Kim: Power Play - Cover

Kim: Power Play

Copyright 2009 Ernest Bywater

Chapter 01

In Australia a salad sandwich usually has lettuce, tomato, onion, beetroot, and a few other common local vegetables like carrot, but no mayonnaise or similar dressings nor any meat.


Happenings

The sound of several girls’ screams of horror pierce the noisy chatter of students moving between classes. Their screams are just reaching full pitch when a screech of great agony echoes down the halls as it easily overriding the girls’ screams. All of the people in both of the school buildings freeze while they all wonder what’s going on to cause such sounds. Only those close to the front stairs of the main building can hear the sound of feet pounding while a young man races down the hallway.

Peter Mills has a look of horror on his face while he races for the main power distribution board for this building. After wrenching the door open he reaches in and throws the main power switch to the ’off’ position to shut down all of the electrical power to the whole building as he doesn’t have the time to find the right circuit. Closing the door he locks it, pulls the key out, then he puts the key in his pocket while he runs back down the hall. Fifteen metres later he grabs the end of the handrail while he bends down to grab his large work first aid kit with the other hand. Stopping by the older man lying on the mid-stairs platform labouring for breath he opens the kit and pulls out the small cylinder of oxygen while he asks, “Got your tablets on you?” The man shakes his head no just as Peter slips the strap of the face mask over it. While slowly shaking his own head Peter grabs a small bottle of tablets from the kit and pops one into his hand. He slips the little heart medication tablet under the man’s tongue before sliding the mask down over the man’s mouth and nose so he can breathe pure oxygen. Opening the valve on the oxygen bottle with one hand as he slips the vial of tablets in the man’s top pocket with the other while he swears at the situation they’re in at the moment.

Moving toward the young boy lying on the stairway landing Peter gets his mobile phone out of his pocket and hits the speed dial for the emergency services. They answer as Peter kneels beside the injured boy. He clips the wireless microphone and earpiece to his ear with one hand while he reaches out and drags the electrical leads away from the boy whose upper body is still jerking about. Peter gives emergency services the address and he’s asking for an ICU ambulance at the same moment as he touches the boy’s neck to check his pulse.

Peter grunts with pain when he hits the side wall of the stairwell very hard. While swearing he grabs one of the rubber safety mats and throws the mat down beside the mat the boy is on. Now able to be isolated from the ground Peter kneels on the mat to check the boy’s pulse which is very weak and erratic. He’s concerned about the boy and his injuries but he can’t do much for the boy until he can get rid of some of the electricity in the boy’s body. Peter grabs some wire and tools to make an earth wire with a circuit breaker in the line. He soon has the wire ready and plugged into the earth socket of a power point as even with the power off the earth line is still connected and fully grounded. On carefully touching the wire to the boy’s arm Peter sees a bright spark just as the twenty-five amp circuit breaker trips. Four times he resets the circuit breaker after he touches the boy with the open wire before it stops sparking. On the fifth touch it doesn’t trip the circuit breaker. The boy has stopped jerking around so Peter checks his pulse again. It’s still weak and erratic, but is much better as it’s stronger and not as erratic. He leaves the boy as he is since he’s very concerned about the way the boy is lying over the tool box in the middle of the mat. Looking up at the watching students upstairs he sees one of the teachers has arrived and is moving the students away.

A female voice yells, “Why did you turn the power off? I told you it has to stay on while you work, we can’t be interrupting everyone’s work.” He looks down the flight of stairs to see the high-school principal, Mrs Whitty, walk into view. She stops to stare at the scene. A moment later, when the sound of sirens are heard approaching them, she turns and goes back to her office. In another minute Peter smiles when two emergency medical technicians come dashing into view and up the stairs. He quickly briefs them on the situation and they take over both patients.

Peter sighs while watching the EMTs at work because some of the boy’s injuries are outside of his basic first aid training. Pulling out his phone again he calls the local Work Safety Officer to inform him of the incident. Fearful of the worst possible outcomes he also calls the local police to come to check the scene. Sighing again he makes the call he should have made before them but he was putting off until now, but he can’t delay it any further so he calls the company’s office.

