I See You Too

“We’re getting an admission,” Cathy Bolger said in a voice that the other four nurses on the unit could hear.

It was 30 minutes past midnight, the night shift, in the Intensive Care Unit number two, ICU-2, of the Westview Children’s Hospital. You could tell it was the night shift because it was quiet and only subdued task lighting was on, and most of the children were asleep.

The year was 1977 and it was raining outside which was normal for October in Kansas City, Missouri.

Cathy Bolger, RN was 26 years old and had worked in the Westview ICU for three and a half years and she was the charge nurse tonight and that technically meant it was her unit, but running an ICU at night, especially a kid’s ICU, was always more of a team sport.

There are 3 truths to pediatric ICU nurses.

1. Everyone on nights starts out young and gets old quick.
2. ICU in a kid’s hospital is a high pressure job that eventually breaks your heart.
3. You work in the ICU because you want to help kids.

All four of the other nurses in the unit turned to face Cathy to see if they were going to be taking care of the new patient being admitted.

“Who’s going to take it? I’m kinda swamped here.” Sandy Thurmond said. She’d only recently gone full time and quit her other night job in an ICU for grown-ups across town. Someday she hoped to have some kids of her own. For now, she just liked working with them.

Cathy took a quick look at the assignment sheet and decided. “Tim will take the admission and I’ll cover your kids while you help Tim get them settled. Matty stays with the heart.”

Mathilda Reynolds looked up from the tiny 11-month-old girl who’d had open heart surgery the previous morning and nodded with a thumbs up. She then turned around and continued running a tool that looked like a set of pliers with rollers over some yellow rubber tube coming out of the infant’s chest. The mother of the baby, who had heart surgery to repair a hole between the two main chambers earlier the previous day, sat in a wooden rocking chair on the left side of the baby girl’s crib watching Matty care for her daughter.

In Westview, parents could visit their children at any time of the day or night, unless there was a “problem” in the unit.

Cathy looked around and said, “Where’s Martin?

“I’m down here!” said Martin Keesler, a quiet guy of 25 years with thinning light brown hair and thick eyeglasses stuck his head out from the behind the foot end of a cart two spaces down from the heart surgery bed, about three feet off the floor. Cathy could see a flashlight in his hand.

“I’m draining a Foley bag,” he said.

“Lucky you! Martin, you spread out and cover anything we’re missing. I might need some help with Sandy’s kids.” The crew of the night shift was used to having loose assignments and lending a hand wherever it was needed. There was always a lot to do and the day shift just didn’t want to hear about how busy it was on nights.

Tim Reyvik, the nurse getting the new patient, was 24 years old, six foot tall and 195 pounds. He’d played football in high school and still played pickup games when he went home to visit. He’d worked in the ICU for one year.

He took a few steps toward Cathy and said, “I’m taking the admission? What is it?”

Cathy looked down at a small scrap of paper she’d taken a couple notes on during the phone call from the House Supervisor.

She said, “Neurosurgery. Eight-year-old girl, unrestrained MVA, unconscious at the scene, intubated, A-line, IJ.  Coming from X-ray, may be going to surgery in a while. The neck, chest and abdomen prelims have been cleared. Facial lacs, fractured left lower leg, splinted. We’re watching the closed head injury.”

That was the short version, they’d get a lot more at the time of transfer. The motor vehicle accident had happened at just after 8:00 PM and so for four and a half hours the patient had been in the system, mostly in the emergency department, getting checked out and stabilized, and having some tubes and lines put in to treat and monitor her.

“Can we put him in three so I can be close to Mr. Chambers,” Tim asked.

Cathy looked at the clock and said, “Good thinking. It’s a she and they say she’ll be here in 20 minutes, two-zero minutes.”

Tim nodded. “Right, I’ll get vitals done on my beds and 4 has meds and a gas at 1. I’ll get it a few minutes early. Then I should be good for a while.”

