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Views: 856 Created: 2014.08.19 Updated: 2014.08.19

A Pain in the Gut

PART THREE

Sara woke up a couple of hours after she got home and promptly threw up. Pain shot through her abdomen, and she groaned, curling up into a ball, trying to make it ease. She shivered in spite of how hot the room felt to her. Something was very wrong, and she knew it. “I should have listened to Mark,” she whispered to the room at large.

It took a lot of effort, but she got up from her bed. She’d kicked off her shoes when she got home, but was otherwise dressed in the scrubs she’d changed into at work. She looked around desperately for her clogs, finally spotting them sticking out under one of the armchairs in the living room. Each movement hurt, but she managed to wedge her feet into the shoes. She grabbed the small handbag on the dinette and her keys, making sure her phone was in her pocket.

Clutching her stomach, she locked her apartment and headed to the L. She knew she’d never make it if she had to drive, although that would be a quicker way to go. Fortunately, the L had just pulled up when she arrived at the station.

Sara collapsed into the closest seat she could find. She was sweating from the exertion and pain. It was a 10-minute ride from her apartment to the stop closest County General. She pulled out her cell phone and dialed the ER.

Jerry heard the phone ring and picked up. “ER.”

“Jerry, this is McCrery. I need to talk to Mark Greene, now.”

Jerry was puzzled. “Dr. Greene’s with a patient right now, Dr. McCrery. I can have him call you back.”

“No, Jerry. This is urgent. I NEED to speak with him now, even if you have to transfer me to the cordless phone and take it to him personally.” He heard Sara shift the phone from her mouth and groan.

“I’ll see what I can do. Wait…” Jerry saw Mark heading towards the desk with a chart. “Dr. Greene, it’s Dr. McCrery. She said it’s urgent.” He passed the phone to Mark.

“Mark Greene.”

“Mark, it’s Sara. Something’s seriously wrong. I’m in trouble. I should’ve stayed like you said!” Mark could hear she was on the verge of tears.

“Calm down, Sara. Where are you? Are you driving?” Mark motioned for something to write on. “Tell me where you are; I’ll get an ambulance to you.”

“No, I’m on the L. I’ve got one more stop. I’m coming in. Oh, Mark, it hurts so bad!” Now she was crying.

“Shhh. It’ll be okay, Sara. We’ll get you taken care of.” Mark shifted the phone from his mouth. “Jerry, get a bus to the L station, now! Sara’s coming in, and it sounds bad.”

“I tried to sleep, but woke up vomiting. It hurts, Mark!”

“I know, Sara, I know. We’re gonna help you. Where are you now? I’ve got an ambulance dispatched to meet you at the platform.” Mark felt helpless.

“I see the station now.” He heard her groan as she got to her feet. “Ooh!”

He could hear someone in the background talking to Sara. “Are you okay, miss? Do I need to call an ambulance?”

“No, I’m headed to the doctor’s. I’m okay.”

“If you need anything…”

“I’ll make it, thanks.”

The phone pulled closer to her mouth. “Mark? I’m here, but I don’t see anybody. I’m heading towards the ER.”

Mark was torn. Part of him wanted her to wait for the ambulance, but he also knew that she needed to get to the ER quicker than waiting on a crew that was possibly coming from across town. “Okay. We’ll be ready for you.”

Sara hung up the phone. Mark stared at the receiver in his hand for a moment before hanging up the phone.

“Jerry, get me a trauma room cleared.” Mark glanced at the staff close by. “Carol, Haleh, Dr. McCrery is coming in, and she sounds pretty sick. I need a room ready, and put OR on alert.”

Mark grabbed one of the yellow gowns and a pair of gloves. He grabbed a nearby wheelchair and pushed it to the Ambulance Bay entrance, ready for when she would arrive.

Suddenly Morgenstern burst through the bay doors. In his arms was a very pale Sara McCrery.

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Morgenstern headed outside after a grueling OR session. He breathed in the air of a sunny mid-April day in Chicago, and headed towards the Ambulance zone to see if there was a pick-up game of basketball going on.

He had been hoping to catch Dr. McCrery that week, but it seemed like they were ships passing in the night, as he only seemed to be seeing her over a critical patient the last few shifts. He guessed he was just going to have to set up an appointment with her. He made a mental note to do that as he decisively nodded his head at his decision.

No game was going on when he rounded the corner to the bay, but that didn’t matter. He found an empty space of wall and sat down on the low ledge, allowing himself to rest. Tough week, grueling schedule, and the wrap-up of another group of med student rotations were weighing on him.

“Okay, time’s up. Gotta get back to work,” he told himself, even as he hung his head and stayed put on the ledge.

He saw her as his pager started beeping. “Oh my goodness! Sara? Are you all right?”

Sara had made her way from the L station 2 blocks away and had turned the corner into the Ambulance bay. She was stumbling, trying to keep herself upright, while clutching and guarding her lower right abdomen.

Morgenstern saw that she was crying hard, and was about to collapse. He ran to her side and picked her up, looking around, momentarily at a loss. Then he gathered his wits and ran for the bay doors. He pushed through with intensity, focused only on getting her inside and to a treatment room.

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“What the…?! Take her to Trauma. One of the rooms is ready.” Mark directed. “C’mon, Sara. Stay with us. We’ve got you.”

Morgenstern pushed through the doors to Trauma 2 and laid Sara on the gurney. “Get me some vitals, and let’s get her in a gown. IV, LR, and draw blood for CBC, Chem-7, PT, PTT, hematocrit, UA. Sara, tell me what’s wrong. Get her on the monitor, and establish a Foley.”

