Chapter 67: Doctor Mike, Ever the Rebel

April 14-15, 1991, McKinley, Ohio

I arrived at the hospital at 10:50pm on Sunday and made my way to the new ED, parking in the new lot reserved for ED staff. I went to the locker room, changed, then stashed my clothes and bag in the locker with my name on it. I attached my combination lock, then went into the ED proper, just as Ghost and Kellie Martin came through the staff doors from the parking lot, followed a few seconds later by Becky Compton. They all changed and joined me near the nurses' station.

"I suppose we should put our names on the board," I suggested.

"There are plastic strips with magnets in the case beneath the board," Kellie said. "All the doctors and nurses have one with their name pre-printed."

"That's cool," I said.

I opened the case and was immediately unhappy.

"M. Loucks?" I griped. "Nobody knows who that is!"

Kellie smiled and handed me another plastic strip, this one with 'Mike L.' on it.

"I saw the tag last Monday, so I had a correct one made for you," she said. "Nicknames are prohibited, but Doctor Wernher granted an exception to allow your first name and last initial."

"Thanks," I said.

I accepted the replacement tag and put it on the board under the 'Residents' heading. Ghost put his under 'Attendings', and Kellie and Becky put theirs under 'Nurses'.

"We'll have a clerk at 11:30pm, along with your students," Ghost said. "I think the biggest challenge is the new configuration of the trauma and treatment rooms. The drawers and cabinets are different, so supplies are in different places."

"Then I'm going to check every single cabinet and drawer in one trauma room and one treatment room," I said.

"Good idea, Mike," Ghost said. "Here are your keys. Several of the cabinets are locked, but everyone — doctors, nurses, and clerks — will have keys to those drawers and cabinets, as well as the supply room. Attendings with federal narcotics licenses will have keys to the drug locker, as will nursing shift supervisors."

I acknowledged him, then went to Trauma A. The new trauma rooms were designated as letters A through F, while the beds were numbered 1 through 14. The exam rooms were 100 and 101, and the suture room was 200. The consultation rooms were numbered 301, 302, and 303, while the offices were numbered 400, 410, and 420. Nurse Kellie followed me into Trauma A while Ghost went into Trauma B.

The cabinets were labeled with letter/number designators, and my initial thought was that it had been laid out in a way that would be reasonably efficient, with the items we used most in the most accessible cabinets and drawers. Kellie and I familiarized ourselves with where things were, though I was sure in the 'heat of battle' we'd have to refer to the laminated lists on the wall next to the door.

"I didn't see where the ultrasound machines are," I said.

"The door to the left of the window that looks out on the waiting room is the equipment storage room. There are three ultrasound machines and a portable X-ray machine. That's also where wheelchairs are kept."

"Doctor Mike?" Walt said, walking into Trauma A.

"Hi, Walt. There is a bank of lockers for medical students at the back of the locker room. We're only handling EMS runs until 6:00am, so change into scrubs, please. You can put your slacks, shirt, and tie on just before we open the waiting room."

Kellie laughed, "Doctor Mike, ever the rebel!"

"I'm just being pragmatic," I said piously.

"Sure you are," Kellie teased.

"What am I missing?" Walt asked.

"It's Doctor Mike's contention we should all wear scrubs all the time. He wears his red scrubs because he's technically a surgeon until the end of May."

"Black ones after that," I replied with a grin. "And I'll continue to lobby for scrubs for all of us. Make sure you put on your medical coat, Walt. That's one thing where Dutch Wernher won't allow any deviation for medical students."

"OK," Walt said.

As he was walking out, Margie came in, and I gave her the same instructions. A few minutes later, Teri, one of the experienced clerks, came in, went straight to her desk, and turned on her computer workstation.

"What do we do?" Walt asked when he and Margie came out of the locker room.

"Just hang loose for another twenty minutes. EMS runs after midnight will come here, and anyone coming on shift will report here. We'll open the waiting room at 6:00am, and they'll close the one next door and empty out the old ED."

"I'm all set," Teri announced about five minutes later. "I'm going to do a pair of radio checks, and if everything is good, they'll turn off the radio in the old ED, and we'll be live."

