Fred had had his own excitement that evening. After seeing Meghan safely in Jerry and Bill’s care, he returned to the classroom, cleaning up the mess left behind, straightening up the classroom to be ready for the medic class he would be teaching in the morning. He went ahead and put papers away in his briefcase, tucking in a set of incident report forms to fill out, and secured Meghan’s as well. He left hers sitting on her desk in the office, and tucked her turnout jacket back around her chair where she liked to keep it. He locked the office door, glanced at the classroom once more, and locked the classroom door after turning out the lights.

Fred carried his briefcase through the hall, passing by the Fire/Rescue classroom. Brad and Jerry were heading out of the classroom and locking up as well. Jerry spotted Fred and hailed him. “Hey, Fred! Know anything about the response to the school tonight? We didn’t get notified about anything, but the kids saw the trucks.”

Fred grimaced but nodded. “Sorry I didn’t call y’all – I was busy taking care of Meghan.”

Brad looked shocked. “Meghan? Is she alright?”

Fred shook his head. “Her blood pressure took a nosedive on her tonight. I wound up sending her to the ER via ambulance.”

“Tough break! Are you going to the ER?” Jerry asked as they stepped outside the building.

“Yeah, I’m heading there now.” Fred started towards his car.

“Let us know how she’s doing, okay?” Brad asked.

Fred waved in reply, walking to his car. He unlocked it, opening the back door to toss his briefcase in. He closed the door… right on his right hand. The sudden pain had him yelling, holding his wrist as he held the injured limb close to his body and moved around with the pain.

Brad and Jerry were next to their own vehicles when they heard the shout. They came running over to Fred’s side as it was obvious he had hurt himself.

“Easy, Fred! Easy! What happened?” Brad came up next to Fred’s side first. “Here, sit down. What happened?”

The two men helped ease Fred down to a sitting position on the ground next to his car.

“Slammed the door on my hand,” Fred gritted out, hissing through his teeth.

Jerry nodded at Brad and ran back into the school. Brad reached into his pocket and pulled out a pair of gloves, donning them. “I’ve done that before, and it sucks. Here, let me see.”

Fred gingerly held out his hand, still holding onto his wrist. Brad carefully looked at the hand on both sides. “It looks like you’ve got a laceration close to your thumb. Can you wiggle your fingers?”

Fred attempted to do so, hissing as the movement caused more pain. “Feels like fire through my palm. I think I broke something.”

Jerry came running up with a trauma kit. “What do you need?”

“Gauze, tape, a roller gauze, and a splint. He’s got a gash to his thumb and might have broken something in his hand.” Jerry nodded and pulled out supplies. They dressed the laceration before carefully putting the roll of roller gauze in Fred’s hand to keep it in a neutral position. Then, pulling out a SAM splint, they formed it to his arm and splinted his hand and forearm.

Brad secured a sling around Fred’s neck as Jerry cleaned up the packaging from all of the supplies. “Okay, Fred, we’ve got you bandaged up. I’m sure you don’t want to have us call an ambulance for you…”

“No!” Fred stated, adamantly.

“… but you can’t drive yourself either, not with that hand. I can drive you to the ER in my car. Do you have your keys so I can make sure your car is locked?”

Fred used his good hand to dig his keys back out of his pocket. “Here. I’ll take you up on that ride.”

Brad accepted Fred’s keys, making sure the car was securely locked. He handed them back to Fred, who tucked them back into his pocket.

Jerry came to one side of Fred, while Brad stood on the other side. “Okay, Fred, let’s get you up. One, two, three.” They helped Fred get back on his feet and made sure he was steady. Brad led Fred to his car, opening the door so the man could get in. Making sure Fred was in, Brad closed the door and rounded the car. He looked over the top of the vehicle at Jerry. “I’ll get Fred to the ER. Want me to do the paperwork on this?”

Jerry waved him off. “Nah, I got it. I’ll grab a form and fill it out at home when I get this stuff put away. See you in the morning.” Jerry bent next to the car door. “Fred, take care. We’ll see you soon.”

Fred waved with his good hand as Brad climbed in the car, shut his door, and started the engine. “Okay, Fred, let’s get you to the hospital.”

It was a short 10-minute drive to County Medical, and Brad chatted with Fred about Meghan’s incident as they drove. “Wow. I had no idea she was having so many issues. Has she said if the doctors were investigating what is going on?”

Fred nodded. “Yeah, her doctor has been doing a lot of lab work to get to the bottom of it. I know she hated my having to call for an ambulance tonight, but it was the only safe way to get her there. I’m just afraid that if they don’t find out what’s going on soon, she’s going to have a real health emergency that’ll land her in the ICU.”

