- Joey's POV -
Skeeter handed to me a clean pair of pukey green pair of boxers, a pair long underwear - tops and bottoms, and a set of bib-overalls that were way too big. I got all put together then pulled from under the bed a pair of work boots that I'd cleaned the night before so at least a I could start out with foot coverings that were not all covered in chicken, cow and horse shit.
The night air, hey, it was 3:40am, was biting cold. That's just the way it is in the springtime - cold at night, and warming during the daylight hours, especially in the wide-open spaces without tall skyscrapers and big buildings to block the wind that is so common in the Chicago area and its surrounds.
The first stop was the barn to check on one of Luke's goats that had been in labor. Dan was furiously helping the mother give birth to her offspring. Briefly, Dan explained that the baby goat was being born breech, that is butt first rather than head first. Luke looked worried as hell. He kept telling Dan over and over again to hurry because momma was hurting, bucking, whining, and whathaveyou. Clearly frustrated, Luke got down on his haunches then sat on the ground, pulled momma's head into his lap and began speaking to her very clearly, comfortingly, reassuringly, calmly, encouragingly, and collectively which calmed the bitch mother down. Within 10 minutes the offspring was delivered and stood on its own then headed directly for the teat that would provide to him life sustaining sustenance.
I'd never seen anything born ever before in my life. The experience was awesome, to say the least.
Dan was impressed. Once mom and baby were 'bonded', something that does not ALWAYS happen between mom and child, he pulled Luke into his arms and provided to his son appreciation, love and thanksgiving for calming the bitch so that she could give natural childbirth. Luke was taking it all in, reveling in the affections his father was readily providing to the son who'd only made his break into actually belonging to the family who loved him so much, and to the family he also loved but had been unable to say so - at least using words.
Without a second thought, I fetched up the pale that Luke and I had used to carry feed and water to his goats, and did so, one pale at a time. While I was doing that, Skeeter made sure to feed and water the other animals in the barn. We finished at about the same time.
The next chore was feeding the fucking chickens and shoveling their shit so we headed for the coop but found the lights were on already. We also heard a voice saying all sorts of fucks, damns, shit, fuckers, cock suckers, and other terms of endearment. Immediately we recognized the voice as belonging to James.
Upon entering the coop, Skeeter and I were greeted with a shovel full of chicken shit that had been tossed our way by an unknowing James… that is until he looked up and saw us standing there in the doorway, stepping on a pile of chicken feces.
You gotta understand that the family was filled with pranksters, and I'd been having lessons, and I'd been waiting for the perfect opportunity - the opportunity presented itself.
Needless to say a bunch of chicken shit flew past, some of it, actually a good portion of it making contact with the lobbee, and the lobber.
Eventually, err hmm, the chicken coop was presentable, the eggs were gathered up, the lights dimmed in anticipation of another warm day, and well the dinner bell had rung notifying us that it was time for the breakfast feast.
The problem was: obviously, we weren't ready for breakfast, not by a long shot, in fact we would not be permitted into the house in that current state of affairs what with the gunk and smell of four nasty teenage boys.
Knowing that Vera would, in no way, be any degree of 'happy', we stripped to our skins just outside the anteroom door, which was freezing ass cold to say the least. Skeeter said, "Just toss your clothes on the ground; I'll get to them later. Christ, my nuts hurt…"
"I'll never find mine again." I said with absolute certainty.
James, teeth chattering away, groaned, "I'm choking on mine. Hurry up damn it."
Skeeter entered the anteroom, James next and I followed up the rear… speaking of rears, James had a nice one… but I wasn't paying THAT much attention. Surely, I'd need a dentist. James yelled into the, "Naked!" It was the 'standard' warning call that one person, or more naked people, were about to streak through the house without a stitch of clothing, on the way upstairs to the bathroom or bedroom… usually resulting from mass mud, or in our case - shit strewn, thrown or otherwise put upon with precision.
I was too fucking cold to worry about who did or did not see everything that I had. Modesty went out the window. I raced to the stairway and began leaping each step one by one until James flew by and Skeeter began pushing my butt getting me to hurry up… I wasn't taking my time, damn it!
A very loud wolf whistle shrieked through the air. Skeeter yelled "PERVERT!" as we hit the top step, turning right for the bathroom. James was getting into the shower just as we arrived. Quickly and efficiently James had turned on the water.
