Chapter 10
Joe Early is just going over some x-rays on a ten year old boy who wrecked his bike. He's in need of some fancy stitches across the top of his head but before he sewed him up, Dr. Early wants to make sure there are no surprises under the laceration. As he's studying the x-rays the boy's mother and his nurse are doing their best to keep the terrified kid calm and still.
As Dr. Early leans forward to examine the x-rays closer Dixie walks into the room and gives the people in the room a friendly smile before stepping up next to Dr. Early.
"There's a Dr. Frick on line four for you. He said he needs to talk with you about a patient he's having transferred here for you to take care of." As Dixie delivered the message she also handed him a patient history form already attached to a clip board.
"Sure, Dix. Would you set up a complete suture set and contact the anesthesiologist on call, I want to use a little more than just a local on this one."
"Sure Joe, right away."
"Did you say line four?"
"Yes."
Joe stepped over to the phone in the corner of the room and once he had the clip board pushed against his hip he picked up the phone and pushed the lit up button number four.
"This is Dr. Early,"
-0-
Six hours away, lying in a hospital bed with the head of the bed raised and on oxygen, rested one very pale and unhealthy doctor Frick. Standing at his bedside was a nurse holding a syringe full of pain killer and impatiently waiting for the doctor who was also a patient to finish this phone call before she injected it into his IV.
Sometime during the previous night, Dr. Frick had been awakened from his slumber at the hospital to deal with the aftermath of a drunken brawl. While trying to wrestle with a very uncooperative patient, Dr. Frick experienced a sharp pain in his chest, accompanied by shortness of breath. A wise old nurse who had just enough military training to throw her weight around ordered the doctor moved to his bed and called the emergency phone number for a network of doctors who will give medical instruction over the phone in an emergency. As a result the patients were transferred two hours away to have some simple stitches and to sleep it off but Dr. Frick refused to accept a transfer to the hospital four hours north because like Julie had reveled to Roy and his friends that doctor there thought he was a god and should be worshiped as such. And quite frankly Dr. Frick didn't like dealing with the guy when he had to and he had no intention of letting him get his hands on his body for any reason.
Sighting the needs of a patient he just couldn't leave, Dr. Frick remained in the hospital but was ordered and had agreed not to leave his bed for any reason. A group of medical residents were on their way to cover the medical needs of the area and until they got there all patients that couldn't be treated from his bed were asked to wait or sent to the next doctor over who was two hours to the east.
The receiving doctor was another country doctor like himself Dr. Clay was looking for semiretirement and set up in what he thought was a quiet recreation area where he was joined by his son on weekends to treat the skiers during the winter and the hikers during the summer. He wasn't enjoying the influx of patients from so far away but he did understand.
Dr. Frick took a deep breath through his oxygen cannula and fought to clear his mind as he began to talk about the one patient he was sending outside his established network.
"This is Dr. Richard Frick, I have a patient who was vacationing in this area and was in an automobile accident. He sustained a head injury that was originally diagnosed as a mild to moderate concussion but is now experiencing complications of a bloody nose and fluid in his left ear. The normal medical network in this area would have us transferring him four hours further from his home to get the additional testing that his condition requires and he is requesting to be sent to you instead even though the transfer is two hours longer than the one in our network. He says you know him, a man by the name of Roy DeSoto."
-0-
Back in the treatment room of Rampart Emergency, Dr. Early came to immediate attention at the name given.
"Yes, I know Roy DeSoto, what more can you tell me about his current condition?" Hearing Dr. Early's words also brought Dixie to immediate attention as she was setting up a suture pack across the room.
"Just a minute, let me get to another phone." Dr. Early realized he had a few people listening in on his conversation. "Dix, after you call the anesthesiologist will you ask Kell to meet me in the next room."
The call was placed on hold and Dr. Early slipped through a side door into the next treatment room that just happened to be empty of a patient at the moment.
Joe had just finished listening to a detailed report on his newest patient and was relieved to hear about his current clear mental state when Dr. Kelly Brackett stepped into the room.
"What have you got, Joe?" Kell asked as he looked over his shoulder at the notes he was taking as he talked.
"What kind of treatment options are available during transportation?" Dr. Early asked his counterpart on the phone. "Would it be possible to keep him on oxygen and run an IV of Ringers TKO during the ride?"
While Joe waited for the doctor to respond to his question he pulled Kell's attention to the name of the patient by tapping the top of the page with his pencil. The sudden change in his colleague's expression said all he needed to know. The phone was switch to speaker so that Dr. Brackett could hear everything else that was said.
-0-
Back in his hospital bed, Dr. Frick thought that even though he trusted Julie Clark explicitly and would have no trouble letting her take care of an IV for the whole journey, he didn't want to do anything to cause her trouble in finishing her four year nursing degree. He was sure that she was certified in only three states and California wasn't one of them.
"Well," he spoke as he thought out loud, "they'll be accompanied by someone who can manage that with no trouble but she's not certified past the California state line. Roy's partner, I can't remember if I got his name or not, but he's one of you guys' paramedics, will be with her, too. Can he take over at the state line?"
-0-
Back in the Rampart treatment room two doctors are sharing eye contact and both realizing they have a bit of a problem. They too wanted Roy DeSoto under their care not sent someplace farther from his home, and them, for that matter.
"I'm afraid our Paramedics aren't certified outside of LA County," Dr. Brackett spoke up. "Is there someone you could send who can handle things until then?"
"We could try and meet them at the state border with one of our nurses," Joe spoke softly, his words meant for Kell's ears only. "I'm sure Dix would be willing."
