Mortal Remains Read Free

R.N. Earl always called her J.S. In her early twenties, three rings piercing her right nostril, J.S. was a bright, cheerful, sometimes zany presence in the ER. Now she hovered over an ashen-faced, middle-aged man lying on a stretcher. Without looking up she slid a large-bore needle the size of a three-inch nail into his arm.
    Stepping to her side, Earl asked, “What have we got?”
    She hooked her patient to a bag of saline and thumbed the valve wide open. “Bleeding from both ends – coffee grounds up top, both black tarry stool and bright red blood by rectum. Vitals, ninety over sixty and pulse one-ten.”
    “Coffee grounds” meant blood turned dark brown by stomach acids. “Tarry stools” indicated blood also originating in the stomach, but rendered black by those same acids during their longer passage through the intestines. “Bright red blood” meant either a second source of bleeding below the stomach, which was unlikely, or that the hemorrhage was so severe the blood ran through the gut too fast for the digestive juices to work the color change. Bottom line, the man would soon slip into shock. “Name?” he asked.
    “Dr. Garnet, meet Mr. Brady,” she said, the worry in her eyes belying her reassuring smile.
    “Hi, Doc.”
    “Well, Mr. Brady, looks like I’m your host, and you are our VIP patient this morning. Hang on. We’re going for a ride. Don’t worry, J.S. here and I just passed stretcher-driving school.”
    Together they rushed him down the hall to a resuscitation room, picking up help on the way. Earl kept up the banter so everyone would stay loose.
    “How many metal detectors did your nose set off today, J.S.?”
    “Hey, I’m a one-woman security check. You should pay me extra.” They skidded to a stop, and she immediately started to secure another IV line, this one in the groin.
    “Okay, people, listen up,” said Earl. “Who’s got the head? Who’s on the tail? We need full monitoring, bloods, type and cross for six units, and hang up two of O-negative stat.”
    “Tails,” an orderly said.
    “Heads!” called a tall, model-thin woman with a boyish haircut as she pushed through to the table and applied oxygen prongs to the man’s nose. Her name tag read SUSANNE ROBERTS, NURSING DIRECTOR. “Morning, Dr. Garnet.”
    “Glad to see you here, Susanne.”
    “What happened? You were late at being early this morning.” She’d been director of nursing for as long as he’d been chief, and knew his routine as well as her own.
    “Breakfast with Brendan.” Gloving up, he swabbed Mr. Brady below the right collarbone.
    “With competition like that, we’re lucky to see you at all.” She ripped the wrapper off a coiled green catheter, anointed one end with a glob of sterile jelly, and stood ready to pass it down the back of Mr. Brady’s throat into his stomach, but through a nostril.
    “Don’t worry. The nanny always throws me out by seven-twenty-five.” He draped a sterile towel over their patient’s chest and explained as he worked. “Now I’m injecting a bit of freezing, and then we’ll put a central line through the vein under your clavicle to better replace the volume of blood you lost with normal saline.”
    A young medical student hastily joined him, obviously eager to try the procedure. Seconds later, under Earl’s expert guidance, the boy announced, “I’ve got it!” sounding surprised at his success. He looked up, beaming proudly, and promptly broke sterile technique as he shoved a shock of curly red hair out of his eyes.
    “Good show,” Earl said. “Now change your gloves!”
    The orderly who had taken tails was draining the contents of the bladder through a tube to a transparent collecting bag marked for measuring output. A reassuring grin spread across his ebony face. “Your kidneys are working fine, Mr. Brady.”
    “Bloods drawn and gone for type and cross,” Susanne said at Earl’s ear, still waiting to pass her tube, “and GI’s been called to scope