Obviously, I'm going to have to write another one to go with this...but here' s this one anyway....

"ER"
"Out of Control"
by Robin

Carol:

Another busy day in the ER with everyone bustling about and grabbing things they needed for the day. I was sifting through the mail and found a letter addressed to me. It had been returned from my old apartment address and forwarded to the hospital. I didn’t recognize the return address, but I recognized the handwriting. It was from John Taglieri. It had been almost two years since he had walked out on our wedding, but he still kept in touch. He dropped a note or a card to say hello and fill me in on what was going on in his life. I smiled as I opened the note and read over it.

"My Dearest Carol - Just a note to stay in touch with you...I do think about you almost every day and wonder how you are and if things are going all right for you. Should ever our paths cross again, I hope we can just smile and be friends. I did take your advice and I got a cat from the pound...something to put life into the house. I do miss you, Carol. And even though you will never love me I hope you know I will always be here for you. All you have to do is call. Love always, John"

I smiled and folded the note to return it to it’s envelope. Then I reached to put it in my purse to take home and answer later. Tag was someone special in my life. He had given me strength at a time when I really needed it and that was something I would never forget. My thoughts were broken by the sound of Mark Greene’s voice in an irritated state.

"Has anybody seen Doug Ross?"

This was becoming a daily question around the ER. Although Doug had yet to fail in showing up for work, he was cutting it pretty close lately. He always seemed to be running late and he always looked like something the cat dragged in when he got here. His eyes were beginning to sink back into his head and sported deep, dark circles around them. And he didn’t talk much anymore. He always seemed to be sullen and reclusive. More than once I had heard Mark ask him ‘what’s going on with you?’ but he never had an answer.

"Not this morning!" Kerry Weaver shook her head. "Is that anything new?"

"When he gets here, I want to see him" Mark gave us a quick nod and turned away.

"Like he thinks it’s going to do any good" Kerry scoffed.

"Doug listens to Mark" I offered quietly.

"And then does as he pleases" Kerry nodded as she started away. "If Mark starts docking him, that might wake him up" she added as she went down the hall.

I sorted through Doug’s mail to put it in his box. There were the usual newspapers and magazines for Pediatricians and there was a letter from Hope Children’s Hospital in Pennsylvania. Almost everyday there was mail for him from another hospital. It made me wonder if he was looking to leave County and go someplace else. I hadn’t really talked to him lately...maybe it was time I did that.

He came in about twenty minutes later and nearly a half hour late to start his shift. I followed him into the lounge and stood at the door as he hung up his jacket in his locker.

"Mark is looking for you" I told him quietly.

"OK" he nodded without looking at me. "Thanks"

"Doug, are you OK?" I asked him curiously.

"Do you care?" he shot back at me...not angrily...but annoyed just the same.

"If I didn’t care I wouldn’t have asked" I told him truthfully.

"Trying to clear your conscious, Carol? So that if anything happens you’ll know you tried to find out a way to prevent it?" he turned around and gave me a very sarcastic smile. "I’m fine"

"You’re not fine" I shook my head. "Just LOOK at you! You’re a mess, Doug. You’re always late...you have raccoon eyes...I’m really concerned about you right now"

"I appreciate your concern" he told me quietly. "But I can take care of myself"

"You always smell like breath mints. Are you living on them now? Using them to cover up the fact that you’re drinking your breakfast now?"

"What I do outside this hospital is nobody’s damn business" he told me sharply. "The only thing you people need to concern yourself with is what I do inside these walls...and I don’t think anybody has any complaints with that so far"

"You didn’t learn anything from that episode with Nadine, did you?" I felt angry at him now and I was sure my face reflected that.

"Yeah" he nodded sarcastically. "I learned that everybody in this hospital walks on water and I’m the only ‘Bad Boy’ around here"

With that he pushed past me and went on out the door. I shrugged my shoulders lightly and went out the door and back to my desk.

Doug had been spinning out of control for quite some time. I wasn’t really even sure how far back it had started. He just had been drinking more heavily than usual. He never showed up for work drunk or anything, but he was seldom sober away from the hospital. He had been become reclusive...never associating with any of us away from work anymore. He used to do things with Mark but he had pretty much stopped that too. He never went with us to Doc Magoos anymore. And he rarely had anything to say to any of us that wasn’t patient regarded. The latest incident had been a woman he brought into the ER in a seizure. They had been drinking together and Doug had taken her back to his apartment with him for sex. When she went into a seizure he brought her in but she died soon after he got her here. A blood test revealed she had cocaine in her system. When Mark demanded a urine sample from Doug, he had become very belligerent. None of us could believe that when asked he did not even know this woman’s name or who to call in an emergency. This kind of irresponsibility from him was just the breaking point for most of us. Each one of us had taken our shot at reading him out over this until he just had retreated completely away. I was angry at him but I was more concerned for him. He was so completely out of control I didn’t know if he could be reeled back. And I dreaded to think of the consequences. But, Doug was a big boy...I had to assume that he knew what he was doing. And no one could help him if he didn’t want our help.

