Go Baby Grow

Chapter 47 – Take Your Son to Work Day

Saturday, June 13th

Saturdays in the ER were often busy. Early in the morning, pediatric cases such as ear infections or high fevers were common. As the day unfolded, most of the patients needed immediate treatment for injuries were not life threatening. Mishaps on a hiking trail, falls from skateboards, or home improvement projects gone wrong accounted for the majority of cases. Interns and residents consistently spent their weekends suturing. On some weekend afternoons and evenings, a more serious injury made its way through the ER doors. Water skiing, boating, car accidents, and club sports produced injuries helped interrupt the monotony of seemingly non-stop suturing. The steady rhythm, however, quickened every week as the evening unfolded.

When Ryder and Owen arrived at the hospital on Saturday night, the ER was full but not beyond capacity. Doctors, residents, and nurses were busy but not swamped. A handful of people sat in the waiting room, hoping to be treated sooner rather than later.

"By 10 or 11pm," Owen predicted as he turned toward Ryder, "this room will be bursting at the seams with people needing medical attention."

Knowing he was shadowing Owen in order to see the dangers of alcohol use firsthand, Ryder consciously chose his reaction. Being engaged, interested, and curious would offer the best results. Accordingly, Ryder scanned the room and thought up a question. "How long do people have to wait when it's that busy?"

"Sometimes a couple hours or even longer. Wait time depends upon how many emergencies are coming through and the organizational abilities of the acting supervisor. The hope is that nobody waits over an hour. In reality, I've seen wait times for non-life-threatening cases extend as long as four or five hours," Owen shrugged as he walked toward the Attendings' Lounge.

Ryder followed a step behind Owen and sat down on the sofa once they reached the lounge. "Here," Owen advised as he threw a pair of white scrubs to Ryder, "change into these. The different colors are a quick way for the staff to identify who's who."

"And white means 'kid who was busted with a flask'?" Ryder joked as he changed his clothes, replacing his t-shirt and shorts with scrubs.

Owen chuckled and clarified, "White means orderly – someone who performs tasks that pose no risk to the patient." Owen changed into indigo scrubs and set his stethoscope around his neck. After throwing on his lab coat, he checked the pockets twice to make sure that he had everything he would need: prescription pad, protein bar, pen, magnifying loupe, pen light, cell phone, and marker.

"Let's go see what awaits us," Owen urged as he led the way back to the ER. As they walked, Owen explained what Ryder needed to do when ambulances arrived and while Owen was running traumas. He wanted him to have a front row seat, yet needed him to stay out of the way so medical personnel could treat the patient. During their dinner break, they'd debrief the cases and activity they'd seen.

They stepped off the elevator and approached the main desk. "Perfect timing," Kepner reported when she saw Owen. "Chopper en route with injured camper. Fell down a bank. Compound fractures, lots of bruising. Torres is on her way in."

"Heading to the roof," Owen nodded as he scanned the room and asked, "Can I get another set of hands?"

"Take O'Leary," April suggested as she called out to the resident and ordered her to follow Owen.

As the three rode the elevator to the roof, Owen introduced Ryder and Jane to one another.

Warmly, Jane inquired, "What brings you here tonight, Ryder? Are you interested in following in your dad's footsteps?"

"Not exactly," Ryder replied. "It's a long story." Jane nodded and forced a small smile, waiting for the elevator doors to open.

As the chopper landed, Owen instructed Ryder to remain back. The two doctors proceeded to the helicopter and listened to the bullets as they wheeled the gurney toward the elevator. The man's blood alcohol level had already been taken and was 0.18. Once inside and on their way down, Owen asked the patient a series of questions to assess mental status. O'Leary took a BP, listened to the patient's heart and noted basic vitals.

When the doors opened, Owen looked at Ryder and instructed, "Help us wheel him into a trauma room then stay about three steps behind me."

Two nurses and another doctor were waiting in the trauma room. Owen ordered, "On my count… 1… 2… 3." The team worked together to address the patient's needs. They swarmed around the hiker, attaching monitoring devices, inserting IVs and assessing the situation.

"Talk to me, people," Owen called out as he cut then ripped the hiker's pant leg.

"BP 160/100," O'Leary reported.

"Let's start some hydromorphone. Start with 0.015 bolus with repeat dosage every five minutes as needed," Owen ordered. "Somebody hand me an injection of Depo-Medrone." He put his hand out and a syringe was immediately placed in his hand. As he injected the anti-inflammatory near the patient's injury, he ordered antibiotics and told O'Leary to be ready to intubate. Owen hoped to keep the patient semi-conscious until Torres arrived in case she had any questions for him prior to surgery.