 Mr. Chambers was the 11-year-old patient in Bed 4 who had drowned the day before in an indoor public swimming pool. Tim called all his patients by either Miss or Mister and their last name, nobody seemed to mind. Mr. Chambers was doing pretty well, still on a ventilator and unconscious, but he seemed to be slowly coming around. Tim was mostly needing help cleaning him up and changing linen on the bed periodically since Mr. Chambers was beginning to have large bouts of foul smelling diarrhea as his intestinal tract started coming back on line and needed to shift its contents which included a large amount of chlorinated water he’d swallowed during the drowning.

Tim had two other patients who were more stable and required only minimal attention. Those two no longer needed to be in ICU and would likely be transferred tomorrow.

“Sandy, did you hear me say two-zero minutes?” Cathy asked.

Sandy raised an arm in the air and said, “I heard. I’ll start getting vitals and some charting done so I’ll be free.”

 “Thanks. I’ll need report from you on new stuff so that I’m up to speed,” Cathy reminded her.

 “Can we do that now? I’ve got a minute if you’re free,” Sandy asked.

“Sure. Let me turn down an antibiotic and I’ll be there.” Cathy adjusted the drip rate on a fluid chamber at the bedside of one of her sleeping patients.

Cathy walked over to where Sandy was working and Sandy brought her quickly up to date on the three patients that she’d been assigned.

It was 00:37 hours, supposedly 13 minutes before the new patient was to arrive. “Supposedly,” because hospital time is quite relative, especially when patients are involved.

Tim went over to the bed space labeled 3 and turned on the lights and wall mounted monitors to get ready for the new patient. He checked to make sure the two garbage cans were lined with plastic bags and that the suction unit was clean and working and then checked the supply drawers to make sure they’d been stocked. When he was satisfied that he was as ready as he could be, he unlocked the cart that was already sitting in the space and rolled it across the room to a dark corner. There was a tan metal door in the corner with a push-bar and an illuminated sign above it that said “EXIT” in red letters. This was where spare equipment was stored in the unit. There was a narrow path to the door as required by the safety code. Tim locked the wheels of the cart so it couldn’t roll.

The new patient would arrive in her own bed and with a lot more equipment. Tim went back and began taking vital signs on his other patients, starting with Mr. Chambers, to get some of his work finished before the new girl with the head injury arrived.

It was 40 minutes past midnight when the phone at the desk began to ring and the doors to the ICU opened and the House Supervisor, Harriet Beecham, RN, strode in chewing her ever-present piece of gum, and announced to the room, “The closed head injury is rolling off the elevator now, right behind me. Where are they going?”

She was carrying a load of X-ray folders, charts and large envelopes in her left curled arm and she had the bearing of a command sergeant major organizing the first troops on the beaches of Normandy.

Harriet Beecham was a substantial woman, 55 years old, without a discernible sense of humor, who looked like an overbearing nurse from a Hollywood casting company, complete with costume. She was the only nurse in the hospital that still dressed that way, every day. She wore a white dress to below her knees, white hose, white clinic shoes with thick white rubber soles. She also wore a white lightweight sweater over her shoulders, and Harriet Beecham may have been the only nurse in the United States who still wore her school pin and her official nursing hat. To complete the stereotype, she wore reading glasses on a beaded chain around her neck.

Her white clinic shoes squeak loudly on the commercial vinyl floor as she crossed the room.

Matty walked to the foot of the infant’s crib and pulled the curtain across to isolate the cubicle and the baby’s mother from the commotion in the rest of the unit.

Cathy Bolger spoke in answer to Beecham’s question. “She’s going into three. Tim’s the nurse.”

Cathy put down the chart she was holding and walked over to the patient Sandy was taking a blood pressure on and took over for her.

Sandy left the bedside, washed her hands and went over to cubicle three and stood across the space from Tim, ready to accept the new patient.

Everyone’s attention turned to the large electric double-doors at the front of ICU-2 as they swung open and a mob of seven people in scrub suits, who all seemed to be physically attached to a single cart, rolled into the unit. They looked like the entire family of the “Flying Wallendas” moving in rigid formation, as Harriet Beecham stood to the side of their path and, like a traffic cop, pointed an outstretched arm with three extended fingers, toward the far corner of the room.

