The Doctor

***Trigger warning: Contains scene about death/dying in hospital***

The Doctor

“What do you think Doc?” Charlene looked over at her colleague. Paul was an older gentleman, his hair was thinning but you could still see he was a redhead. His cheeks sagged and he had wrinkle lines in between his eyebrows. “Well,” he gruffed. “Bed 1 most likely has appendicitis, but we can’t confirm that till after his scan is done.” Charlene nodded. It was another busy day in the emergency room. She had been working here for about two years now, still feeling “new.” She was thankful when Paul took her under his wing and showed her the ways. She learned something everyday from him. She reminisced about when she first started working, “Now, don’t drink too much caffeine because you’ll crash later, you have to have just enough to stay awake but not crash, got it?” Paul was stern when it came to teaching his colleagues but full of fun and laughter once you got to know him. 

The charge nurse came around the corner, “Ambo- cardiac arrest, ETA 10 minutes, going to bed 26.” Then she disappeared around the corner just as fast as she came. Charlene looked at Paul. They both were thinking the same thing. Cardiac arrest are the worst. You never knew what you were getting. “What are you going to ask EMS?” Paul looked at Charlene with his poker face. Charlene thought for a minute, “I’m going to ask them how long has the patient been without a heartbeat.” Paul blurted out before she could continue “No-Before that, we’ve gone over this.” “I know, I know, I guess…” “No guessing, you know this Charlene.” Charlene nervously smiled at Paul, “Right.” She took a deep breath and tired to relax, she continued, “What are the circumstances around the heart attack? Like was the patient exercising? Then, we ask was someone with him when his heart stopped? Does this patient have medical history-especially with the heart? Was CPR started immediately? Has EMS had a shockable rhythm, a pulse, anything-” Charlene looked up at Paul waiting for an answer. “Sounds good kiddo.” His eyes were fixed on the automatic sliding glass doors. He stood up. Just as Charlene looked up the doors opened and in came EMS with a man on a stretcher. “BED 26!” Charlene could hear the charge nurse yelling. Charlene followed right behind Paul’s footsteps.

Charlene and Paul entered the room. There were three EMS personnel around the stretcher. One doing CPR, the other squeezing a clear bag of saline into the patient’s IV line, and the other who Charlene figured was the ambulance driver was giving a report out loud to everyone in the room. “Wife called, found him lying outside next to the lawn mower.” Paul nudged Charlene with his elbow. “Any medical history?” she asked. Pual nodded in a “job well done” style. The EMS driver looked at her, “None according to the wife, but also said he hasn’t seen a doctor in years, she did mention he was born with one kidney, but never had any issues from it.” EMS continued to talk. Charlene drowned out the man’s voice. She looked at Paul, “Well, what’s causing this. What are you thinking?” “Charlene, how hot is it today?” Paul asked inquisitively. “It’s r-e-a-l hot,” Charlene exaggerated on the ‘real’ part. “The news said a high of 110 degrees today.”  Paul nodded and looked down, “and what do you do when you are hot?” Charlene answered, “Sweat, duh.” She slightly giggled to herself, why is Paul questioning such a basic thing? She thought to herself. Paul continued, “and when you're outside mowing the lawn on a 110 degree day, you….?” Paul trailed off looking up at Charlene. “You sweat!” Charlene answered, almost annoyed now. Time was wasting for this man. Charlene needed to move fast to save him but she didn’t know where to begin. “And when you sweat profusely what does this put you at risk for?” Charlene knew this, why was Paul asking this. This was basic 1-0-1 of being a doctor. “Dehydration” she stated in an irritated and annoyed way. “Right, and one kidney-this man is what 60 ish?” Charlene answered, “yea, EMS said 62 I believe, what does that have to do with anything Pual?” Paul looked around the room, “one kidney after 62 years of life, how well do you think it’s working?” 

The answer hit Charlene like a ton of bricks, “HIS POTASSIUM!” she shouted. Everyone stopped what they were doing, they looked up at Charlene confused. “Check his potassium levels! His kidney has done the work of two kidneys since birth.” Her voice was fast paced and pressured. She was nervous and excited at the same time. “If your kidneys or lack of aren’t working as optimal as they should be, your electrolytes get imbalanced. The body can’t excrete the way it needs to, so you get high levels of potassium, combined with severe dehydration equals an even more highly concentration of potassium in his system, one that can stop the heart!” She looked around the room to see everyone nodding. A nurse spoke up, “what medication do you want to give him?” Charlene knew an oral medication would take too long, she needed something fast. “Insulin, give him insulin, it will work the fastest!” Charlene turned to look at Paul. He would be proud of her. She made the connections. She was going to save this man’s life. But to her dismay, Paul was gone. Strange, she thought, but quickly went back to the situation at hand.

The man’s heart started beating after receiving insulin. Charlene was proud of herself, as was everyone else. “Great job in there Charlene, no one would have thought of that! Great work!” The change nurse patted Charlene on the shoulder as she walked by. Charlene spotted Paul by his computer. She went and sat next to him. “Wow! That was amazing! We saved that guy’s life!” Paul looked at Charlene with disgust. “You mean I saved him. If it wasn’t for me you would have never made the connection. But it’s always you that seems to ‘save the day.’ You never give me any of the credit. Paul was heated, his face red. “Why do you ALWAYS do this to me? Why do you take credit for my work?” Charlene’s heart dropped to her stomach, “Paul, you’re dead, no one but I can see you.”