As Ryder watched, he thought about how smooth Owen ran the room. Accustomed to calling out orders and having them followed immediately and without question, his expectations for his children began to make sense. Follow the request, debrief later if at all, Ryder pondered. The other observation, which caused Ryder to chuckle, was that after ripping the patient's pants, Owen simply threw the material behind him and to the side. There was no cleaning-as-we-go. Must be nice to have a whole staff picking up after his messes.

Torres entered the room and assumed command, outlining her surgical plan aloud as she assessed the patient. She conferred with Owen, and they both determined that he wasn't needed in the OR. After passing along critical information, Owen stepped away as Callie and her team wheeled the gurney to an OR. Owen ripped off the yellow trauma gown and noticed there was blood on his pant leg. He walked to the desk before determining whether or not he had a chance to change.

"MVA pulling into the bay now," Kepner reported. "Motorcycle versus sedan. Police right behind – DUII suspected."

"Where do you need me? Which patient?" Owen inquired. Ryder was intrigued that the Chief of Surgery was asking one of his subordinates for an assignment. He'd learn later that everyone reported to the doctor who was running the ER so that one central figure was managing the department.

"Take the driver. 35-year-old female," Kepner instructed.

Within a few moments, Owen was running alongside a gurney and introducing himself to the driver. "Ma'am, I'm Dr. Hunt. Are you experiencing any pain?"

With glassy eyes and a ready smile, it was easy to see why the police suspected the woman was drunk. She grasped Owen's hand and cooed, "You're cute…you can treat me all night, sweetheart." Stifling his laughter, Ryder nearly fell to the ground in hysterics.

"I need your consent to treat you," Owen explained flatly as he leaned toward the woman and looked her in the eye.

"Anything, Cutie," the woman purred.

Owen rolled his eyes and began issuing orders as the gurney arrived in a treatment room. "BAC off the bat," he insisted. "Then vitals." He gazed up and saw the motorcyclist being wheeled past the room. The young man was in bad shape. After assessing the woman's injuries and encountering come on after come on, Owen tore off his trauma gown and snapped, "Nothing life threatening. Page me when she sobers up or passes out." He stomped out of the room and Ryder fell in behind him.

The two entered the Trauma Room where a team was working diligently to stabilize the patient. Monitors blared and beeped as various doctors and nurses called out brief reports and orders.

"Stop that bleeding," Kepner commanded as she looked at a resident who was placing pressure on a large leg lac. "He's losing too much blood too fast."

Owen stepped toward the leg and instructed the resident on techniques. Ryder was struck by how calm Owen remained in the midst of all the chaos. Focused only on the task immediately at hand, Owen was able to temporarily slow the bleeding. The noises from the monitors calmed and slowed as Kepner smiled with relief at her boss.

"Heart beat is stabilizing. BP normalizing," she shared. "Let's get him up to surgery." She gazed at Owen and questioned, "Can you join me and work on that leg while I deal with abdominal injuries?"

"Who's going to run the board?" Owen wondered aloud.

"Murphy. He'll page one of us if he feels over his head," April shared as she described the situation.

Ryder followed the team, but knew he needed to sit in the gallery during the surgery. Throughout the operation, Owen muttered and commented on how all the injuries were a result of one person's drinking and driving. His topic led others to weigh in and discuss various alcohol-related situations from the past. While a part of him wanted to turn off the OR speaker and ignore the intentionally chosen topic, he knew Owen would want to discuss it with him later. He listened and surrendered to self-reflection about his own alcohol use. His parents had been right – seeing the results of alcohol-related injuries firsthand was teaching him a lesson.

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Back at the Lake House, the Littles watched a movie in the TV room and Olivia washed the dinner dishes. Amelia was lying on the sofa, attempting to read a journal article about a new method for treating large aneurysms. As her eyelids faded closed, she found her ability to focus on the topic lacking. She blinked rapidly, gulped down some water, and shook her face back and forth in an attempt to revive her energy so she could finish the write up. While undergoing her strategies to find extra energy, a text from Julie came through her phone. It read, Any chance you have a minute?

Amelia pursed her lips and felt her heart hurt for the girl she'd come to adore and love. Before she could send a response, Julie sent a second text that stated, You're busy, aren't you? I'm sorry I bugged you. We'll talk soon.

Deleting what she'd begun to write, Amelia recomposed her response and sent back, Now is great, Julie. What's up?

Are you sure? Julie reluctantly sought to confirm.

Absolutely. I'm totally sure. I'm reading a boring article on brain surgery. Save me! Amelia teased.

Can we talk? Julie requested.

Amelia slipped her Bluetooth on her ear and hit the dial button. When Julie's soft voice answered, Amelia stated, "You sound pretty down, my friend."

"I'm a balled up mess of emotion and confusion," Julie chuckled. She'd been crying but was initially able to hide any hints about her current state.

