Patient John Doe

Our afternoon was much more relaxed than I had expected. Roberts seemed more interested in venting his spleen, just have someone to talk to, than in discussing any real problems. It turned out Cindy had ridden horses and Barrel Raced all through her teenage years, and took complete control of the kids riding activities, even saddling horses for herself and her kids. All the kids seemed to get along perfectly. When they began drifting up to the house a couple at a time for drinks you would have thought they had known each other for years.

The afternoon actually went by a little faster than I think any of us wanted, but after several hours of swimming and riding, along with what turned out to be a perfect meal and huge bowls of freshly made ice cream the Roberts' excused themselves.

"Gee, I'm glad that's over. I hope you weren't too embarrassed, being orphanage kids and everything," I teased as we watched them drive off. I got a couple of mild frowns followed by a pair of warm hugs.

"Well, can Junior come back, maybe all day?" Ronnie asked after a minute.

"Well, I don't know, I don't know if I want you two around a doctor's kid," I quipped. They both hit me in the stomach. I pulled them against me and tickled the tight little bellies for a few seconds before I broke away, running through the house and diving into the pool walking shorts and all, both of them hot on my heels.

Once we relaxed it didn't take long for the day to catch up with my young friends. Only about ten minutes after we all snuggled on the couch to watch some TV, I had a pair of sleeping angels leaning against me, tightly tucked under my arms. I let them sleep for an hour or so then carried them one at a time upstairs and tucked them into their beds.

The next morning I was a little surprised to wake up alone in my bed. I was sitting on the patio enjoying my second cup of coffee when a thin body pushed under my arm. "I didn't know where I was," Mark more yawned than said. "Our new house is huge. I mean your house."

"Our house," I corrected, pulling him into my lap and kissing his forehead. He leaned his back against my chest, pulling my arms around his thin tight waist as he tucked his head under my chin. "I love the new house too, but getting to share it with you guys is what makes it so wonderful," I added closing my eyes and enjoying his snuggle.

"I love you Doctor Pop," he whispered in his sweet voice.

"I love you, Pumpkin."

"Hey, there's no room for me!" Ronnie whined, pushing against my arm. I slid Mark over onto one thigh and somehow found room for Ronnie on the other. I began to wonder which was going to crater first, my lap or the lightweight chaise lounge we were all crowded into but leaned back enjoying the moment. 'I finally made it, I've got the perfect life,' I thought.

I'm not sure how long we cuddled before one of their stomachs let out a long growl. "Shit, I hope I don't get bit, maybe we better feed that monster!" I quipped, squeezing both their flat tight bellies. "Come on, let's see if we can find some breakfast," I suggested. It wasn't until they climbed out of my lap that I noticed both of them were only clad in tight Speedo.

"What's this, did you guys plan on a formal breakfast, perhaps brunch at the club?" I teased.

"Well, ah, we well, we didn't know if you might want to go swimming," Ronnie blushed.

"Yeah, I appreciate your being so considerate, always be prepared," I snickered. "You guys hit the water, I'll see what I can find to eat," I suggested, popping them lightly on their butts. 'That repaid my entire investment in this place, every penny,' I told myself as I watched them race to the pool and dive in, their happy faces somehow showing even from the back of their heads.

We relaxed and played the rest of the day. We spent an hour or so shooting a video of the ranch and horses for the boys to show to their friends at the Children's home, but all too soon it was time take them back to St. Paul's. I entered a new code for them into the alarm system and showed them where to find the spare key to the house before we left, and we went over a few rules for Wednesday, like no swimming and stay out of my bar, on the way into town. After a series of hugs and kisses, I sadly walked them into the orphanage and signed them in, reminding I guess myself as much as them it wasn't long until Wednesday afternoon.

When I got home I had an e-mail from my contractor saying the supplies for the last part of the renovation project, the house's basement, would arrive tomorrow, and replied that he was welcome to begin work Tuesday morning. After I spent a couple of hours cleaning up from the weekend I also decided 4600 square foot of house was too much for a bachelor to take care of, and added finding a maid service to my list for next week.

Our little patient was holding his own when I checked on him before my morning rounds. When I stopped back in before leaving the hospital for my office, both Roberts and Ryan were just outside his room, both studying an x-ray.

