“I will.” Leila turned and quickly gave orders for the patient to be moved up to the OR.
Her adrenaline was pumping, heightening her awareness as she prepared for surgery. The young man’s name was Anton Mayer and as she finished her scrub and entered the OR, she noticed his condition wasn’t any better. In fact, if anything, he looked worse.
Feeling slightly sick to her stomach, Leila reached for her scalpel. She was going to keep her promise to Quinn and do everything possible, but she had an awful feeling that Anton was going to die.
Not yet, she reminded herself grimly, doing the fasciotomy to both lower extremities first and then preparing to explore his abdomen. He wasn’t going to die yet.
But after working on his legs, she moved to his abdomen and when she saw he had a severely fractured kidney, she knew things were worse than she’d feared. She took the damaged kidney out but the bleeding was profuse. She could barely see where the source of the bleeding was coming from in the sea of blood.
“We’re losing him,” Dirk Greenfield, the anesthesiologist, warned. “I can’t sustain his blood pressure.”
“Keep trying,” Leila said, praying she could find the source of his bleeder. Although there was likely more than one source. Sweat dampened the back of her scrubs, running down the sides of her face. She tried to tackle one emergency at a time.
“Blood pressure is gone, he’s in PEA.”
PEA was pulseless electrical activity, which basically meant the kid was bleeding to death. Or he’d already herniated his brain from all the fluids they’d given during the trauma resuscitation.
“Bolus him with epi, I found the arterial bleed.” At least she’d found one of them, though she suspected there could be more.
“I already bolused him with epinephrine several times. Now he’s in a wide complex rhythm.”
“No!” Leila didn’t so much as glance at the heart monitor, keeping her gaze focused on what she was doing. One more stitch and she’d have the artery closed off. Then she could take a look at his spleen. Maybe that was the other major source of his bleeding.
Finishing with the artery, she quickly switched the focus of her exploration on the area of his spleen, cutting the splenic artery in an effort to minimize the blood loss. But once the artery was open, she realized the blood wasn’t pulsing at all, but simply oozing at a slow rate.
Horrified, she glanced up at the monitor, realizing it was too late.
“Didn’t you hear me, Leila?” Dirk asked. “I said he’s gone.”
She momentarily squeezed her eyes closed and dropped her chin to her chest. She hadn’t heard, hadn’t wanted to believe what her professional eyes were telling her. After taking a moment to compose herself, she lifted her head and glanced at the clock. “Time of death 1:32 a.m.”
There was nothing more they could have done. She knew it, yet that didn’t make the prospect of telling Anton’s parents that their seventeen-year-old son was dead any easier.
When she returned to the ED, Quinn immediately crossed over, although he stopped abruptly when he saw by her expression that the news wasn’t good.
“I’m sorry,” she said in a weary tone. “I did the bilateral fasciotomies, but he had a severely fractured kidney, a ruptured spleen and so much other internal damage along with his head injury that I just couldn’t save him.”
Quinn stood there for a long moment, his jaw clenched, his gaze dark and resigned as he gave a brief nod. “I’ll talk to his parents.”
She wasn’t sure why, maybe because he seemed to be taking the news so hard, but she reached out to touch him. “I’m the surgeon of record. I should do it.”
As still as a statue, he stared at her hand on his arm as if it was something he’d never seen before and then finally raised tortured eyes to hers. “We’ll both go,” he said in a low, gruff voice.
Surprised by his acquiescence, she simply nodded and walked alongside him to the small private waiting room he’d given to the boy’s parents, not far from the larger public one.
His mother took one look at them and promptly burst into tears.
Quinn opened his mouth, but no sound emerged from his throat. He swallowed hard and sent Leila a silent plea for help.
Leila stepped up. “My name is Dr. Ross. I took Anton for emergency surgery, but he had too many injuries, to his spleen, his kidneys and his brain. I’m so sorry to tell you, he’s gone.”
“No-o-o,” wailed the mother, collapsing onto her husband for support. When Anton’s father broke into harsh sobs, his large shoulders shaking with grief, Leila felt her own eyes well up, too.
This part of her job never got any easier. Never.
“Why did he do this?” Anton’s mother asked. “Why?”
Again she had no answers. She glanced toward Quinn, whose face was drawn so tight he almost looked angry, but the agonized expression in his gaze reinforced his struggle to hide his own grief and helplessness.
“It’s not your fault,” Quinn finally said, taking a step forward to put a reassuring hand on the sobbing woman’s shoulder. “Please know, this isn’t your fault.”
“It has to be our fault!” The woman cried, nearly incoherent in her distress. “How could we not have known he was so unhappy? How could we have missed it?”
“It’s not your fault,” Quinn repeated.
“Teen suicide is very tragic,” Leila said in a soft tone, picking up a pamphlet from the rack of educational brochures on the wall. “It’s normal to feel responsible, but you need to know Dr. Torres is right. This isn’t your fault.” She slid the pamphlet toward Anton’s mother. “There’s a support group here for parents just like you. When things calm down after a few weeks, please consider giving them a call.”
Anton’s mother continued to cry and didn’t take the brochure. Anton’s father pulled himself together, the gut-wrenching sobs eventually quieting, and he reached for the information, folding the pamphlet before sliding it in his pocket. Leila sincerely hoped they’d get the help they needed.
After a few more minutes, she and Quinn left them alone. The ED nurses would keep an eye on the parents and for now their job was over.
“That was a rough one,” Leila murmured to Quinn. “He was so young.”
“Any suicide is rough, regardless of how young the patient is,” Quinn said in a harsh tone. “Suicide is a horrible thing to do to a family.”
Shocked by his outburst, she didn’t know what to say.
Instantly, his face changed, resuming the remote, cold mask he normally wore. “Excuse me, but I need to make rounds on the other patients in the arena.”
He left and Leila stared after him, the brief moment of camaraderie between them having vanished in a heartbeat.
Yet