The formation crossed the room and wheeled 180°, just short of the cubicle and then backed into the space, slowing and stopping just before the respiratory therapist, who was squeezing the rubber Ambu breathing bag, was pinned to the counter at the head of the patient’s cart. They’d all done this before.

Sandy began organizing tubing and lines attached to the patient and the machines while Tim spoke to the nurse from the ER who had accompanied the patient.

The ER nurse, whose nametag read “Etta,” next to her picture, began reciting the history of the eight-year-old girl’s accident, what had been done, what had been found out.

“This is Sarah-Lynn Jeffries. She’s eight years old. She’s 132 centimeters and 28 kilograms and she was riding shotgun, without a seatbelt, in a car that struck a power pole at about 8:00 PM last evening. No idea how fast, but the police said probably about 40, no skids marks. She was unconscious at the scene and it took approximately 20 minutes to extract her. Because of head and facial injuries, she was intubated with 6.0 uncuffed tube without difficulty with 20mg of succinylcholine in the ER.

“She had an obvious closed tib-fib fracture of the left leg mid-calf that was reduced and splinted in the ER by orthopedics. Her facial lacs had a couple deep bleeders that were ligated in the ER and interim dressings applied. She arrived in the neck collar she’s wearing now. Lateral and AP C-spines were taken and read as negative. We left the collar on for grins. Dr. O’Flaherty of neurosurgery resident is taking care of her.”

The neurosurgery resident, whose name was Ernest O’Flaherty, MD, looked pretty good for having been working hard since 6:00 AM yesterday morning. His shift would end in about five hours after morning rounds. He wore green scrubs with a white lab coat over them. The pockets of the coat and scrubs were stuffed with small books and papers. He carried a pack of about 35 index cards held together with a thick rubber band, in his hand, and he had blocks of writing on the thighs on both legs of his pants. He was about five feet four inches and his legs were short. This made his pant legs pile up on his shoes. It was the same thing with his short arms and the sleeves of his lab coat. It gave him an undeserved, comical look. He was a good resident though. He always listened to advice from nurses. That had saved his, and his patient’s, life more than once.

“What’s her temperature?” Dr. Ernie O’Flaherty asked.

Tim checked the girl’s temperature and announced, “35.2 degrees.”

Sandy and the nurse from the ER plugged the bed into the wall, and connected and adjusted all of the tubes and monitoring lines connected to the patient.

The doctor said, “Looks like she’s cooled a bit. X-ray is a drafty place. Let’s call for CS for a K-Thermia unit and grab a medium blanket.” Then he moved up to the side of her head and opened her eyelids one at a time, flashing a penlight in each.

“Pupils, left larger than right. Left sluggish.”

A young male R-1, a first-year resident, at the foot of the bed raised the girl’s right foot and ran the butt of his reflex hammer up the sole, from the heel to just short of the toes. The girl’s toes curled into a fist. The R-1 smiled and Ernie O’Flaherty heaved a sigh and turned his head toward the young man, scowling over the tops of his glasses. “Doctor,” he said, “could you postpone your examinations while we attempt to save this child’s life?”

The young man’s smile evaporated and he looked downward and took a step backward.

“Did you call for a ventilator?” Tim asked as he worked busily.

“RT’s trying to shake one free and they’ll bring it up,” the ER nurse, Etta said.

Dr. O’Flaherty gave a long series of orders on what monitoring parameters to watch, what settings to use, what medications to give and under what circumstances they should call him and then left the bedside to go over and write several pages of orders for the patient’s care.

“What about the parents?” Tim asked.

The ER nurse looked up from her writing.

“Dad’s probably in jail by now. He was apparently the driver. He left the scene of the accident, left some empty liquor bottles and drugs behind, along with his broken daughter. Mom’s name is Ellie and she’s in the ICU waiting area outside with two smaller kids. I’ve called Social Services to see if they can help her out. I told her it would be a little while before she could see Sarah-Lynn.”