"Good morning, you might want to look at this, good news indeed!" Ryan greeted me. I had time to glance at the film long enough to see a pair of fully inflated, seemingly functioning lungs when Roberts interrupted my concentration.

"Oh, we forgot about your specialty," he began. "This is an X-RAY, it's like a picture, but lets us see inside a body. These are ribs, they're bones in your chest, and this is a shoulder!" he added, his tone clearly patronizing.

"Yeah, and see that 'L' letter?" I responded, pointing at the orientation marker x-ray techs place on every film before shooting it. "I know you saw-bones types can’t read or write too well, but that stands for LOSER!" I quipped. "As in the skill level of those that would be reading it!"

"Just ignore him, Doctor," Roberts retorted. "He's still recovering from the last shock treatment I gave him." My arm flinched in reaction.

Roberts and I exchanged light-hearted snubs a couple of times before Ryan cut us off, turning back to the x-ray. "The boy is making a remarkable recovery, I expect about two percent scar tissue on his lung, that's unheard of from a hemothorax and the size wound that was inflicted. We are waiting on the latest blood-work, but we might try weaning him off the respirator later this morning."

"What are his odds now?" I asked.

"If we can get him breathing on his own he's probably going to make it," Roberts injected. "His heart muscle is doing equally well, better than I have ever seen. But understand, Adam, we don't know what will survive, if he's going to be a vegetable or an alive kid, if he wakes up," he added, his tone both professional and somber.

I looked away from the x-ray into the bay, holding back tears as I studied the tiny little creature. He looked so restful, even with the dozen or so tubes and wires running into his little body. "He will, you guys just make it happen," I almost sobbed. "Keep me posted, I want to be here when he wakes up," I added, getting mixed looks from my colleagues.

The rest of my workday went surprisingly fast. After afternoon rounds I stopped back to Pedi-ICU and happily found our little patient sleeping comfortably, the massive tubes and mask that had hidden his freckle laden face now replaced with a small oxygen tube running under his nose. His nurse not only told me he was doing well, but that Ryan had upgraded his condition from Critical to Stable.

When I got home I wasted no time in changing into a pair of old, soft Levis, letting my hair loose from its pony-tail and heading to the tack room. I saddled Zeus and prodded him into a full gallop, running for probably an hour as we both enjoyed the wind in our faces and the beauty of the Texas hill country. I found myself amazed at the big animal's stamina, although I rode him hard until it was almost dark, and my muscles were starting to complain, he was almost angry when I led him back to the barn and groomed him.

The next day went well. Between patients, I interviewed several candidates from the maid service and contracted an elderly lady that struck me as honest and hard working. Our John Doe seemed to still be improving, but little change.

'I wonder how Stewart and the boys are getting along, well Stewart and the horses!' I thought as I gave my big cat her head on the way home. 'I have to cut this shit out, I'm going to get a MAJOR traffic ticket!' I told myself as I watched her speedometer push on the 120 mile-per-hour mark. I was a little concerned as I began the trip up my long driveway, for the first time no horses to be seen. That concern was short-lived, as I drove up to the house both of my little buddies were sitting on the pasture fence talking to all six horses.

"Doctor Pop!" Mark howled, diving off the fence and rushing toward me. His big brother was right behind, both of them slamming into me with hugs. The horses quickly chimed in, baying and running around as if joining in on the celebration. I leaned back against the car and just enjoyed their loving touch for a minute or so.

"How was your lesson, did you have fun?" I asked.

"Yeah, it was neat! Mrs. Stewart is totally awesome!" Ronnie replied.

"I got to ride Zeus!" Mark added. My stomach bounced off my rib cage, but I left his statement at that.

"Yeah, Hera and me raced Mark and Zeus and we almost won!" Ronnie bragged, making my larynx ricochet off my rectum.

"Did not!"

"Did too, come on, we'll race you again!" Ronnie challenged, pushing his brother against me.

"Woe, guys, ah, I think we better let the horses rest," I interrupted, not anxious to tempt fate again.

"Well, but can we go swimming now?" Mark asked. "Please, we been waiting and waiting!"

I wasn't too surprised that they were wearing Speedos as they shed their pants on the way through the house. I changed into a pair of trunks and quickly joined them in the pool. They were right, the cool water and warm sunshine felt much more than wonderful. We swam and played together for an hour or so before I slipped back inside and started cooking the frozen pizza and breadsticks I had planned for our supper.