I went down the hall to the supply room and while I was gathering up the things we needed to stock the exam rooms, I overheard the conversation between Doug and Mark outside in the hall.

"Where the hell have you been?" Mark demanded. "You’re a half an hour late!"

"I’m sorry" Doug responded. "I overslept"

"Because you were sleeping off a hangover" Mark was emphatic.

"That’s none of your business"

"When it makes you late for work it becomes my business! What is going on with you, Doug? This is all odd behavior even for you"

"I thought this was what you expected?" Doug’s voice had a disturbing sneer to it. "After all, I just low life scum, isn’t that what you told me?

Something you scrape off the bottom of your shoe and throw away?"

"I don’t think I ever put it quite that way..." Mark sighed.

"You might as well have. Look, Mark, what I do in my time is my business and none of yours so just back off!"

"OK, I’ll give you that much. But if you’re late for work again, I’m docking your pay! Is that understood?"

"I hear you" Doug nodded shortly.

"And I expect you to make up the time you missed today before you leave here!"

"Yes, sir!" Doug gave him a mock salute.

Mark shook his head and went off down the hall. Doug dropped his head and heaved a heavy sigh. I got the impression this tough act was starting to wear him down. He pinched the bridge of his nose with his thumb and forefinger and shook his head just slightly before going on off down the hall back to work.

Later in the day, several patients later, he stopped by my desk and leaned casually on it to speak quietly to me.

"Do you have any aspirin?"

"Sure" I nodded. "You need some?"

"Yeah...I got a pounding headache" I shook out two aspirins and gave them to him. "Thanks"

He went down the hall to the water fountain, leaned over for a drink, popped the pills into his mouth, and threw his head back to swallow them. He stood still for a minute, like he was either collecting his thoughts or getting stable on his feet, and then he went on down the hall.

I went looking for him later when I hadn’t seen him for a while. I checked all his usual places...supply room...empty exam room...broom closets...but he wasn’t in any of them. Finally, I ventured out onto the roof...someplace I knew he liked to go when he just needed to get away or maybe to think. He was standing at the edge of the helicopter port, leaning on the rail on both arms, just looking out blankly at the Chicago skyline. I walked quietly up behind him, pulling my scrub coat around me against the whipping wind. I stood beside him and looked to see if I could figure out what he was so focused on but there was nothing there. Just like when I looked into his eyes...there was nothing there to see.

"Doug?" I broke the silence quietly. "Can I talk to you?" he looked over at me with a nodding look.

"I don’t suppose I can stop you anyway" he shrugged.

"Doug, what’s going on with you? I don’t think I’ve ever seen you like this. You’re sullen and brooding..."

"And why do you suppose that is? It wouldn’t because all of my co-workers are treating me like I have a contagious disease or anything, would it?"

"OK, I admit maybe we’ve been a little harsh lately..."

"A LITTLE harsh?" he chuckled.

"It’s for your own good, Doug..."

"For my own good" he nodded. "And how do you figure that?"

"We’re just trying to get you to wake up and realize that you are throwing your career away....throwing your LIFE away..."

"Yeah, well, you know what? It’s my life. I think that’s one thing I still have the right to control, don’t I?"

"But, that’s just it. You’re out of control!"

"Well, what do you care anyway? Isn’t this what you expected out of me? Isn’t this why you didn’t want me in the first place?"

"Doug, I DO care about you...I care very much...you’re my friend and I don’t want to see anything bad happen to you if I can help it..."

"If you can help it? So, this is a plea to make your own self feel better! So that when something happens you can say ‘well, I tried and he wouldn’t let me’ so that makes it all better? You want to stand there and lecture me for my conscience when you’re just trying to clear your own?"

"Doug, WHAT is wrong with you?"

"All of you is what’s wrong with me! All of you high and mighty perfect people who never made a mistake in your whole damn life!" he yelled loudly at me, waving his arms in the air.

