When the Smoke Clears

I thought about Jess today. Rather, I thought about his parents. For some reason they suddenly showed up in my mind like an old favorite movie starting on a television in another room, a tickle of something familiar heard, something comfortable. Maybe it was the old ball-cap, not my own, I found in my Jeep.

Jess’ parents came to the emergency room one night, dressed in their symphony-attending best. Between them shuffled Jess. His mom’s hands held Jess’ forearms, barely able to make more than a half circle, long fingers wrinkled and veiny. They had had their son later in life than most couples, and now they were dwarfed by the man who stooped between them.

“Please. We don’t know what’s wrong.”

It was near the end of my shift in triage, but as the nurse grabbed a clipboard, I went for the basic diagnostics. Jess looked ashen and disoriented, an arm wrapped around his stomach. He was burning to the touch. His father never let his eyes leave his son, tired eyes that were weary from many years of worry hidden behind a stoic countenance. Something was very different. Something did not sit right in my mind. These parents appeared to me to be the typical, highly wealthy, children-as-an-accessory couple, but the way Jess was dressed, it was clear his parents left whatever social event to attend to their son. His mother’s hands glistened under a myriad of precious stones in expensive settings, yet she looked as if she were ready to toss them in the trash just so she could hold her son tighter.

I sat him down. He was a big young man, a typical, natural athlete with all the benefits of a wealthy life, all the things I envied: chiseled jawline, broad shoulders, decent clothes, height, and parents who were there for him when he called for help. No doubt he drove an expensive car as well. He grabbed my arm in a weak grip. “Please,” he said awkwardly through a contorted mouth straining against pain.

Reporting his vital signs to the nurse, most notably his 103.8° fever, I suggested we immediately move him to a room. She was already on her way. Jess’ parents came to his side to help him up as I placed my hand on his arm and said, “hang on, I’ll get a chair.” His eyes wandered about desperate for some focus, finally zeroing back in on me. “Please,” he mumbled again.

Once in the room, the doctor quickly joined us and ordered the standard battery of tests and fluids. I don’t think Jess noticed as the needle went in, his eyes searching for his mother who stood by his side, watching as we found the vein, blood rushing into tubes, never once did she flinch. Again, it wasn’t as I was expecting from these people. So many times parents brought their children to us, expecting us to care and feed and handle all the problems, often leaving the children to go have a cigarette or make some telephone calls, like they were dropping off a car for repairs, the more expensive the model, the less they wanted to be involved in the service work.

Triage time was over for me and I was assigned to the block that included Jess’ room. The doctor suspected an infection but it would be days before the tests could confirm it. Still, he started fluids and antibiotics.

Jess’ fever came down quickly, but I kept checking on him and his parents more frequently than my other patients. Something still did not add up. They did not want to leave his side, but eventually, his father had to use the restroom. “Will you help her?” he asked. I assured him I’d stay with them while he was away. Pulling up a stool next to Jess, the color returned to his skin, his head lolled to the side, looking towards me. He smiled.

“Please,” he said as a statement, still sounding like he had a mouth full of mush. A hand reached out. I held it for a minute, looking at him, then over at his mother, who was still on edge, still holding herself together, slightly smiling, dark lines of age furrowed down from her nose out to the edges of her tight mouth.

His father returned, seeing me there. I let go of Jess’ hand, giving up my stool so he could be next to his son.

Back out at the nurse’s station I looked for his chart so I could fill in what meager things I could contribute, when I heard Jess yelling “Nonononononono!” The nurse and I entered his room to see him looking scared, his father and mother worried.

“It’s okay, son. We’ll take care of it. It’s okay. It’s okay.” Turning to me he asked, “Is there a shower?” From the faint odor I could tell what had happened, and it had to be incredibly embarrassing for a young man.

“Please,” Jess said as he looked at me, this strong son nearly in tears.

“Yes, sir. I can help him get there.”

“It’s okay, I’ll go.” We hadn’t had time to have Jess undress before now other than his shirt, but things were starting to make sense. His father, still in his tuxedo shirt, bowtie and cummerbund helped his son get his feet under him. Jess turned to look towards me again and said, “Thank you. Please.” He sat in the wheelchair.

Jess’ body was far more mature than his mentality. I hadn’t managed to read his history or talk to his doctor about it all, nor was I listening as well I should have when the nurse was gathering his history. As we got to the shower, I offered, “Sir, if you want to, you can stand over here, but I’ll help him get cleaned up. I can always put on another set of scrubs.”

“It’s okay, he’s my son, but I could use your help. I’m not as strong as I used to be.”

A few minutes later we had him back in his bed. I asked a friend to run up to surgery to get a couple of sets of scrubs, one for me, one for his father whose tuxedo was now wet and soiled in spots.

As a precaution, the doctor ordered a spinal tap. I had held countless babies during their taps, the occasional toddler, but never someone so much bigger than I. It was essential he remain still during the procedure and we couldn’t be certain he understood. All I knew was that another person and I were about to hold him against his will while yet another person inflicted some pain on him he might not comprehend. Before we started I looked him very closely in the eyes and gave a short explanation then said I was sorry. He whispered “nonono” a few times, and resisted just a little, but seemed to know we didn’t want to hurt him.

The night slowed and I had attended to the basic duties of vital signs, wellness checks, etc. of my other assigned patients. I headed back in the room. Jess’ father sat in a chair, sleeping. His mother was still next to him. He smiled as I entered, murmuring “Please.”

“He likes you,” she said kindly.

“He seems like a nice man.”

“He was. He still is.” She began to explain: two years earlier they had taken Jess in for an operation. He was sixteen. He was a good athlete, not the star, but he was an excellent scholar with a love of history. Something happened during the operation and the oxygen to his brain was reduced for several minutes, long enough to result in serious damage. They were a wealthy family, but for the last two years, most of their lives had been devoted to their son in a way they never anticipated.

They normally took Jess wherever they went, but tonight he didn’t want to go with them, so they asked a family member to come spend time.

I would have thought such a couple to have found caretakers for their son. I would have thought them embarrassed by him or otherwise using him as a symbol for how much they suffer in their own lives, a magnet for pity. I had seen that many times before with other families.

But these two were far from that. They had no intention of abandoning their son, even after years of living with him in a state that was nothing like the way a parent dreams of his child.

I so admired their strength. Occasionally Jess would attempt to politely add a “please,” or a “wow,” to our conversation. I eventually ended up talking with him, asking questions to which I would occasionally receive one word answers, he always smiling. The night was slow, I could take my time. I had an old baseball hat with me that Jess seemed to like as well. After the doctor decided to admit him, the nurse and I went to tell his parents. I put the baseball hat on him and he smiled. “Thank you.”

For a couple more nights I would go up to check on him before my shift started. His parents were there, reading to him or talking with each other. When he saw me he always said, “Thank you.” He always had the cap on when I came by. He was a boy who sensed deep down the love his parents had for him, no matter what. I wish I had been able to check on him and his parents after they left, but that was not to be. I hope I never forget their bravery, their honor and their love.

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