I had just opened a beer when Mark ran into the family room and grabbed his and Ronnie's shoes. "We're gonna go feed!" he announced as he rushed back outside. It took me a few seconds to digest what he had said and looked out the window, seeing the boys rushing toward the horse barn, a fan club of Arabians trotting toward it on the other side of the pasture fence. 'Damn, even volunteering for chores,' I thought, 'Stewart is one hell of a teacher!'

As we finished eating I was impressed as I watched the boys clear the table and load the dishwasher, again without being asked. Ronnie seeming to take extra care, carefully scrubbing the kitchen counter. As soon as they were done they both leaned against me, snuggling under my arms.

"Ah, Doctor Pop, we sorta wanted to ask you something," Mark began.

"Well, is it okay if we stay here tonight, maybe if you take us to school tomorrow?" Ronnie added, pushing against my hip.

I bit my lip, thinking what a good idea they had but forced the more rational side of me to respond. "It would be great guys, I'd love it, but it's a school night, you guys have homework and stuff."

"We brought our books, we can do it here!" Mark declared. "We promise we'll do all of it!"

"I know how you feel guys, but what about clothes for tomorrow?" I tried.

"We got lots of clothes here, we got our own bathroom and everything!" Ronnie answered.

"Please Pop?" Mark chimed. I stiffened as they pushed against me, Mark offering what was clearly a well-practiced sad face, complete with a downcast frown that would have made Hitler agree to join a Synagogue.

"Well, I don't know," I answered. "It sounds like too good an idea for a couple of little rats to come up with." I let that soak in for a minute or so before adding, "Let's ask St. Paul's, but if they say no, no arguments, no one gets mad, okay?" Ronnie handed me the cordless phone, magically within his immediate reach.

The Nun I spoke to was more than happy to allow the boys to stay over, I think if I had pushed her she would have released custody of them to me over the phone. I tried my best to show a concerned look as I hung up. It seemed to work as the boys remained silent, staring at me for almost a minute.

"What did they say?" Ronnie finally risked.

"Well, they didn't want you to get waterlogged or anything!" I answered as I picked both of them up by their thin waists and carried them outside. I tossed them into the pool laughing. "Dry out by tomorrow!" I shouted after them.

I graduated from high school when I was a 16-year-old, and whizzed through both college and medical school with honors, but soon found myself pulling my hair out as I tried to help diagram sentences and recall State Capitol cities, but somehow we survived an hour or so of homework. The kids were great all evening offering no argument when I announced bath and bedtime. I wondered if I should even bother to, but I made them promise to sleep in their own beds as I tucked them in. A few minutes after getting them settled in I retired to my bedroom and watched the news before falling asleep.

I had no idea what time it was when my bladder woke me from a wonderful dream. I lay in bed for a few seconds trying to remember what I was dreaming about. After another prompt from my abdomen, I grabbed the warm, soft blanket draped over my chest and pushed it off me, only to have it whimper. 'Was I still dreaming?' I wondered. As I climbed out of bed I discovered it wasn't the warm blanket draped over me but Ronnie's arm, his little brother tucked tightly under it laying between us.

At first, I was a little angry at them for not staying in their bed as they promised, and was considering waking them and making them go back upstairs. When I returned from the bathroom I stood looking at the beautiful, innocent little faces, the soft moonlight reflecting off their golden hair almost like haloes. 'Yeah well, you can be the hard-guy tomorrow,' I thought. I sat on the bed and kissed each of their foreheads.

'Thanks, God, thanks for saving them,' I silently prayed as I stroked their soft hair. 'God, what a change,' I thought. Almost without realizing it I sat cross-legged against my little angels as I thought back over the last few months, and how far they and we had progressed, how they had blossomed from frightened, hostile animals I had first met.

I was serving as a volunteer screener for Texas CPS (Children's Protective Services) one Saturday afternoon, interviewing some of their more troubled kids that were in the Emergency Receiving Shelters. No private interview rooms there, just get a kid off to the side and evaluate him. CPS was looking to get commitments to a treatment facility for the kids I was talking to, but even as a neophyte Psychiatrist I didn't automatically sign off on this practice.