The phone is answered and he says, “We’ve had a work accident. I’m waiting for the safety inspector to arrive and investigate. You best shut the office and get down to the hospital, Mum. A student will be headed there with some serious injuries and so will Dad. He had a minor heart attack. He should be OK because I got his tablet and oxygen to him in good time. I’ve got to wait for the investigators, so I’ll catch you later.”

Jennifer Mills, Peter’s mother, agrees and promises to call him later when she’s at the hospital and knows what’s happening. He hangs up.

The EMTs are happy with the condition of Patrick Mills, Peter’s father, but are very concerned about the boy. Peter watches while they work to fully evaluate the boy’s injuries. They place a large bandage over the torn scalp and damaged skull on the side of the boy’s head. After a few minutes one of the EMTs leaves, and is soon back with a gurney and the special equipment for a spinal injury. One EMT is setting out all of the equipment to immobilise the boy while the other is assisting Patrick down the stairs and onto the gurney. A few minutes later another pair of EMTs arrive and they take over the care of Patrick by moving him to their gurney and taking him to the local hospital. When he’s asked for it the team leader hands Peter a receipt for the oxygen cylinder from his kit so the hospital will give Peter a replacement cylinder when he goes to get it.

Peter gets out his phone to use the camera option to take photos of the scene and the boy’s position. He also takes photographs of the EMT checking the area and picking up some bits of bone he puts in a plastic bag. A little later the boy is immobilised and being carried to the gurney in the same position as he ended up in after his fall down the first flight of stairs to the landing. While Peter takes more photos of the scene the EMTs take the boy to the main city hospital because his injuries are too severe for the local hospital to deal with.

About half an hour later the Work Safety Officer arrives, and so do the police scene of crime people from the nearby city. Both are soon busy taking their own photos and asking questions of Peter and the other witnesses. They take about an hour, then Peter is allowed to finish the job Patrick was working on and to tidy up the scene, including the blood on the wall where the boy hit it before falling onto the tool box and the live power cable Peter was working on. His final act, nearly two hours after the incident, is to return to the main board to turn the power back on. After locking the door he goes to the office and hands the key to the high school’s senior clerk for her to return it to their key locker.

After packing the tool kits and first aid kit back into the work truck Peter pulls out his mobile phone to check the unanswered calls. Two calls are work related ones which Peter quickly deals with, and there are twelve calls from his mother. He leaves for the local hospital while deciding to speak with her there after he gets to the hospital where his father is. He sighs while he gets into the work truck, then he drives away from the school.


Hospital

The ambulance stops in front of the entrance to the ER (Emergency Room). The ambulance’s back doors open while the driver gets out to hurry around to the back of the vehicle. She reaches the back just as her partner needs a hand getting the gurney out. With practised ease they soon have the gurney on the ground and are wheeling it through the automatically opening doors. A nurse approaches them, and the other EMT says, “Suspected spinal injury in the lumbar region, major electric shock, fractured skull, concussion, and suspected displaced shoulder.”

The experienced triage nurse nods to show she heard him while she reads the EMT’s notes on the patient and treatment they’ve given him so far. She signs the form while saying, “OK, Treatment Three.” She waves to another nurse while she follows the EMTs and the patient to Treatment Room Three. Stopping in the doorway she says to the other nurse, “Call upstairs, we’ve got a spinal case.” The EMTs take a lot of care when they move the patient to the hospital’s gurney in the treatment room. They leave, taking their gurney and paperwork copies while the Triage Nurse gives orders to one of the Emergency Room nurses to set up the needed monitors to check the patient’s vital signs.

Nurse Brown is bent over checking all of the monitor leads of both the EEG (electroencephalograph) and the ECG (electrocardiograph) for the fifth time. However, neither is reading properly, but she’s positive she wired them up right. She even changed the machines in case they were at fault. But she’s getting the same weird readings, and neither is like what they should be. Two doctors walk in while she’s closely checking the leads connected to the patient. One of them coughs, she jumps and stands upright. With a weak smile she says, “The readings of the EEG and ECG are weird, so I’m checking they’re connected right.”