Nurses were scurrying to help McCrery undress and get into a gown, starting IVs, drawing blood, and hooking her up to the various monitoring equipment. A curtain was drawn for privacy past the double doors to the room, and a Foley was inserted.

Morgenstern and Greene focused on their exam and questioning. “Sara, where does it hurt?”

“I should have listened to you, Mark. I thought it was just the stomach flu, honest. But I kept throwing up, even with the Compazine. Right lower quadrant pain.” Sara cried, feeling too miserable to do anything else.

“Sorry if this hurts worse,” Mark said, as he palpated her abdomen over her appendix. She screamed as he let go the pressure. “Sorry, sorry. Sara, do you still have your appendix?”

“Yes. Surgery?” She looked at Morgenstern with tear-filled eyes.

He nodded. “Yes. We need to get you upstairs. Do you know your blood type, just in case?”

“O positive. Just get it out so the pain will stop!”

“Ok, people. Let’s get upstairs. Tell OR we’re coming up!” Morgenstern unlocked the wheels of the gurney as nurses scurried to unhook monitors and switch IVs to the poles on the bed. Sara’s gurney was wheeled out of Trauma 2, down the corridor to the elevators, and up to the OR.

Dr. Lewis joined Mark outside of Trauma 2, where he stood staring at the elevators, peeling off his gloves. “What did you just have?”

Mark removed his glasses and rubbed his eyes. “Sara just came in with a hot appendix.”

“Oh my goodness! She’ll be okay.”

“I hope so. I let her go home, thinking it was stomach flu. I shouldn’t have let her go home.” Mark threw his gloves into the nearest trash can, forcefully.

Carol approached him. “Mark, you didn’t know, and she refused to stay. It’s not your fault. It’s not anyone’s fault.”

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The first thing Sara was aware of was someone holding her hand. She struggled to open her eyes against the pull of the residual anesthesia.

Mark noticed the fluttering of her eyes. “Hey, Sara. Welcome back!”

Sara started to try to say something, but croaked instead, her mouth dry and throat sore from the endotracheal tube placed during the operation. Mark gave her a couple ice chips to suck on, which she gratefully accepted.

“Hey. Welcome back to the living.”

Sara swallowed. “Thanks. Am I gonna live?”

Morgenstern, having just entered the recovery room, overheard her question. “Despite your efforts to prove me wrong, you are going to make it just to make my life miserable.”

She turned her head to look at him. “Well, someone has to keep you on your toes.”

“You don’t make life boring, that’s for sure. I saw my first appendectal rupture with you. It burst just as I had the surgical field open and ready to start the removal of the appendix.”

“So how long am I in for?” Sara struggled to reposition somewhat on the bed.

“I’ll keep you here a couple of days, so you can start healing and get a couple days’ antibiotics in your system.” Morgenstern noticed her shifting. “How’s your pain right now?”

“Around a 6. I just need to not be quite so flat on my back. It kills my lumbar spine to be so flat.” She sighed as Mark raised the head of the bed a few degrees. Morgenstern motioned to a nearby recovery nurse, who administered 2 mg Morphine into her IV drip. “Thanks guys. That’s much better.”

“I have to keep myself in your good graces. I need to talk to you about a project. No, not right now,” Morgenstern replied hastily. “I’ve been trying to catch you for the last week, and we seem to keep missing each other. But I’ve got you hostage in a hospital bed now, so I’ll chat sometime before you’re discharged.”

Sara nodded. “Ok.”

“I’m going to get you up to your room. I’ll be back in a couple minutes.” Morgenstern patted her shoulder, and walked towards the nursing desk.

Sara turned to Dr. Greene. “Thanks for everything, Mark. You have no idea how much I appreciate it.”

Mark shook his head. “I’m so sorry, Sara. I should have caught the appendicitis and not let you go home.”

“I insisted that it was stomach flu and made the decision to go home, if I remember right. The pain was still diffuse, not localized. It’s not your fault, Mark, it’s mine.” Sara gave his hand a squeeze.

“Still, I should have caught it.” Mark looked over and saw the nurse headed their way, with a couple techs in tow. “Looks like they’re gonna bust you from here and move you upstairs. I’ll visit you later.”

The nurse and the techs made quick work of removing monitoring equipment and securing IVs, preparing her for transport upstairs. “She’ll be in room 619 on the Med-Surg floor, doctor.” The techs unlocked the wheels to the gurney and started directing it towards the door.

“I would appreciate that. Any and all visits welcome! Later Mark.” Sara looked at him as they wheeled her down the hall. “And thanks!”

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A week later, Dr. McCrery entered the ER. She breezed into the doctor’s lounge and headed straight for her locker. She grabbed the stethoscope, name badge, and white lab coat that resided there. She looked intently at the lab coat, running one hand down the material, before putting it on. She attached her ID badge, slung the stethoscope around her neck, and shut the locker door.

Sara walked out into the hall, only to be stopped by Carol, who thrust a yellow coverall in her hands. “Ambulance coming in 5 with an apparent heart attack!” Sara took off rushing down the hall towards the Ambulance Bay, putting the coverall over her clothing as she went.

The Bay doors burst open, revealing the whole ER crew. A handmade sign proclaimed “Welcome Back Dr. McCrery!” and people were carrying cans of soda and wearing surgical bouffant hats.

Sara shook her head even as she laughed. It was good to be back!

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