Sunday, November 7, 2010

I killed Emil...

I just reread this scene, and I'm really happy with how it came out - which is really bizarre on a first draft.  Feel free to tell me how to make it better.

Chapter 13

I weaved through the room until I got to the far side of the bed.
“Ruby,” I said, “where’s Bronte?”
“Hannah, what are you doing here?  Can you…”
I cut her off. 
“I can’t.  I’m off the clock and under the influence.  Garrett’s here – I’ll stick to emotional support.  He wants to come in.  What happened?”
“I have no idea.  One minute everything was fine, the next, his pressure bottomed out and his heart rate dropped and then stopped altogether.  I would have called Garrett sooner, but I was in a scramble to start coding him.  As it was I had to have the supervisor call him because I was in the middle of doing chest compressions.” 
“That’s fine, is Bronte on his way?”
“Yeah.  We paged him first.  He should be here any minute,” she said, and she turned to the code sheet.
“We’re due for another epinephrine,” she called, and handed it over to Elyse, the nurse who was giving the meds.
“I’m going to bring Garrett in, are you guys ready?”  I looked around the room and found Alden.  Thank God the nurses weren’t the only ones in the room with brains.
“Epi’s in,” Elyse called, and Ruby marked the time on the code sheet.
“Family’s coming in,” Ruby called, and the side conversations hushed as I made my way back out the door.  I met Garrett just outside the door.
“Ready?” I asked.
He nodded.  I wrapped my wrist around his upper arm to guide him and started talking as we walked through the door.
“There’s a lot going on right now.  From what Ruby told me, he was fine and then suddenly his blood pressure dropped and his heart rate slowed and then stopped.”
The forest of white coats made a path that effectively guided us to the far side of the bed.  The side rails of the bed were down to allow Elyse access to the intravenous sites.  It also allowed Garrett access to his father’s arm.  He hesitantly rested his hand on his father’s and gave it a gentle squeeze.  I released his arm and rested my hand lightly on his shoulder so he knew I was still there.
“Hold compressions,” Alden called, and the room was still, all except for the medical resident at Emil’s groin who was holding the Doppler to the femoral artery.  Instead of the whoosh-whoosh of a pulse, there was only the static caused by the medical resident searching for a pulse.
“What’s the rhythm?” Alden called.
“Asystole,” Ruby answered.
 “Elyse is giving him medications to try to start his heart again,” I said quietly.  “Ruby’s in charge of keeping track of what’s been done.  Frank is doing chest compressions to circulate the medications so they reach you dad’s heart and Cheryl is using the ventilation bag to breathe for him and give him oxygen.”
Garrett nodded, staring down at the bed.  His expression was resigned, almost stoic, until there was a commotion in the hallway.  Garrett’s head snapped up, and he darted for the door.  He caught Rosemary just as she was about to enter the room and I saw the terror in her face as she took in the scene.  Her eyes were wide and her hand covered her mouth.  She buried her head in Garrett’s shoulder and as I approached them, I could hear him murmuring in her ear.  Another woman, who must have been Rose’s partner Martha, stood a few feet back, tears streaming down her face.  I could hear what Garrett was saying now that I was next to them.
“Are you sure you want to go in?” he asked Rose.  She nodded, her face still buried in his chest.  “It’s not pretty, and he doesn’t look like himself.”
“I don’t care,” she sobbed, “I want to see him.”
I motioned to Martha to come closer, but she shook her head.  I looked around quickly, and found a chair in the hallway that wasn’t being used and pulled it over for her.  She nodded, and rested her hand on the back of it.  It was clear by her rigid posture that she wasn’t about to sit, but it was the best I could do for the moment.  I turned back to the room to see Garrett walking Rosemary over to the bedside.  I quickly followed them in, not knowing how Rose was going to react, and wanting to be close in case Garrett needed help. 