Brad shook his head in concern. “She doesn’t need that. We just got her healed up a few months ago. Well, if you see her, tell her we’re thinking of her and want her back to work soon.”

Brad pulled into the hospital drive. “Should I drop you off at the desk, or shall we sneak through the ambulance bay?”

Fred chuckled. “Eh, the desk will be fine. I’m not critical.”

Brad pulled around to the ER entrance and parked. “Here you are, my friend. If you need a ride, just give me a call, okay?”

“Sure thing. It’ll probably be a few hours. At least it doesn’t look too busy at the moment.” Fred undid his seatbelt, opened the door, and stepped out, keeping a hand on the car for a moment to be sure of his balance. He closed the car door and waved before heading through the double doors into the ER lobby. Brad made sure that Fred made it inside before he pulled out. He sighed, putting the car in drive, and headed home.

Fred approached the front desk, recognizing the nurse on duty. “Hey there, Maria. I need to check in.”

Maria recognized Fred and looked concerned when she saw his arm in a sling. “Fred! What happened to you? Wait there just a moment…” She left her desk on the other side of the plexiglass and stepped into the hall, pushing the button to open the doors to the ER. “Come this way.”

Fred followed her through the doors to a triage room. He sat down in the chair gratefully. “Well, I slammed my hand into my car door. I’ve got a laceration around my thumb, and I’m afraid I might have a broken bone or two in my hand. It’s hurting like the dickens.”

Maria frowned, busily wrapping a blood pressure cuff around his arm. “Under your tongue,” she instructed, placing a thermometer in his mouth. She took his blood pressure while the thermometer registered his temperature. It beeped, and she removed it, throwing away the barrier sleeve before placing the probe back in its housing. She jotted down vital signs as she spoke. “Temp is 98.4 degrees (F), blood pressure 136/78. Let’s get your pulse rate.” She placed a pulse ox probe on his left hand. “Approximately how long ago did you get your hand caught in the door?”

“I’m guessing about 30 minutes ago?” Fred answered. He glanced at the readings on the pulse ox out of habit. Maria also took time to jot down the numbers and removed the probe from his finger.

“How would you rate your pain right now?”

“Pretty painful. I’d give it an 8/10,” Fred admitted.

Maria gave him a sympathetic smile. “Well, good news is that the patient load is pretty small at the moment, so I’ll be able to get you right back. We had a critical patient come in about an hour ago, though, so you might be waiting a bit to be seen.” She motioned for him to follow her.

Fred stood up carefully and followed Maria out of the triage room and down the hall into the main ER. They passed by the nurse’s desk on the way to Room 5, and Stan, one of the ER nurses, recognized him.

“Fred! What happened?” Stan rounded the nurse’s station and followed them as Maria led them into the room.

“Well, I accidentally slammed my hand in my car door,” Fred replied, settling himself onto the gurney. Stan accepted the paperwork from Maria and she left the room.

“Ouch!” Stan sympathized. “I’ve done that once and bawled like a baby, it hurt so bad. I’m sure you didn’t bandage yourself up; do you have an idea as to the damage?”

Fred nodded, sitting back on to the gurney after kicking off his boots. “Brad and Jerry from the Fire school were nearby and bandaged me up. Said I have a gash around my thumb, and I’m pretty sure I broke something in my hand. I’m not sure the extent of the gash, though.”

“Well, let me see if I can wrangle a doc in here to look at that hand. It might be a bit – we had a critical patient come in about an hour ago.”

“Yes, I know,” Fred replied. “How is Meghan?”

“How’d you know Meghan was here?” Stan looked at him, puzzled.

“I called the ambulance for her. She was teaching at the college with me tonight.” Fred looked down at his hand.

“Well, there’s not much to tell yet. Her blood pressure is pretty low, and she’s still rather out of it. I think they are discussing trying to raise it pharmacologically,” Stan replied. “Listen, I’ll go see if I can round up a doc for you, and I’ll try to keep you informed, okay?” He glanced at Fred’s socked feet. “Want a blanket? They’ve got it rather chilly in here tonight.”

“Sure, Stan, thanks.” Fred watched him go and scooted a bit on the gurney, trying to get comfortable for what he assumed would be a long wait.

About 15 minutes later, Mitch walked through the door. A tech had brought Fred a blanket, so he was comfortably resting when Mitch entered. “Hey Fred! Wanna tell me what happened to you?” Mitch sat down on a stool and wheeled himself close to Fred’s side. Stan entered behind him, carrying some supplies, which he lay down on the counter.