"I’ve made plenty of mistakes!" I was yelling now. "And I don’t pretend to be perfect! But I also don’t sleep with people that I don’t even know their name!"

"Well, shame on me!" he retorted. "Like I’m the first to ever do something like that"

"I’m sure you’re not" I shook my head. "But, Doug, I don’t think you realize the seriousness of what happened with Nadine. Don’t you understand that you could have been charged with negligence? Or even manslaughter? You could have gone to jail..."

"I didn’t give her the cocaine! I didn’t cause her seizure!"

"OK! That was determined! But do you have any idea how it looked in the beginning?"

"Only to warped minds"

"Come on, Doug, be fair. If a man had brought a woman into the ER and you treated her, what would you have thought? You would have gone after the man like a maniac and you know it!" he was quiet now. His head down. He seemed to be listening. And thinking. "You need to get some help, Doug"

"Yeah" he nodded slowly. "You’re right"

"There’s plenty of places you can go...anyone in the hospital can refer you somewhere..." he pinched the bridge of his nose again, like I’d seen him do earlier. "Still got that headache?" he nodded shortly. "Maybe you should let Mark look at it"

"It’s just from my hangover" he insisted. "It’ll get better"

"I have to get back inside" I told him. "You coming?"

"In a minute" he nodded, then looked blankly back out over the skyline like he was doing when I came out. "I love you, Carol" he told me just as I turned to leave. I didn’t know what to say and my silence made him turn to me. "How many times do I have to tell you I’m sorry?" he pleaded with me. "How sorry do I have to be?"

"I know you’re sorry, Doug" I told him. "I’m still waiting for you to change" and with that, I walked quickly away and left him standing there alone.

Things didn’t change much after that, except that Doug started showing up on time. But he would stop by my desk two and three times a day asking for aspirin. Concerned about this, I went to Mark Greene.

"Doug’s popping aspirins like candy" I told him quietly in a private room.

"Yeah, they usually help a hangover" Mark chuckled.

"I’m really concerned about him, Mark. It might be more than a hangover"

"Well, even if it is, what do you want me to do about it?" Mark asked me with an a touch of exasperation in his voice. "I can’t force him to have an exam. He’ll have to come to me"

"I was just concerned..."

"I know you are...I’m concerned too! He’s had to step out more than once treating a patient. That concerns me"

"Well, if it’s starting to effect his work, isn’t there something you can do?"

"Not until he kills somebody" Mark told me very matter-of-factly. "Then I can do something. He’s on a one way crash collision with a wall, Carol...and there’s nothing I can do to stop it"

Though Mark’s sounded somewhat cruel, I knew he was right. Doug was the only one with the power to do anything about what was going on with him. And he didn’t seem to want to. And thinking it over, I knew he didn’t have any incentive to want to. He felt like his friends had all deserted him. He had no stability in his life other than his job and he did seem to genuinely care about that. He had no one in his life to focus on. He came to work alone and he went home alone. I felt bad for him, but at the same time I knew this was all his own fault.

I was working at the desk later that afternoon when Doug got off the elevator down the hall. I watched him come out and he stopped and stood still for a moment, like he was trying to steady himself. He took a couple of steps and stopped again, pinching the bridge of his nose that was becoming and common action for him. He took a couple of more steps and then raised his hand quickly to his head, stopping still and leaning his other hand on the wall to hold him up. Just as I started around the desk to go to him and see if he needed some help, he crumpled to the floor in a heap.

"I need a gurney down here!" I shouted as I ran down the hall to him. "Doug!?" I leaned over him, but he was unconscious. Jerry came down the hall with a gurney as Mark came running up from the other end of the ER.

"What happened?" Mark asked me quickly.

"I don’t know. He got off the elevator and stopped a few times to regain his balance...then he just hit the floor"

"Let’s get him into three..."

By the time we got Doug off the floor and wheeled into three, he was awake. He looked up at Mark and blinked at him, his face full of confusion and pain.

"Take it easy, Doug...we’re gonna take care of you" Mark assured him in his best professional voice.

"BP 150/102" I told him. "Pulse is racing with a throbbing motion"

"OK, let’s try and get it down a little....give him an IV and tap some Procardia under his tongue"

"OK" I started the IV and cracked open a Procardia capsule. "Open you mouth, Doug" he either didn’t understand what I said or didn’t want to cooperate because he didn’t open his mouth. I took his face in one hand and pinched his mouth open by squeezing on his jaws and dripped to procardia in under his tongue. He made a bitter face and tried to roll his head away, but Mark had his hand on his Doug’s forehead, gazing into his eyes.