"F… F… F… F… eeeeeuk!" James chattered through clenched teeth as we all huddled together in chattering silence.
"N… N… N… N… O…. Shit!" Skeeter groaned.
I remained as silent as I could be though my teeth were pounding together, surely they'd fracture into a million gazillion pieces… thankfully they didn't. We'd take turns, although we were closely knit together, dunking our heads under the hot steaming water… finally… warmth was replacing the bone chilling cold, seemingly drop by drop.
As if we were on autopilot or something, I grabbed the bottle of shampoo, squeezed a large dollop onto my hand then began washing Skeeter's hair. I handed James the bottle. He began washing mine. With my other hand I paid close careful attention to his, and knocked a couple of brown gooey globs from our escapades from his hair while he did the same to mine, and I did to Skeeter… yucko!
After carefully inspecting our heads for any lone rangers, one at a time we rinsed under the jets and then began washing our bodies in perfect harmony. Skeeter then washed my back, and paid close careful attention to that area of my body reserved for pleasures and reliefs while James did the same for me.
As you might have guessed plenty of testosterone was present, and willing, and needing to be released. Since I had Skeeter's back end close to me I snickered and pulled myself into him. I looked back to James and shrugged my shoulders, and then nodded.
Let's just say that we experienced a very colossally pleasant shower and drying off session.
When we returned to Skeeter's room he made a 'comment', "You're a horn dog!"
Laughing I chided back, "I didn't see or feel you resisting, oh horny toad."
"A toad eh? Well ya gotta know one to be one." Skeeter replied happily.
We made it to the dinner table, on time, together. No sooner than we'd sat down Stacy offered, "Nice butt there, Joey."
Dan glared at his daughter then looked to Luke. He said, "Luke, are you ready to say Grace?"
Luke smiled sheepishly then nodded. Using a perfectly clear and reverent voice he said:
Dear God, I guess I'm not pissed at you anymore. Thank you for my family. And, oh yeah, thank you for bringing Joey to our table. Thank you for our food and bountiful farm. Amen.
"Amen." All said in unison.
The boys, and Stacy, the only girl daughter in the house, ceremoniously got up from their seats, walked to Luke, hugged him tightly and kissed his cheek. There were but few dry eyes in the house, and then the plates, bowls, containers, salt and pepper dispensers went around the table, small talk was plentiful, and a good time was had by one and all.
- Mom's POV -
With my hand deep inside this boys' chest, knowing we were going as fast as we could possibly go, I kept on rhythmically squeezing the patient's heart, hoping against all hope that our manual interventions were enough to keep him from experiencing catastrophic brain damage or death.
The elevator seemed to take forever and a day. I asked, "Time?"
"We're at 2.5 minutes. We've probably got another two to two and half minutes before..." Sandra, our chief trauma resident replied urgently, professionally.
The rest of the ride was silent save for our breathing and the periodic squeeze for inhalation and exhalation heard from the breathing bag attached to a tube going in the young man's throat.
Finally, it seemed like forever had passed, the elevator jerked to a stop. The doors opened. A full complement of hospital personnel were waiting to take us back to the major trauma operating room.
I began reciting a litany of needed instruments, cardiac bypass equipment, monitors, anesthesia, medications, and other such items that I'd need to use if this child had any chance at all to survive. I knew my requisitions were simply nervous energy as everything would already be in place, ready for us to go.
I didn't even bother scrubbing, instead a nurse sprayed my left hand with an alcohol based solution then gowned and snapped a latex glove on my left hand... my right hand was busily pumping the boys' still stopped heart.
The patient was transferred to the operating room table quite roughly, not carefully and nicey nice as we would normally do with a conscious patient… we were in a hurry to get things going in a controlled environment with the latest and greatest of lifesaving equipment and staff.
I knew Wayne was going south, and he was going south in a big time hurry. His chest had filled with blood during transport. To determine the full extent of his injuries, I used an actual ladle to scoop out the blood. I then found a small nick wound through the back side of the left ventricle which I repaired with two stitches.
"Time?" I asked urgently. Was it too late?
"Six minutes and fifteen seconds." The anesthesiologist replied urgently. He added, "Pupils are reactive sluggishly. Dilated. BP - none."
"Paddles. Charge to 80 joules." I barked.
Shock. Shock. Shock. Nothing. Shock. Shock.
"Time?" I asked, and at the same time asked for a stitch to close another smaller non-heart wound. "Was it too late?" I asked myself knowing the answer already.
