Stitches

LaVieEnRose

On your average day, my ER is not active. We're pretty under the radar as resort towns go, especially this time of year when it's too cold to get in the water. Most of the traffic we do get is tourists, since this town has a permanent population of about six, and that includes me and the rest of the hospital staff, but for anything major we have to send them to a bigger hospital about twenty miles away, so...it's a lot of weird rashes and swimmer's ear.

And then every once in a while something actually happens in this town, and there's a five-car-and-one-school bus accident and we're the closet hospital, and all of a sudden our ER is flooded, and it's very exciting for everyone. And this was that day, and the ER was seeing more activity than it had in a month, which meant the two guys who came in for something unrelated got triaged by Katie and were determined to not be dying, so they weren't getting seen any time soon. I didn't pay much attention to them, honestly. The taller guy had his jacket halfway off and slung protectively over the blond one who was tucked under his arm, so that was kind of sweet, but I was a little busy trying to figure out if the EMTs had found the foot of a guy who came in without his, soooo...

But at some point during the evening I was behind the intake desk trying to reach the family members of people in the accident, and I looked up and the blond guy was standing in front of me, leaning on the desk. He looked pretty wrecked, shaky and pale and sweaty, which on an ordinary day would have gotten him a VIP ticket through, but, like I said. Not an ordinary day.

But then he said, “My husband...there's something wrong with my husband. I think we've been waiting for a long time. I think there's something wrong. I'm here with my husband.”

“Okay,” I said. I looked where I was pretty sure they'd been sitting, but the seats were empty. “Where is he?”

He stared at me like he wasn't quite sure if I was there. “Um, it...he cut himself. I cut him.”

“You cut him?”

“I had a knife.”

“You had...sir, are you saying you attacked your husband?” I put my hand on the phone.

“I'm sorry, I don't...” He wobbled and steadied himself on the counter. No matter what he'd done to husband, he certainly didn't seem like any sort of threat now. He could barely stay on his feet.

I noticed a medical bracelet on his wrist. “Can I see that?”

“Can you...what?”

I looked back at where I was pretty sure he'd been sitting, but the seats were empty. “Sir, where is your husband?”

He just said, “I'm sorry,” again, but a second later the question got answered for me. ”Where did he go?” a voice barked out from across the waiting room, and just about everyone jumped...except the guy in front of me, who didn't react at all.

The tall guy was standing in the middle of the waiting room, one hand wrapped in a towel and held to his chest while he looked around, the expression on his face somewhere between frantic and murderous. “The guy who was here, where the fuck is he?”

I waited for the blond guy to say something, but he still didn't react, so after a beat I put my hand in the air and said, “Um, sir?”

He looked at me and his face relaxed and then hardened again in a second, and he speedwalked over to me. He put the hand he wasn't cradling on the smaller guy's shoulder, and he startled and looked up at him.

“Justin,” the taller guy breathed, and he pulled him in briefly before he held him out at arm's length and looked at him intensely. “Go sit down.”

“I don't...”

“God, how are you fucking...Look at me.” He pointed to the chairs. “Go sit down. You understand?”

“Sit down?”

“Yes.”

“Yeah. Yeah, okay.” He started to go, then stopped and touched the towel around the other guy's hand.

“No. Sit.”

Justin nodded heavily and went over to the chairs. He was unsteady on his feet, and the other guy watched him until he'd sat down and folded up, his face hidden in his knees, and then sighed and ran his non-swaddled hand down his face. “Did he say anything?” he said to me. All the panicked energy he'd had a minute ago had drained right out of him.

“Sir, what's your name?”

“Brian. Kinney. That was Justin. Did he say anything?”

“Did he hurt you?”

“He talked to you. Out loud?”

“Out...”

“He's Deaf. He didn't mention that?”

“No, he didn't—”

“Christ, Justin.” Brian exhaled.“What did he say?”

