The ER
I left the school parking lot and considered my options on how to get to the ER. The school is not far off the interstate. It’s also on a highway that parallels the interstate and leads to the same highway I’d be on when I got off the interstate to head to the ER. Since I wasn’t super worried I opted to take the highway.
Years before my wife and I were on a date and drove down this highway to a movie theater. As we drove along I saw a chicken in the road. This is not a divided highway and at this point there is 1 lane going north, 1 lane going south, and a turning lane between them. The chicken was in the turning lane and walking away from us.
I decided to slow down and move over to the right as far as I could. For some reason the chicken decided at the last second to turn around and try to fly over the car. Chickens can fly short distances, but not very well. This one didn’t make it over the car. It hit right on the driver’s side mirror. One second there was a mirror and the next it was hanging by the wires. I never saw what happened to the chicken. I hope it was relatively unharmed.
When we got home and told the kids a chicken broke the mirror my oldest son refused to believe me.
I thought about this as I drove along the highway. Didn’t want to hit another animal.
When I did arrive at the ER and went to check on Megan, they had no record of her. Apparently I had arrived before the ambulance. This surprised me as I thought it left before me and I assumed it took the interstate since I didn’t pass an ambulance on my way in.
This was a pretty typical ER with tile floors, bright fluorescent lighting, and easy to clean seats. I remember thinking that I should take some migraine meds because fluorescent lighting is one of my triggers. The ER wasn’t super busy that morning. A few people sat in the waiting room and another person was at the reception desk filling out paperwork.
As I waited I overheard someone else come in to check on Megan. I went over to see who it was and found that the director of the Governor’s School had come. She began to tell me what happened.
This was not the simple thing I thought it was.
Megan had gone to her class and said good morning to her teacher. She was the first and only student. She put her bag down on the chair, then collapsed. No warning, no noise, just collapsed.
She hit her head on the chair and the teacher rushed over to check on her. He called out and another teacher called the office. The director went up immediately and they got campus security involved who called 911.
When the director arrived she noticed Megan’s lips were looking blue so she started CPR. The EMTs took over CPR when they arrived and it apparently took them a while to get her back in rhythm including a few shocks. Then they took her down stairs to load her into the ambulance and bring her to the ER. That is when the director left to come to the hospital.
At this point Megan still had not arrived and I started to panic. I called my wife and explained what I had been told. She had not left for the hospital yet, but that changed.
I couldn’t stay in the waiting room any longer. Felt the glaring lights and the people just sitting there like an oppressive weight on my chest. Where was she? Don’t they know how urgent this is?
I went out to the ambulance entrance for the ER and waited. It felt like an eternity. I walked back to the ER waiting to check with the school director and back out multiple times. Time was standing still. Nothing was happening. This was hell and it was never going to change.
Eventually an ambulance rolled up and people started getting out. They pulled a gurney out with a young person on it, but with all the activity and equipment I couldn’t verify it was my daughter. They wheeled past as I strained for a better look and one of the campus security officers came over and checked to see if I was Megan’s dad. It was my daughter and I desperately wanted to follow her in, but I was redirected to the other entrance.
By the time I arrived someone was waiting to take me back to a family room.
I’ve experienced the family room at the ER before. I remembered the first time many years ago when a friend found her mother unresponsive on the floor of their apartment. She called my wife from the ER and we left to be with her. We arrived just as they were taking her back to the family room. We went with her and did our best to comfort her as they explained that her mother could not be resuscitated.
As I walked into the room I couldn’t help but remember that moment. My life paused. I couldn’t breathe. It was impossible. I had to be dreaming the worst nightmare ever.
The next time I entered a family room was when my wife had an ectopic pregnancy. This was her third pregnancy following two early term miscarriages and we were so excited because she had gone further along without miscarriage. We thought this was going to be the time we had our first baby. Then the doctor told us the horrible news.
Until September 7, 2021 I think that was the worst day of my life. We were faced with an impossible decision. How to end a pregnancy we both wanted? The doctor gave us two choices and we were just sick. It wasn’t a decision anyone should have to make. We called friends and mentors but couldn’t reach anyone. Time stood still that day too. We wrestled with this decision for hours in that office.
In the end Susan’s tube ruptured and the doctor rushed her in for surgery. We were spared a decision but not the aftermath.
The doctor’s office connected to the hospital by a skybridge. Susan was rushed across and I ran to keep up. Then we waited in pre-op as the doctor argued with the anesthesiologist. That doctor was concerned because we had lunch after Susan’s ultrasound before the horrible news so it was only a few hours since she last ate. This presented a risk and he didn’t think Susan’s tube had ruptured because she wasn’t screaming in agony the whole time. Susan’s OB won the argument and they prepared her for surgery.