"Eight minutes, fifteen seconds."
I asked the anesthesiologist, "How are his pupils? Anything?"
"They're dilated and sluggishly reactive. He has no blood pressure."
"Ice him down. Do it now. I found another small hole in the upper chamber of his heart. There, the hole is completely closed. Give me the paddles. Keep those IV's going. Pump those fluids into him. Hang two more units of blood, three units of platelets, six more units of fresh frozen plasma. Keep the blood coming; pour it in if you have to."
Somewhere in the back of mind, I heard a change in tempo, and another voice but I paid no further attention until, "Dr. Mauer, do you need some help?" Dr. McCarthy, our chief of cardiac surgery asked hopefully.
Without giving him a 'yes' or 'no' answer, I recited the patient's history, "The patient presented through the trauma center. He's got a repaired through and through stab wound to the heart, a punctured lung, a lacerated diaphragm, and interrupted collateral circulation. We got his heart started in the ER however he arrested on his way up. If he doesn't get systole within 5 minutes I'm going to call it. We've done everything we can."
The anesthesiologist gave his report… still, his pupils were sluggishly reactive to light stimuli. He's his own. He hadn't been given any anesthetic drugs that would suppress his nervous system.
"9 minutes, 45 seconds, forty six, forty seven." A nurse rang out then she added, "Holy shit, I just got his lab toxicology results… he's off the charts for methamphetamine and cocaine."
That changed everything.
Dr. McCarthy scrubbed in and worked opposite me on the patient's left side. "Let's institute full cardiopulmonary bypass. Dr. Mauer, the repair looks perfect. I'm concerned that the 'Bundle of His' was interrupted by this laceration… the stab wound is very, very close to where it branches off to control the ventricles. Shit okay… hurry, get the bypass machine set up… let's go… let's go…"
"I think we might get his blood cleared faster if we instituted dialysis, what do you think?" I asked.
"We could try it… sounds reasonable. Let's do it. Scalpel. Give me tubing, lots of it. Cooley clamps. DeBakey aortic occlusion clamps."
Seeing that Wayne was in good hands, "Dr. McCarthy, I'm going to go talk to his mother."
I'd met Wayne's mother, Clare, a number of times when Joey had been hospitalized with his difficulties. I located her in a conference room off the trauma bay. Nobody had told her that her son had been taken to the OR upstairs.
I walked into the conference room, poured us two cups of coffee. The liquid looked like it would be strong enough to be classified as 'battery acid' with huge doses of arsenic… just what the doctor ordered.
Clare had gained a lot of weight since I'd seen her last. She heaved her heavy frame around in her seat in the oversized, overstuffed sofa and looked at me expectantly with tears in her eyes.
"Clare, I have to be honest with you. If Wayne survives his injuries it will be only because of a miracle. Right now, Dr. McCarthy, our chief heart surgeon is instituting cardiac bypass. Your son is also being placed on dialysis to remove toxins from his blood. You see, he tested off the charts for methamphetamine and cocaine. He's a very sick boy. I have to be very honest with you; I don't believe in sugar coating reality. He's got his youth and generally good health going for him. He's strong. But I have to tell you that his chances for survival are nil to none. Even if we do bring him back I suspect that he'll have catastrophic brain injury due to oxygen deprivation… I'm sorry."
"Oh Lardy Lardy. Dr. June, he bees mah whole life. Whats I evers do witout hees brights smile in da mornins. Ahh sweet Jesus has mercy on us." Clare said then collapsed with racking sobs that shook her whole body. My heart went out to her.
"Clare, now's not the time to give up all hope. Like I said, he's young, strong and generally healthy… these are very strong attributes… we're doing everything we can possibly do. The rest is up to him, basically."
"If he dies... oh Lardy Lardy… cans his organs be donated, Lord hep me?"
"I'm sorry Clare. That's not possible."
"I know. I just had to ask."
"I'd ask the same question if he were my son." I replied genuinely, knowing that I would indeed ask that very same question.
"How's Joey? I love dat chile likes he been borns to mah my own." Clare said tearfully though she was getting hold of herself, somewhat.
"He's doing well, really well. Right now he's visiting Skeeter who moved to Kansas with a really good family." I replied positively yet reservedly because of her son's condition. Then was not the time to gush his accomplishments and well being.
