“Sir Roses”

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Difficulty.  Difficulty is primordial, pervasive, prosperous, and persevering.

    Diagnosis hangs in the air, permeating the entire small emergency room, the odor stronger in the enclosed “ground zero” of the exam room. The white sheets contrast the jaundice which, under the industrial neons highlights alien life form. The flat pillow’s case has a map of black gastric contents that also cakes the neck and one cheek. An ink oily liquid can be seen slowly snaking up the tubing, collecting in the suction canister on the wall. Trauma shears snick snick off the remaining garments that are then collected into a white plastic “PERSONAL BELONGINGS” hospital bag. The firm and rotund arc of abdominal ascites wiggles in waves with any movement. From an unfocused gaze the icteric scleras roam about the room while gibber mostly mumbled, stream from the stretcher head. A yellow liter of “Gomeraid” vitamin solution drips from the suspended bag to an IV whose gauge is too small for the future transfusion needs. A missing dose of Thiamine is urgently requested, then “pushed” via a newly established large bore site. These precious IV sites, as well as the nares taped NG, are prophylactically protected from being “pulled”, with soft restraints. The jaundice blends without clash with the snug orange “Doctor Down” transport wrap.

     The exit from the emergency department passes the public waiting room where curious eyes watch in guilty glances. Pressing the elevator button brings an immediate “DING” and the doors slide open. Out of the incoherent word salad, out from the pumpkin stretcher bundle, a clear and coherent and almost prophetic, “Going up!”. Keyed, the elevator ascends to the rotor wing on the roof. The patient history records the clear behavioral path leading to the dysfunctional physical state and the disturbing ammonia and liver panel labs. A pile of patient records have been neatly arranged, the top recent record generated by the ambulance EMS. Penciled in the “Previous Medical History” charting line of the ambulance call record are the words “Sir Roses”