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  It was another twenty minutes before my name appeared and I was sitting in front of one of the phlebotomists who was poised and ready to draw my blood. She did so without much conversation and dismissed me to my next destination without so much as a “thank you, have a nice day.” I moved quickly downstairs to the next department I was to visit where another aloof staff member took three images of my chest.

  Before I knew it, I was back in my car in the parking garage, waiting for the endless sea of vehicles looking for an empty parking space to pass before carefully backing out of my slot. The bright sun sparkled off my windshield as I emerged from the structure and made my way to the main road which would eventually lead me home.

  I had no faith in Kellogg Premier. They would likely just message me later that nothing was amiss and that I just needed to stress less. That was for sure, but it didn’t stop me from wondering if there wasn’t something more involved. The clinic where I worked toiled hard to diagnose the patients and refer them out for specialty care wherever it was needed, but that place, they were a joke. It was surprising considering they were outwardly highly regarded and respected. Unless you were subjected to their sub-par healthcare, no one would ever know, and I was growing quite tired of being ignored. Something had to give, it just had to, and I quietly hoped it would be sooner, rather than later.

  -2-

  Elaine

  I hadn’t noticed it right away. It took me several weeks to get the bigger picture and what I saw concerned me. Perhaps it was all in my head, something my overactive imagination concocted to keep me on my toes at my new place of employment. While I was busy trying to explain it away, my mind was putting the pieces together. Little did I know, it was a lot bigger than I could have ever imagined.

  I took the job to get experience under my belt. A new nurse may have trouble finding good work experience in the field as most people barely spared my resume a glance. When an opportunity to work for Kellogg Premier opened up, I practically jumped at the chance, typing in the employment application, attaching my resume and submitting it as fast I possibly could.

  Kellogg Premier was one of the biggest healthcare organizations in the country. Well known, highly regarded, and I imagined it had the biggest patient base around. I had heard somewhere that it was also the least expensive in the area so practically any employer could afford to offer it their employees. That seemed strange, but I overlooked it in favor of the prospect to serve as many patients as I could, getting much needed hands-on practice. I needed that to go with my impressive grades and shortened length of time it took me to reach my goals in school.

  When the Human Resources Department called me, I was a little surprised. The competition for the positions available was surely bigger than anywhere else I could have applied but, there I was, talking to someone about scheduling an in-person interview as soon as possible. The voice on the other line was low and soothing, and I just knew I sounded far too excited. My voice was grating on my own nerves as I took down the information: where, when and with whom I would be interviewing. I thanked them for calling and hung up the phone before screeching at the top of my lungs. I had not expected to land an interview with such ease, considering I was right out of school. I was overjoyed that it was for one of the bigger health systems.

  The interview went off without a hitch. Smiling nervously at a panel of three, stone-faced individuals as they asked their questions and I offered what I considered reasonable answers. I was rambling of course, spewing forth my achievements in a matter of moments as the threesome scribbled notes onto a piece of paper in front of them. The technical questions were no sweat, I had studied hard and graduated at the top of my class, so I had plenty to say in that department. When they started asking about my character, I used that opportunity to brag about the many hours of volunteer work I had done, the projects I had assisted in and the research I had conducted while earning my Registered Nurse degree. Perhaps most impressive was the amount of time it took me to complete my studies. I had finished in three-quarters of the time it normally took and that was definitely something to boast about.

  By the end of the week, I had received the phone call I had been waiting for. It was Brenda Saxon, Lead RN herself, who contacted me. She had been on the interview panel and was very impressed with my answers and the expedited timeline in which I had finished my education. It was unheard of and yet, there I was, sitting in front of them, my grades in black and white on the pages I had given them. She noted that she did not typically contact the candidates herself, but she wanted to tell me herself and congratulate me. It struck me as odd for a moment, but in my elated state, I quickly dismissed the strange feeling I had gotten. Brenda had given me explicit instructions for my first day. I had written them down so I didn’t accidentally forget something as I somehow knew she was testing me to determine if I really would be a good fit for their team.

  It seemed to have worked as I was ushered in and welcomed by the other staff with open arms. Ms. Saxon would brag about me to others as I was introduced to another, and then another staff member. I hadn’t noticed back then, but as I sat and pondered my situation, it occurred to me that everyone operated in the same monotonous and robotic fashion as the others. It was like they were just going through the motions of their day. Not really achieving anything, not helping anyone in particular. It seemed like they were just…there.

  Ragan Jensen, that was her name. The patient who ultimately had me taking a closer look at what I was doing there at Kellogg Premier. She had presented at urgent care, where I was working that month, with what she described as a fluttering sensation in her chest. Not pain necessarily, just that strange fluttering that came and went at random. Her blood pressure was definitely elevated, and I was particularly concerned with the Diastolic pressure that had climbed to above 100. That was never good, especially if you considered the other symptoms she was describing.

