Excitement Over
#18 of Love Letters - The Whole Story
We were standing by the nurse's station, Nev and I, poring over the chart of a certain Mrs. Baines, 67, overweight, high blood sugar, high blood pressure, high cholesterol, diabetic, choleric, you name it.
Just your average patient, really, a victim of every indulgence provided by the modern world.
"So, what do you think? Should we prescribe more furosemide?" I asked from the wolf.
"Well, based on these lab results - "
"SPECKLE!"
That was Dale yelling, from the door of the exam room the fox held open.
"NUMBER ONE IS CRASHING!"
Shit.
"Let's go," Nev said.
He dropped the chart onto the nurse's desk and we raced down the corridor, our white coats flapping behind us as we made the journey of about fifteen yards, across the hallway lined with gurneys and then through the swinging door into the acute care clinic. Dale had pulled open the curtain separating bed number one from the rest of the room, and upon it, a lion was quite obviously seizing up.
"How long?" I asked as we stepped over to the bed.
"About twenty to thirty seconds now," Dale said, "I called you as soon as he went down and I put him on his side on the bed. He went clonic just about when I came back over here."
I put my paws over the lion's hip and side and let them sit there, not pushing down, just making sure that he would not be jerking around to harm himself against the sides of the bed. Dale's paws were on his neck, ready to assist if necessary, though he too was refraining from active intervention.
"I'm grabbing the crash cart," Nev said, "get a pulse ox going and check the airway as soon as he goes postictal."
"Sure do," I said.
The doctor disappeared into the hallway, leaving the two of us to handle the case.
"What's the story with him?" I asked from Dale. "Do we got an ID or history?"
"Francis Thorne, 25, came in complaining of having a cough and fever for about a week and painful blocked sinuses, wanted to be checked out," he said, "I was just about to start filling up his chart and work him up when he started seizing."
"Doesn't sound like meningitis at least," I mused, "unless it's an opportunistic CNS infection."
I hoped not. This ER was not a good place for anyone with a poor immune system, whether it was because of chemo, immunosupression, or HIV.
The unconscious lion continued the strange jerking motions underneath us, making the whole bed rattle under his rapidly, uncontrollably moving weight. The stench of urine suddenly hitting my nose told me that he had voided himself as well. At least he wasn't biting his tongue or hitting his head against anything that might hurt him.
"Better try to check the records for any previous information on him," I said.
"I'll get the file as soon as he's through with this," Dale said.
True thing, suddenly the lion's movements stopped and he was lying there, limp and panting rapidly. I could feel the body underneath my paws relax, and even his tail, which had been bouncing about the bed, remained still and unmoving.
"There we go."
"Open the airways and check for breathing," I said. "I'll check the chest for heart sounds and resps."
I popped my stethoscope out of my pocket and put the earpieces in to listen to the heart, while Dale made sure that our patient was getting adequate air by tilting his head a little and lifting his jaw to ensure that his tongue wouldn't be blocking his throat. Just as we were employing these small measures to make sure he got proper breaths, the door swung open and Nev entered, with Libby pushing the crash cart in front of her.
"What's the status here?" Nev asked, all business."
"He just stopped seizing," I told the wolf once he was inside, "gone post-tictal after about a minute to minute and a half of tonic-clonic seizures."
"Breathing sounds good," Dale said, "don't think he aspirated anything. Teeth seem to be intact. No tongue-biting."
"Let's turn him over to his back," Nev said, "do we have a name?"
"Francis Thorne, 25, no further information yet," I said. "Dale didn't get to start a chart."
"I'll check from the records," the nurse replied.
We helped the lion over to his back, and Dale lifted the head of the bed a little so that it would be a bit more comfortable for our mystery patient. His eyes were open now, and his maw was partially open as well, but he was not speaking, nor making any noise besides the hiss of his breathing.
"Get the pulse ox cable here, Libby," I told her.
"Mister Thorne?" Nev addressed the lion on the bed. "Francis, can you hear me?"
The lion blinked.
"Let's give O2 via nasal cannulae," Nev ordered, "might draw basic bloods too, CBC, electrolytes, serum glucose, creatinine, calcium, magnesium, and a tox screen."
"I'll get the kit," Libby said.
I put the oxygen-administering tubes into the lion's nostrils and turned the lever on the wall to get the life-giving gas bubbling through the humidifier and through there into the lion's lungs. Meanwhile, Libby clipped on the oxygen saturation sensor onto one of the lion's fingers, and read out the results from the screen of the Lifepak sitting on top of the crash cart.
