The Unexpected Patient.

Margot heaved a sigh as she parked her car next to the old brick building. Beginning her shift at the South Hollow Care Center wasn’t usually hard for her, but today was different. Margot had a ten day beach vacation starting tomorrow and the next twelve hours were the only thing keeping her from it. She gathered her purse and work bag and pulled her long chestnut hair into a ponytail before she headed inside. The smell of the crisp morning mountain air helped to wake her up, almost as much as the local gas station latte she sipped on as she clocked in. She greeted the weary night shift crew and got her report and cart keys. She could hear the usual morning sounds of residents waking, the kitchen staff banging pots and pans, and the caregivers conversing about assignment schedules. The smell of bacon and toast wafted through the halls and Margot was immediately grateful that she had eaten breakfast before leaving this morning.

She began her medication pass at the far end of her hall. This way she knew by the time she would be done, she wouldn’t have to navigate the large cart through a sea of wheelchairs and meal carts. She cheerfully greeted each resident by name and patiently waited until they took their morning pills. The few that needed more help, were given a spoonful of applesauce to ease the swallowing of coarse tablets. She made casual conversation with the two caregivers on her hall, Shiela and Amber. Giving instructions about certain residents' care for the day. Margot paused at an empty room at the head of her hall and heaved another sigh. “I bet they fill this one today”, she wondered out loud to herself. With that thought, she went back to the nurse’s station and parked her cart for the rest of the morning.

As Margot finished checking wound treatment schedules for the day, her co-nurse, Sarah, entered the station and sank into the other chair. “Tim tried to refuse his meds again today! Had to give him a whole pudding cup to get all of them in him.” She spun around a few times in her chair and fluffed her short, blonde curls as she gave her account of the morning. “At least my hall is full, no admissions! I’m sure you’re glad to be on vacation after today!” Margot took a final sip of her now cold latte and tossed the cup into the trash. “Yep! So glad! Ten days on Myrtle Beach. I’m just hoping the rest of today goes by fast.” Margot collected her tray of gauze and tape to do bandage changes on the few residents that were due. She hurried to finish as it was almost time to check blood sugars for lunch. As she arrived back to her station, she internally groaned as she saw the familiar manila envelope waiting for her.

“Well, that figures!” She exclaimed to Sarah, who was now halfway into a bag of chips and a soda. “Yeah, Kelly said he’ll be here around six”. Margot sank into her chair and ripped open the envelope filled with admission paperwork. She felt a dull ache in her chest as she read the name. “Dale Somers”. At first she thought it was a coincidence. She scanned the records for date of birth and social security number. It was the same Dale. The man who tormented her life with abuse for five years. She had divorced him three years ago and hoped to never see him again. Tears stung her eyes, she fought the lump now forming in her throat. Sarah watched her wipe her face with tissue. “Hey, don’t cry over a lousy admission! I’ll help you! Give me the med list and I’ll at least put those in.” Sarah grabbed the pile from Margot but was stopped. “I’ll take your help but that’s not it. This man is my ex husband. The one I told you about when I first started working here. He’s coming here tonight!”

Sarah’s eyes widened as color drained from her cheeks. “What are you going to do?” She stammered, as she now began to read his files. “I don’t know! Do you think you could do the assessments? I’ll put all the meds in and call Dr Spencer. Please Sarah! I can’t face him!” Margot was now actively crying, tears spoiled her mascara and she was shaking in her chair. Sarah tossed her chips and soda in her bag and grabbed her purse. “Come on. We’re going for a smoke.” She assisted Margot to her feet and called down to Amber that they were going out. As they reached the smoke tent out back and settled in, Margot began to relax a little. “When was the last time you saw him?” Sarah asked as she dropped her lighter in her purse. “About a year ago. He lives in West Fork now but comes down here sometimes to visit his Mom. Ran into him at the grocery store.” Margot flicked her ashes and wiped her eyes again. “Listen…” Sarah began, “…Kelly is not going to let up on that new policy with admissions. She’ll let me put the meds in and call the doc but she is strong about the assigned nurse doing assessments. You’ll have to ask her about that.” Sarah got up and put her cigarette out in the ashtray and squeezed Margot’s hand. Margot lit another cigarette and waved as Sarah went back inside.

