“Married?” said Sanger, laughing.
Martin waved her off. “Administrative worries. Don’t get me started! Let’s get this Lynn Anne Lucas up here and do the CAT scan and X rays I couldn’t do on Lisa Marino.”
“You realize it is a bit late. The CAT scan technician closes the unit down at ten and leaves. We’d have to call him in. Are you sure you want to do all this tonight?”
Philips looked at his watch. It was ten-thirty. “You’re right. But I don’t want to lose this patient. I’m going to see that she’s admitted at least for the night.”
Denise accompanied Martin back down to the ER, leading him directly into one of the large treatment rooms. She motioned for him toward the right corner, and pulled back a curtain separating a small examining area. Lynn Anne Lucas looked up with bloodshot eyes. She’d been sitting next to the table, leaning on it, with her head on her arm.
Before Denise could introduce Philips, her beeper went off and she left Martin to talk with Lynn Anne by himself. It was immediately apparent to him that the woman was exhausted. He smiled at her warmly, then asked if she would mind staying overnight so that they could get some special X rays in the morning. Lynn Anne told him she didn’t care, so long as she was taken out of the emergency room and could go to sleep. Philips gave her arm a gentle squeeze. He told her he’d arrange it.
At the main desk, Philips had to act like he was in a bargain basement, pushing, yelling and even hitting the countertop with an open palm to get the attention of one of the harried clerks. He asked about Lynn Anne Lucas, wanting to know who was in charge of the patient. The clerk checked the main roster and told him it was Dr. Wayne Thomas who was currently down in room 7 with a stroke.
When Philips walked in he found himself in the middle of a cardiac arrest. The patient was an obese man who draped over the examining table like a huge pancake. A bearded black fellow, who Philips soon learned was Dr. Thomas, was standing on a chair giving the patient cardiac massage. With each compression Dr. Thomas’s hands disappeared into folds of flesh. On the other side of the patient, a resident was holding defibrillator paddles while he watched the tracing on the cardiac monitor. At the patient’s head, an anesthetist was ventilating him with an ambu bag, coordinating her efforts with Dr. Thomas.
“Hold up,” said the resident with the defibrillator.
Everyone backed up while he positioned the paddles over the conductive grease on the patient’s ill-defined thorax. When he compressed the button on top of the anterior chest lead, a surge of current raced through the patient’s chest, spreading electrical havoc. The patient’s extremities fluttered ineffectually like a fat chicken trying to fly.
The anesthetist immediately recommenced respiratory assistance. The monitor readjusted itself and a slow but regular tracing appeared.
“I got a good carotid pulse,” said the anesthetist with her hand pressing on the side of the patient’s neck.
“Good,” said the resident with the defibrillator. He hadn’t taken his eyes from the monitor, and when the first ectopic ventricular spike occurred, he ordered “seventy-five milligrams of Lidocaine.”
Philips walked over to Thomas and got his attention by tapping his leg. The resident climbed down from his chair and stepped back, although he kept an eye on the table.
“Your patient, Lynn Anne Lucas,” said Philips. “She has some interesting X-ray findings in her occipital area extending forward.”
“I’m glad you found something. My intuition has been telling me there’s something wrong with the girl but I don’t know what it is.”
“I can’t help with the diagnosis yet,” said Philips. “What I’d like to do is take more films tomorrow. How about admitting her for the night.”
“Sure,” said Thomas. “I’d love to but I’m going to take a lot of flak from the boys if I don’t have even a provisional diagnosis.”
“How about multiple sclerosis?”
Thomas stroked his beard. “Multiple sclerosis. That’s a little out on a limb.”