  What shocked me the most, was how everyone reacted. In essence, they didn’t. I literally heard the Medical Assistant who triaged her tell her that she had seen higher, as she scribbled the numbers down onto a piece of paper to put into her chart later. Ms. Jensen appeared outwardly frustrated, unsure how to react or what to say in response to her dismissive attitude. She was led to the farthest corner of the Department, where she was left to wait for the doctor covering the floor that day. I shook my head at the notion that it seemed that they intended to do absolutely nothing for her, not even ease her distress with some kind words.

  The other nurses looked at me funny as I picked up my stethoscope from the counter at the nurses’ station and made my way toward her room. Wide-eyed, as if they were in a panic, they looked on as I reached for the doorknob and turned, pushing my way inside. I scanned her chart as I approached her, the large computer screen was already ready with her information. I took a mental note of the blood pressure, heartrate and overall symptoms she reported. In my mind, they should have moved on that particular case. She was showing signs of Cardiac issues still to be discovered and yet, no one seemed to take heed.

  I greeted her kindly as I made my way to her bedside and began to prepare the EKG leads. I pulled off the paper backing and stuck one to each ankle and had her sit back and relax as I pushed the button that would start the test. She looked at the wall in front of her, her gaze never leaving the colorful posters that hung there as I did my job. My mind was scrambling with what to say to her, but instead, I kept my mouth shut and was all business. It was almost too awkward to stand.

  Once I was finished, I smiled warmly at her and assured her the doctor would be right in, before sliding out the exit and back to my station. As I left the room, I saw her head roll to the side toward me and regard me through a glossy haze as I left the room. It was eerie, but she seemed to know the drill around there and did not kick up too much of a stink that she was waiting still.

  Eventually, I saw the urgent care provider rap on the door with the back of her hand before cracking the door and making her w
ay inside. I was relieved for Ragan. She had been waiting over two hours and was finally going to see the doctor, something I myself would have completely lost it over, but she remained calm and simply waited. There was something underneath the surface there that I could not quite put my finger on. Something that lurked just behind the veil that hunkered down into the shadows anytime someone approached.

  The back office was packed that day. There were so many patients to treat, it kept me jumping for the rest of the afternoon, but my mind continued to wander back to Ragan. Her eyes tried to tell me a story, pleaded with me to understand, but I did not take the time to figure out just what that something was. Like all the others, I carried on, moving the patients in and out of the urgent care until my shift winded down and came to a close. In the back of my mind, her blue eyes still burned into me, willing me to get an unspoken message I was not ready to hear. Not yet anyway.

  That night, as I lay wide awake staring at the ceiling, my girlfriend Riley snuggled in next to me snoring lightly in my ear, Ragan’s face floated in my mind’s eye. I wonder how many more are there like her? My overactive imagination was clearly not going to allow me to sleep as I pondered the question numerous times. As I listened to Riley breathe next to me, I closed my eyes and attempted to find my way to sleep. It would be many hours before I actually was able to, my mind kept flashing back to Ms. Jensen’s medical record that had been left open as I wired her up to the EKG. Inside my head, I could not get it into focus so the words danced slightly out of my reach as I continued to spiral down into a fitful slumber fraught with nightmares of standing in the middle of the courtyard at Kellogg Premier’s main facility and screaming at the top of my lungs. Dozens of people passed by me without sparing me so much as a glance as they moved on toward their destination as I remained, frozen in place and struggling to be heard.

  -3-

  Ragan

  A couple of weeks later, I was back at Kellogg Premier for my treadmill stress test. I had received the phone call a day or two after visiting the urgent care facility, at which time they informed me that they were to schedule an appointment for whenever was most convenient for me. Since I had a full-time job, that was an oxymoron: there was no time most convenient for me. If I wanted to get to the bottom of things, however, I had no choice but to go through the motions one fruitless visit at a time.

  It seemed to me that was all the doctors at Kellogg Premier ever did. They went through the motions, doing as little as possible to make it appear as if they were actually attempting to find out what was going on. The doctors, as well as the nursing staff, with the exception of Elaine Cooper, had done as little as possible for everything I ever went to them for. Now, if I was presenting to take part in one of the handful of procedures that they received a kick-back from the government for performing, they would have gone the extra mile to make sure it happened. Since I was attempting to get to the bottom of something altogether different, the staff moved slower than molasses in the middle of January.

  The signs on the walls guided me toward the Cardiology Department, where I stood in a short line to check in with the intake staff at the front desk. Once the woman had scanned my card and taken my co-payment, she handed me a half-sheet, laminated card with instructions on it and a large number written in bold Sharpie at the top corner of the document. I turned and made my way to the elevators on the other side of the lobby and waited for the doors to open with the rest of the group of patients that had gathered there.