"Good. Good. Bless mah babe. His moma, she bees proud of da boy. We'ins promised each other dat we'd look out over our chilren iffin one of us dahed… oh Lardy Lardy… I brokes dat promise, yes ah did." Clare said then broke down again.
I took her hand in mine, squeezed lightly… there wasn't anything left I could say or do. Unfortunately, the situation was for her to reconcile.
Heaving, she blubbered, "Dis bees mah punishment." Stealing strength she added, "God bees punishing mah for doin him wrong, I knows it is, Lawd help da chile."
"Clare, I don't believe that's true. God doesn't hurt us just because we break a promise we can't keep. I think we hurt ourselves when that happens."
"No, no, no, you don't understand. Dr. June, I'm a drug addict." With her heart breaking, she disclosed in confidence to me, "Dr. June, I gives dose young'ins dope and hooch. God's punishing me for giving it to them. I know He is, yes He is."
"Clare, does it really make sense that your God would intentionally hurt Wayne to get back at you?"
She looked into my eyes. She didn't answer my question... the lines in her face relaxed even though she was deep in thought. Maybe she realized what she'd been taught was no longer true.
I said, "I'm going to go back upstairs to see about your son. When I know something, I'll be back to talk to you. Don't give up hope."
I then got up, left Clare to her own thoughts, me to mine, and then stopped at the doctors' lounge. I called Dave:
"Hi honey." Dave said assuredly.
"Hey back. I'm going to be really late. I'm not able to leave right now…" I then went on to explain what the situation was. Normally, he and I do not talk shop takj' but occasionally we make exceptions when something is really eating us up. We hadn't yet experienced catastrophe at the same time. I had no doubt that we'd get through it.
Dave, of course, gave me the boost of energy and resolve that I had desperately needed. We ended the call professing our love and commitment to each other.
I decided to make a quick call to Joey then Nathan then Derrick. Timmy didn't want to talk to me. Nathan said that Timmy was still ashamed of his outburst; he thought I was still mad at him; he thought that I'd surely kick him out when I got home from the hospital. He'd thought I'd left to get away from him. I didn't tell Joey anything about what was going on with his ex-boyfriend - that needed to be done in person.
After hanging up with Joey, my mind wandered about what the hell had happened to Timmy. Why did parents do that to their children…? I had no answer, none that made any sense to me anyway. I sincerely hoped the system would dispense and exact punishment on his birth mother… some things cannot be forgiven and forgotten, at least not overnight, sometimes not in a lifetime.
I hit the facilities then headed back upstairs to OR #1. I looked in and saw the staff working feverishly. After formally scrubbing in, and getting properly gowned and gloved, Sandra, the chief resident stepped aside thus permitting me back in as the chief co-attending-surgeon.
Wayne was on full-bypass. Everybody was pretty much in a 'wait and see' mode, waiting to see if the dialysis and fully filtered bypass would clear his bloodstream of toxic levels of illicit drugs and whatever other impurities were in his system. Dr. McCarthy was talking about his oldest son's latest accomplishments at school where he participated in most nearly all sports, and that he had received a full-ride scholarship to Harvard medical school, that he wanted to be a heart surgeon just like his dad, or an oncology surgeon like his mother. He was proud. It was somewhat sickening to hear his borderline 'gloats'.
Yuck, pushing that all aside, I got back to the business at hand. Since Wayne was open from top to bottom, I explored his belly looking for any other injury or abnormality that could be 'fixed' through surgery.
Many times, a surgeon will remove a patient's appendix to save a future operation since the outgrowth off the colon had been found to have no real purpose… I removed his appendix while we waited.
The Bob Seger song, "The Devil Went Down to Georgia" began playing. I found myself humming right along with the lyrics while Dr. McCarthy sang it with vigor. Mind you, he could not sing his way out of a wet paper bag… but still it was fun…. the atmosphere in the tense situation lifted just a little bit… we all needed it. I noticed that Cheryl, the scrub tech, was keeping time with a Kelly clamp against the Mayo stand. The anesthesiologist was playing drums on his anesthesia cart. It was a riot; a pleasant riot.
The devil went down to Georgia. He was lookin' for a soul to steal. He was in a bind 'cause he was way behind, and he was willin' to make a deal, when he came across this young man sawin' on a fiddle and playin' it hot. And the devil jumped up on a hickory stump and said, "Boy, let me tell you what.