"Pupils...right one reacts well..." Mark leaned in with a penlight to look into Doug’s eyes, "Left one....a little slow to react but it does respond. Let’s get a CBC and Blood Gases...I also want to check his Lytes..."

"OK..." I nodded. I grabbed the syringe off the tray and turned Doug’s arm over to swab his wrist with alcohol. I noticed that his fingers were curved in just slightly and he didn’t seem to be resisting the stick of the needle to gather blood for gases. In fact, I noticed that his hand didn’t even move when I plunged the needle into his skin. "Mark..." I spoke quietly for his attention.

"Yeah?" he turned to me sharply.

"Did you see that?"

"See what?"

"His hand...it didn’t’ even move...see how his fingers are curved in like that?"

"OK, I want to get him up to CT...I want a full skull series...." Mark was barking out orders in true form and we were all responding quickly. "Just take it easy, Doug....you’re gonna be OK" Mark patted Doug’s shoulder and Doug blinked his eyes at him, his eyes still misting with confusion and pain. Once he was wheeled out I looked at Mark carefully.

"What do you think?" I asked him quietly.

"I don’t want to make any predictions until I get some of the tests back" Mark shook his head.

"The way his hand was curved in...the fact that he didn’t talk...he had a stroke, didn’t he?"

"There’s a good possibility, yeah" Mark nodded slowly, a painful look on his face. Mark turned away and angrily threw his rubber gloves onto the tray behind him. I closed my eyes against the pain that suddenly ripped through my stomach.

I went back to the desk and tried to work, all the while watching for the test results to come back down from upstairs. After the CT scans were done, Doug was returned to a room close to where I was working. I could look up and see his bed. He lay flat on his back, staring up at the ceiling, his eyes fluttering lightly. His right hand kept flexing and turning. It was never still. And his left hand never moved.

"Are any of those test results back on Doug Ross yet?" Mark asked me from the other side of the desk.

"Not yet" I shook my head. "I’ve been watching for them"

"Well, Damn it to Hell! What’s taking them so long!" Mark pounded the desk in frustration.

"I’ll let you know as soon as I see them" I promised him.

"OK" Mark nodded and started away. "Keep an eye on his vitals, OK?" he turned back to me.

"OK" I nodded to him.

I went around the desk and into the room where Doug was resting to check his vitals. His eyes picked me up at the door and followed me all the way over to his bed. I smiled down at him as I looked over the machine beside him for numbers.

"How are you feeling, Doug?" I asked him quietly. "Any better?"

He tried to tell me something, but his mouth didn’t seem to do what he wanted it to do. The left side of it just kind of stayed in one place. When I looked at him, I noticed the left eye was drooped slightly in a downward slant on his face.

"Are you in any pain?" I asked him. He shook his head ‘no’. Then he took his right hand and pressed his fingers to his lips, giving me a desperate look from his eyes. "Yeah, I know, but, it’s OK you can’t talk right now. We’re gonna take care of that, OK?" he nodded slowly...yeah...’ok’...he was telling me. I smiled at him and touched his head reassuringly. "Everything will be OK, Doug. Don’t worry" I wrote down his vitals and walked out of the room.

When I got back out to the test, an envelope packet was there with the name ROSS, DOUGLAS printed on the top of it. I snatched it up and looked around.

"Anybody seen Mark Greene?" I asked loudly.

"Not lately" Lydia Wright shot back at me.

I picked up the phone and punched in Mark’s pager number. He came running down the hall just minutes later, charging up to the desk with a demanding "What?" look on his face and I handed him the envelope.

"Carol, bring his chart, please! Kerry! Can you look at these with me?" Mark barked out at he started quickly down the hall.

I grabbed the chart and raced down the hall behind Kerry and we all went into the x-ray room. Mark put the x-rays from the CT scan up and he and Kerry stood looking at them together. I looked up...and even I saw it...a dark spot just behind his right eye. It looked just like a little balloon filled with ink had exploded in his head and I knew that meant there was blood.

"We’ll need to check and see if that’s still hemorrhaging" Kerry told Mark emphatically.

"It’s not" Mark shook his head. "There was no blood in the ear canal and none behind the eyes either"

"OK, that’s good" Kerry nodded. "Looks like a small blood vessel...shouldn’t be too severe...with rehabilitation he should have a complete recovery"

"Any idea how long?" Mark mumbled.

"Well, that’s pretty much up to him. You want to get him into rehab as quickly as possible"

"I guess we’ll have to keep him here in the hospital since he lives alone..."

