Not Quite Enough By Catherine Bybee
To every ER nurse and doctor I’ve ever had the privilege to work beside. You know who you are.
Chapter One
“Don’t let my baby die.”
Monica stared into the desperate eyes of a mother on the verge of losing her seven-year-old daughter. The little girl made the unfortunate mistake of riding her bike in the street and into the path of a passing car. A mistake that would most likely end her life.
“We’ll do everything we can,” Monica told the mother. Her reassuring smile was a pathetic attempt, but she had to do something to give the woman hope.
Monica ducked into the trauma room, where no fewer than fifteen people worked feverishly to save the child’s life.
With the help of the ER staff, the paramedics moved the child from the stretcher to the gurney and whisked their stretcher from the room.
Dr. Chuck Meeks, the trauma surgeon on call, stood at the patient’s head and listened to the report from the medic. Monica listened while she helped the emergency medical technician and another nurse remove the remainder of the child’s clothing.
“The car struck her and tossed her thirty feet from the point of impact. Her friend said she was moaning after it happened but when we got there she was unconscious.”
As the medic spoke, Monica ran down her own list. A, airway… the child was already intubated. B, breathing… the doctor was listening to the patient’s lungs as the medic spoke. Blunt force trauma could result in a collapsed lung, internal bleeding… any number of injuries. But Monica was getting ahead of herself.
C, circulation. The patient’s heart rate was too fast with a blood pressure of 68/50. Monica systematically moved down the child to check for pulses.
“Let’s get her off the backboard,” Dr. Meeks instructed. “X-ray, I need a chest film here to check this tube. Did CT clear?”
“CAT scan is ready when you are.” Patricia Keller, the nursing supervisor, stood at the door and informed the doctor.
Monica cut through the child’s jeans. D, disability and neuro status. A CAT scan would let them all know the extent of the head trauma, but some less life-threatening injuries could be seen with the naked eye.
“What’s her name?” Monica asked the medic. Using a pronoun for her patients, instead of a name, didn’t feel right.
“Bethany. Her friend called her Beth.”
When removing the jeans from Beth’s lower limbs, Monica noticed an obvious break above her right knee. “Dr. Meeks?”
Meeks glanced Monica’s way with a nod. “Pulses?”
Monica checked for pulses distal from the injury, found a faint rapid tap to match the child’s heart rate.
“Faint, but they’re there.”
“Get a box splint on it until we see what else is going on. I don’t like the sound of her right lung. Get a chest tube ready, X-ray, push in and let’s get a picture.”
“Pressure’s dropping, Chuck.”
Valerie, the other ER nurse in the room pulled everyone’s attention to the monitors at the head of the bed. Beth’s blood pressure dropped dangerously low.
The chatter that had hummed over the room stopped, and everyone moved faster.
Thirty minutes later Monica walked out of the operating room where she’d given Bethany’s report to the nurse taking over. Shattered femur, collapsed lung, internal bleeding, most likely spleen but the doctors would have to determine that in the OR and work to fix it. The bump on Bethany’s head turned out to have no significance, which begged the question as to why the child was unconscious. It was as if God swept down and said, “Time for you to take a little nap, sweetheart.” Maybe, just maybe, with the skills of the surgical staff Bethany would live to ride again.
So Monica hoped.
Back in the ER, the noise of the department swelled up inside of her until her ears rang with the energy of the room. New patients moved into the halls, while others walked, rolled, or limped their way out.
Just another day. She loved it. All of it. Well, most of it anyway. There were some things she didn’t love about her job at Pomona Valley Hospital. Like the sunken eyes of a loved one when they learn that someone hadn’t made it, or the politics that forced non-emergent cases into the ER on a daily basis. Understaffing… union battles. OK, maybe she didn’t love all of her job.
The computerized board indicated a couple of vacant rooms and highlighted a number of patients in the waiting room. Seemed like the number of patients in need always outnumbered available space. There were two ER doctors on, a dozen nurses, and several EMTs.
Monica nodded to the clerk, Nancy, and asked, “Do we have any runs coming in?”
“Nope.” Nancy had an ear to the phone and was simultaneously entering orders for the doctors into the computer system. They’d yet to go paperless. Most of the hospital was completely computerized, but so far, the ER had resisted the change. Monica couldn’t wait for a shift in management to recognize the benefits of computerizing and streamlining their system. Anything to help move people through faster.
Monica grabbed a chart from the rack and moved to the lobby door to call in the patient.