"Sounds familiar. I've been there a time or two," Amelia responded gently.

Silence hung on the line. Julie knew if she put words to her feelings, she'd dissolve into tears. At the same time, she so badly needed a Mom. She needed to hear that all of the overwhelming realities swirling in her midst would not win the day and knock her down forever.

"Take your time," Amelia encouraged. Olivia approached, but noticed immediately that Amelia was on the phone. Amelia patted the empty space on the couch and Olivia snuggled next to her.

After a small sniffle, Julie disclosed, "It's been a really tough week. I feel like I've lived through about a month's worth of bad days."

"Like you're carrying a ton of bricks?" Amelia prompted.

"Something like that," Julie chuckled as she wept lightly. "I'm so exhausted that I don't even know where to start or what to say.

"How about starting with the first crummy experience of the week?" Amelia suggested as she squeezed Olivia close to her and caressed Livie's curls.

"I-Day is coming up and I'm excited and scared and worried and eager," Julie began without pausing for breath. "That's a constant cloud over me. Saying goodbye to my brother sucked. I feel like I barely visited with him and who knows when I'll see him again. Then the floor crumbled under my feet," she rambled.

"How so, JJ?" Amelia asked with compassion.

Beginning to weep, Julie managed to share her news, "My boyfriend broke up with me."

"I'm so sorry, Sweetheart," Amelia sighed. "A broken heart is heavy to carry."

"A part of me knew we couldn't last forever, but I really wanted to believe we'd find a way around that," Julie reported not knowing that Amelia understood the situation in detail.

"He was your first?" Amelia inquired without judgment.

"My first real boyfriend," Julie detailed. "We didn't… we almost… but we didn't…" she sputtered, unable to utter the words about whether she and Nate had consummated their relationship. Tearing up further, Julie added, "And I don't care about rules or that we shouldn't be together. I loved him," She admitted. "I still love him."

"Do you want to come over?" Amelia offered. "Owen and Ryder are at the hospital all night. Olivia and I are hanging out on the couch and the kids are plugged into a movie."

"Yes and no," Julie replied. "If I left, I'd have to go downstairs and talk to my dad. He can't know a thing about the relationship, and he'll wonder why I've been crying."

"I wish I could wrap my arms around you and hug you," Amelia shared gently.

Julie inhaled deeply and said, "It hurts so bad. I feel completely broken."

"I know," Amelia resonated. The poor kid was experiencing her first heartbreak and the pain was washing over her like a tidal wave.

"Why did it have to happen like this? I don't want to say goodbye to him. I love him," she sobbed.

Whispering, Amelia repeated, "I know."

"I feel so empty," Julie disclosed with vulnerability.

"It hurts," Amelia echoed softly.

"It hurts so much," Julie added as she began to sob. Amelia remained on the phone, but said nothing as Julie unleashed her tears. "All I want," Julie eventually stated, "is to be held by him. I want his arms around me. I want to trace his muscles and rest my head on his shoulder."

"His embrace felt safe and secure," Amelia mused, knowing the experience of loving someone and being held.

"It did," Julie whimpered. "Nothing else in the world mattered if I was in his arms. Now I feel like nothing at all matters."

Amelia's eyes became misty as she listened to Julie's grief. Telling Julie that the feeling would pass or correcting the statement about how nothing mattered would not help. Julie needed to feel and experience the pain, not be distracted from it. As Amelia considered the situation, she wondered why she could so easily identify the need to grieve in others when she had been so adept at denying her own pain throughout the years.

"The tears eventually bring healing," Amelia shared, not sure that her words would provide any comfort.

"I don't want to heal," Julie responded. "I just want him."

"I know, Julie. I know," Amelia uttered with gentleness. In that moment, allowing Julie to wallow in grief was the greatest gift Amelia could provide. "I'm here 24/7. I'm here. You're not alone," Amelia assured her.

Forty-five minutes later, Julie thanked Amelia. She was exhausted mentally, emotionally, physically and intellectually. "I'm going to try to sleep," Julie shared as she sniffled.

"Call me in the morning," Amelia advised. "I'll be thinking about you all night, JJ."

After ending the call, Amelia leaned away so she could better glimpse Olivia's face. Livie had fallen asleep with her head resting on Amelia's shoulder. Unaware of Olivia's internal struggles, Amelia brushed back Livie's red hair and thought about her daughter. She's still so young and naïve… not a care in the world other than wishing she wasn't grounded. I wish I could take away all the heartbreak and pain that will flood her way in the years to come. I wish there was a way to box up 4-year-old Livie and keep her that way forever – carefree, jubilant, silly. The idea of this sweet girl ever experiencing heartbreak or pain is too much to imagine. I wish I could protect her and shelter her forever.