“He said he hurt you. Mr. Kinney, is there someone you'd like us to—”

“Jesus, he's so confused. He didn't hurt me. He was holding a knife and he had a seizure and I grabbed it before it fell on him.” He considered his towel-wrapped hand. “Poorly.”

I looked over at Justin. “He had a seizure? Did you tell that to the triage nurse?”

Brian set his jaw. “He's not the patient.”

“If he had a seizure he needs to be checked out.”

“He's epileptic, he has a lot of seizures.”

“Even so—”

“He's allergic to everything and he's immunocompromised. You don't have his records, you don't speak his language, and I know what he needs. Nobody is laying a hand on him, you understand? Just leave him alone.”

“Mr. Kinney...”

“I wouldn't have brought him here except we're here alone and I couldn't leave him and I needed to...” He looked away, them back at me, hard. “It's my right hand.”

“I understand.”

“No you don't, I....he's Deaf, our friends are Deaf, my kid's Deaf. This is my signing hand and it needs to be okay.” He kept looking at me, like if he were serious enough I could click my heels together and un-stab his hand.

“I really think Justin should be looked at,” I said.

“No. I'm getting my hand fixed and I'm taking him out of this fucking...cesspool. He hates hospitals, he doesn't know where he is, he just...he wants to go home. I just need to get my hand fixed.” Some of the desperation from before was starting to show again. He must have been in pain. Grabbing a falling knife. Yikes. He'd be lucky if he hadn't snapped some tendons.

“We're going to get you through as soon as we can, okay?”

“Yeah, okay. Thank you.” He started to walk away, then stopped and said, “Do you have an interpreter here?”

“A...”

“A sign language interpreter. ASL.”

I'd worked here for four years, since I got out of school, and this was the first time we'd ever had that request. And I hated the answer I had to give. “It's...we're a small hospital.”

He ran his hand over his mouth. “Yeah. Yeah. Okay.” He went back to where Justin was sitting, readjusted his hand against his chest, and pulled Justin into his side, resting his lips against his temple.

I got pulled in to help with one of the car crash victims, and the next time I saw Brian and Justin was when I was setting up their gurney and Stephanie lead them over. Justin was shivering, and when I pointed Brian towards the gurney, he said, “No, he needs to lie down.”

Justin looked up at him and said something in sign language, looking confused.

“You can lie down right here,” Brian said. “It's okay.”

Justin just watched him.

“You are so bad at reading lips. It's a bed. Lie down. Come on.” He guided Justin to the gurney and helped him onto it. “Jesus, easy,” he said, even though Justin wasn't looking at him anymore. “It's okay. You're okay. I know.” Justin curled up on the gurney with his arms wrapped around his head, and Brian said, “I know,” again.

I pointed to the chair, the one that's supposed to be for the family member of the patient and not the patient himself, but hey. “Sit.”

Brian did, but he still looked uneasy and his eyes kept darting over to Justin. This was going to hurt, so I figured that was probably my way to distract him.

“How long have you been married?” I asked.

He shrugged a little, watching Justin shift on the gurney. “I don't know.”

“You said you have a kid?”

“Uh, yeah, I have a son. He's thirteen.”

“And he's Deaf too?” I started unwrapping his hand, slowly.

“No, that's...that's Justin's daughter.” He swallowed and looked away from Justin and watched me mess with his hand. “Her mom...uh, she was born Deaf, it's hereditary.”

“Justin wasn't?”

He shook his head a little.

“Does he hear at all now?”

“No. And I can't sign with my left hand and he doesn't read lips, so this needs—”

“I understand.”

Justin breathed in sharply then and let it out in a whimper, and Brian winced but said to me, “He doesn't want anything, he's fine, he doesn't know he's doing it.”

I said, “You know, we have a neurologist here—”

“No. I know what he needs.” He hissed as I finished unwrapping the towel from his hand. “God.”

It was hard to tell how bad the wound was on sight. Hand wounds bleed like crazy whether or not they're serious. “I'm going to clean this up and then we'll get a doctor to take a look and figure out what our next steps are, okay?”