The doctors look at the readings, and their eyebrows go up. One reads the patient’s records then slowly nods his head while saying, “They’re the weirdest I’ve seen, but I’ve seen something almost this bad once before. A patient with a large electric shock, like this patient, had some residual electricity in his body that was interfering with the sensors. Turn the sensitivity right down low to see if we can get something that looks like it might be readable.”

A moment later the sensitivity of the machines are turned to the minimum with the display scale minimised. Thus only the larger spikes are showing, and they have some graphs that kind of resemble what they expect from a live human patient. Not exactly what they should be, but enough to indicate if there are any major problems. Now they’re happy with what the monitors are telling them they set about giving the patient a thorough check as they list all of the injuries they find on the record.

While the doctors are checking the patient Nurse Brown is checking his pockets and noting down the contents. When she opens the wallet she sees his government issued Medicare card and writes all the details in the correct spots on the forms. From the identity documents in his wallet she completes the forms. She makes a note to call the boy’s mother and the other contact person listed in the emergency contact details in his wallet, noting both names on the forms in the contacts and ’authorised persons’ section. He’s unconscious and none of the procedures are intrusive yet, so they don’t need guardian approvals. The patient is sent to radiography for an x-ray and other scans. Nurse Brown calls the two contact numbers to tell Mrs Helen Wells and Ms Amanda Casey the boy, Kim Majors, is in hospital and his current condition. Mrs Wells promises to come in, and Ms Casey asks to be kept up to date on his condition then she gives a fax number for authorisation forms to be sent to her.

Nurse Brown is a bit concerned when she notices Kim spends over three hours in radiography. On his return the nurse who took him up explains how the x-rays of his head, shoulder, and back went OK but the MRI didn’t. They set him up and started the machine. When he slid in there were electrical sparks between the machine and Kim as he jerked about. The operator was quick to turn the MRI off and pull the patient table out. They ended up giving Kim a full body Computed Tomography (CT) scan because that was the best all over scan they felt safe doing.

Kim is back in the treatment room when his mother, Mrs Wells, and his sister, Lee Hanes, arrive to see him. Nurse Brown takes her time to explain his injuries and the doctors are waiting to closely examine the x-rays and scans before commencing any treatment. Just over half an hour passes before doctors arrive to speak to Mrs Wells and start treatment.


Wake Up Call

Kim Majors is lying in the hospital bed he was transferred to in the children’s ward after the surgery to his head and arm a few days ago. The bruises and cuts are responding well to their simple treatments of clean, cover, and leave alone. The shoulder has been put back into place and a follow up x-ray shows it’s settled without any complications. Prognosis for all of his injuries are good, except for the spine. The back injury is a full fracture of two vertebrae and a total severing of the spinal cord, he’ll be confined to a wheelchair or a bed for the rest of his life. The doctors aren’t sure which because they won’t know the extent of his control or lack of control until after he wakes up and they can do more tests on what he can and can’t do.

Nurse Brown has finished her duty rotation in ER and this is her first day at work in the Children’s Wing after a two day break. She’s beside the bed looking down at Kim when the assigned physician, Dick Fisher, is hooking up the EEG and ECG. When they moved Kim up from ER the doctors didn’t reconnect him to the monitors since they saw no benefit in doing so, mainly due to the non-standard readings setting the alarms off all of the time. However, Dr Dick, as the staff call him, now wants Kim hooked up to the monitors again.

The last sensor is in place and the machines are turned on. Nurse Brown notices Kim’s arms twitching and she points it out to the doctor. He shrugs and keeps on adjusting the display settings.


Kim is resting peacefully as the pain has stopped and he can sleep. Then the sharp stabbings in his chest and head start again, but much worse is the constant buzzing in his mind. It all hurts and it’s very annoying. He thinks for it to go away as it stopped after a while when he did that before. This time it’s not going away and it’s getting worse. It grows louder and hurts more, much more than before. He can’t stand it any more! He jerks upward and screams. His eyes pop open very wide. He’s in a hospital and he wonders how come. He notices the leads to his chest, right to where the pains are. No slow thinker - he knows the leads are causing the pain he’s in. His left hand reaches down and jerks the leads away while his right reaches up to his head to find more leads.