As they reached the bedside, she reached down for Emil’s hand and then her knees gave out and she was kneeling at his bedside.  Garrett kept his arms around her, and I quickly pulled over a chair.  Together, Garrett and I helped her into it, and once she was settled, he stood behind her to watch.  I put my hand on his back, and then moved a few steps away, letting my hand slip down to rest on the footboard of the bed.
Dr. Bronte came in at that point and spoke with Alden and Ruby.
Around us, the code team continued to give medications, do CPR and breathe for Emil.  Rosemary’s shoulders shook as she cried and Garrett rubbed her back, tears streaming down his cheeks.  This wasn’t fair, and I wanted to yell, but there was no one to yell at, no one to blame.  It wasn’t fair for them to have to go through losing their father after losing their mother.  And it was so incredibly frustrating to know that there was nothing I could do to stop it from happening. 
Dr. Bronte came over then to speak to Garrett and Rosemary.
“From what the nurses and doctors are telling me, I don’t think your father is bleeding again.  I don’t see any benefit from taking him back to the operating room for another surgery.  It’s not going to stop what’s happening here.”
Rosemary sobbed harder, and Garrett took a deep breath in and held it before letting it out again.
“What are you saying?” he asked, steeling himself for the reply.
“The medications aren’t working, and although we can continue to try to resuscitate him, the outcome isn’t likely to change.  I believe we’ve reached a point where this is out of our hands.  Do you want us to keep trying to bring him back?”  Dr. Bronte was as gentle, yet as honest as he could be.
“Garrett,” Rosemary said, her voice hitching, “I think they should stop.”
“I know, Rose, me too.  Dr. Bronte?”  Garrett let the question hang in the air.
“Ruby, what’s the time?” Dr. Bronte asked.
“One twenty-nine a.m.” she replied.
“Time of death, one twenty-nine a.m.  Thank you every body.”  And with that, Dr. Bronte dismissed the medical team.
The sounds of activity faded, and one-by-one the members of the team left the room as Dr. Bronte stood with me next to Garrett and Rosemary.
“I’m very sorry,” Dr. Bronte said.  “If there’s anything else I can do, Hannah knows how to reach me, and you have my card.  And again, I’m very sorry that there wasn’t more that we could do.”
Garrett shook his hand and thanked him, and I walked with Dr. Bronte to the door of the room.  Martha was sitting in the chair I had given her, her elbows on her knees and her head in her hands.  I walked over to her and invited her into the room.  When she looked up, the room was nearly empty, except for Garrett, Rosemary and Ruby.  Ruby was finishing with the monitor so she could turn it off.  Martha seemed hesitant, until Rosemary’s brittle voice called, “Martha?”  With that, she was up and crossed into the room so quickly, I didn’t bother to try and keep up.
Garrett had stepped back and sunk into a chair against the wall.  I pulled another chair over next to Rosemary for Martha, and she sat, putting her arm around Rose.  I handed her a box of tissues, then grabbed another for Garrett and myself.  Rose leaned forward, resting her forehead on her father’s arm and let out a high, keening cry, then dissolved into shaking sobs.  As tears streamed down my face I wept for a man I’d never actually met and realized that I’d never gotten so close to any other family in my career.
“Hannah,” Rose choked.
“Yeah, Rose?”
“Does he have to have all those tubes in him?”
“Not any more.  Do you want to leave while we take them out?  You can come back in as soon as we’re finished.”
Rose nodded.  She and Martha pushed back their chairs and gathered up their tissues.  Ruby left to get the supplies we would need and some fresh linens.  Garrett didn’t make any motion to leave.
“Are you sure you want to stay?  This part isn’t really pleasant,” I warned.
“I’ll be ok,” he said, “I’d rather be where you are.”
“Oh,” I said, surprised.  “I don’t have to help Ruby.  I can ask another someone else to come in and I can go out to the waiting room with you.” 
He shook his head, closed his eyes and leaned back in the chair.  I felt a little better that he wasn’t watching.  Ruby came back in with the supplies, and we began getting Emil cleaned up.   As we worked to remove Emil’s tubes and drains, I felt Garrett’s eyes on us.  I looked up to see him studying his father and then shifting his gaze back to me.

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