"Sat is 87," she said.
"Better keep giving oxygen," I said.
"Francis, can you tell me where you are?" Nev asked from the lion while still staring down to him calmly. "Do you know where you are?"
He pulled out a penlight from his coat pocket and shone it to the lion's eyes.
"Pupils are equal, round and reactive to light," Nev announced. "Seems a bit sensitive to light, though."
Who wouldn't be, having a flashlight pointed directly into their eyes? That wasn't exactly diagnostic a thing to note.
"Uhh...."
"Patient seems to be coming to," Nev commented.
"Hello," I greeted the lion, "do you remember coming to the hospital, Francis?"
He blinked again.
"N-not really..."
"You seem to have had a seizure, Francis," I said, "have you had a seizure before? Have you been diagnosed with any seizure disorders like epilepsy? "
"Pulse ox is up to 96," Dale said, looking at the monitor.
"Uh..."
"You seem to have everything handled here, Speckle" Nev told me after a final glance at the patient and the Lifepak, "I've gotta go back to checking on Mrs. Barnes. Ask me back if you need to push any drugs or order more tests."
"Will do," I told him.
The wolf left, and I turned my attention back to the lion on the bed.
"Can you hear me, Francis?" I asked him again. "You're probably feeling quite confused at the moment, but it's alright, it happens with seizures. We're just going to find out why it happened."
The lion coughed, blinked, snorted, and tried to sit up. I put a paw on his shoulder and held him down gently.
"I think it's best you stay put for the moment," I told him, "You've just had a seizure and you are still feeling quite confused."
"I'll better pull these curtains and get some privacy for you," Dale told to the lion with a gentle smile as he tugged the curtain into place to hide the lion from general view, "and I think you'll probably want to change, too, I'll have to find something for you to wear."
"Change...uh...change?"
"You had a bit of an accident when you had the seizure, but that is extremely common, "I told him very calmly, matter-of-fact. A little bit of grown man piss was an everyday event here. This was actually a polite one, since he'd only started pissing once he was unconscious, and not sitting on one of the plastic chairs at the waiting area, either,
The lion glanced down at his matter groin.
"Oh, man," he said, and coughed.
"We'll get you something to wear," I told him, "but before that I have to ask you a few questions. We didn't have a chance to fill your chart yet."
"I...just had the flu..." the lion said.
"Are you taking any medication, Francis?" I asked. "It's very important we know if you are taking anything."
He seemed to be thinking for a while, and in this state, it likely took him much more effort than it should be, really, before he spoke again.
"Topamax..." the lion said.
"That's an anticonvulsant," I said, "are you being treated for epilepsy, Francis?"
"I...haven't had...an...an...attack in...in...years..." the lion said.
"Well, that explains a lot," I told him, "that means we probably don't have to do as many tests as we initially thought we would. Can you remember if you've had any problems with your medication lately?"
The lion still appeared tired, but was starting to have more strength to speak up.
"I...I...I've been sleeping a lot and...might've missed a dose?"
"Well that would certainly do it," I said, "these drugs must be taken very regularly for them to have the desired effect."
"Oh, man..." the lion's ears flattened. "I've really done it..."
"I doubt there is anything seriously wrong with you, but we'll take a few blood tests to check a few things up and you'll probably be out of here in a few hours," I told him.
The lion didn't seem too happy.
"I was meaning to work on an essay for my class...ugh..."
"You should simply rest for now, though, I think," I told him, "these kind of seizures are huge strain on the body, after all."
"I can't believe I pissed myself," the lion shook his head. "I've never fucking pissed myself before...Jesus..."
"Don't worry about it, it's a perfectly normal event during a generalized seizure," I said. "The nurse will be here in just a bit to help you change and get cleaned up."
"Thanks," the lion said sourly.
"We'll probably be able to move you to one of the monitoring beds, it'll be a bit more comfortable there as well," I told him.
"Okay, thanks," the lion slumped onto the bed.
"Excuse me?"
_ _
My ears perked at the noise. It was coming from the other side of the curtain.
"Excuse me for a moment."
I stepped out and saw that there was someone sitting on the second bed, a bear with a rather interesting cut on his paw.
"Is someone gonna come and look at this any time soon?" the bear asked.
"I'll be right there," I told him.
Excitement over. Back to the assembly line.