Mark was about the third kid I was to interview, knowing his older brother was next on my list. From their files I knew both boys had a history of abuse that made me want to vomit into their case file and go hunting their parents; CPS knew Ronnie's dad had sexually abused the boy for over a year, sharing the lad with a few of his friends. They suspected Mark had been abused too but had no proof.

Mark was as polite as he was frightened as I began my interview. After a couple of unsuccessful tries at breaking the ice between us, I suggested we go for a walk. He hesitated but leaned against me slightly as I wrapped my arm around his shoulder and tucked him under my arm. We walked about ten feet when he tensed up and pulled away from me as he emitted a frightened whimper. Instinctively I grabbed his other arm and tried to pull him back next to me to reassure him.

"Get the FUCK away from my brother! LET HIM GO DON"T HURT HIM!!!" I a high pitched voice rang from behind me. I was about to turn around when a piercing pain ripped into my upper arm as the sharp pain of a well-placed kick shot into my calf muscle. When I reached around with my other hand, hoping to block whatever was attacking me, I found almost an exact copy of Mark biting into me, snarling like a wild animal.

I remembered how angry the CPS workers were when I blocked their attempts to lock Ronnie away, at the time wondering how much business I had cost myself. Ronnie ended up spending almost a month in the hospital being treated for rectal tearing, and he and I both endured a painful series of Gama-Goblin shots after his throat culture came back positive for Gonorrhea, but thankfully he joined his little brother at St. Paul's. A series of HIV tests for both of us also thankfully returned negative.

'Thank God,' I silently repeated as I lay down, pulling my little angels into a snuggle. I kissed Ronnie on his pixie little nose before I closed my eyes.

We were again snuggled together when my alarm clock began its morning attack. I renewed my hatred for engineers when, as programmed, the snooze button failed to silence the beast after the third time, but begrudgingly stirred back to consciousness.

"Morning sunshine," I whispered as I gently shook the boys. "Time to rise and shine," I added, kissing the top of their heads. Ronnie opened his eyes first, giving me a wide grin. "I thought you guys were going to sleep in your beds," I commented as he pulled our hug tighter.

"We did," Mark mumbled. "Well, you didn't say we had to all night!"

"Good try Turkey, but no cigar," I countered. "Come on guys, you have to. . ." I stopped, as they kissed both my cheeks at the same time. "I love you guys," I said, blowing off any attempt at discipline. "If we get up right now we have time to take a quick swim, then we can stop and eat breakfast on the way to school," I suggested.

Instantly they jumped out of bed and, clad only in their briefs, rushed out the door into my bedroom and out through the patio area. A second later I heard a pair of splashes through the still open door. 'What the fuck,' I thought as I followed behind, still in my underwear. A ten-minute swim and quick change of clothes later we were cruising down my long driveway, our four-legged fan club next to us. "Whatever, tomorrow afternoon isn't far off," I told my two sad-eyed buddies as we waited for the gate to open.

After watching them wreak havoc on an all-you-can-eat breakfast buffet, I dropped them off at school and made my way to the hospital. I was disturbed to see our little John Doe back on the respirator, that he had gone into respiratory arrest after breathing on his own for several hours, but I was glad to see he was stable.

Ryan and Roberts were waiting for me when I returned to ICU after my morning rounds. "I'm starting to get concerned," Ryan began as we sat down in a small conference area. "Having to put him back on the respirator isn't too surprising, often it takes more than one try, but he should have regained consciousness by now."

"His vitals are good, his heart muscle is healing nicely and circulation is excellent," Roberts added. I began rifling through the boy's patient chart as they discussed the latest x-ray and blood test results.

"Let's get an EEG, is he strong enough for a CT Scan?" I asked. "Why are you still using a Morphine drip?"

"I see no problem with the CAT, I'm keeping him on Morphine trying to prevent any pulmonary edema, his lungs are still healing."

"It's also a Beta blocker, and in some patients blocks the production of serotonin," I replied. "Let's get the brain scans, I'll have them e-mailed to my office so I can review them." I checked my PDA for appointments before adding, "Why don't we go over the results over lunch, want to meet downstairs at 11:30?"

