A Wonderful Evening at the Emergency Room
By Glenda Council Beall
“And something is sticking up on it. I can’t see what it is,” he said.
I called the caregivers on his floor at the assisted living facility where he and my sister, June, had recently moved. Nobody on staff knew about Charlie’s toe. I asked Mildred, who answered the phone, to check on him. After a few more calls to the staff, I realized I needed to take Charlie to the Urgent Care Clinic. Mildred said the staff was not allowed to do anything medical for a patient, not even bandage his toe. She said she had offered to call an ambulance and have Charlie taken to the emergency room at the hospital. He refused.
I’d have refused to go to the ER in an ambulance for a hurt toe. Charlie, however, had a problem I didn’t have. He takes Coumadin, an anticoagulant to keep his blood thinned. That’s the reason I told Mildred if she would get him ready, I’d come and take him to the Urgent Care clinic. I knew that if I called him, he would refuse to go. But if Mildred told him to get dressed because I was on my way, he would be ready.
Charlie waited at the door, dressed with shoes on his feet. I assumed his toe was wrapped in gauze. We hoisted his walker into his car, and I maneuvered through Friday evening traffic hoping to get him to the clinic by five o’clock. Charlie knew the drill. He went to the window and pulled out his billfold. He had his Medicare card out when the receptionist appeared.
I told her we needed someone to look at Charlie’s foot. “He’s on Coumadin, and he has injured his toe. We’re afraid of infection, and we want to make sure it stops bleeding.”
You would have thought I had asked her to take off his leg. Her eyes widened. She said, “I don’t think we can do that here.”
“Put your cards away, Charlie,” I said. They can’t help us.”
By then she had hurried back to speak to a doctor and returned with her face frozen in an emphatic negative expression.
“We can’t do anything for his foot. He needs to go to the hospital.”
“You mean you can’t bandage a bleeding toe?” Incredulous, I stared at the woman.
“What do you handle here?” Charlie asked.
“Well, we can’t do everything. Just like -- if you had a heart attack, we would have to send you to the hospital.” She seemed to think that made perfect sense.
Charlie looked up and stared at the woman. “If I had a heart attack, I wouldn’t come here in the first place,” he said. Charlie put his cards back into his billfold, grabbed his walker and followed me back to his Lexus.
Although he didn’t want to go to the hospital ER, I didn’t give him any choice. I didn’t know how badly his toe had been injured, but he had told me it bled all over the carpet before he realized it. That, alone, was enough for me to take him to a doctor, even if the only one was at the Emergency Room at North Fulton Hospital in Roswell, Georgia.
I let him off at the front entrance while I parked his car. When I entered the waiting room, the receptionist had met Mr. Charlie and given him papers to fill out. Although he had some difficulty getting up from the low seat he had chosen, I helped him and he made it to his walker. He led the way to sit down in a small room and give answers to another woman who entered his information in her computer. Then it was back to the waiting room again.
I felt positive we would be out of there within the hour. I saw only two people ahead of Charlie and they didn’t look very sick. In about fifteen minutes, Charlie was called and put into room 9, the last one on the hall. He was told to lie on a pristine sheet-covered cot. He lay back on the thin pillow, his thick head of gray hair resting on his forearm, looking as uncomfortable as a beached whale.
Charlie has developed a little potbelly in his later years. Carrying that paunch around has likely added to the reason for his recent back surgery, which led to his having to use a walker.
A tall dark-skinned orderly settled Charlie in, making little jokes and giving him the TV controls. He didn’t know how long before we would see a doctor. Before he left, the orderly pulled off Charlie’s loafers. As the right one came off, something flew out and landed on the floor. The young man jumped back as if a cobra had risen from the shoe.
“What was that?” he asked, coming over to peer at the blood covered object.
“That’s his toenail,” I said, laughing.
“Man, look at that thing.” He seemed quite impressed. “I guess I better keep it.”
He found a four-by-four gauze pad and picked up the long toenail and stuck it into a plastic bottle.
Charlie has small feet. His left foot was neat and clean. His right foot was bloody from his toes up to the middle of his foot. I couldn’t believe he had worn no sock over the injured toe with all the blood. I learned later that Charlie can’t reach down to put on socks because of his bad back. He wears loafers so he can just step into them and easily step out of them.
A kind nurse came in and joked with Mr. Charlie. She made a face when she saw his bloody foot. Carefully, she wiped his toe and foot until she had cleaned away all the blood.