The doctor told me the surgery would be relatively quick. As I waited some friends finally got the messages we left and came to sit with me. An hour went, two hours, three hours passed before the doctor finally came out. It was dark out and the waiting room was empty except me and one friend still waiting with me.
The doctor was exhausted. His shoulders slumped. He led me to the family room and I froze. I couldn’t go in. I refused to go in.
The place was deserted and the doctor stopped and assured me that Susan was doing fine. Things didn’t go as planned, but she would recover just fine. He showed me pictures he took to prove the tube had ruptured. He explained how the procedure started off textbook but after he took the pictures he used an instrument to take hold of what was left of the tube which “burst like a balloon.” So they had to open up her abdomen in order to clamp off the bleeding and stop the hemorrhaging. That meant it took much longer to close up and make sure she would recover well. After that he told me I could go back to recovery to be with her as she woke up.
Standing in front of the family room I was having flashbacks. None of this was possible.
I wanted to throw myself on the floor and have a full on tantrum, but some lady I had just met was there and I needed to keep it together, so I made myself breathe and walked through the door.
Shortly after a chaplain came. He was such a blessing. He prayed with me but also worked as a liaison. He went to check and see how Megan was doing and brought drinks and snacks, not that I could tolerate anything. The room felt stiflingly warm. The air was too thick. I couldn’t breathe and thought I might throw up if I ate or drank anything.
At some point I called my parents to let them know so they could pray and I posted to Twitter to ask for prayer. My parents were planning on coming up the next day, but they packed the vehicle and drove up immediately.
The chaplain brought my wife back when she arrived and later when my parents made it he escorted them to the room where we waited.
He was the one who told Susan and I that Megan was stable and we could go see her before the life flight crew took her.
It was a short walk down the hall to the trauma room. I’ve never seen so many people working on someone. We walked in and Megan was in a normal sinus rhythm but they had to use a “bag” on her because the ventilator couldn’t breathe strong enough for her. They had to take turns squeezing the bag hooked up to the tube going into her mouth.
Sadly we aren’t strangers to medical trauma. After my wife’s ectopic pregnancy, she carried our oldest to near term. Courtnèe was born at 36 weeks and 6 days. She was a preemie by a day. Other than that one day she was healthy and strong and got to come home with us.
Alex, on the other hand, was a surprise all around. When Susan was 30 weeks along she woke me up in the middle of the night and insisted we needed to go to the hospital. I didn’t believe her at first. I thought she had a dream, but she assured me it was urgent. We arrived and they bypassed triage and went to the delivery room. As I was trying to call a sitter for 10-month-old Courtnèe, Alex was born en caul. The nurse was none to happy about catching since the doctor hadn’t arrived yet. They rushed him to NICU and the next time we saw him he was on a ventilator and had all manner of wires and tubes on his little body.
Megan looked so small and fragile in that trauma theater. I wanted to pick her up and hold her. To assure her that daddy loves her and everything would be ok. In my mind she would be fine if I held her in my arms.
They had her somewhat covered with a sheet. Her face was so swollen that she wasn’t even recognizable. There were red dots and circles all over her face and neck from blood that had sprayed out of her mouth. I couldn’t comprehend how this had happened. How could my baby, my princess be laying there like that.
With all the people working on her, preparing her for a trip on a helicopter, there was barely room to squeeze in between all the equipment. I kissed her forehead and began praying “Talitha cumi” over and over. Again I wanted to scream. To melt down. To throw myself on the floor and wail, but I held her hand and prayed.
Then alarms started going off and they pulled us away. They started doing CPR and shocked her till she was stable again. We got to go by her side and for a few more minutes. Then she crashed again.
It happened over and over. She would be stable, then crash, then stable, then crash.
They eventually took us back to the family room and we waited.
I’m not even sure how long it was before we were taken back. They thought they had her fully stable again, but she started crashing again. This time someone took us to a hall on the other side of the room where we could watch as they worked on her.
It is something family should never see. But by this point I was losing hope that she would survive and this could be the last time I saw her before they put her in a casket. I couldn’t look away. I should have, but I couldn’t.
I watched as they did chest compressions over and over. At some point her left arm had slipped off the bed and was flopping lifeless with each press. I watched as they shocked her over and over. Her little body would jerk. I watched as this amazing team fought well past reason for my daughter.