She glanced at the name the triage nurse had written on the assessment, recognized the name, and cringed. Owens! She looked at the complaint. Stomach pain.
Gary Owens was a frequent flyer who didn’t have a mileage card. He visited the ER no less than once a week, most of the time coming through the back door via ambulance. The man was an alcoholic who’d brushed aside death more times than Monica could count.
The man had a death wish. As much as Monica hated herself for thinking it, she wished he would just get it over with already. It was hard to feel sorry for someone who self-inflicted nearly every medical problem he ever had.
Mustering an ounce of propriety, she opened the door to the lobby and glanced over the eager faces of the waiting patients. Patients who deserved her attention. Don’t pass judgment, Mo.
Too late.
“Owens?”
Gary sat three rows back with crying children on both sides of him. His head was dipped into his chest, his eyes were closed.
“Owens?” she said louder.
He didn’t even look up.
The bastard was asleep. Probably drunk. Unable to avoid the inevitable, she moved past the door and walked over to the man, smelling him long before she shook his shoulder. “Gary?”
He startled awake, glanced around the room. His expression softened when he realized where he was and he stood with a slight waver. Monica had no desire to have him drag her to the floor, which might injure her back and put her out of work. “Do you need a wheelchair?”
He swallowed and his glassy eyes met hers. “I’m good. Fine.”
After a moment, he followed her back into the busy ER where she led him into a private room. One where he’d probably sleep for the better part of the night. Abdominal pain workups often took hours and they’d likely find nothing inside they could help mend. Which meant he’d go out and drink himself back again next week.
Monica shook the thought from her head.
It wasn’t easy. She thought of the child in OR fighting for her life and here this man was pissing his life away.
Without a smile, Monica walked Gary to a room and pointed toward the gurney and the hospital gown sitting on top of it. “You know the drill, Gary.”
He nodded and started to undo his shirt. Monica left him to inform the ER doctor of Gary’s presence.
“Walt?” Dr. Walter “Walt” Eddy would be just as thrilled with Gary’s presence as she was.
Walt glanced up from the chart in his hands and offered a smile. “Yeah?”
“Gary Owens is in room sixteen.”
Walt rolled his eyes, something she’d refrained from doing.
She grinned.
“GI bleed?”
“Not this time. Abdominal pain.”
“He drunk?”
“Isn’t he always?”
“Drop a line, draw labs. I’ll be there in a minute.”
After grabbing an IV tray, Monica turned to make her way back into Gary’s room to begin the daunting task of finding a vein. She knew from experience the task wasn’t easy. Gary had been in some kind of fire several years before, leaving scar tissue over both arms and half his back.
At least the man had never been toxic with her. He didn’t come in cussing and fighting. He wasn’t a mean drunk, just a drunk. The age on his chart said forty-three, but he looked sixty.
A woman from medical records stepped up to the desk and started piling charts. It was routine for any returning patients to have their charts pulled and brought up. Monica recognized Gary’s overstuffed manila folder, which was a good four inches thick.
She picked up the chart and walked down the hall to Gary’s room. Each step built frustration with the man. She cautioned herself briefly before entering the room and closing the door behind her.
Gary sat with his legs dangling off the edge of the gurney. The blue and white spotted gown covered most of him.
He wouldn’t look at her.
Fine.
Monica set the IV tray down quietly on an overhead table and paused.
“Do you know what this is?” she asked him, her tone cold.
His gaze flickered to the chart in her hands. He shrugged.
“It’s your chart. Your ER chart.” She dropped the heavy folder on the gurney beside him.
He flinched.
“Most charts are no more than a handful of pages. Yours… yours is proof that you’re trying to kill yourself.” Anger boiled as she spoke. “People come in here every day and fight to live. You come in here nearly every day fighting to die.” The image of the child she’d just left flashed in her memory.
“I’m not trying to die.” His voice was flat and he never met her gaze.
“Drinking yourself to death isn’t trying to live. When are you going to wake up, Gary? One of these days you’re going to come in here too sick for us to do a damn thing for you.”
His tired eyes hardened and he finally met her stare. “What does it matter to you?”
Good question. Why was she closed in this room reaming him a new ass? Her boss didn’t like her to begin with… this little stunt could get her written up, or worse.
She shook her head. Did this man have kids? If so, where were they? Did they wish their father was sober? “None of us live in a bubble. Someone out there thinks about you.”
His jaw twitched.
Monica swallowed, picked up his chart, and turned to leave the room. She’d find him another nurse. She wasn’t objective enough at the moment to deal with him.