Both Doctor Fisher and Nurse Brown jump when Kim screams. His upper body comes partway off the bed as his eyes open. He looks at his chest, and his hands are like striking Cobras when they flash from the bed to rip-off the sensors on his chest and head. The monitors shrill their alerts when they register a patient in terminal shock. Doctor Fisher turns to start emergency treatment, only to be shocked on seeing his patient ripping the last of the leads off his body and throwing them to the side.

Doctor Fisher grabs new leads and goes to put them on Kim. A hand flashes out to grab the doctor’s coat at the upper chest. After pulling the doctor down to his face Kim snarls, “Keep those bloody wires and pain machines away from me. I don’t need them or want them.”

Fisher is shocked, “They’re monitors to tell me how you’re doing.” In a stronger tone, “I’m your doctor and I’ll decide what you need.”

“I don’t care who you are or what they are. They hurt me, keep them away or I’ll smash them.” Kim turns to the nurse. “Please get me the registrar, my mother, and a telephone.” He lets go of Fisher.

It’s at this point Nurse Brown has a closer look at the patient, and sees his upper arms and chest are well muscled. Although they’re still under the covers his legs look like they’re well-muscled too. She nods to the two antagonists and leaves the ward. Leaving them to stare at each other. While she walks to the nurse’s station she wonders who’ll win the fight. Doctor Dick is known to be very pushy and demanding, in many ways, while the boy doesn’t look like the type to give in easily.

Changes

At the nurse’s station Nurse Brown phones the Hospital Registrar, he’s the senior permanent doctor who assigns doctors to patients and he does most of the medical related administration. She also places a call to Kim’s mother, but gets no answer. She hangs up and returns to the ward. Almost laughing when she sees the two antagonists.

Dr Fisher is standing beside the bed, but back a pace with the leads in his hand and staring at the boy while he gives a long talk on who’s in charge; his voice is very hard and harsh. The boy stares at him with no expression at all as he obviously watches him while ignoring his words.

Nurse Brown waits a moment for Fisher to take a breath and says, “The Registrar is on his way down. Your mother isn’t answering either her cell phone nor the house phone and there’s no connection for a phone in here. Your own cell phone was taken away along with all your other personal effects by your sister, Lee, when you were brought in.”

Kim smiles at her, “Thank you. But somehow I’ll have to ring my guardian to talk to her, and very soon, too.” Nurse Brown slowly nods because that’s what she thought he wanted the phone for.

“I can get my personal cell phone from my locker during my break, if you promise to reimburse me for the call.” Kim nods his thanks.

Fisher is starting to talk again when a tall, solid man in a white coat enters the room, he says, “OK, Nurse Brown, what’s the problem?”

She gestures to Kim with her hand, “This patient, Kim Majors, asked to see you. I think he has a problem with Doctor Fisher as his attending physician as he doesn’t trust or like him and he wants another doctor.”

Before answering the man glances around the small ward, Kim is one of ten patients in this ward. After taking a deep breath he sighs, turns to Kim, and holds out his hand, “Good morning, Kim. I’m Doctor James, the hospital registrar. This is the number one children’s ward. We have six wards like this in the children’s wing and no more beds in the wing. Doctor Fisher is our senior paediatrician and the doctor in charge of this ward, so all of these patients are under his care. Technically, I could exchange your bed with one in another ward, but that would disrupt the doctor patient relationship of another patient when they change wards and I’m not prepared to do that to another patient. So, unless you want to be moved to another hospital you’re stuck with Doctor Fisher.” Dr Dick now has a very nasty smile. “I strongly recommend you stay in this hospital because we’ve the best specialists and equipment in the region.”

Kim gives him a close look while he listens as they shake hands. Specialists and equipment! He wonders exactly what’s wrong with him. He nods at the statement and asks, “Do you have any private rooms?”

“Not as such, we have semi-private rooms, two beds to a room in a wing of six rooms with one nurse to the wing. Most are empty at present since nearly all of our patients are on Medicare and in the public wards, like this one. Our policy is to place only one patient per room in the private rooms until we have a seventh private patient. I can shift you to the private wing where you’ll have to arrange your own attending physician or I can have one of our older interns take on the duty. That would be OK because the specialists will be the ones deciding the main treatment. That’ll all cost a lot, can your family afford to pay for it?”