Margot immediately saw Kelly, the nursing manager, as she turned down her hallway. “Kelly! I need to see you about this admit coming!” Kelly turned and followed Margot to her office. “Both nurses may not break at the same time. The floor was unattended…” Margot felt her face flush, her eyes stung with fresh tears. “Dale Somers is my ex-husband, you have to let Sarah do his admission assessments! I can’t be his nurse! You don’t understand.” Margot watched Kelly’s eyes dim as she spoke, her attention focusing away from what was being said to her. She pulled the blue reading glasses from her forehead off of her short, red, greying hair and looked at Dale’s chart on her desk. “Clearly,” Kelly began, “he is going to be assigned to your hall. There is nothing I can do about that. You know the policy in place, you all agreed to it when it was implemented…” Margot snapped at her supervisor. “THAT was before I knew the devil himself would be coming through our front door! I feel unsafe, Kelly! Doesn’t that count for something?” Margot was shaking again as she took the seat in front of Kelly’s desk. Kelly placed Dale’s file in front of her and pointed to the diagnosis list. “Surely you don’t think someone with two broken legs, a fractured wrist, and five broken ribs can do you any harm?” She smiled at Margot, possibly in a reassuring way, but Margot felt the condescension in her tone. Kelly was an old time nurse from the hospital, taking an administrative job in the nursing home after an injury on the floors. Her lack of sympathy irritated Margot “I don’t have time to try to make you understand. I’m not going to spend the next six weeks of his rehab panicking everytime I drive into the parking lot.” Kelly closed his file and sipped on a diet soda. “What you can do is just…” Margot cut her off by leaving the office. She wanted to get through the lunch med pass as quickly as possible. Surely there would be something she could do.

Margot stared back at her reflection in the bathroom mirror after splashing her face with cold water, and drying off with a towel she grabbed from the linen closet. She wanted to compose herself before the lunch med pass so as not to concern her residents. She thought about her life with Dale, and after him. How they met and got married when she was younger. Before she knew what her dreams and ambitions were in life. The various forms of abuse she suffered because of him. How she finally summoned the courage to leave their home behind, living in a motel in Greenfield and working nights so she could go to nursing school. How she graduated with honors and got her job in South Hollow. Still, she didn’t think she could face him today. She made her way back to her cart and found Sarah with Dale’s file, typing quickly at the computer. She saw Margot and spun around to face her. “Any luck with Kelly?” Margot shook her head. Sarah let out an exasperated groan as Margot fished out the cart keys. “I’m running late already with the noon meds. I’ll be back and we can catch up.” Sarah gave a thumbs up and went back to her screen. Margot quickly finished her med pass just in time to hear the meal carts rumbling down the hall. She would usually be relieved to have lunch, but she couldn’t muster an appetite today. She grabbed some saltines and a can of ginger ale from the kitchen and went back to the nurse’s station to get an update from Sarah.

“He’s in rough shape, you’re right about that. Wrecked his motorcycle out on route 5 two weeks ago. He was in the hospital in Greenfield this whole time. Had five surgeries to put his legs and wrist back together. PICC line and chest tube have been out since Tuesday. Expected to recover…” Margot tried to listen as Sarah read the hospital history. She wasn’t surprised that he crashed his bike. He would always tear off on it in a rage. She shook herself out of her thoughts when she caught Sarah watching her. “I will go in with you when he gets here. You won’t be alone with him EVER.” Her stern, yet reassuring tone settled Margot a little. Sarah was bold and outgoing, the opposite of Margot. She could count on Sarah indefinitely. Sarah poked at Margot’s crackers and ginger ale. “I’m getting a sandwich from my cousin Mike’s shop. We’ll split it. This can’t be your lunch.” Margot smiled weakly as she watched Sarah leave for her cousin’s deli. She looked at the screen and saw that Sarah put in the medications and diagnoses. She also did his contact information. His file was typical for someone who had suffered this kind of accident. She usually felt pity on people who came in to recover from their injuries, but not this time. She felt a sense of reparation, like he deserved this. She clicked out of his chart and brushed off this feeling. She didn’t want to go down a road like that.

Sarah returned with a huge turkey club sandwich, chips and two sodas. They sat at their desks and finished lunch. Margot found herself hungrier than she thought. The rest of the afternoon the two nurses finished charting, answered a few calls for pain medication, and emailed lab results to the doctor. Around four o’clock the phone rang. Margot felt the dull ache in her chest again as she picked up the receiver. The nurse from Greenfield County Hospital spoke quickly as she gave Margot report. Telling her everything she already knew. Margot listened, not wanting to give away who this person was to her. She made sure the hospital physician would include prescriptions to send away for Dale’s medications. Margot took a deep breath and asked what she was dreading. “When will he be leaving?” She could hear papers rustling as the nurse answered. “We’re hoping to send him around five but right now the ambulances are out on other calls. We tried to get a team from South Hollow but they just took someone all the way out to Richardsburg and won’t be available. Do you want me to call when he leaves?” Her cheerful tone irritated Margot but she calmly assured her that it wasn’t necessary. She hung up the phone and prepared to pass the dinner meds, full of apprehension.