The nurse she’d asked to take over returned to Monica’s side a few minutes later and reported that Gary had left.
Two hours later Monica sat in the break room with her aching head in her hands. The day hadn’t gotten better. The only redeeming feature was when news came from the operating room that Bethany had survived surgery.
That was the most important news.
The door to the room opened, letting the noise of the department leak in.
“You OK?”
Monica glanced up at Deb, a fellow nurse and sometime nightclub friend when they both had the same day off.
“Bad day?” Deb asked.
“It’s been busy.”
“Maybe John will make it better.”
Monica attempted a half-ass smile. John. She hadn’t thought about him once all day. They’d dated for the better part of two months. She should have known better than to sleep with a coworker. They’d had a good time but it wasn’t working, not for her anyway. John seemed genuinely into her and that sucked.
“Oh… that is not a good look,” Deb said.
“What?”
“Things aren’t good with you two?”
“It’s OK… I guess.”
Deb, who always had her hair pulled back in a tight ponytail, narrowed her eyes. “You guess?”
“He’s a good guy. Thinks he’s more a doctor than a nurse.” He was a nurse. A good one, but one with too much ego and not enough education. “He talked about moving in last week.” A conversation she quickly snuffed out. She lived in a two-bedroom apartment she’d first shared with her sister, Jessie, and her nephew, Danny, before Jessie married Jack and moved to Texas. Then Jack’s sister, Katie, had moved in for a brief while with her daughter. Now it was just Monica and she wanted it that way, for now anyway. “I don’t want a roommate.”
“John would be more than a roommate.”
“I know.”
Deb sat beside her on the worn-out sofa and patted Monica’s knee. “If you’re not into him… you might want to cut it off sooner than later.”
“I know.” She sucked at relationships. Two months was a long stint for her. She had to admit if it wasn’t for the fact that John worked with her, she’d have cut it off by week four.
“I mean it, Monica. He asked me if you liked round diamonds or square ones last week.”
A chill ran up Monica’s spine. Her eyes snapped to Deb’s. “You’re kidding.”
Deb sucked in her bottom lip and shook her head. “He asked me not to say anything to you.”
“This is bad. Oh, so bad.”
“When do you see him again?”
“I’m off tomorrow. We were going to get together for dinner.” A dinner that was supposed to be a dress-up affair. Monica dropped her head in her hands again. “Am I too old to run away?”
“Yes.”
“But—”
“No buts. Let him go before he pops the question. Men don’t recover from that kind of rejection.”
“You really think he wants to marry me?”
“Diamonds aren’t for promise rings.”
Monica pushed off the couch and moved to her locker. Inside she fished through her purse for aspirin. “Two months. We’ve only dated two months.” She didn’t see this coming.
“You’ve known him for over a year.”
“So?”
“Didn’t your sister agree to marry her husband in less time than that?”
“They were different.” They loved each other to bits. Mutually.
Monica didn’t love John.
This needed to end.
Tonight. Before anyone got hurt.
Wearing scrubs… possibly the most unattractive outfit ever, Monica insisted that John meet her for a drink at a quiet bar not far from her apartment. She opted for her hospital-issue uniform in an effort to hide her curves. She swept her blonde hair up into a ponytail and rid her high cheekbones of the blush she’d had on earlier in the day. There was no hiding her light blue eyes unless she wore sunglasses in the dim bar. After sending him a brief text that they “needed to talk,” she hoped her words didn’t translate into anything romantic.
She’d found a quiet table in the back, away from the men walking in and searching for a good time. Her earlier conversation with Gary Owens kept her from ordering anything other than an iced tea. As much as she wanted the liquid courage, she would wait until she got home and sank into a hot tub with a glass of wine.
Three televisions lit up the space behind the bar. Two were focused on baseball games while the third was on the evening news.
She sipped her tea and checked her watch right as the door opened letting the evening sun into the room.
John was easy on the eyes. Light brown hair cut military short. Not quite six feet tall, he strode into the room and spotted her.
Monica nodded and attempted to smile.
Her earlier headache started to pound again.
“Hey.” He slid into the seat opposite her. “Must have been a bad day if you’re drinking Long Islands.”
“We were busy.” She didn’t correct his assumption.
He slid his hand over the table and covered hers. “I’m glad you messaged me. I know I don’t like going home alone after a bad day.”
Monica flinched.
John’s eyes narrowed. “Is everything OK?”