They checked their appointments and agreed. I spent a minute writing out my orders before stopping in to see our little guy. I spent the next ten minutes or so examining him, verifying for myself what I had read on his chart. I could find nothing contrary to what I had read, nor anything that would indicate brain damage. After I carefully examined his eyes I kissed him on the forehead and whispered, "Come on, little one, you can do it!"

"Doctor?" his nurse said as I straightened and stepped back from his bed. When I turned to look at her she was holding out a box of tissue, it took me a second to realize I was crying.

I checked my e-mail between each patient as I started my morning. I received one I didn't expect from Ronnie and Mark's school. I took a deep breath before opening it knowing it had to be bad news, but instead found a JPG, a scan of a drawing. Nested in the middle of a dozen or so outlines of hearts and puckered lips were the scribbled words, "Thanks Dr. Pop, we love you!" I fired it to our color printer before going into my private restroom and washing my face with cold water.

The test results finally arrived, of course, less than an hour before my meeting. Neither the EEG nor the hundred or so images of the boy's brain and upper spinal cord showed any damage, even after I reviewed them for the tenth or so time. 'Good and Bad,' I told myself. I leaned back in my chair, almost blindly clicking between images as I prayed for a clue.

"Let's try losing the Morphine," I suggested as we unloaded our cafeteria trays onto the snack bar table. "I think gradually, so we can monitor his lungs, but dilute the dosage, maybe have him on straight D5W by morning." After Ryan, Roberts and I threw the idea around a few times we agreed, I even managed to nibble on a few bites of turkey and ham mixed in the Chef's salad I didn't eat.

I could feel the tension draining from my neck and shoulders as my whitewashed fence came into sight, Zeus and his harem waiting for me at the gate. Two pickup trucks from my contractor were sitting in front of the house, along with another displaying a sign reading 'The Billiard Factory' on it.

"Hi Doc!" Billy-Ray, my contractor's country accent rang out as I walked inside. "Come on, you gotta see this!" he continued, pointing toward the basement stairs.

"Wow!" was my only reaction as I pushed my way through the old west style saloon doors at the bottom of the stairs. As with the rest of the old house, he had done a perfect job. The entire room had been turned into a replica of an old wild west saloon, complete with a ten-foot bar at the far end. He had cleverly hidden the home entertainment center behind concealed cabinet doors, the control panel hidden behind a false door, complete with a rustic sign reading 'Privies' (outhouses, outdoor restrooms).

The centerpiece of the room, a very old pool table that was the reason I had chosen this decor, had been restored to perfection. When I first looked at the property I was going to have the table removed, but soon found out it was made from one large slab of marble, two foot thick. Not only could no one figure how to get it out of the basement, but they had no idea how it got there, especially over a hundred years ago. My engineer suggested they probably lowered it into the basement and built the house around it! 'We'll have fun tomorrow night! The boys are going to freak out!' I told myself.

Our little patient was stable when I checked on him in the morning. I was thrilled he was back off the respirator and remaining stable, but was still in a deep sleep. I ordered another EEG, asking the electrodes be left on after the test this time, and a machine kept quickly available. To my surprise, the results were waiting for me when I got to my office. I made my first patient wait for fifteen minutes or so, something I vowed never to do when I opened my practice, as I reviewed the test, but there were no changes, no hints at the problem.

I was trying to stay awake later in the morning as I met with the parents of a new patient. After listening to them for ten minutes, they were putting me to sleep as they for the tenth time or so told me what an evil bitch their daughter was. I was deciding how to tell them, not only to shut up, but that they were wrong about their daughter - that she was just a kid testing her limits; when a soft knock on my office door distracted me. My nurse quietly slipped into my office not waiting for a response, telling me something VERY MAJOR was amiss. Interrupting a patient session was all but completely forbidden. I took a deep breath before unfolding the small note she handed me before she slipped just as quietly out of my office.

'Contact Central Baptist ICU STAT. Re Patient John Doe.' I read. I probably lost the patient, or at least the support of her parents, as I all but threw mom and dad out of the office, but dialed the number at the bottom of the note before they had closed the door. I called my nurse everything but human when I got the automated answering system connected to the hospital's main, public phone number, asking me to 'press one to continue in English, press two to. . .'

I began reviewing my incoming calls on my cell phone, looking for the hospital's ICU number, as I rushed out of my practice toward my car, finding it as I climbed into the car.