"Yeah, he can’t stay alone right now"

They kept talking while I stood behind them, looking at the x-rays and listening. My ears started to buzz...then the noise turned into a roar. My emotions were racing and I couldn’t think straight. Doug had had a stroke. That was confirmed now.

"I better go back and tell him" Mark sighed sadly.

"Yeah...and get somebody from rehab down here to assign him to someone. We can move him upstairs later"

"Yeah" Mark nodded. "OK. I’ll go tell him"

"Do the blood gases and everything else back it up?" Kerry was looking over the results quickly.

"Yeah" Mark nodded again, his eyes dull and sad. "They do"

"OK, then, you better tell him and let him get adjusted to it so he can start working on getting better"

"OK...thanks, Kerry"

"No problem, Mark...glad to help out" and with that, Kerry turned and walked out of the x-ray room.

I stood there, waiting for Mark to say or do something, but he just stood staring at Doug’s x-rays in silence.

"Want me to go with you when you tell him?" I asked Mark quietly.

"That’s up to you, Carol. I don’t know how you feel about it right now..."

"He’s going to need some support"

"Yeah" Mark nodded. "Just like he needed it before now...and we didn’t give it to him then so I don’t imagine he’ll be too inclined to accept it now. This is going to be a hard blow"

"Mark, you know we couldn’t do anything to stop this...Doug did this to himself..."

"That doesn’t make it any easier" Mark shook his head. "I guess we better go tell him..."

Mark and I went back down the hall to Doug’s room. He was still lying on his back staring up at the ceiling. He wanted to move his left arm and he reached over with his right hand and pulled gently on the left sleeve, tugging the arm up on his chest where he wanted it. To watch him struggle like that was almost more than I could bear. We went over to his bed, Mark on one side...me on the other...and looked down at him. He looked up at me, and then over at Mark, his eyes reflecting anxiousness.

"I had a stroke, right?" He mumbled at us, his speech just slightly slurred.

"Yeah, Bud, you did" Mark nodded sadly. "But, don’t worry, OK? It’s very mild. With rehabilitation, you should have a complete recovery. We’re gonna move you upstairs in a little bit and get somebody from rehab to assign you but you’re gonna have to stay here for a while..."

"No, no, no" he groaned and rolled his head from side to side.

"It’s gonna be OK, Doug" Mark put his hand on Doug’s head to try and reassure him. "We’re gonna take good care of you..."

"Leave me alone" he slurred at us.

"OK, Buddy...I’ll give you some time to let this sink in but I’ll be back, OK?"

Mark looked over at me and motioned me out with him. I followed him out into the hall and Mark spoke in a quiet voice.

"Just leave him alone a while...keep a check on his vitals....he’ll be OK...he just has to get used to the idea..."

"OK" I nodded.

Working at my desk I could look up and into Doug’s room. He had hardly moved at all. I watched his chest rise and fall and it suddenly became evident to me that there was a shaking motion in his chest. I moved around the desk and into his room to find his face wet with fresh tears. I snatched a tissue from a nearby box and started wiping them away for him, but he reached up and grabbed my hand in his right hand and jerked the tissue away.

"Do it myself" he mumbled.

"I’m sorry" I told him truthfully. "I was just trying to help"

"Don’t need your charity" he spit out at me angrily.

"I’m not offering you charity, Doug. I’m a nurse. Taking care of people is my job" I wiped his tears away and he let me this time. "Don’t cry. It’s going to be OK. We’ll take good care of you and you’ll be on your feet in no time"

"Don’t deserve it" he turned his head away.

"Sure you do" I turned his head back to look at me. "You deserve the same courtesy and the same treatment that anyone else off the street would get from us. But you’re one of our own so you’ll get even better care"

"Do I look funny?" he wanted to know.

"No more than you ever do" I smiled at him and this time he grinned a little. "Everything’s going to be OK, Doug. You just relax and let us take care of you"

"Don’t want to go upstairs" he told me, shaking his head.

"No? Why not?"

"Want you and Mark"

"Mark and I will still be able to take care of you even if we move you upstairs...it’ll be OK...just trust me, OK?"

He reached his hand up to me and slipped it carefully around my own hand. I squeezed his hand gently and smiled down at him, smoothing his hair away from his face and giving him my best comforting look. He kept his eyes fixed on me and I just smiled back at him. Both of us knew the road ahead of him was long and rough and I knew getting him over it wasn’t going to be easy...

September 24, 1998