Harriet Beecham, the “House Super” stood a couple feet from the foot of the bed listening and writing notes on her clipboard when her pager beeped. She quickly checked the number and walked, squeaking, back to the main desk, picked up a phone and dialed.

“Beecham,” she said into the phone as an annoying solid tone sounded on a public address speaker recessed in the ceiling.

The tone lasted three seconds and then an announcement said, “Attention! Attention! Code White, Emergency Reception. Code White, Emergency Reception. Code White, Emergency Reception.”

Harriet Beecham listened to the phone then put it back in its cradle and strode, squeaking, out the double doors without saying a word.

The report continued at bed 3 but the announcement had registered with everyone there. Such announcements were fairly common and usually everyone carried on with their business with the exception of those people who were designated to respond.

The “Code” system was designed to alert people to problems quickly and mobilize forces. The most common was “Code Blue” which meant medical emergency, usually a cardiac arrest. There were codes for external disasters, like tornados and large power outages, and for internal disasters like burst water mains. There was a code for fire or more usually, a fire alarm, and even things like bomb threats.

“Code White” was used commonly used for disruptive disturbances. It could be a fight, or someone with a weapon, or a mentally ill or drunken person putting up a spirited defense. Usually, it also included something called a “show of force.” A show of force meant that any personnel that were currently available should come to the area mentioned to lend a hand with a problem or just show up to intimidate someone who was threatening violence.

Staff involved with patients just ignored calls for show of force unless they had time or the call was nearby.

The only person in the ICU-2 that needed to pay attention was Harriet Beecham. As the “House Mouse,” it was her hospital until she was relieved, so she had hurried to grab an elevator down to the action in the ER.

As the handoff of Sarah-Lynn from the ER team to the ICU-2 was finishing up, people left the bedside and headed back to their jobs elsewhere. Eventually, there were only three people left there, Tim and Sandy continued “admitting” the girl. The other person at the bedside was Salma Ostler, the respiratory therapist, who was left “holding the bag,” literally.

Since no ventilator had yet been found to breathe for the little girl and she wasn’t breathing on her own, someone had to periodically squeeze a rubber Ambu bag to push air through the breathing tube into Sarah-Lynn’s lungs. That job fell to Salma, since she worked in Respiratory Therapy. Any of the other staff could have squeezed the bag but there were a lot of things to do and it was RT’s job.

Dr. Ernie was standing at the desk writing in the chart. He needed to finish up his orders and progress notes so that he could go check on his other patients. Ernie was a fourth-year resident, and as an R-4 he’d learned to be organized. It was either that, or wash out of the program.

The scene was quiet for another five minutes as everyone did their jobs, then Ernie folded the orders pages he had written on the diagonal so that the tails of the pages stuck out the side of the chart and closed the plastic lid.

It was 1:52 AM as he walked back over to bed three and looked at Tim and Sandy.

“I’m going to fifth floor to check on a shunt. Any problems here?” Ernie asked as he looked up at the monitor showing the EKG and blood pressure. Salma had moved a stool over so she could sit as she “bagged” Sarah-Lynn.

“The dressing on the side of her face is a little wet so I marked it and reinforced it,” Sandy said as she knelt and checked the urine bag for output.

“I’ll try to shake whoever’s covering plastics and see if they can hurry somebody up to sew up her face,” Dr. Ernie said suppressing a yawn.

“OK, we’re about settled and then I’ll go talk to the mom. Hopefully, they’ve found someone to sit with her kids while she visits,” Tim said.

“OK. Thanks, guys. Call me if you need anything. I think I’ve covered everything in the orders.”

“Thanks, Ernie,” Tim and Sandy said in sing-song unison. There was an informality at night when no one else around that wasn’t allowed to exist during daylight.

O’Flaherty moved away quickly on his short legs trailing the tails of his white lab coat behind him.