Just as Dr. Early is about to go pull Dixie into their conversation Dr. Frick speaks up. "Well now that might be something we could work out but there's a few strings attached. You 'all wouldn't by any chance have someone in that spacious palace you call a hospital that can deal with phlebitis now do you."
"Of course we can handle that," Dr. Bracket spoke up again.
"How about an OB that can handle high risk twins for the last few weeks of the pregnancy?"
"Of course we'd need the patient's complete medical records but I'm sure that could happen." Dr Brackett was beginning to wonder just what was going on in this one horse town.
"Well that'll be no problem as my nurse is working on that at the moment. Complete with x-rays and lab tests. If you'll accept the package deal we'll be putting a doctor on board that transport."
The rest of the conversation was about what time to expect their patients to arrive and recommended treatment enroute. When Dr Early suggested a police escort he got a little nervous at Dr. Frick's answer.
"Our driver says a police escort will just slow him down. We'll be fine, we should be on the way in sight of an hour and the next time we talk will be when we're closing in on your location."
The phone call was disconnected and Joe shared with Kell all that was discussed before he entered the room.
"Sounds like we're getting a bus load; I wonder what they're driving to get here." Kell asked in hindsight.
"I don't know, but I hear some of these small communities buy ambulances where they can hang the patients from the ceilings."
"Six hours in an ambulance like that is enough to fry anyone's nerves. I sure hope Johnny is up to it."
"He'll be taking care of Roy and we both know either one of those two would move heaven and earth for their partner. Johnny'll come through with flying colors.
-0-
Back in the bunk house above the barn Johnny was covering Roy with a blanket to keep him warm. He had checked his ears one more time and was watching Roy's pupils; so far all looked the same as it had twenty minutes before.
Frank was still at Roy's side quietly holding Roy's hand as Chet watched on in wonder. Julie just stood by the phone and whenever Johnny checked Roy over in any way she questioned his findings.
When the phone rang she picked it up on the first ring. "Hello, oh, hi, Oz. Uh hum, okay, sounds good. Okay, we'll be ready," Julie said and the phone was hung up.
"All right everyone our transportation will be here in about an hour and we'll have you all homeward bound. You need to get packed up. But we're going to be tight on space so your camping and fishing gear are probably going to have to stay behind until you get your truck."
"I'll take care of getting our stuff ready," Chet stepped forward and quickly pulled out the three duffle bags in preparation of packing them.
"Frank, you're going to be staying with my dad for a couple of days. Is that going to be alright with you?"
"Y-y-yes, ma'am."
"I'm not a ma'am I'm a Julie." Julie spoke with a growl to her voice but a smile on her face as she tussled Frank's hair with her fingers causing him to duck his head and blush.
With Frank appropriately teased, Julie then made eye contact with Johnny and hooked her thumb toward the balcony. Johnny got the message.
"You just sit tight, Roy. I'll be back in a minute."
When Johnny reached the balcony Julie was waiting for him with her arms carefully folded across her chest and a worried look on her face. She didn't wait once he closed the sliding door she just started talking.
"Your Doctor Early ordered Roy to be transported with an IV and on oxygen. He wants him to have something to keep him calm and keep his stomach settled on the trip. He still wants us to do neuro checks every two hours on the trip."
John let out a deep breath, there was nothing said that went beyond what he thought should be done anyway. "Okay."
"There's more," Julie stopped Johnny from hurrying back to Roy's side. "Roy's not going to be our only patient. We're going to have Doc Frick on board. Not only is he not really responding to his own treatment, last night the police drug in a couple of drunks that had gotten into a brawl in one of the local pubs. One of them shoved Doc against the wall, and then started fighting amongst themselves again. Before the Sheriff got them under control again something of key importance was broken on the x-ray machine and Doc was on the floor with extreme chest pain and shortness of breath. According to Ozella Peterson, the nurse that was pulled into the hospital to cover for another nurse, the lump in his calf is measurably bigger this morning. She called the state medical authorities and had Dr. Frick declared temporarily incompetent to practice medicine because of his health. Every patient since then is being treated by phone conference with Ozella or being sent to another doctor until a group of residents arrive tomorrow. Frick doesn't want to be treated by either the residents on the way or the doctor calling the shots over the phone. Apparently the two of them have history, and from the words Ozella refused to repeat I'm guessing it's not a good history.
"To sum this all up we are making this trip AMA and could find ourselves scrambling for the nearest hospital at any point on this trip for either patient and we could be on somewhat shaky ground as far as legal talk in the area between the California state line and the LA county line where you can legally take over under the directions of your doctors. Ozella said there was a Dr. Brackett working things out. Jack has been given a radio frequency that we should be able to use to get in direct contact with your hospital fairly soon after we cross the state border but no one's sure how soon. Are you okay with all of this?"
"I'll do whatever I have to, to get Roy home where he belongs." Johnny spoke with resolve.
"And I'll do whatever I have to, to get Doc to the treatment he needs and will accept." Julie let her position be known.
"I hope you can work with me and we can bounce things off each other on this trip." Julie gave Johnny a questioning look.
"Consider yourself my temporary partner, and that's just what partners do," Johnny responded. "I have to admit this is the longest patient transfer I've ever assisted in."
"Not me, I rode with a congestive heart failure patient all the way to New York once so she could die with her family. Now that was a long, eternally long, transfer. We only got her there a few hours before she slipped into a coma and passed away the next morning. But when she died she had the most peaceful look on her face. That made it all worth it. I'll give everything I've got to this trip too."