I guess you didn't know it but I'm a fiddle player, too. And if you'd care to take a dare, I'll make a bet with you. Now, you play pretty good fiddle, boy, but give the devil his due. I'll bet a fiddle of gold against your soul, 'cause I think I'm better than you." The boy said, "My name's Johnny, and it might be a sin. But I'll take your bet, you're gonna regret, 'cause I'm the best that's ever been."
Johnny, rosin up your bow and play your fiddle hard, 'cause hell's broke loose in Georgia and the devil deals the cards. And if you win you get this shiny fiddle made of gold. But if you lose, the devil gets your soul.
The devil opened up his case and he said, "I'll start this show." And fire flew from his fingertips as he rosined up his bow. And he pulled the bow across the strings and it made an evil hiss. Then a band of demons joined in and it sounded somethin' like this:
When the devil finished, Johnny said, "Well, you're pretty good, old son, but sit down in that chair right there and let me show you how it's done.
Fire on the mountain. Run, boys, run. The devil's in the House of the Rising Sun. Chicken in the bread pan pickin' out dough. Granny, does your dog bite? No, child, no.
The devil bowed his head because he knew that he'd been beat. And he laid that golden fiddle on the ground at Johnny's feet. Johnny said, "Devil, just come on back if you ever want to try again. 'Cause I told you once, you son of a BITCH, I'm the best that's ever been."
Copyright "The Charlie Daniels Band"
Several other songs played from various artists and bands over the next two and a half hours while we waited and waited some more.
At three hours and thirty minutes Dr. McCarthy announced, at my urging, since the maximum dialysis period of time, under the circumstances, had been reached, "Okay, let's try to get him off the pump. It's getting close to do or die time. George, let's take the pump to seventy percent. I want to know his oxygen saturation levels every 30 seconds. June, are you in agreement?"
"I am. Let's give the process 60 minutes. If we do not get conversion in 60 minutes then I'm ready to call it. We've done all we can do here. Does anyone object?" I stated professionally.
The anesthesiologist countered, "I've ordered a brain activity, EEG, trace to see what we're working against. His pupils are fully dilated though they are quite a bit sluggish."
I looked to Dr. McCarthy. We both knew, against all hopes that the 'do or die' time had arrived. I nodded. We waited to begin the weaning process.
The technician arrived about 15 minutes later, hooked up the leads and then instituted the test. Both Dr. McCarthy and I carefully observed the tracing which was directed to the various monitors located around the OR. Those monitors display pictures, laboratory data, and other testing modalities to medical students, staff in the observatory, and in the OR.
In the absence of anesthetic drugs, an EEG will determine any and all brain activity, if any is present.
Wayne's tracing, while suppressed, showed normal alpha, beta and moderately abnormal theta waves meaning his brain was in the neighborhood of eighty percent functioning. While that is relatively low it did tell us that he would be capable of maintaining his activities of daily life though he'd probably never be able to work or perform other detailed activities. While the testing revealed subnormal functioning it was nevertheless encouraging. I looked to the pump technician, "Institute weaning… seventy percent to start out. Give us oxygen sat levels every one minute." To the circulating nurse I said, "We're going to have problems with clotting due to the massive transfusions the patient has received, please hang 3 units of platelets. Give him a bolus of vitamin K. Okay, gang let's begin."
Dr. McCarthy began measuring and analyzing outflows from the heart to make sure the small blood vessels were patent and not leaking. Everything appeared a 'go'. I then ordered a fifty percent weaning. "Paddles." Charge to 100 joules, please."
- Joey's POV -
During breakfast the airline called to deliver an automated message that said that my flight had been delayed for 2 hours due to severe springtime electrical storms between Kansas City and Chicago.
That met with everyone's approval. I relaxed knowing that they were going to wait before sending us up in midair to deal with thunderstorms that had been predicted due a slow moving cold front. All the parameters for an outbreak of bad thunderstorms, hail, and even some long-tracked tornadoes were possible.
Kevin, busily eying me throughout our meal made a beeline body slam once we got outside. The temperature had risen at least 10-15 degrees since we'd begun breakfast break an hour and a half previously. He was jabbering up a storm asking this and that, and telling me that and this. When we got to the garden area, with wide open eyes and happiness written all over his face and in his body language he was quick to point out the little buds that were beginning to rise from the soil in Vera's vegetable garden. We went to the flower gardens and noted that the flower bulbs were poking through loud and clear.
