It was Christmas Eve—early afternoon, at least, on the day before Christmas. Morton Memorial Hospital was busy, but the staff was in a collectively buoyant mood. Strings of tiny colored bulbs sparkled on the half-dozen lush, professionally decorated trees in the bustling main lobby. The floor was wet and streaked with dirt in the wake of the light snow that had fallen that morning.
The census—the number of patients in the hospital—normally dips in the days before major holidays, particularly Christmas. But this year the census had held steady and Morton was nearly full. The hospital was alive with visitors bearing gifts. Here comes Santa and Mrs. Claus, sled and reindeer supplanted by a Chevy Suburban. There goes a group of bright-eyed high school carolers. The kids were singing what were supposed to be referred to as ‘holiday tunes’ but once again the often testy nurses had rebelled against political correctness and insisted they be called ‘Christmas Carols’.
A small black dog ran down the hall, pursued by another larger dog. Visits by furry friends, it has been determined, convert patients’ frowns to smiles and speed the healing process. Comfortably familiar Christmas songs played on radios in offices throughout the hospital. The enticing aroma of brewing coffee and the Ronettes’ version of “Frosty The Snowman”, and all was right with the world.
There is a palpable excitement in the air. Nurses and staff discuss holiday plans and the presents they’ve bought for kids, spouses and parents. Some of the nurses wear Santa hats or reindeer antlers; Morton nurses are a quirky bunch all year long. There are lines in the coffee shop and gift shop. The doctors are enjoying a relaxed, catered end of year luncheon in a first floor conference room.
But this IS a hospital, we sometimes forget, not the nirvana-like cocoon that it sometimes feels like and often seems to be, a refuge from the harsh realities of the world beyond. Things can and do change in the blink of an eye, or an irregular beat of the heart.
There is an overhead page for Dr. Gregory to call the extension for the Emergency Department, STAT. Dr. Gregory is the chief of emergency medicine. There follows within minutes similar overhead pages for Dr. Ritter the chief of cardiology, Dr. Heflin, Morton’s chief of pulmonary medicine, and Dr. Cromwell, head of the Department of Surgery. This is unusual. Clearly something of significance is going down in the ER.
A number of doctors can be seen hurrying toward the elevators, looking rather grim. I wonder what could be going on down there that would necessitate the immediate presence of so many heavyweight physicians of various specialties.
No one can quite figure out the exact etiology of the process but at Morton, no doubt at most hospitals, news good or bad travels very quickly. Something can happen on the ground floor and within minutes everyone on the fourth floor is aware of it.
I was standing by a third floor nursing station when the phone rang. One of the nurses answered it. She listened, speaking quietly and then hung the phone up, looking upset. Other nurses gathered around. She told them what she had learned. The nurses appeared rather shaken.
“What is it?” I asked.
“A baby,” one of the nurses said. “A baby in the ER.”
The news spread rapidly, along the floor and through the hospital. A baby in the ER. Exactly one year earlier, on the previous Christmas Eve, a baby had been brought into the ER in critical condition. The baby had died, despite the best efforts of a very good ER staff, sending the entire hospital reeling into an emotional tailspin. The baby, it turned out, had been shaken or battered by the father, later charged with and convicted of manslaughter. It had not been a happy Christmas Eve at Morton Memorial, particularly on the ground floor. Even at the best of times the corridor that connects the Emergency Department, operating rooms and ICU can be depressing, lined with distraught family members of the critically ill or recently departed.
On that Christmas Eve the doctors, nurses, techs and paramedics had all been crying and consoling one another, something rarely seen. They must at least pretend to be clinically detached. They do their best, but sometimes their best isn’t enough, and there is nothing more to be done.
When one works in a hospital for any length of time, one by necessity becomes inured to people dying, so used to it in fact that you barely even take notice of the sobbing relatives, of the body in the room, of bodies transported to morgue, to loading dock and waiting hearse.
Yes, people die all the time in hospitals but the majority of them are older people who have been ill for some time. Few are babies, especially at Morton. The hospital doesn’t have a pediatric or obstetrics department, or a pediatric intensive care unit.