As slowly as she could, Monica removed her hand from under his. “I had a hard day, but that isn’t why I wanted to meet with you.”
Someone at the bar yelled at the TV, drawing her attention away for a moment. She hated this part. Not that she was an expert at it or anything, but hooking up was always easier than splitting off.
“What’s up?” John tucked his hands in his lap, his gaze pinned to her face.
She glanced around the dark bar. It was quiet… early. She kept her voice low. She got right to the reason she’d asked him there. “The other night, when you were talking about moving in… I realized that maybe we weren’t looking for the same thing.”
He fidgeted and sat taller. “You’re not ready to move in with me. I get it. We’ll slow down.”
She shook her head. “I don’t think slowing down is going to help. I’m… I’m not ready for commitment.”
He sat back and crossed his arms over his chest. The defensive move wasn’t lost on her. The smile on his lips fell. “What are you saying, Monica?”
She rubbed her hands on her cotton scrubs. “We’ve had a good time.”
His mouth opened, then closed. “A good time?” He rubbed his thumb against his forefinger. “I was a good time? I thought we were getting along.”
“We were. Are. This is hard, John. We work together. I don’t want to mess up my job… your job.”
“Then don’t.”
If only it were that easy. “I think you’re into us more than I am. I wish I felt more, but I don’t.”
He ran a hand through his hair. “You’re breaking up with me.”
Monica sat on her hands. “I’m sorry. I’m not ready for a committed relationship. I don’t even have a pet.”
“Is there someone else?”
“No. Of course not. I don’t want to lead you on. Make you think I want something deeper when I don’t.” He had to understand that… right?
“I really thought we had something special.” Through the veil of anger was a lining of hurt behind his eyes. For that she was very sorry.
“I’m sorry.” She couldn’t look at him.
“Commitment is part of growing up.”
Instead of saying anything, she skirted her gaze across the room.
“You have to grow up sometime.” His words were harsh. Considering the shitty day she had… very harsh. She was trying to spare his feelings. Trying to let him down easy.
The noise from the bar hushed and someone turned up the volume on the news.
“Don’t make this harder than it has to be, John. We were friends before. I’d like us to stay that way now.” She did. Though she wasn’t stupid enough to believe being only friends would work.
“That’s it? I don’t have a say?”
“You can say what you want. It isn’t going to change my feelings.” She met his eyes.
John stretched his neck and pushed away from the table. “Maybe in a few days I can say something nice. But right now I want a drink… alone.”
“I’m sorry,” she said to his back as he walked out the door.
That went well.
She pushed a long-suffering breath through her lips and pushed out of her chair. One dirty martini wouldn’t hurt.
Monica made her way to the bar and flagged down the bartender. She ordered her drink and looked over her shoulder.
John wasn’t coming back.
Monica pulled a ten dollar bill from her wallet and set it on the counter. When the bartender placed her drink in front of her he asked if she needed change.
“We’re good,” she told him as she lifted her drink.
“Can you believe this?” he said as he slid the ten in his palm and motioned toward the television.
“Believe what?”
“The earthquake in Jamaica.”
Breaking news had interrupted the local broadcast to show amateur footage of devastation.
Waves broke on the shore… only it wasn’t a shore. It was the inside of a small town. People were screaming, cars and entire houses were floating out to sea.
Monica’s insides chilled. She set her drink down before one sip.
“Can you turn that up?”
The bartender picked up a remote and upped the volume.
“… three hundred years past due, this earthquake has been predicted for decades. Preliminary reports placed the quake at 7.5 on the magnitude scale. Much larger than the 1692 quake that killed over five thousand people in Port Royal.”
Monica’s back teeth ground together. A man stood on a porch of what looked like a beach town boardwalk holding on to a child. He grasped onto a wooden beam as a wave of water retreated from the camera, taking everything with it.
“Oh, God.”
“Makes me damn happy I don’t live on the beach.”
Inside her purse, her cell phone buzzed.
She fished it out, staring at the broadcast.
“Yeah?” she asked without looking at the name on her phone.
“You watching the news?”
It was Walt.
“I am.”
“I put in a call to BD. You in?” BD stood for Borderless Doctors. Monica helped with Borderless Nurses. The relief organization put in time and skill from trained professionals to help with aid after nature shook, flooded, or blew up an area. With Borderless Nurses, she’d go straight into the devastation, live out of a backpack for a couple of weeks… help.
Getting away from John and the ER for a while wouldn’t suck, even though she knew she’d be walking into the soggy depths of hell.
“I’m in.”