Spring time was and still is my favorite time of the year what with everything appearing 'back to life' after a long winter's sleep. It's kind of like waking up in the morning after a really good, restful and relaxing night's rest.
Mark, James and Skeeter joined us as we walked around to the north side of the house. Those plants were nowhere as advanced, for lack of a better word, as those on the south and west sides.
Kevin, the Ever-Ready battery of energy soon took off running for the barn to see where his daddy was - despite - admonishments from his brothers to stay put, to not go to the barn alone. We knew Dan was off in the east field tilling and turning soil, getting it ready for planting a month or so down the road. But still…
We relaxed when Thomas was seen exiting the barn. Kevin ran to him in a dead run. I was glad to see that I wasn't the only body-slam recipient. Of course, as he always did with his newest little brother, Thomas acted like Kevin had bowled him over like a steam engine screaming down the tracks toward an unknown destination.
I giggled at the antics and at seeing Thomas tossing Kevin in the air, easily catching him, and then the 'apparent' crisis of being 'dropped' only to be saved at the very last possible second.
Skeeter put his arms around my shoulders, squeezed lightly, "I've got to do the hay yet. The goat pen in the barn needs to be changed. You can stay here. It won't take me long to changeover; whatever you want to do is fine."
I decided to go with Skeeter. James announced that he was going to go take care of his horse, Coltrane, which met with everyone's approval.
When James and Skeeter were out of sight I was going to head into the house but Mark walked to me and asked, sheepishly, "Joey, do you think we could take a walk? I kinda want to talk to you about something… no nevermind, you need to get ready to go…"
"It's okay… we've got a couple of hours… sure… so you want to talk here?"
He shook his head. We headed for the implement out building. Nobody was around there. We stopped by the doors leading in. Mark absent mindedly scratched the ground with his toe, and looked to his feet, to the indentation his efforts was creating. He looked back up and into my eyes. It appeared that maybe he needed a hug so… with great hesitation, he reached out his arms as I reached mine to him. I gathered him into my arms then with reservation he joined and slowly applied more pressure until we were firmly hugging. We stood there for several minutes, swaying once in a while then at other times just standing still, not moving other than breathing.
He began to lower his arms as if to separate us but then would squeeze more firm than previously. I quickly but firmly kissed his forehead. He put his face against my neck and inhaled deeply. Releasing his breath slowly, he said, "I'm sorry I embarrassed you and Stephen. I just had to say that." He squeezed me hard then let go, took a step back despite my attempt to hold him into our hug.
"Thanks Mark. Yeah, we were a little embarrassed but it was no big deal as you found out." I replied, giggling.
He smiled, "Yeah, the joke was on me. Are we okay?"
"Yeah, we're fine. We always were, Mark."
"Really? You kissed me though. Why did you do that?"
"I don't know. Uhm, well, I guess I'm learning to love from my heart. I used to be mean and violent, Mark. I wouldn't tell anyone I loved them, not even my Ma. I hated a lot of people. I'm sorry, I shouldn't have kissed you, a hug should have been good enough, and anyway I won't do it again, okay?"
"No, no, it's okay. It's not like you have cooties or anything, do you? But we're guys..." Mark said with a wry smile on his face.
"Yeah, definitely, we're guys. At least I know I have a thing in my pants."
Mark giggled and smiled widely, "Yeah, I've got a thing down there too. Joey, can I ask you a question?"
"Sure, shoot. You can ask me anything anytime."
"Uhm, this is embarrassing. But it involves Kevin so I've got to ask you..."
"What's up, Mark? Just ask me, okay? I'll try to answer your question."
Mark regarded me carefully…
"Okay, here it goes… uhm, well, Kevin has been asking me a bunch of questions, asking what you were doing to his brother… he's caught you and Stephen… uhm… in the act… he's just curious. Like, he woke up last night… well… he woke me up by grabbing my dick… he's 4, Joey."
"Oh shit. Errrm… I'm sorry about that Mark. I really don't think he really knows what we were doing. It was dark. We made damn sure he was asleep before, well you know. Okay, I'll talk to Skeeter about it... we certainly didn't mean to..."
"I know you guys didn't mean to. I know how it is. Usually he sleeps with me, and well, I wait until I KNOW he's sound asleep before, well you know... he's woke up a couple of times during my moment', if you know what I mean. "
"We'll be more careful, promise."
