse were examining the abdominal wound closely. The man's skin was a translucent white, like fine Italian marble over well developed but lean muscles. Delicate blue veins were visible under the skin. "Christ, He must have exanguinated most of his blood volume." Diane stated while bending closer to look at the abdominal wound. The hilt of a dagger protruded from the man's stomach, two inches above the umbilicus.
"Look at this. What the heck could have done this?" she said softly. The base of the wound appeared to be charred, the flesh melting and bubbling around the blade. Diane turned to the radiology technician, "Let's get several pictures of this abdomen and prep to get that knife out of there."
Minutes later the x-rays were being examined and puzzled looks were upon all faces. "I just don't understand" Sarah said pointing to the first film. "Where the hell are his liver and bowel?" Turning to look at Diane, Sarah noted that the momentary confusion on the senior residents face was suddenly replaced by recognition. "What's going on Diane?" Sarah whispered.
"Nothing. Probable pre-injury surgical history." She stated briskly, moving back to the patient. "Sarah, I'm going to remove the knife on the count of 3 and I want you to apply deep pressure to the wound." Diane handed a large bulky dressing to Sarah and placed her hand around the hilt of the knife.
"Shouldn't we get him up to the OR to do this?" Ian cautioned, "I think we'll risk doing more damage trying to get it controlled here Diane."
"If we don't get this thing out immediately, he won't make it to the OR." She replied sharply. As if on queue, the alarm sounded on the blood pressure monitor, indicating a sudden drop in Mr. Doe's pressure. "OK Sarah, on 3. One.Two...THREE!" The dagger slid out of the wound easily, and Sarah's hand firmly pressed the dressing deeply into the wound.
Diane briefly examined the dagger she'd placed on the abdominal tray then moved to place her gloved hand over Sarah's. "I've got it." As Sarah moved her hand away.
"His pressure is coming back up." Ian noted, and shot a questioning look to Diane. She glared meaningfully at him and glanced to Sarah briefly, while raising her eyebrows ever so slightly. Ian nodded slightly.
"Sarah, could you check the central line." He asked, replacing the ambu bag on the ET tube and ventilating the man manually. I think we should get him upstairs and check for internal damage."
She moved to the head of the bed and examined the line. Securing the line to his skin with 2 inch tape, she brushed the patient's long dark hair from his neck and shoulder. Stubborn strands fell back onto the dressing. "Let's just tuck this behind your ear." She carefully gathered the hair into her hand and moved it upwards and looked at the man for the first time.
His fine boned features were somewhat obscured by the ET tube and tube holder, but Sarah could see that he was quite handsome. On closer examination, she noticed that his eyebrows arched towards his temples, and felt a slowly growing sense of familiarity. She gently tucked the hair away, her hand trembling as she saw the elongated ear.
She stumbled back away from the gurney as it was moved out of the trauma bay by Ian and several nurses. Images of a maze, and piercing mismatched eyes flashed in her mind, as she stood numb and frightened.
Chapter 2.
Questions, questions, questions..
Jacket in hand, she slowly walked into the intensive care unit. Sarah was exhausted but needed answers to her growing list of questions.
Diane hadn't been much help. She couldn't explain the visible exterior oddities and when pressed to explain the radiology findings, Diane turned to her and said, "I have no idea Hon. Maybe he's had major retooling of his bowel. Guess we won't know much more until after sleeping beauty wakes up."
There was something about the mischievous glint in the red head's eyes that prompted Sarah to believe that she knew more than she was telling.
"Anatomy like that isn't something you see every day. Doesn't it strike you as bearing further investigation?" Diane stiffened. The question was abrupt, the tone all the more so.
Without looking up from the chart in her hand, Diane shook her head, "No Sarah. I don't. That chap has just come back from a rather nasty injury. I'm not sure he's even going to recover from this. He needs our best TLC and lots of rest. Nothing more."