I still see this when I close my eyes. My daughter laying dead in the ER. I see the blood and I hear the urgent conversations and shouted orders. I hear a nurse call “time” and the person doing compressions switches out. Someone yells, “clear” and everyone steps away. I see that arm just bouncing up and down. A hand that once closed around my finger. Eyes that looked at me with trust to fix everything and keep her safe from all harm were swollen closed.
At some point during this my parents arrived. There was a brief period when Megan was stable again and they let them come to see her. I remember hearing my mother praying over Megan during that short visit, “come back to us Megan. Come back!”
Still she continued to crash. She wouldn’t stay stable long enough to make the flight to Inova.
I sat there in the hall begging God to save my little girl. “Talitha cumi! Little girl rise up!” I said it over and over. It was my mantra, my battle cry. “Talitha cumi! Talitha cumi! Talitha cumi!”
We were back in the hall. Susan had started getting sick and some of the staff were tending to her while more and more took care of Megan. Those heroes fought well past when others would have given up. They fought through exhaustion. They couldn’t give up when this girl had so much life left to live.
Then I heard one of the doctors say, “it’s been over two hours. Someone needs to talk to the family.”
He had given up hope.
I heard the other doctor say she wanted a consult from cardiology first. There had to be something they hadn’t tried.
The cardiologist told them to try a different medication. He was on speaker phone and I heard him say, “it’s old school but it works.” They also sent down a team to check her. One of the doctors said, “we have to do ECMO.”
I had no idea what that was at the time. I can tell you now it is “ExCorporial Membrane Oxygenation.” It’s a bypass system that oxygenates the blood. In a sense this is how babies “breath” when in the womb. The umbilical cord allows blood to flow out into the placenta where it is given oxygen and nutrients in exchange for CO2 and such. They wanted to hook Megan up to a machine that would provide blood flow, pressure, and oxygen for her while her heart and lungs recovered.
There was just one problem, Megan was 15 and technically this unit wasn’t suppose to do ECMO on pediatric patients. Part of this is training, but mostly it is an equipment issue. They had adult sized tubes to make the connections with her blood vessels.
So the doctors agued. One would say, “She’s 15, we can’t do ECMO.” Followed by, “She’s 15 we have to do ECMO.”
Fortunately the doctor pushing for the ECMO won and they came to get permission. They explained risks and the reason they aren’t equipped for this procedure on pediatric patients. Megan is a tall young woman, but she is still a teen girl, not an adult. This means certain things are still growing. She is smaller than a typical ECMO patient for the adult system they are equipped for.
ECMO was the only way she was going to live so we didn’t hesitate to sign the paperwork.
They had to send us back to the family room while they prepped Megan and did the procedure. They let us see her again after she was stable. They had to take her by ambulance to Inova because with the ECMO equipment and the additional support staff, there wasn’t room in the helicopter. There wouldn’t even be room for one of her parents in the ambulance.
After my parents, Susan, and I saw her in the trauma room with the new machine hooked up we waited outside. The chaplain came and prayed with us again and one of the ER staff came by to check on us. She had tears in her eyes. I could tell she wanted to say something and she asked for us to let them know how Megan was doing if we could.
Looking back I’m just overwhelmed at how personally they all took this. You hear that doctors and nurses have to be emotionally distant so they can make calm and rational decisions, but these heroes cared. They went beyond calm and rational. They fought far past the time others would have given up. I can never thank them enough for loving my baby girl.
We waited for them to take Megan to the transport ambulance and walked out with her. when they finally loaded her up we went to the car and waited for them to pull out. It took some time to get all of the equipment situated for the ride. We followed them out of the parking lot and onto the highway.
Later I would have an opportunity to talk with one of the nurses that went on the transport run. She normally didn’t do transport, but they needed her to watch the ECMO machine.
It’s a little over an hour from Winchester Medical Center to Inova just outside DC. It was early afternoon so traffic was light and the ambulance made good time, but there is a big difference between sitting in the front seat of the car and being in the back of an ambulance paying attention to equipment.
The swaying of the large vehicle began to make her feel motion sick and she nearly vomited on the way there. Then after dropping Megan off and doing the handoff with for the ECMO the rest of the crew went to get some lunch. She struggled to eat anything due to the nausea.
I can’t share this story without thanking these people who endured so much for my daughter.
During the pandemic I remember signs going up outside the hospitals saying “heroes work here.” For many this is an empty platitude. So many nurses and other staff were used up and have walked away, but I truly believe those men and women are heroes and deserve so much more than I could ever give.