"What does that indicate to you?" Patrick's gaze narrowed.
"Possible clot."
"And?" Patrick took the doctor-in-training through the chain of diagnosis and treatment. He sighed watching the deer-in-the-headlights reaction form. "Dilaudid, 4.0 mg. Now." The resident flew out of the room at the snapped command. "We’re going to try this, Avery. If you’re still hurting, we’ll try something else. We’ll keep you comfortable."
A nurse came in the door with the syringe behind the anxious resident. "I have it, Doctor." Confirming the medication, she injected it.
Relief dawned over the patient's face. "Give me a little time, Avery," Patrick said.
Outside the room, Patrick turned to the group. "We do not let patients suffer like that. Remember, there is more than one med. Doctors, is it all right to let the patient dictate your examination? These are people, not procedures to check off. Each one is different. Some you may like, some you may not. Some are easy to care for; some are very difficult. That doesn't dictate the level of care. They come to us on the worst day of their lives. They all need someone to care for them and by extension their family. Are we clear?" Patrick's voice cracked like a whip. Elizabeth bit her cheek to hide a cheer.
"Dr. Reed, pick up on two," the clerk broadcast over the loudspeaker.
Elizabeth listened as the emergency department doctor described the unit's newest admission. "Get images and then send her up in thirty minutes." She hung up the phone before the ER doctor could respond.
"What?" Patrick asked.
"Are you sure you want to help?" Patrick's eyes crinkled. "All right, eighteen-year-old body packer, meth overdose with signs of an MI. Police custody."
The ER couldn't tell time. Twenty minutes later, screaming echoed down the hallway. "Take these off me. I'm going to kill you all. Let me go!"
Martin stepped from Austin's room at the sound of the woman's shrieks. In the company of Silverton PD and a resident, two ER personnel wheeled an agitated and thrashing woman, handcuffed and tethered to the stretcher, down the hall. When Elizabeth stepped into the fray, Patrick flashed an okay sign.
"Shh." Elizabeth ducked between one of the police officers and the patient. "Honey, we’re here to help you."
"You don't understand. I can't go back to jail."
"Shh, you aren't going anywhere except into another bed."
The clerk ran out and handed Patrick a piece of paper. "Beth, she's HCG positive."
Sick, pregnant, and in danger of dying, Tonette Torres continued to fight the restraints and scream. Elizabeth palmed her face. "You need to stop this. You’re going to kill yourself and your baby."
She stopped cold. "Baby? Doctor, please save my baby and me.” Her screams became a whisper.
"I need you to work with us." Elizabeth stroked her cheek.
Elizabeth and Patrick directed the residents working to stabilize the young woman. Testing showed she had a moderate heart attack. “Pat, it’s close to noon; you need to go back to Austin. Thank you for your help.”
Sweaty and out of breath, Tonette asked to speak with her. "Dr. Reed? Can you figure out how pregnant I am?"
"The obstetrician will be able to figure that out. Do you remember your last period?"
Tonette started to shake. "If I tell you something, will anyone else know?"
"Your health information is private.”
"I got out of jail two weeks ago." Her hand rubbed at her throat. "I spent six months inside."
Holding her hands, Elizabeth leaned in close. "Tonette, did someone rape you?" She swallowed hard.
Tonette's eyes rolled back in her head, and her heart stopped. With the work of the team, Tonette's heartbeat came back. Even with the prompt intervention, she remained unconscious and on a ventilator. Elizabeth's cheeks brimmed red with anger.
Reverend Brookfield sat at the nurse's station, listening to Elizabeth speak on the phone. "Lois, can you come up here? New patient, meth OD, MI, vented, unresponsive, unknown status of pregnancy. Possible assault. I ordered an ultrasound to determine how many balloons are still buried inside her and to look at the pregnancy. Cardiology is with her now." She glared at the reverend and took a huge sip of her coffee.
Before she could make her next call, Reverend Brookfield interrupted her. "Elizabeth, you need to accept that some things are God's will."
Irritated, she remembered the words around Martin's tattoo. Her voice rose above the sounds of the busy floor. "You know what, Reverend? God may judge, but my skills decide the time of the meeting. Now, if this..." she swept her hand in the shape of the horseshoe of rooms, "…is God's will, then I have a dinosaur bone to pick. I have a cop who was doing nothing but his job and is fighting for his life because some evil person shot him. There is a corrections officer who tried to kill himself for some unknown reason, and he will likely succeed. There is a man who almost bled to death because he won't stop drinking, and a woman, who, despite being offered every program known to man, let her husband beat her. Thankfully, he is no longer able to do that.
