“Come on Jim. It’ll be a good learning experience.”
Slumping his shoulders, the resident led the way back to the station where Warfield was signing charts.
When they arrived, Horton opened the discussion by saying, “Hey Morgan. I’ve asked Jim to present an unusual case of abdominal pain to you. It may be psychosomatic, but I’m worried we’re missing something.”
Warfield rolled his eyes, “Don’t you want to just put the guy in stasis and let the next shift’s crew figure it out for you?”
Warfield was always hitting him with annoying little jibes, but Horton kept a smile on his face. “We’ll do that if you don’t have any ideas.”
Warfield snorted. Then he said, “You know, tonight might be a night when we really could use the damned thing. We’ve sent a bunch of people up to the interventional people for various stents and clot busters and localized clotting agents. There are people down here waiting for procedures who really shouldn’t be waiting.”
Horton gave him a wide-eyed look. “What?! Your stance is softening?!” He turned to the resident, “Jim, make a note,” he checked his watch. “At 11:53 PM, the night of November twentieth, Morgan Warfield acknowledged there may be some justification for stazing patients.”
Warfield said, “Wait a minute—"
But Horton cut him off by sitting in the chair next to Warfield and saying, “Go ahead and present your case, Jim. No point of you getting dragged into our little disagreement.”
Jim gave a nervous chuckle and began to present the case.
The resident was about a minute into it when Warfield nudged Horton with an elbow.
Horton turned to see what the man wanted, thinking he was going to make some comment on the young resident’s inept presentation.
Warfield had fallen asleep! Or was pretending to. Which was funny, but extremely rude to a young nervous resident. Horton frowned, wondering how to handle it.
Jim’s presentation stumbled to a stop, “Dr. Horton! I think Dr. Warfield’s had a stroke!”
A spike shot down Horton’s spine. He jerked erect, then leaned around to look at Warfield from the front. When he moved away from his position beside Warfield, the man slumped even farther to his right. Holy crap! Warfield’s face was drooping on the left. “Morgan!” he barked at the man, but Warfield didn’t seem to understand. It’s a left hemisphere stroke!
“We need a gurney over here!” Horton shouted as he grabbed Warfield’s shoulder to keep him from falling out of the chair. He turned to the resident, “Start admission orders! We need a cerebral MRI with contrast. Find out how long it’s going to take to get it!”
Horton looked around. Several nurses were staring at him in surprise, obviously having no idea why he wanted a gurney in the doctors’ work area. He focused his eyes on one of them. “Elaine! Dr. Warfield’s had a stroke. I need a gurney and some help. Now!”
She jolted into action.
Once they’d manhandled Warfield onto a gurney and put him in an exam bay, Horton did a quick neurological exam, then asked Jim how long until they could get him in the scanner.
Jim said, “There’re three people waiting on the scanner. Want me to bump him up the line?”
“What do the others have?” Horton asked, dreading the answer. Bumping someone critical ahead of someone who wasn’t was the right thing to do. Bumping a VIP ahead of someone with a worse or even the same diagnosis without good justification was… unethical.
Two of the three people ahead of Warfield were just as critical. One of them had also had a stroke.
Shit! Horton thought. My ethics say I should staze Warfield. Warfield thinks I shouldn’t… Or that’s what he did think… He did just say that we might need the stazer this evening…
Horton got up. “I’m going to get the stazer.” He ignored the shocked looks people gave him. He knew a lot of them had seen the debate between himself and Warfield when he’d made his presentation to the ED about stasis. They think I shouldn’t do this. But I’m the one who’d have to live with it if I didn’t.
As he hustled past the main ED desk, he told the clerk to call in the reserve ED attending, something rarely done. But with Warfield out and me taking care of Warfield, we’re gonna be seriously shorthanded, he thought.
A couple of minutes later, they were sliding Warfield from his gurney to the one with the stazer. As soon as he’d stazed Warfield, Horton thought, In for a penny, in for a pound. He asked where the other patient with a stroke was. They stazed him too.
A resident came over and said, “Dr. Horton, one of my patients is bleeding from a splenic injury. He’d been stable but now his vital signs are crapping out. The OR’s swamped so I’m giving him more blood, but…”
Horton sighed, “You want to staze him too, right?”
She nodded. “Would that be okay? He’s a really nice guy.”
Horton closed his eyes a moment, decided he couldn’t get in any more trouble than he may already be in, and grabbed the gurney with the stazer on it, “Let’s go do it.”
Epilogue
Kaem was walking back to his desk from talking to Lee about the “space tower extruder” as she was calling the construct she was planning to use to build the tower. It was something like a self-building crane in that it consisted of a box you could side-load segments of the tower into. Then they would push the segment up until it locked into the next higher one like a Lego, but using Morse tapers. Once they were jammed together under high pressure, three Stade spot-welds would be applied—one to hold it, one for insurance, and a third for paranoia. They were a new little widget Gunnar had