His brow furrowed. “What do you mean, next steps? You stitch it up, I go home.”

“Depending on the type of damage, it's possible this might need surgery.”

“I can't have surgery.”

“If you—”

“I need to take him home,” Brian said.

“You told me that what you need is to keep function in this hand,” I said, as I got a betadine swab ready. “You're going to want to do what the doctor says.”

Brian breathed out in frustration and put his head back against the chair as I cleaned off his hand. We were quiet for a few minutes while I worked, the silence punctuated by occasional noises of pain from Justin, and eventually a quiet, “Brian?”

Brian reached over and put his left hand on Justin's back. Justin started coughing, and it sounded bad, hoarse and hollow and hacking, and I raised an eyebrow at Brian.

“Pre-existing condition,” Brian said shortly. “He's fine.” I dabbed at his palm and he hissed in through his teeth. “Easy with that, come on,” he said.

“Didn't they give you something while you were waiting?”

“Yeah, but I'm not known for my pain tolerance.” He glanced over at Justin as he started to sit up. “And on the other hand. Hey. Don't look.”

Justin stared at Brian's hand, his face scrunched in concern, until Brian snapped the fingers of his left hand in his face and pointed to his lips.

“Don't look,” he said. “Are you okay?”

Justin started to sign something, then stopped.

Brian rolled his eyes and sighed. “He doesn't understand that he can still sign,” he said to me.

“What?”

“He...he's not used to be speaking in front of him, he doesn't know where he is, he's...he's used to being postictal but I'm usually not bleeding and speaking to him out loud in an unfamiliar hospital when he's trying to calm his brain down.”

Justin looked from me to Brian and back again. “Um...”

Brian looked at him. “Sunshine.”

“Yeah. Yes. Okay.” He paused. “Sunshine?”

Brian nodded.

“Okay. Yes.”

Brian tilted his head to the side a little and looked at Justin, and Justin pulled his lips into his mouth, and they held eye contact for a minute before Brian nodded and turned to me. “Can we turn the lights down in here maybe?”

“No, it's either on or off.”

“Yeah.” He looked at Justin. “Sorry. I know.”

Justin took a shaky breath and started signing, and Brian said, “Okay, there we go,” and watched him intently. It was...really cool, honestly, and the fact that Brian and I were both watching the same thing and I was getting absolutely nothing from it and Brian was understanding all of it was such a mind-trip.

Except when Justin finally stopped, Brian said, nice and calmly to him, “Okay, so that didn't make any sense.”

Justin squinted at his lips.

“You're fine,” Brian said said. “You're just scared and your brain's traumatized so you're losing your mind a little bit. Everything's okay.”

He gestured towards Brian's hand.

“It's a cut. I'll be fine.”

Justin signed something.

“Yeah, I know. I'm sorry.” Brian turned back to me. “He doesn't understand me.”

“Do you want a pen and paper?”

“I can't write with my...oh, hang on.” He took his phone out of his pocket. “God, I'm an idiot,” he said into the phone, and then held it out to Justin, who read it and smiled. “Speech to text,” he said to me.

“Smart.”

“Yeah, it took me two hours to think of, I'm a genius. Anything you want to say to him? Namely that I'm going to be fine and he can stop worrying?” He held the phone up to me.

I gave Brian a look that showed exactly how likely I was to be manipulated. “I'm going to finish cleaning this up and then we'll have a doctor here to look at it and figure out what our next steps are. We're going to take good care of him.”

Brian glared at me but showed the phone to Justin, and Justin nodded and said, “Thank you.”

“Of course.”

Justin reached for the phone, and Brian said, “No, you can still sign, I still understand you. God, you are stupid after seizures. I'm just going to text this to you,” he said, and then he hit something on his phone and smiled a little when Justin's phone vibrating in his pocket made him jump.

Justin read it and signed to Brian.

“Yeah, I know,” Brian said. “One gimp hand is plenty for the both of us. I'm going to be fine.”