"Joey, are you really coming back, honest?"
"Oh hell yeah, I love it here. You guys are so kewl... I'm so glad that Skeeter has a nice home and people all around him who love him like you all do. He definitely deserves you guys. Mark?"
"You too deserve your family. And they deserve to have you in their lives. Sometimes we have to have bad times so that we know when good times come. We've had bad times in our lives, Mark. It's time for good times. We'll just take it a day at a time, okay?"
"Yeah, that's what I do. It helps. Dad taught it to me... just pay attention to right now, right?"
"Thanks Joey for being my friend. I've got some other stuff to talk to you about sometime when you come back, okay?"
"Okay sure. Is everything okay? Is there something you need to talk about right now?"
"No, it'll take too long." Mark replied smiling.
Then his face turned serious, intent. He looked at me in depth with his bright gray eyes. Not loosing eye contact, he pulled me into his arms, squeezed tightly then kissed my cheek. He let his face remain on mine. Slowly, without any planning whatsoever, our lips slid together seemingly on their own volition, and then stayed together... until the sound of a tractor driving up interrupted our moment. Quickly we parted, and Mark tore out and ran off toward the machine shed. I was hard, and its presence was obvious. Errrmmm… I rearranged myself then took off for the barn where Dan was dismounting the tractor.
As I was walking and observing everything in sight, not from worry but from wonderment, Eric and David ran to their dad who grabbed them up in his massive arms. He started swinging them wildly though he was at all times in control. When I arrived, he looked up, smiled warmly then let the boys down. Before I could say or do anything he sucked me into his arms and did the same acrobatics. To add insult to injury the boys began tickling my ribs (remember, I wasn't ticklish, right? Well… that's a load of bullshit!)
Dan went into the barn seeing that we were 'preoccupied'. No sooner had Dan opened the door and entered than both boys slammed me to the ground for another round of tickle fest… in the process, Eric grabbed a firm hold on my still very hard pendulum. I quickly removed his hand then began tickling him until he screamed that he was going to pee his pants if I didn't stop.
I stopped. Both boys immediately got up then scampered into one of the stalls. Dan walked over to me. He put his hand on my shoulder and said seriously, "I hope you'll come back and visit, Joey. We've loved having you here. You've been a lot of help in more ways than one. My wife and I talked last night... we're going to let Stephen visit you over spring break, but only if it's okay with you and your folks."
"Oh my God! Yes it's okay, it's more than OKAY... woo hoo, holey moley, oh thank you! YES!" I yelled, and at the same time hugged Dan fiercely even though I couldn't get my arms around his waist... not even halfway around. I think, no, I'm absolutely sure that he got the message'.
"I thought you might like it. Go tell Stephen. He's down at the stables helping James feed the horses."
Not wasting one precious second, I tore out of that barn like my pants were on fire (they were on fire but that's beside the point!). As soon as I rounded the corner of the barn, I stopped, whipped it out, and released the catheter clamp… ahhhhhhhhh… relief!
- Mom's POV -
I applied the paddles to the correct places on Wayne's heart, "CLEAR!" Everybody stepped away from the table. I pressed both buttons that are required to be activated before the energy is passed.
Shock. Nothing. Shock. His naked heart quivered… it was more of a response than we'd seen. "Clear!" Shock. Quivering, the heart 'jumped' on its own a few times and then stopped. Things were looking up.
Shock. Nothing more. "Please charge to 150 joules." I said hopefully. Shock.
Beat. Beat. Beat. Normal sinus rhythm, for about 2 minutes then seeing that while his heart was beating it was largely ineffective. I barked orders to have calcium and potassium added to his IV, requested an ampoule of epinephrine that I injected the contents of directly into the heart muscle.
The pumping action increased to capacity. I was pleased that his heart was beating on its own. Dr. McCarthy performed outflow tests. They were perfect so he completely weaned Wayne off of bypass, and then repeated the outflow tests. We kept the bypass equipment available and connected for another 30 minutes until we were sure his heart would continue beating… it did… so he removed the tubing and cross clamps, looked at me and said, "Okay, I think he's got a chance. Call me if you need me."
He broke scrub all the while singing an oldies Eric Clapton song that was playing on the in-room stereo system.
I quickly explored Wayne's chest, repaired the diaphragmatic laceration, and then cauterized several small bleeders, inserted chest tubes on each side, and after another brief exploration to make sure there was no further bleeding I began and completed the laborious process of closing up his chest and belly after placing pacing wires to the outside of his heart. The wires would be connected to an external defibrillator should he arrest again.