Stan started undoing the sling from Fred’s arm, and Mitch helped hold the splint while Stan did so.

“Well, I accidentally slammed my hand in the car door,” Fred stated, then hissed as his hand position moved as they unwrapped the splint.

“Sorry, Fred. Stan, go get Morphine, 5 mg and an IV setup of normal saline.” Stan nodded and left the room. “Fred, I’ll need to get x-rays of that hand to know for sure, but I think you might be right about a broken bone or two. There’s a lot of swelling and bruising here to your metacarpals. I’ll wait until we get that morphine on board before I look at your hand further.” Fred nodded.

Stan bustled back in with more supplies. “Okay, Fred, let’s get an IV in. Do you want any labs, doc?”

Mitch shook his head. “Here, I’ll let you have the stool. I’ll be back in 5 minutes to look at that hand.” Stan nodded and took a seat as Mitch left the room. “Okay, partner, show me a big vein.” He wrapped the tourniquet around Fred’s arm as the other man chuckled. The IV went in easily, and Stan hooked it up to fluids. “And now for some pain juice.” He slowly administered the Morphine through the IV. Fred visibly relaxed as his pain level significantly decreased.

Mitch breezed back in as Stan cleaned up. “How’s the pain? Better?” He sat back down on the stool.

“Much,” Fred agreed. “How’s Meghan?”

Mitch sighed as he pulled on a pair of gloves. “Not doing great, but she is stabilizing. I’ve got a specialist coming in to take a look. Now let’s look at this hand.” Mitch carefully removed the tape holding gauze over the laceration on Fred’s thumb. He probed it carefully. “Well, it’s not bleeding much, but it does look deep enough for a stitch or two. Let’s get this cleaned out and stitched, and then I’ll send you for x-rays.”

Mitch wound up putting in three stitches. Finishing up, he asked, “When’s the last time you got a tetanus booster?”

Fred thought a moment. “It’s been several years, not really sure to be honest.”

Mitch looked at Stan. “Stan…”

“On it, Doc.” Stan disappeared again, coming back with a syringe. “I need an arm, Fred.”

“I’ll go put in the orders for those x-rays, Fred.” Mitch smiled, then left the man’s room to put in orders.

It took about an hour for Radiology to come get Fred, do the x-rays, and get him back to his room. And it took about 30 minutes before the radiologist on-call was telephoning Mitch. So, it was very understandable that Mitch found Fred asleep when he re-entered his room.

“Fred,” Mitch said, gently nudging the man’s left shoulder.

Fred woke up. “Oh, hi Doc. Any word?”

Mitch nodded and held up an x-ray film. “You, my man, have indeed broken your hand here and here.” Mitch pointed out the breaks on the films. “I’ve called the orthopedist on call to come in and take a look, because the more medial of the two breaks is dislocated. Fortunately for you, Dr. Rothman is the same ortho who took care of Meghan’s sister recently, and I know he’ll do a great job for you.”

Fred nodded. “Do you think the fracture will be surgically reduced?”

Mitch smiled reassuringly. “No, I don’t. I think he’ll probably give you some more pain meds and just do it here in the ER before sending you home in a splint.”

“Oh, okay.” Fred looked at his hand and sighed.

“I do have an update on Meghan’s condition,” Mitch offered.

“Oh? How’s she doing?” Fred sat up straighter, mindful of his hand.

“Well, her blood pressure is stabilized now. We wound up giving her a vasopressor, and she’s on a drip now. I’ve called in an endocrinologist, and he is thinking she might have Addison’s disease. We’re waiting for pharmacy to send down some corticosteroids now.”

“Wow. I wasn’t expecting that. Could that account for all of the recent health issues?” Fred asked.

“It would definitely explain the low blood pressures, syncopal episodes, and irregular lab values,” Mitch replied, sighing. “I can only wait and see how the corticosteroids affect her, but I can guarantee she’s going to be in the hospital for a few days. She is one sick gal – I’m just glad that this happened when she was around others. I’d hate to think what could have happened if she’d been alone.”

“She actually wanted to drive herself over to your house. I’m glad I was able to convince her to call you instead.” Fred shook his head in wonder.

“Yeah, me too.” Mitch looked out the door and saw Bob beckoning him. “Okay, I need to go check on Meghan again. Dr. Rothman shouldn’t be too long. Let us know if you need anything between now and then.” Fred nodded as Mitch patted his leg before departing.