  When the doors chimed and slid open, those inside pushed past us, excusing themselves politely as they went. After the space was vacated, I slid inside the car with the others and pressed the button for the basement, where the card in my hand instructed me to go. Make a left after exiting the elevator, then an immediate left again. Go down the long hallway to the third doorway on the right and enter. Hand this card to the person who comes to collect it and have a seat in the waiting area.

  It didn’t take long to find the waiting area I was looking for. Of course, the nurse who opened the large door and peered out at me appeared annoyed that I was still in my work clothes and not ready to hop on the treadmill immediately. In my defense, the card did not tell me that part, nor did the woman at the intake counter, so how in the hell would I know to do that unless I was instructed to? I dismissed her disdainful stare and walked toward the three dressing rooms on the far side of the waiting area.

  Yoga pants, a tank top and comfortable shoes on and I was ready to go. I had to wait for the woman to reappear to show her that I was all set so I sat back down and trained my attention on the images that flashed across the television mounted on the wall across from me that was accompanied by soft, peaceful music. Closing my eyes, I allowed the soothing sounds to calm my nerves as I waited once again.

  Several minutes later, she finally opened the door and beckoned me inside. I followed her down a series of hallways, twisting and turning our way around the area, before coming to a stop at a room with a large treadmill set against the far wall. Another woman sat in a chair in front of a computer monitor, clicking away at the keyboard as she copied my information into the fields on the screen. She greeted me with a quick, sideways glance and a nod before turning her attention back to her task at hand.

  The other nurse instructed me to lift my shirt up and proceeded to stick several leads to different areas across my chest and abdomen. She looped the wires together and held them out of my way as I stepped up onto the treadmill. Moving with expert precision, as if she had done the task a million times before, the nurse plugged the leads into a piece of equipment that hung at the ready on the handrail and nodded at the woman facing the monitor.

  “Ok, Ms. Jensen,” she turned her attention to me and offered me some simple instructions, “I am going to start the test now. The treadmill will increase in speed and incline every several minutes. These wires will monitor your heart, while the cuff I am about to put on your arm will keep an eye on your blood pressure. If at any time you feel dizzy, weak or are unable to breathe normally, please tell me right away and we will stop the test. Do you have any questions?” the young woman looked on expectantly, waiting for me to shower her with a barrage of questions. I really didn’t have any as the test seemed pretty straight forward. I shook my head slowly as she nodded and placed the blood pressure cuff around my left arm. Once she was finished, she nodded at the other woman who clicked several buttons and commenced the test.

  The platform I stood on started to move. Slowly at first, then the speed increased along with the incline at three-minute intervals. Periodically, the blood-pressure cuff squeezed my arm and registered the numbers at the bottom corner of the monitor in front of me. Initially, the readings appeared just above normal. Several minutes in, however, the diastolic number began to rise quickly. I watched horrified as it spiked to over 120. I wasn’t as concerned with the top number jumping to above 240, that was supposed to happen, it was that bottom number that had me concerned. It was never supposed to get that high while exercising. In fact, I had read several times that number should only go up slightly in response to increased activity. Instead, it climbed rapidly and kept going.

  Every time the blood pressure reading appeared on the screen, I heard the woman who was monitoring me directly utter the numbers and add “LBP” to her statement. That went on for several minutes before my chest began to compress and I was gulping for air. I tried to continue as long as I could, but soon the pressure became too much to bear and I was looking at the nurse in desperation. After a few minutes of trying to maintain the increased pace, I raised my hand and grasped at my chest, clawing at the tank top that clung to my sweaty skin and pulling it down.

  “Is everything alright, Ms. Jensen,” she questioned me without looking at me. It struck me as odd that she appeared to be rolling her eyes at me as she glanced down at the nurse who was sitting next to her.

  “My chest hurts, and I can’t breathe,” I managed to pant out between breaths. She sighed audibly and
pressed a series of buttons, shutting the machine down and ultimately concluding the test. She moved quickly to remove the leads from my chest but left the blood pressure cuff on and pressed the button to manually check again.

  I was struggling to regain control of my breathing. My chest and shoulders heaved with the effort as she led me backward and helped me sit down slowly on the bench behind the treadmill. I sat down, gulping for air and waiting for the pounding in my temples to subside. When they didn’t, the nurse pressed the manual BP test button again and watched as the numbers came back, still elevated. She instructed me to lay down and relax, as she was unable to allow me to leave while my blood pressure was that high. I complied immediately, swinging my feet up and turning to face the wall to my right as I eased myself down.

  When I finally left that day, I hoped that the test would reveal something, anything at all. What I was told later was that “everything was fine,” as always. Since the flutter continued, and my blood pressure was still all over the map, I insisted on a follow-up appointment with my primary. She was one of the more open providers I had come across at Kellogg Premier and I was sure that she would elevate me to the next step without much of an argument. The soft voice on the other end of the phone confirmed my appointment and repeated the date, time and location, before uttering what sounded like a rehearsed salutation and disconnecting the call.