Four minutes after O’Flaherty left ICU-2, another long tone sounded on the ceiling speaker followed by the operator saying, “Attention! Attention! Code Yellow, Housewide, Lock down all units. Repeat - Code Yellow, Housewide, Lock down all units.”

Simultaneously, Sandy, Tim stood up straight and turned toward Cathy at the desk. Matty pulled back the curtain and looked at the desk as well. They traded puzzled looks.

They’d never heard this call before. Code Yellow was supposed to be a Bomb Threat, but the procedure was not to lock down units in a bomb threat.

“I’ll call. Let’s lock up for now,” Cathy Bolger said and grabbed a phone.

Sandy quickly walked across the darkened center of the unit to the front doors, then reached up, stretching as much as she could, and flipped a switch that turned off the electric motors in the door. She stood for a moment looking at the big stainless steel levers that ran up and down on both doors and pulled them down, throwing bolts into the floor and ceiling, locking the doors from the inside. She had never done that before, never heard of it being done before.

Sandy looked out through the tall two-inch wide reinforced glass viewports in each door into the darkened corridor outside the doors. Only the subdued night lights could be seen in the hallway. To the right were closed doors of the elevators and to the left was the lounge where, at this time of night, exhausted parents would be sleeping fitfully in chairs, covered with hospital blankets.

Everything was quiet out there and she wondered where, in the hospital, the problems were.

“I can’t get through to anybody in the communications center. The lines are busy. I’ll keep trying,” Cathy announced to the room from behind the main desk.

Tim made rounds and checked on his other patients and then returned to bed three, looked at Salma the RT, and said, “How’s your hand? You need a break? It could be a while before we can even open the doors to let in a ventilator, even if they find one. I’ve got a couple minutes if you need to go to the bathroom or get a drink of coffee.”

“I’d love both if you could manage it,” she said twisting her neck back and forth to loosen her shoulders.

“Sure,” Tim said looking at the monitor as he stepped up to the head of the bed and took over the Ambu bag from her.

Salma shook her right hand to get the stiffness out of it as she walked away toward the restroom as one of the other lines at the desk rang.

Cathy reached down and pushed the button to pick up the line, “ICU-2, Charge Nurse,” she said.

She listened for a few moments.

“OK. How long?”

then, “All right,” and she hung up.

“I need to talk to everyone at bed three, now,” Cathy said, in a voice that everyone heard as she began walking toward Tim working the Ambu bag.

A few moments later Sandy, Matty and Martin had joined Cathy and Tim at the bed of the little girl with the head injury.

“Where’s Salma?” asked Cathy.

“I gave her a bathroom break,” said Tim.

“OK. Here’s the deal. Some whacked out guy came in through the ER doors a few minutes ago with a gun. He shot the policeman that’s normally stationed there. I guess he fired some other shots to scare people but so far they said the policeman was the only person injured.” Cathy spoke quickly but softly enough so that only the people standing around bed three could hear.

“Holy shit!” Martin said quietly.

“Yeah,” replied Sandy.

“So the guy was ranting and raving and took off from the ER into the stairwell. They called the police already and they’re starting to get here, but they don’t really know where the guy is. He said something about his daughter.”

“Do we have his daughter somewhere?” Matty said, glancing over her shoulder at the bed with her little open-heart patient.

“They didn’t know. Maybe his daughter died here, or was here and got discharged, or maybe she’s here. They don’t know.” Cathy said looking around.

“Should we let my mom in on this?” Matty said, nodding her head in the direction of the woman by the open-heart crib.

“I don’t think so. Not yet, anyway. They may take care of this without it ever involving us.”

“I vote for that.” Tim said.

“Yeah,” said Sandy again.

“So for now, the doors are locked, we just carry on,” Cathy said with more confidence than she actually felt.

“What about the emergency door back there?” Martin asked, turning his head to indicate the door with the dimly lit red exit sign over it, in the dark corner with the extra carts parked in front of it.

“That’s an exit, not an entrance. It’s locked from the other side in the corner stairwell,” Matty said. “It has an alarm too. People used to go into the stairwell to smoke and they’d prop the door.”