A knock on the door shortly thereafter startled Fred, who was about to doze off again. “Hi, I’m Dr. Rothman. You must be Fred.” Dr. Rothman came in and settled on the stool Mitch had vacated.

“Yes, sir.” Fred shook the man’s hand awkwardly with his left hand.

“Dr. Branston called me about your hand, and I just reviewed the x-rays. One of the fractures is definitely displaced. I’m going to give you a little bit more pain medication, and it’ll be over quick. We’ll x-ray your hand again to be sure everything is in place, and then put on a splint. You’ll need to call for a follow-up appointment in my office for in a week. Any questions?”

“No, not really. Will you be doing that now?”

“Yes, in just a little bit. Why? Do you have something important in the morning?”

“Yeah,” Fred nodded. “I teach the paramedic classes at the local community college. I have class that starts at 8 tomorrow morning.”

“I’m pretty sure you’ll be ready to go a few hours before then,” Dr. Rothman chuckled. “Now, with the pain meds, I wouldn’t suggest driving yourself home tonight, although you should be okay to get yourself to work. Do you have someone who can give you a ride?”

“Yeah, one of the Fire guys said he would get me home. I just need to call him.” Fred reached for his phone, but the doctor stopped him. “Let’s get that hand taken care of first before you call.”

“Oh, okay.” Fred nodded.

“Let me go get everything arranged. See you in a few minutes.” Dr. Rothman left the room.

Stan came into the room after a few minutes. “So, partner, are you going to pass out on me?” He chuckled.

“Sheesh! Work with a guy for 8 years, and this is the care I get. You’d think your former partner would show some compassion to an injured coworker.” Fred put on an air of mock affront.

Dr. Rothman had come in during the exchange, chuckling. “I take it you two used to work together.”

Stan nodded. “I was a paramedic before I became a nurse, and Fred, here, was my partner.” He slapped a hand on Fred’s good shoulder.

“Well, I guess we’d better take good care of your partner, then!” Dr. Rothman gloved up. “Stan, go ahead and give Fred the morphine.”

Stan administered the drug through Fred’s IV and stood next to his friend. “Need to hold my hand?”

Fred looked at him askance. “Not unless you want a broken hand too.”

Dr. Rothman looked at Fred and grasped the injured hand. “Ready Fred?”

Fred nodded, steeling himself.

“One, two, three…” Dr. Rothman reduced the fracture and looked over at Fred, who had turned pasty white. “Stan…”

Stan was already lowering the head of the gurney as Fred went out. Amused, Stan reached for a nasal cannula, hooked it up to oxygen, and placed it in Fred’s nose. Fred’s eyelids twitched, and his eyes opened.

“Welcome back, partner,” Stan said. “Have a nice nap?”

Dr. Rothman kept an eye on Fred while carefully palpating his hand further. “Well, Fred, I think you’re back in place. I’ll have x-ray double check the placement, but let’s go ahead and get you splinted.” Stan helped Dr. Rothman to securely splint his hand and forearm before suspending it in a sling.

“Okay, Fred, now you can call for that ride! Once the x-rays have been checked, you should be free to go.”

“Thanks, Doc. I’ll call tomorrow to make that appointment.”

**********

An hour later, Brad pulled into an empty spot in the Emergency parking lot. He yawned, stretching as he walked through the double doors and up to the nurse’s station. “I’m here to pick up Fred Bellarmine,” he stated. The nurse buzzed him through the ER doors, meeting him in the hallway.

“Right this way.” She led him down the corridor, and around the nurse’s station. “He’s in Room 5.”

Brad headed that way and saw Fred perched on the edge of the bed, boots on, struggling to get them zippered. He gave up just as he saw Brad arrive.

“Brad! I’m glad you’re here. Get me outta this joint!” Fred winked, as Stan looked over from the nurse’s desk, amused.

“I will just as soon as they say you can leave,” Brad retorted. “What’s the prognosis on your hand?”

“Three stitches to his thumb, and he broke two bones and had to have them reduced. Took a bit of a nap when the doctor was putting the bones back into place,” Stan chuckled. He handed Fred some paperwork. “You know the drill. Keep it clean, come back if it’s looking infected, and sutures can come out in 12 days. Dr. Rothman has written a prescription for pain meds and wants you to call his office to schedule an appointment within the next week. His office info is in the papers. Any questions?”

Brad accepted the paperwork for Fred.

“No, I don’t think so,” Fred replied.

“Well then, go home and get some sleep. You’ve got class in the morning, partner!” Stan made a shooing motion.

Brad chuckled as Fred rose from the gurney. “Well, even if he doesn’t, I do! C’mon, let’s get you home.”