Justin read the text and rubbed his circle in a fist on his chest.

“Cut it out,” Brian said. “You got a bed, I got morphine. We're going to be fine. Can you lie down now, please? You're shaking.” He watched Justin read the text and lie down, his arms curled around his head, then shook his head a little and looked at me. “He's not usually like this. He's...frighteningly smart.”

“Seizures are rough.”

“Yeah, sure seems like.” He took Justin's hand and squeezed it, then let go. “I don't know how the fuck he does it all the time.”

“How often does he have them?”

“Not as much as he used to. A few times a week, but they're usually small. He doesn't have big ones like this very often. This...was a bad one.” He took a deep breath. “He's been so sick, and we're moving in two weeks and he's been stressed and getting these headaches so I thought a weekend away might...and he likes to cook, and he was feeling okay, but he hadn't slept well the night before and that's a trigger for him.”

“That's a common one,” I said.

“He poured boiling water on himself once but I was right there this time, I could grab it. Would have fucking stabbed him in the stomach, but I grabbed it.”

“Yeah, I can see that.”

“He feels really sick right now. I've got to get him out of the light. I don't usually talk this much.”

“It's the pain. Does weird things to people. One guy once recited the whole Gettysburg address to me.”

“Yeah. He doesn't know what's going on.” Brian reached out and pushed some of Justin's hair out of his eyes. “I think he has a fever.”

I nodded and took the thermometer off the wall and ran it over his forehead. “Hundred point three.”

“God. Great. I've got to get him out of here.”

I taped some gauze over Brian's palm. “Well, I've cleaned you up here, and I didn't see any muscle.”

He shuddered. “Good?”

“Very good. I'm going to get the doctor here to look at you, okay, and we'll get you out of here as soon as we can.”

“Yeah, okay.”

I pointed at Justin. “You sure you don't want someone to look at him?”

Brian shook his head. “He hates doctors and no one here can talk to him and this isn't his hospital. He's okay. He just feels really bad.”

I let the doctor know that he was ready to be seen and stopped at the nurse's station to do some paperwork. The next time I looked over, Justin was fidgeting around uncomfortably on the gurney, and Brian got up from his chair and climbed onto it, carefully shifting Justin against him and pillowing his head on his chest.

When the doctor let me know he was heading over there and asked me to get a tray, they were still on the gurney, but now Justin was vomiting into a bedpan, Brian's arm firmly around his shoulders.

“I thought this was a cut hand,” the doctor said.

“He's not the patient.” I looked at Brian. “Right?”

“Right,” Brian said. He kissed Justin's temple. “I told you the lights were too fucking bright in here.” He held his bandaged hand out to the doctor without looking away from Justin.

The doctor took the dressing off Brian's hand and examined it while I got rid of Justin's bedpan and brought him some water and took his temperature again. Brian paused in his explanation of his injury when he saw me get the thermometer out and said, “About a hundred and one?”

“Point three, yeah. You don't even want a Tylenol or something?”

Brian laughed a little. “He's very allergic.”

“To Tylenol?”

“I wasn't kidding about it being every fucking drug. We have everything we need back at the house, I just need to get him there.” He sighed when Justin whimpered again and put his hand on his back. “I know. I'm sorry.” Justin wrapped his arms around Brian's waist and hid his face in his side, and Brian said, “Oh,” softly and rubbed his left hand in a circle on his back. “I know.”

The doctor tested the sensation in Brian's fingers and had him move each one individually. Brian complied while he kept soothing Justin, and when Justin lifted his head and signed what looked like some anxious questions, Brian kissed his forehead and guided his head back to his shoulder.

“Well, Brian, you're a lucky man.”

He looked down at the head on his shoulder. “Yeah, so I've heard.”

“Everything here looks superficial. We'll stitch it up, and assuming it heals well, the only memory of this will be a small scar.”