Sarah was more optimistic as Margot shared the report from the hospital. “Maybe transportation will get hung up! He may not even come until after night shift gets here. By then, you’ll be safe at home packing your bags and waiting for your cousins to pick you up. You’ll be on the beach and he’ll be here hoping that it’s time for a pain pill!” Margot locked her cart and began to clean it up for the night shift. “I can only hope so.” She thought to herself. Her phone vibrated in her pocket. “I just got a text from Becky and Janice. They are stopping for the night, they’ll be here by nine tomorrow morning.” “See!” Sarah exclaimed, “the day’s almost over and things are starting to look better! I won’t even mention your name while you’re gone, and neither will anyone else.” Shiela and Amber were nearby and nodded in agreement. The sound of Kelly closing her office door for it the evening drew Margot’s attention. As she watched her leave, she felt sullen that her manager didn’t support her more. Only to maintain some rule made up by people who work in a corporate office, who had probably never seen the inside of a nursing home.

While Margot sat at her desk writing report for night shift, the ringing phone jolted her. She listened to the hospital nurse announce that Dale was on his way to South Hollow. After she hung up the phone, Margot scanned the hall for Sarah. She found her chatting with the aides and she approached her trembling, “Sarah” Margot whispered, “he’s coming now.” Amber took off down the hall to prepare the room with towels, linens and toiletries. Sarah tried to reassure Margot. “I’ll stay with you the whole time. We got this!” Margot still paced at the nurse’s station. She stopped once when Shiela told her that a resident was asking for a pain pill. As she was returning to the station, she saw Sarah and Amber running down the hall to a room on Sarah’s assignment. Margot followed them and found that one of Sarah’s residents had slid out of her chair. “Is she ok Sarah?!” Margot called to her friend. “I think so” Sarah said as she knelt down to the woman to examine her for injuries. Looking up at the wall clock, Sarah saw that it was nearly seven. “Margot, I’m sorry. I have to stay here for a while to check her out. It looks like you’re going to miss him though!” Margot backed out of the room into the hall. She hurried to the glass door at the end where she could see the road that led to the parking lot. She hoped to see her relief’s cars before the ambulance. The anticipation made her sick to her stomach.

Ray’s blue pickup truck came into view down the road. Relief washed over Margot as she watched him park and walk towards the building. She hurried to the nurse’s station, waving to Sarah as she passed. She could hear Ray whistling as he made his way to the station. He noticed Dale’s chart on the desk and picked it up. “Is he here yet?” He smiled crookedly and flipped through the pages as he stashed his backpack under the desk. Margot answered quickly, “No, but he’s on the way. All the meds and his profile are in the computer already though.” “Well, that’s good enough.” Ray replied cheerfully. Margot hurried through the rest of report, only giving essential details about Dale. She quickly handed over the keys and collected her purse and work bag. Sarah saw her leaving, “Tori’s late huh? Well, you made it! Have fun and post a ton of pictures, ok?” Margot hugged Sarah goodbye and rushed to clock out.

As she made her way to her car, she saw the ambulance pull in down the road. She jumped inside her vehicle and sank down low. Behind the ambulance was a car she didn’t recognize. She watched the ambulance park under the canopy in front of the building and the other car park in a handicap spot nearby. She saw Dale’s mother and sister emerge from the car and proceed to the ambulance’s back door. She peered over the dashboard as two young paramedics opened the door and pulled a gurney out onto the asphalt driveway. Dale was mostly covered by a blanket but she could see that he was severely disabled. His face and arms were badly scarred and bruised. He hung his head weakly as he was pushed inside the building with the two women following. Margot pulled up the lever of the seat, raising her to a sitting position. Seeing him now, weak and dependent changed her perception of the situation. She felt like she could face him in this state. She had become independent and capable without him. “Surely, he deserves to see me better off.” She said to herself confidently. The prospect of seeing the look on his face when he saw her next week made her smile a little as she drove home. She started to feel absurd for being so nervous about his arrival. She resolved to make up for this now by having her success be her revenge.