"My point exactly." Sarah said, "But how can we give him the best degree of care possible if we don't fully understand his physiology?" She pressed
"Sarah. You are one of my best friends." Diane sighed, looking up at her friend. "Please don't make me pull rank on this one. The universe loves wondrous variety. Let's leave it at that" She placed a hand on her shoulder, and gave Sarah a small smile. Nodding, Sarah went back to work.
Now, here she was, 12 hours later, Jacket in hand, standing by his bed. The nurses had bathed John Doe upon his arrival to the ICU and he looked better for their care.
He was still unconscious and appeared to be resting comfortably. Sarah gently smoothed his soft black hair back from his forehead. His skin was still very pale, but was now warm to touch. She touched the pinnia of his ear, tracing the firm cartilaginous ridge to it's pointed tip.
She heard the soft whisper, "Sarah." a voice she recognized as deeply familiar stirred her soul.
"How are you tonight Dr. Williams?" a nurse asked, starting Sarah out of her trance, as she checked the ventilator settings.
"Tired and a bit confused by our young guest." Sarah admitted, "but, I wanted to check on him before I left for home." They moved to the nurse's station several meters away.
Sarah glanced at the nurse's name tag. "How is he Catherine?"
"Holding his own. Vital signs are stable and we don't see any evidence of infection. He hasn't roused yet." She shrugged. "Do we know anything more about him? Family or next of kin?" The nurse asked as she sipped a steaming mug of coffee.
"Nothing yet. However, police and social services are checking on their respective ends." Sarah replied, looking back at the young man. "How bad was the abdominal wound?" she asked.
Catherine chuckled, "Not bad enough to merit an exploratory laparotomy. He came straight to us from Cat Scan Doc." She looked up at Sarah with puzzlement. "You would think that a stab wound, severe enough to cause a code, would have done some degree of internal damage, right?"
"Makes sense to me. Drugs perhaps? Did we run a toxicology screen with his trauma panel?" Sarah asked picking up Mr. Doe's hospital chart.
"Yup. Clean as a whistle. Nothing on board that shouldn't have been there." Catherine said with a tight smile. "What's your take on this guy?"
"I'm not really sure Catherine." Sarah admitted. Flipping through the chart to the lab work, she scanned the labs, her brows knitting together. John's electrolytes were all elevated above normal limits. Muscle contractility, cardiac and renal output would be altered due to these values. "Did Dr. Chapters see these values?" she asked turning the page to the hematology panel. Her eyes widened in surprise.
His hemoglobin and hematocrit, the oxygen carrying component of the blood, were below the critical values. His tissues wouldn't be oxygenated and would eventually start to die off. She turned the page.
Arterial blood gasses were normal however. Her brow furrowed deeper. This just didn't make any sense at all.
"We called her with the results. But she felt that he was doing well, and didn't want to upset the apple cart." The nurse replied. "Ordered us to let him rest. So we've been letting him rest." Catherine was obviously displeased with Diane's lack of response to the abnormal lab values. Sarah grinned at her and wondered if Diane had pulled rank on them, as the ICU nurses had reputations of arguing patient care to death. She had to admit however, that if she were critically ill, she would want her nurse advocating for the best care.
"Would you give me a hand examining him Catherine?" She asked, picking up a stethoscope and neuro light from the desk.
"His renal output has been normal, and I can't explain why he's reading perfect oxygen saturation on the monitor with his hemoglobin level as low as it is. We tried 3 different machines, and had the same results each time." Catherine reported as they reached his bed side.
Sarah leaned over him and gently touched his face. "Can you hear me? I'm Sarah Williams, one of the doctors at the hospital. Can you open your eyes Sir?" No response.
She turned the over bed light off and smiled her thanks as Catherine handed her the flashlight. She noted that his pupil reacted briskly to the application of light. "Blue eyes." the nurse murmured.
Sarah nodded and moved to check his other eye. Gently she moved the lid away, exposing his eye. She froze as the light illuminated the quick contraction of his pupil and increased the visible portion of his soft brown iris.
"That's something you don't see every day, doc. One blue and one brown." Sarah wasn't listening. She already out of the unit, walking as fast as her feet would carry her.