She used the phone to call the 9–1–1 dispatch center and arrange for them to radio her. That check went smoothly, and then the dispatch center had Squad 5, which was at its station, make a radio call as well.

"All set," Teri reported. "Ghost, is it OK to make us active?"

"Yes."

She nodded, picked up the phone, and called the old ED to ask them to turn off their radio.

"All set," she reported.

"Which way does this go?" I asked Ghost. "Crazy because it's our first night, or slow because we're champing at the bit?"

"My money is on a typical Sunday night in April — quiet. Of course, now that I've said that..."

"Yeah," I chuckled. "What's the protocol if we have multiple calls before 2:00am?"

"Mary Anderson will come over, along with her students."

Five minutes later, the radio squawked, and Squad 2 reported they were bringing us two victims from a low-speed MVA.

"I'll take the first, you take the second," Ghost said. "Should I take Margie or Walt?"

"Margie, please."

"Then let's go wait in our brand new ambulance bay for our first patients!"

We all donned disposable yellow gowns, goggles, and gloves, then went out to the new ambulance bay. It was configured to accommodate three squads arriving simultaneously, and they would park at an angle with their rear doors facing the building. Three minutes later, Sam jumped out of the cab.

"Evening, docs! Two male patients transported from a low-speed MVA. No obvious injuries; vitals stable; both GCS-15; one patient reports neck pain and is in a cervical collar. Both ambulatory."

I always smiled inwardly because 'ambulance' had the same root as 'ambulatory' — from Latin for 'walking' or 'moving about by foot'. It was a reference to the fact that early medical transport was carried out on litters borne by men on foot.

"I'll take the neck pain," Ghost said.

"Jack Williams, twenty-two; pulse 75; BP 120/70; PO₂ 99%; cervical collar for complaint of neck pain."

Sam and Bobby helped him out of the squad, and Ghost, Becky, and Margie took him into the new ED.

"Jim Williams, nineteen; pulse 73; BP 124/72; PO₂ 99%; no reported injuries."

Sam and Bobby helped him out of the squad.

"Hi," I said. "I'm Doctor Mike. How are you feeling?"

"OK. My brother insisted I come get checked out."

"A wise move after an accident. Come with us, please."

We escorted the younger Mr. Williams to Curtain 2, as Ghost had the elder brother in Curtain 1, as the small placards attached to the end of the beds designated them.

"Just have a seat on the bed, please. Walt, H&P?"

"Good morning, Mr. Williams," Walt said. "Can you describe the accident for me, please?"

"My brother was driving and swerved to avoid hitting a deer, got the right front tire in gravel next to the road, and we spun with the back bumper hitting a tree."

"How fast were you going?"

"Maybe twenty and a big-ass buck just jumped out right in front of us."

Given the damage that would have been done by hitting the deer, they were probably better off with a spin into the tree. Walt completed the history part of the H&P with nothing remarkable, and a basic exam turned up no injuries.

"What people call whiplash can take some time to become symptomatic," I said to Mr. Williams. "You might wake up with a sore neck in the morning. If so, see your family physician or, if you don't have one, the hospital's Urgent Care Clinic is the next driveway to the south."

"That's it?"

"That's it unless you have any aches or pains."

"Where is everyone else? The place seems empty."

"Across the driveway in the old Emergency Department. You and your brother are our first patients in the new one. We just opened for patients at midnight."

"That's cool."

"Let me finish your paperwork, and you can be on your way."

"Is there a phone I could use? I need to call someone to come pick us up."

There were pay phones in the waiting room, but the lights were off to ensure nobody would attempt to enter before 6:00am.

"Walt, he can use the phone in my office."

"Mr. Williams, if you'll follow me, please."

I completed the chart, then stepped around the curtain to have Ghost sign it. He did, and about ten minutes later, he finished with his patient. Both men were then discharged, and we had them sit in a consultation room while they waited for their ride.

"Not exactly a memorable start," I observed.

"The adrenaline junkie didn't get his fix," Becky teased.