Nurse Brown interrupts, “Dr James, Kim wants to call his guardian, but I need a cell phone to do that from here. Perhaps you can use yours. I think his guardian can and will pay for private care.” He turns to look at her, so she gives him a small smile, “The guardian is in Adelaide. I’m from Adelaide and I’ve heard of the firm she works at. I suspect she’s a trustee of an estate because she has a different family name.”

He gives a nod to show he understands, reaches into his coat pocket, pulls out a cell phone plus a small external speaker with microphone, which he plugs into the phone. When he opens the phone Nurse Brown picks up the clipboard with Kim’s file then she reads out the phone number. Dr James punches in the number, and it rings.

A moment later the phone is answered by a woman saying, “Casey, Owens, Patrick, and Evans, attorneys-at-law, Sheila speaking. How may I help you?” The eyebrows of Doctor James go up quite a bit.

Nurse Brown says, “Miss Amanda Casey, please.”

“I’m sorry, Miss Casey is in an important meeting at the moment. I can’t disturb her for another half hour or so. May I take a message?”

Dr James says, “Yes, please. This is Doctor James at...,” he stops as Kim is waving rather frantically. He looks at Kim and inclines his head.

Kim speaks up, “Sheila, Kim, I need to speak to Mandy, please.”

“Kim, why didn’t they say it was you at the start? She’s in the weekly partners’ meeting, but she does want to speak to you soonest. Oh, grab a pen and paper to write this number down.” She gives him a phone number which Nurse Brown writes down for him. “That’s my personal number. If you need to talk to someone on a personal level give me a call, any time, any day. I can help, as I’ve been there.”

“Ah, right, Sheila, thanks. But I’m not sure what for.”

Another woman’s voice comes on the line, “Kim, how long have you been conscious?”

“Morning, Mandy, about five or ten minutes, why?”

“And I bet you’re calling because you have a problem with staff.”

“You do know me well, don’t you? Yes, the doctor and I don’t get on. He insists on using some sort of torture device he claims is a harmless monitor, but he won’t listen to me when I tell him it hurts me a lot.”

“OK. You urgently need to be given a full run down of your medical condition. I guess you want a private room, own doctor, and designated nursing staff all of your own. If one of the hospital admin staff can talk to me and send me the forms I’ll organise for all the approvals and money. But, on a more personal note, Kim, please promise me you won’t take any drastic action until after we’ve spoken and agreed on it.” He hems a bit. “Kim, please, promise me right now, you’ll ’stand to and hold the line’ no matter what, until after I agree to anything. Please?”

Kim is worried because she’s begging him not to do anything until after she approves it. She’s even using a special family code to make him give an iron clad promise. He’s now extremely anxious about what’s wrong with him. He gives a heavy sigh then says, “I promise, ’until the twelfth,’ I promise. OK!” Her huge sigh of relief on his promise is of more concern to Kim than anything else. Then it hits him, Sheila’s been there and can help, but where could she have been that he’s now heading to? She’s a paraplegic and has been since she was twelve years old. Then the rest of his mind kicks in despite the mental shock from the physical trauma to his body, and he does the additions. “Mandy, how bad is it?”

“They don’t know yet. They’ve been waiting for you to come out of the coma to conduct detailed tests. You may be bed ridden for life.”

He closes his eyes while he thinks on the information. All of his life he’s been very active, a very physical person, and now may be bed ridden for the rest of his life. After taking a deep breath he opens his eyes to see Nurse Brown and Dr James are watching him. Both of them are very worried about him while Dr Fisher looks angry at being side-lined so easily, and by a teenage boy.

Nurse Brown is concerned because they didn’t have a chance to break the news to him gently. She watches Kim close his eyes when he comprehends what he’s been told, she’s not sure how what she’s heard has conveyed the news, but it’s clear it has. He opens his eyes, and she can see the tears in them waiting to be released. He glances over his audience as the whole ward is silent while they watch and listen to this little play in their midst. Then his face changes! It loses a lot of the childish softness so it’s now harder, more strong. Yes, strength is how she decides to describe the look of his face. His voice has a new strength, a new maturity, when he speaks again. She doesn’t understand the words, but the message is clear, very clear.