“OK. I’ll let you all know when I hear more,” Cathy said and turned away to make the rounds on her patients. It was 2:12 AM.

As the others turned and walked away from Tim and bed number three, Salma Ostler, the respiratory technician came out of the restroom and saw the nurses dispersing in the unit, she walked quickly back to bed three and asked Tim, “What happened? What’d I miss?”

He brought her quickly up to date as she took over the Ambu bag job.

ICU-2 was on the eighth floor of Westview Hospital and there were only two windows that looked outside in the unit because wall space was at a premium. The patient carts were arranged so that the head of the cart sat near the wall and so all of the oxygen and suction piping, electrical outlets and built-in equipment mounts had to occupy that wall space as well. None of the windows opened, they were just let a little natural light in. You couldn’t see much out of them because they were only 14 inches wide and the exterior wall was a little over 22 inches thick so it was more of a deep shelf with a clear glass back, except code forbid setting things in the windows.

However, the windows were tall enough so that if you stood on top of something, you could actually look down at the grounds on the back of the building, where the Emergency Room was. So it wasn’t a coincidence that Martin stood on the top of a rotating stool and looked down at the parking lot as soon as he walked away from the conference.

“There are a lot of police cars by the ER, and more coming,” Martin said loud enough so that the mother at the open-heart bed leaned forward and asked Matty what was happening.

“Life in the big city,” Matty told her. They were sorting things out down there. These things happened sometimes, she reassured the woman.

Cathy and Tim looked at each other across the room and both shook their heads in response to Martin’s remark from the window.

Suddenly there was a loud noise at the double doors that seemed even louder because of the subdued lighting and overall quiet in the unit. Everyone’s heads snapped around and looked at the door at the same time.

“Open the fucking door, you bastards. Let me in. I know you’ve got my girl in there.” A man’s voice shouted wildly from the other side of the door and there was more pounding and commotion from the outside.

“Oh, shit,” Matty and Cathy said out loud. Cathy looked at Tim who was standing near Mr. Chambers in bed four, because bed four was straight in from the front doors and had the clearest view who was making all the noise and also because Tim was the biggest person working in ICU-2 at the moment.

Tim looked at the front then looked at Cathy and shrugged and shook his head to indicate he couldn’t see anything through the little windows on the doors.

The main nursing desk of ICU-2 was in the shape of an open “U” set back around a corner from the front doors so Cathy couldn’t see the door directly, but she moved along the edge of the desk toward to the double doors, in hopes of getting a peek around the corner.

She was nearing the end of the desk when the pounding and cursing began again and she stopped.

“Open these doors, you fuckers! I’m gettin' pissed.” His voice was loud and slightly slurred and he sounded very angry.

Cathy picked up the phone and dialed 1-1-1-1, the emergency number for assistance with cardiac arrests and any immediate emergency.

“Operator,” came the answer and as Cathy opened her mouth to ask for help, she heard a woman scream from outside the double doors, “Jimmy! Jimmy! Go Away! Don’t do this! Jimmy!”

“Ellie, godammit! Fuckers can’t…,” the man’s voice again and then a single gunshot.

Following the gunshot, there were more screams and some yelling.

“Get back. Get away from me!” The man’s voice again.

“Hello!” from the telephone receiver in Cathy’s hand.

Cathy was startled by the voice from the phone. She’d forgotten that she’d even had the receiver in her hand.

“Yeah, this is Cathy Bolger the charge nurse in ICU-2. There’s a ---,” she stopped, thinking about what she’d heard outside the door a few feet away, “guy at the door to the unit. He’s beating on the door and I think there’s been a shot fired.”

“The police are here and there coming up to the eighth floor now. The commander said for everyone to just lock the doors and sit tight. Help is coming.”

Suddenly, there was banging on the windows of the door. The guy outside was hitting the glass with something hard. The glass was breaking but the panes stayed in place in the frames.