“There now, that didn’t hurt, did it?
Charlie smiled. “No. I have neuropathy and can't feel anything in my feet."
“Shoot,” she said. “I wish I had known that. I was trying to be so careful not to hurt you.”
Forty-five minutes passed and still no doctor. Charlie and I were discussing the terrible state of the world today when Gay and Stu, my sister and brother-in-law, arrived. They had just come from visiting the Critical Care Unit.
Charlie asked no questions about his wife who was two floors above us. Gay told him June was unable to speak very well, but she did eat and tried to smile. I imagine the thought of her unable to speak was too hard for him to think about and certainly too hard to talk about. The two of them adored each other.
I told them about Charlie’s dilemma with his toenail. Charlie said he had signed up on a waiting list at the old folks home to get a pedicure, but the clerk had not put his name down, so it would be another two weeks before they would see him.
“What takes blood out of a carpet,” Charlie asked.
Stu quipped, “I think the carpet layers take it out when they put in a new one.”
A discussion on spot remover ensued. Charlie concluded he would call Stanley Steamer.
I agreed that might be the next step.
At this point, Stu spotted the long toenail in the plastic jar.
“What is that thing,” he exclaimed. I passed around Charlie’s former toenail and we all began to ask questions.
Why did the guy save the toenail? Did he think the doctor was going to glue it back on? “It’s not like it’s a finger or a part of a limb,” Stu said. “I’ve heard of saving a bullet that had been removed from someone’s head, but saving a bloody toe nail?”
I asked Charlie if he wanted to keep it and show it to his buddies. He opened the bottle and examined the contents. Then he replaced the top with the utmost care and handed it back to me. I placed it on the tray beside his bed. After all, in this world of modern medicine, who knows what might be done with a broken big toe nail?
As time passed and the wait grew longer and longer, I decided to go out and see if I could hurry them up. It helped. A doctor came. He tucked some treated gauze into the nail bed and told Charlie to soak this out in three days. He also told Charlie to follow up with his doctor. An incompetent woman in a uniform came in and would have dismissed him then and there, but we suggested she wrap his toe. Even I could see that the gauze would not stay on until we got Charlie home.
By that time it was 9:30 p.m. Four hours had passed. I was starving and I knew Charlie had not eaten all day. He could not wear his shoe home on his bandaged toe, so the nurse gave him a pair of red socks, the kind given to in-patients to wear at the hospital. He was happy with them, especially when the nurse put them on him. But he had no sooner got his hands on his walker and taken a few steps, than his sock on his injured foot came off. Gay replaced it and she and Stu escorted him outside while I hurried to the parking lot and brought his car around. They helped him into the front seat and shoved his walker into the back.
We stopped for a bite to eat where Charlie, who insisted on buying me dinner, was overcharged on the bill. The waitress’s error made our simple meal cost $7,056.00. Charlie, still with humor, told the girl, “It was mighty good, but not that good.”
Back in the car after straightening that out, we headed for the assisted living facility that Charlie called The Institution. I knew he would get some laughs from his friends as he told the story of the expensive dinner we had at Martino’s Italian Restaurant. Warmed with good wine and lots of humor, we continued to chuckle over the bill.
Charlie asked me, “Did you sign us out?”
Since I’ve not had to sign out since I was a college freshman, the thought never crossed my mind. It has been hard for Charlie to accept the rule that he must sign in and out. He ignores it most of the time and slips out the back door where he keeps his car parked.
I called the desk attendant and told him we were bringing Charlie to the back entrance. We wanted to be sure he was not locked out.
I parked Charlie’s car in his favorite spot. Gay and Stu helped wrestle the walker out, and put that cantankerous sock back on his foot once again. Being the courtly gentleman that he is, and finding humor in the most unlikely situations, our octogenarian paused at the door, turned to me and said, “Thank you for a wonderful evening.”
It had been a wonderful evening in spite of the long wait at the Emergency Room. We said goodnight and closed the door behind Charlie with the conviction that he would take the elevator up to the second floor and get off right in front of his empty apartment.
For several years he has been the caregiver. He is listed as an independent resident in this non-medical facility, where the regular staff is not allowed to bandage his toe or clean his wound.
Charlie could have benefited from the aide who normally assists his wife, but since his wife was not there, the aide would not be coming. Tonight no one comes. Eighty-eight-year old Charlie was on his own.
Published 2015 Anthology: It’s All Relative, Tales from the Tree, and Edited by Celia Miles