In a strong and vibrant voice Kim says, “Message received! I’ll hold the line until relieved or the twelfth of never. However, I can see my legs are still attached, so it’s a communications breakdown. I’ll find a way to fix that and I will walk again! Of that, you can be certain!”

Dr Fisher is shocked by Kim’s statement while Dr James and Nurse Brown are very relieved. They don’t think he will walk again, but that determination will ensure he tries, he will survive this tragedy. Sheila and Mandy are both relieved at his statement, but they both know him well and they wonder just how he’ll go about walking again.

“Kim, now that you’re awake I’ll have our local solicitor visit you to sort things out, plus a detective who’s investigating the incident for me. Whoever is there on behalf of the hospital, I want a private room for Kim with his own nurses twenty-four hours a day seven days a week, and a different doctor to the current one. Kim can veto anyone off his care roster without any need to say why. I’ll organise for the full payment.”

Kim interrupts, with, “I want Nurse Brown as my nurse coordinator and liaison between me and the hospital. That should reduce issues as she’s already proven herself to be proactive and competent in that role.”

They can all hear the smile in Amanda’s voice when she says, “OK, can someone please organise all of that starting as soon as possible. Shift Kim to the new room and fax me the forms and information for me to approve and start payments, please.”

Dr James says, “This is Doctor James, the Registrar, I’ll get the paperwork started and Nurse Brown can start organising the nursing roster. I notice we’ve got a fax number for you on Kim’s file, so I’ll send the papers there. Do you have a local doctor to recommend as the attending physician or is it OK to assign an intern? I just finished telling Kim we don’t have any spare senior doctors to dedicate to him, but his main treatment regimen will be set by the specialists, so an intern will be quite sufficient in that role and I can spare a senior intern from my rosters just for him.”

“As long as Kim approves the doctor I don’t care if it’s an intern or a more senior person. Kim, regarding the specialists, you won’t have a great deal to do with them on a daily basis, so please try cooperate with the specialists because it’ll be very hard to get qualified replacements for them.”

“Message received, loud and clear. I’ll call again when I’m settled into the new cave.”

“OK, Kim. Thanks, Nurse Brown, Doctor James. Have a good day.”

The phone call ends and Dr James puts his phone away while he says, “Nurse Brown, I see why you thought we should call them. My sister-in-law is a solicitor in Adelaide and she’s spoken to me of that firm. There’s only one Casey there now. The firm was started by her grandfather and his brother, later it was run by her father and his sisters. Four cousins now run the firm and Amanda Casey is the senior partner. Jenny tells me she’d rather go crocodile wrestling than have to fight Amanda Casey in court, because she’s very good and very tough.” He turns to look at Kim. “I wonder what the relationship is, since it’s clear she sees Kim’s welfare and care as being very important to her.”

Kim blushes, “Mandy is my cousin, through Dad. Dad gave her a power of attorney over me when he first went overseas, and that was supported by the Family Court when Mum and Dad divorced. It was part of his will when he died, again supported by the courts. She’s the executor of his estate, my trustee, and my legal guardian. All financial decisions must be approved by her. All other major decisions require her approval too.”

Dr James and Nurse Brown nod their understanding while they smile. This information helps them to understand some of the odd family dynamics they’ve noticed amongst his visitors since Kim was admitted. Dr Dick stomps off on being dismissed by Dr James when he leaves to sort out the administrative issues involved. Nurse Brown leaves to see the Hospital Nursing Coordinator about staff and rosters. They both wish to get the staffing sorted before shifting Kim.


New People

While waiting to be shifted Kim looks around the ward he’s in. The children are all staring at him, partly because of how he tangled with the doctor and partly because of what they heard on the phone. He smiles as he waves at them. He’s the oldest there, most are girls, and all of them are around nine to twelve years old. The next eldest is twelve years old, a girl with scraggly looking hair. He wonders if she has cancer and is on chemo therapy because she looks a lot like how they show them on TV.

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