Several of the children who’d been sleeping now woke up, afraid, and started crying.

The mother sitting in the rocking chair next to her baby who’d had heart surgery got up and looked at her nurse, Matty, for reassurance. Matty looked at the door and then the woman, and for lack of anything more constructive to say, relied on stock phrases from her training and said, “Everything’s going to be OK. Don’t worry.” Although, she wasn’t at all sure that was the truth.

Martin and Sandy moved among the other children trying to reassure them with more meaningless reassurances meant to make them feel safe.

A moment later, the reinforced glass pane in one of the doors, was pushed out onto the floor inside the unit.

Cathy looked on in horror as a bloody hand with a pistol came through the hole in the door and waved around wildly. Then it pulled back through and the hand came in alone and started feeling around on the inside of the door for the locking mechanism, leaving trails of blood on the inside of the stainless steel. All the while, the yelling and cursing continued from the man at the door. It was something out of a movie.

By that time, 12 out of the 15 children in ICU-2 were awake and crying due to the scene at the door.

Cathy realized that she still had the phone in her hand and she put it back into the cradle and moved off quickly toward the patients to help calm them down.

As she ran across the floor to reach the patients, she heard a collective gasp and she stopped.  She turned around and saw the door was open and a tall thin bearded man with long stringy hair was coming through the door. He had blood smeared on his face and hands and he was pointing a pistol straight ahead of him, directly at her.

Cathy, who was in the middle of the open space in the unit, began backing up with her hands raised defensively away from the crazy man as he approached.

It was then that he stopped and pointing the gun straight at Cathy said, “Where’s my Sarah-Lynn? Where have you got her? You’re not taking her away from me! I’d rather die.”

“Take it easy,” Cathy said. She almost turned and pointed to the little girl but stopped herself.

“She’s hurt very badly and we’re trying to help her,” she said to the man.

“She’s fine. She needs to come with me. Where is she, bitch?” the man said and he started walking toward Cathy.

“She’s not fine, she might even die if you try to take her away. You need to leave here now and let us take care of her,” Cathy said, trying again to reason with the man. He just kept walking toward her and he was about six feet from her now.

Martin Keesler, RN was 25 years old, divorced with no kids and not an aggressive man by any measure. He’d worked in the ICU for two years, all of them on nights.

If he saw trouble on the street, he’d steer away from it, but he couldn’t ignore what was happening here. Though he wasn’t close friends with any of the people he worked with, he liked them and thought they were all good nurses. He had reservations about stepping in between the crazy man and Cathy, but realized that if the man got past Cathy, he might just turn his attention to the kids and Martin couldn’t let that happen. No matter if he himself got hurt or not.

Tim felt a responsibility as the largest man on the unit to respond to the threat the man posed. It may have been some misguided sense of chivalry, but it echoed the way he was raised. He didn’t feel like he had a choice and so he decided he was going to have to go against the man. No matter how it went.

Both Tim and Martin started moving toward the man, though somewhat hesitantly. Both of them had their eyes on his gun.

Cathy once again began backing up slowly to postpone the contact, but she knew she was backing up towards the patient beds containing kid, and she didn’t want to have this confrontation right on top of some sick children. She kept thinking that the police must get there soon.

The moment of crisis was imminent as the man with the gun was about to reach Cathy, and Martin and Tim hurried to get between the man and Cathy.

Matty and Sandy, who both had, a few moments before, decided that it would be best if they stayed closed to the children in their beds, watched the convergence of bodies taking place in the middle of the room and could not contain themselves any further.

Sandy had become friends with Cathy through work and figured that Cathy would help her if she got into a scrape so she needed to show some support even though she was afraid.

Matty was married and had two kids. Her father had been a drunk that slapped her mother around and then crawled back repentant when he sobered up. Matty had grown up hating men who pushed women around. So, when she saw the armed man advancing on Cathy, it was reflex that sent her to Cathy’s aid.