"Okay, let's get him to ICU. What was the total pump time?"
"Five hours, 47 minutes." The nurse reported.
"Asystole time? Before bypass was instituted…"
"One hour, 17 minutes."
"Shit, okay. Let's repeat the EEG when he gets settled into ICU. I'm going to go talk to his mother. Call me if he has any problems… I won't be long."
Clare was sleeping on the sofa she'd been sitting on earlier. Startled, she jumped and sat up when I closed the door.
Sitting down next to her I said, "Wayne made it through surgery. Right now, he's being moved to the ICU. We got all the bleeding stopped. He's off of bypass. His heart is very strong. It's beating perfectly. Things can still go either way. He's far from being out of the woods using any stretch of the imagination; we'll watch him carefully and hope for the best. He's young, strong and otherwise healthy - these are his best assets. I looked carefully for other injuries in his chest and belly - all appears fine. We're helping him breathe by using a respirator. This is standard procedure. We'll keep him heavily sedated to give his body time to heal. Clare, I'm sorry but we won't be able to tell if he suffered brain damage until we begin waking him up. I'll be very surprised if he doesn't have significant brain deficits due to his prolonged oxygen hunger - but like I said he's young, strong, and otherwise healthy. I suggest you go home and get some rest."
"Can I see mah boy? Please."
"Let's let the nurses get him settled in first. That should take around 30 minutes or so… how about we go to the cafeteria… maybe get something quick to eat and something to drink… we have time."
With that said we stopped by the restroom. I was about to bust.
The cafeteria was beginning to fill with morning staff. It was 6:15am. We'd worked most of the evening and all night… in fact, we'd worked all afternoon the previous day for that matter. When you're focused, time slips by. The only time I was concerned about time was when we were keeping track of the various milestones during surgery.
I got a grapefruit, yogurt, a banana, an order of wheat-grain toast, and a glass of orange juice. I noted that Clare only had a cup of coffee. She accepted my offer to buy her breakfast… it was the least I could do… knowing her financial status.
That rejuvenated my energy levels but the greasy bacon, fried eggs, 2 cinnamon rolls and a Coke did very little for Clare's… but whatever floated her boat, so to speak.
Once our trays were loaded onto the conveyor belt we took off for the ICU. I checked in at the front desk to make sure everything was on track to get Wayne settled in. The nurse reported that he'd experienced an arrest during transport but the defibrillator did its job. He was momentarily 'stable' so I led Clare to his cubicle.
She gasped at seeing all of the tubes, monitors, wires, beep-beeps, and him lying totally naked on an open multipurpose ICU bed that had no side rails, head or foot boards. Cautiously, as if he were a China doll she approached her son who was hanging onto life by a thread. I encouraged her to touch him, to let him know she was there, to talk to him, to hold his hand, to reassure him, and then go home for some rest.
As I was getting ready to leave, after reviewing his electronic chart and writing some orders, his main nurse arrived with containers of water to give him a bed bath, sat them down on a table close by then left the room to retrieve other items for his care. Clare longingly looked at me. I nodded then left them alone in the ICU room and headed home. I didn't have any cases scheduled and the ER was quiet.
Dog tired I negotiated rush hour traffic with minimal difficulties. Thankfully, most of the traffic was headed into town and I was traveling the opposite direction so the commute took only about 40 minutes.
Dave was on his way out the door. Nathan, Derrick and Timmy were in the process of fixing their breakfasts of cereal, bananas and toast. I got each of them an orange, a glass of milk and their daily vitamin.
Timmy interrupted his preparations, walked over to me and offered out his arms for a hug. After a warm hug he stepped back, "I'm sorry for disrespecting you. I shouldn't have said what I said and done what I did."
"Me too, mom, I'm sorry for what I did and said. I was wrong." Nathan said walking over to me.
Not to make light of the situation, yet to let them somewhat off the hook, I replied, "I accept your apologies with the understanding that there are consequences for your actions, we'll talk later on today. Eat up. Timmy we need to get you enrolled in school this morning."
When I walked into the bedroom, I was very, very pleasantly surprised to see a large vase of long-stem yellow and red roses sitting on our dresser. The card was signed "With much love, Me, Derrick, Joey, Nathan, and Timmy".