The Morton staff is by and large sensitive, caring and empathetic and a baby dying is not something that anyone wants to see, or deal with. I’ve attended too many funerals over the years—parents, friends, friends’ parents, relatives. When you reach a certain age it seems inevitable that there are more funerals than joyful births. They’re never good, but the saddest thing I’ve ever sat through was a Mass of the Angels for a five-year old that died of leukemia.
Now, all most of the hospital staff can do is wait for news from the ER, and pray. The great majority of hospital employees work in specific areas: they have no valid reason to be in the ER, nor are they particularly welcome there. I had a job-related reason to go to the ER, but I wasn’t sure that I wanted to be there just then.
I did go, dreading what I might find upon my arrival. The anxiety-inducing ER isn’t my favorite part of the hospital even under optimal circumstances. I generally prefer to get in and out as quickly as possible.
Real life is not TV or the movies. Most often there is no life or death drama unfolding in hospital emergency departments. Still, the ER is not a particularly pleasant place. One sees human beings at their weakest, and their worst. The sick and dying, victims of heart attacks and strokes, car accidents and workplace mishaps, shootings and stabbings, bar brawls, alcohol and drug overdoses, domestic violence and suicide attempts. Addicts seeking drugs to assuage pain that is more psychic than physical in nature. Hospital security and local police spend more time in the ER than in the rest of the hospital combined.
Now in the ER the attentions of housekeepers, nurses and even other patients are focused entirely on what is happening in Cubicle 3. The baby is crying, which is a good thing, I suppose, given the alternative. Cubicle 3, bright and sterile, is SRO with medical personnel. I count fourteen people crammed into the small room. Nurses, techs, a crash cart, the chiefs of emergency medicine, cardiology, gastroenterology and pulmonary medicine debating as a radiologist studies x-rays, pointing something out. The ER chief is on the phone, in consultation with the chief of pediatrics at Keystone Southeastern Medical Center.
“Why didn’t they just take the baby to KSMC?” someone asks. Our associate facility is the region’s largest hospital and has both a pediatric ICU and a top-level trauma center.
“No time,” a nurse says. “They had to stabilize the poor little guy first.”
“No one can figure out what the problem is. That’s what they’re trying to do now.”
In a waiting room within the ER the upset family members are speaking with a doctor, a nursing supervisor and a case manager, trying to figure out what the problem is and why the baby is having so much difficulty breathing. It is determined that the nine-month old has eaten a slice of apple, now lodged in his throat. An emergency tracheotomy must be performed, to help the baby breathe, and then the apple must be removed. The doctors debate the location of the apple and the most effective method for removing it.
It is an exceedingly tense situation but everyone appears strangely calm as they perform their various duties: teamwork at its best. It’s amazing and impressive how well the disparate group- black, white, Indian, Asian, young and old, male and female–functions as a single entity with a single cause: saving a life. A life that has barely begun and is imminent danger of ending much too soon.
I have other tasks to perform in other places, so I leave the ER, more upset than the doctors working to save the baby. Throughout the hospital groups of people await the result of the ER team’s efforts, hoping for the best, but dreading the worst; a repeat of last Christmas Eve’s gut-wrenching loss. Even visitors and Santa and Mrs. Claus know what is happening but there is nothing that any of us can do except wait, and hope.
One hour later the phone rings at the telemetry nursing desk. “ER,” a nurse says, glancing at the caller ID. The nurses and techs stare at one another in uneasy silence. No one wants to pick up the phone. The nursing supervisor finally does so. She listens…and then she smiles, giving a thumbs-up sign. “The baby is stable,” she announces. “He’s going to KSMC. He’ll be okay.” The nurses, normally a stoic bunch, cheer this news, some with tears in their eyes. The visitors applaud. A minister thanks the Lord. “The Lord and our people,” the nursing supervisor says.
Our people have done it this time. They’ve saved the baby. There will be no flood of tears in the ground floor corridors this Christmas Eve. No banging of walls, no second guessing or self-recrimination. Within minutes the hospital is back to normal, employees, visitors and patients happy once again. Laughing as they watch the dogs chase one another down the hall and small children playing beneath the bright, twinkling trees.
It will be a merry Christmas after all at Morton Memorial Hospital.