Only the mother at the bedside and Salma the RT did not rush to join the knot of people heading toward collision. Salma kept squeezing the bag that was keeping Sarah-Lynn alive and the infant’s mother lowered the side of the crib and leaned over her daughter’s body as if to protect her from the crazy armed man while being careful to avoid pulling on any of the tubes and wires that were attached to the little girl.

So, in the open space just a few feet from the ends of the patient beds, they all came together. The crazy armed man reached out and grabbed Cathy right arm with his free hand, Tim grabbed Cathy by the left upper arm and pulled her backwards away from the man at the same time Martin came in from the side and grabbed the man’s right hand holding the gun. The whole time, the man was yelling unintelligible curses and the all the children who could, cried and screamed loudly.

The other two nurses, Sandy and Matty, were gaining speed and were a few feet away, when what sounded like the voice of God was heard, “STOPPPPPPPPP!”

In a split second, all movement ceased. Almost as in a miracle, the knot of four people froze in place in an almost impossibly complex arrangement. Matty and Sandy tried to stop their forward movement. Sandy skidded into the group while Matty lost balance and fell to the floor at their feet.

There was instant silence as the crazy man stopped in mid-curse and the children shocked by the ferocity of the command, stopped crying with their eyes wide and their mouths agape.

Everyone’s head turned to the source of the voice back by the nursing desk, and they beheld what seemed to the Fifth Member of the Apocalypse, unmounted and clad in glowing white.

There stood Harriet Beecham, straight and tall, head drawn back, chin up, beneath one of the few recessed ceiling lights on at this time of night. The group gasped together at the shock of the sight.

Clad in her crisp white uniform and winged hat and holding a clipboard against her side in a bent left forearm, she might have been one of the Valkyrie, the warrior maidens from Wagner’s Ring Cycle, come to sort the living from the dead and reward the valiant.

“Just what do you think you are doing?” She spoke and eyebrows rose among all those who were conscious. Her voice was loud, but she was not shouting.

“THIS!” she announced in a manner that clearly indicated that there would be no rebuttal, “IS - A - HOSPITAL!” Beecham pronounced each word, strongly and distinctly, as if each were a separate line to be carved into a tablet of stone and taken down the mountain to a population waiting for guidance.

Cathy began to say something but stopped.

“THIS BEHAVIOR WILL END NOW!” and that was the benediction. Tim could have sworn that he saw a chart lying on the top counter of the desk -- vibrate and move a couple inches along the surface as she said this.

Everyone let go of everyone else.

The man shook his head as if just coming into consciousness and pointed the gun at her with a confused look on his face. “I’m here to get my …”

Beecham took a single step toward him, fixed her withering gaze upon him and interrupting him, said, “Put that gun on the floor. Guns are not allowed in the hospital. Who are you and why are you threatening my nurses?”

The man lowered the gun and set it on the floor and looked at the floor at her feet. He spoke slowly.

“I’m Jimmy, I mean James Jeffries. My daughter’s here and …”

The police appeared at the door behind Beecham and ducked their heads around a couple of times to check out what was happening inside the unit. They began to slowly enter with guns drawn and peering nervously around into corners.

“You do not come into my hospital and disrupt our work,” Beecham said, her eyes squinted fiercely. 

The police moved past her, giving her wide berth as if they were trying to avoid her gaze and quickly put Jimmy Jeffries into handcuffs.

Jeffries was led away from the scene and out through the doors, by four officers.

“Thank you for –,” Cathy started and then stopped, unsure of how to phrase what happened.

“Please clean the blood off the door. I will call maintenance to fix the door. Then you’d better get back to your patients. You have barely three hours before report and I’m sure you’re behind.” She looked around at the kids that were awake in their beds. “You children close your eyes and go back to sleep. Everything is just fine.” Beecham said, then turned quickly and walked out of the unit, shoes squeaking rhythmically with her stride.

The entire staff of the ICU-2 night-shift was frozen in a confused group in the open space as the unit suddenly became quiet again.

“She’s right. We better get moving.” Cathy said.

“Wow!” said Martin, “Day shift will never believe this.”

***