He breathed out heavily, then said, “Would you mind writing that down? He'll think I'm downplaying it if I don't provide him with official documentation.”

“He's Deaf,” I explained to the doctor.

Brian ran his fingers absently through Justin's hair. “He worries.”

“It'll all be in your discharge notes,” the doctor said.

Brian said, “We can go home?”

“I'll stitch this and bandage it and Charlotte here will give you aftercare instructions. And then, yes, you can go home.”

Brian took Justin's hand and moved it for him, touching it to Justin's chin and then his cheek, and Justin nuzzled his shoulder. “You have a fever,” Brian said to him quietly, and Justin watched his lips and shook his head a little, and Brian said, “It's okay,” and Justin nodded.

“Just going to give you a shot to numb this up and then I'll stitch it,” the doctor said.

Brian nodded and shifted a little, squaring his shoulders, and Justin said, “Brian,” and then pointed to the doctor and then his chin. Brian made a motion like a gun with his left hand.

“He doesn't like shots,” Justin said to the doctor.

Brian snorted and tugged Justin's sleeve. “Sunshine, it's fine.”

“I don't know what you're saying,” Justin said, barely looking at him, still focused on the doctor. “It must not be important.”

Brian laughed and put his arm around Justin's waist, pulling him into him. “You can protect me.”

Brian watched the shot and the stitching with one eye closed while Justin kept a diligent eye, every once in a while getting Brian's attention and signing something to him that made Brian laugh or wrinkle his nose. Justin mouthed “I love you,” to him, and Brian tapped their foreheads together, very gently.

Once his hand was stitched, the doctor left me to bandage it up and deliver aftercare instructions. “So, you'll need to see your doctor in seven days,” I said. “And they'll either take the stitches out then or tell you need to wait a few more days. But ten days, tops, you should be good as new.”

“But permanently disfigured,” he said with a sigh.

“Palm's full of lines,” I said. “You won't even be able to tell.”

“When will I be able to sign?” he said.

“As soon as it doesn't hurt,” I said. “Be mindful and don't pull the stitches. But I imagine by tomorrow you'll be able to do a little.”

“Good. Okay.”

“Next time,” I said. “You grab him, not the knife.”

“I grabbed him too.” He rested his cheek on top of Justin's head. “I always grab him.”

“Is he okay?” Justin said to me, softly, and he smiled when I gave him a thumbs up.

Discharge papers always take forever to get together, and by the time I brought them back, Justin was asleep, curled up on top of Brian, his breath coming in hoarse wheezes and his brow furrowed. Brian was running the fingers of his bandaged hand up and down Justin's back, playing with his phone with his other hand.

“Here you are, sir,” I said, presenting the clipboard to him with a flourish.

He signed the papers. “How are the people in the accident?”

“Mostly okay, thanks.”

“Mostly okay's pretty good these days,” he said, carefully resettling Justin as he handed the clipboard back to me.

“When are you headed back home?”

“Tomorrow, if he's feeling up to it.”

“I want you to bring him back in the morning if he's not doing better.”

Brian gave me a little smile. “No.”

“Yeah, that's what I figured. Be more careful, okay? He's very cute. Not worth losing fingers.”

Brian rolled his eyes and gently shook Justin awake. It took him a while to really drag himself back to consciousness, and he rubbed at his eyes and blinked around in confusion, first at the emergency room, then at Brian.

“Did you get hurt?” he said to Brian.

Brian laughed a little. “We'll talk about it tomorrow, okay? Time to go home.”

I could tell by the look on Justin's face that he didn't follow, but when Brian nudged him to his feet he got up willingly, holding onto Brian's arm. Brian nodded towards the exit and started to lead him out, but Justin stopped him and turned around and hugged me.

“Thank you,” he said. He felt shaky and warm and fragile, and Brian was chewing on his cheek and trying not to smile over his shoulder, and yeah, okay, I got it.

“Worth a few fingers, right?” Brian said to me, and he winked at me, put his arm around Justin's waist, and led him out the door.