I was backing out of my parking space when an ICU nurse answered. I had just identified myself when the phone went blank for a few seconds and Ryan's voice came on the line. "You asked we call you, the boy is starting to come out of his comma," he said. I'm sure hearing the squeal of my big cat's claws sliding through the five-mile-per-hour curves of my parking garage at thirty or so mile-an-hour he added, "Don't get in too much of a hurry, but, well, what's your ETA?"

"Ten minutes, how is he doing?" I answered, cursing the entire United Kingdom for only fitting my Jaguar with only twelve cylinders, instead of the twenty-four or so I wanted to power her paws right now. When he didn't answer I tossed my cell into the passenger seat and closed the normally fifteen minute trip to the hospital in about seven minutes.

"Damn, did you ride that big horse of yours here or what?" Roberts quipped as I rushed into ICU.

"No, just my big pussy. . ." I stopped in mid-phrase, realizing there were several nurses in the room. "My Jaguar, the car kind," I added, trying not to stutter. "How's he doing, where are we?" I asked.

Before anyone could answer the boy rolled his head slightly at me and blinked his eyes. I moved next to him and said, "Hi, I'm Doctor Owens," as I began stroking his forehead. "Just relax, you are safe and going to be okay. How do you feel?" He blinked several more times before briefly focusing his eyes on my face. "You’re safe, son, just relax." I silently cursed as he took my advice and closed his eyes, drifting back off to sleep.

"Get the EEG hooked up stat, I'll read it in live time," I ordered. I stepped into the hall and called my office. After explaining to my slightly upset nurse why I had disappeared without telling her I had her cancel the rest of my appoints for the day.

"Yes, yes, yes, yes!" I exclaimed as I looked at the readout, "Yes, there is a GOD!" Seeing everyone's curious face I added, "That's a normal sleep pattern. Perfectly normal, actually he's having a dream right now!" Everyone in the cubical congratulated each other, several high five's and hugs being exchanged as a low round of applause rang from other staffers watching from the hall.

"I can't quite read this," I said, pointing to one side of the screen. "I think he's either dreaming about a cute little girl or roller-blades," I joked, the tension draining from my body so fast I was feeling a little silly.

"I've seen that pattern before Doctor," the EEG tech replied. "I hate to correct you sir, but that's a double cheeseburger and milkshake, its either strawberry or chocolate, I'm not sure which."

Roberts actually leaned closer to the screen for an instant before figuring us out. "Now I know why you guys go into your specialty," he quipped. "So the nut cases can treat each other!"

"Let's let him rest a few minutes," I suggested. "I'll try to bring him around in a few minutes." I tore off the printout to review it before my two fellow physicians and I moved into the conference area.

"Oh, thanks for inviting Junior to your ranch tomorrow," Roberts said as he handed me a cup of coffee. I was trying to figure out what he was talking about, had the week been THAT long, when he added, "He really wanted to go, he got into an argument with his mother when she said he had to attend his soccer game. By the way, your older son was a perfect gentleman when he called last night."

'Should I kill Ronnie, or just cut his tongue out?' I asked myself. ' 'My oldest son'. . . I like the ring of that, yeah, just cut his tongue out.'

"Doctor, he's waking up again," a nurse interrupted us. We had to push our way through the crowd of nurses and technicians gathered outside his cubicle but were rewarded with a pair of fairly alert eyes looking around the room as we approached his bed.

"Hi, I'm Doctor Owens, how do you feel?" I asked. He scanned the room again, surveying the mass of monitors and equipment surrounding him. "It's okay, you're in a hospital, and this stuff is just to help us take good care of you."

"I'm thirsty. . . my neck hurts sir," he mumbled. A Styrofoam cup full of crushed ice was thrust into my hand. I explained to him that he had to go slow before I turned a small spoonful of ice, then a couple more into his mouth.

"Can you tell me what your name is?" I tried a half cup or so of ice later.

"Johnny," he answered almost in a whisper. I waited a few seconds before gently prompting him for his last name. "Johnny Doeman," he whispered.

Everyone in the room's eyes seemed to lock in a startled synch as I looked up.

"I'm hungry sir, my tummy hurts," he said before closing his eyes and drifting back to sleep.

To Be Continued…