The Carmex Kid

He's Crazy!

Johnson was a schizophrenic who lived in the basement. He'd pretty much lived in the basement since puberty has set the chemical balance in his brain on fire. His parents only heard whispers of his coming and going. They noticed food missing. That was how they knew he was OK. Slowly, they noticed that less and less food was missing.

They set up a little surveillance to spy on their child. What are parents of schizophrenics to do?

Johnson hardly got out of bed at all and when he did he walked with a pronounced limp. God help them, but they were going to have to see what was wrong. Disturbing the routine of Johnson's type of schizophrenia was always a major ordeal.

With the help of the police and fire crews Johnson was brought in to the ER. His testicles were the size of very, very large softballs. I would say "cantaloupe" sized but I hate to compare gonads to food.

Testicular cancer.
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Surgery and therapy went well. Johnson actually handled the routine of the hospital with amazing grace. Staff worked hard to give him some routines that might help him cope with being out of control. Carmex was his mecca. He loved smearing the caramel flavored variety on his lips. Every few minutes or whenever people made him nervous the Carmex came out.

We took care of him in the ICU for a week or so which is where I met him. He moved down to another floor after he stabilized. That was fine with me, examining a crotch in fine detail first thing every morning was beginning to invade my dreams and give my hard boiled eggs an unhealthy association .
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The overhead speakers blared the warbling tone that is a mix between old school and science fiction. "CODE BLUE, CODE BLUE."

I wonder why we bother with the code system. Presumedly, it spares the docile masses from the knowledge that someone is having their first face-to-face with God a few feet away. Supposing that there may be a few people in America who haven't saturated themselves in medical drama shows - someone, somewhere might not know what a code blue meant. However, the sudden rush of nurses, doctors, and respiratory therapists just might give it away. Sure, we don't yell "STAT" like the TV shows and most people look like they may be wiping pizza off their mouths instead of coming from an exotic surgery but even Paris Hilton can figure out that the free ice cream is in the cafeteria not a patients room.
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I was the first one there. Well, a moment to clarify. I was the first person who could manage the code on the scene. There were several nurses and aids standing around looking at poor Johnson. He was still breathing and had a very weak pulse. His blood pressure was in the toilet.

I put him on the monitor I had carried up and about that time others started to arrive. "Let's get him a fluid bolus," I said to no one in particular. I am tempted to write "Stat" so that everyone reading this will feel like they are reading some high drama.

Dr Blue finally got there after the fluids were started. He really wasn't needed at this one. It was a near arrest. No intubation needed. Us nurses can follow the ACLS guidelines as well as anyone else. As he backs out of the room he catches my attention, "Go ahead and start him on dopamine and get him to the ICU."
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The trip to the unit was uneventful. I was going to be taking care of him in the ICU at least for awhile. The dopamine and fluid had brought his blood pressure up to the low 100's systolic (the top number). He was talking to me as we moved him into bed. Johnson was an adult but his innocence and mentation was closer to a ten year old.

It took about 10 minutes to get him hooked up to all the equipment. "Can I have some water," he said.

Not just no, hell no. You just brushed up with death and ruined half the hospitals lunch, I thought. "Let me see but it will take me a few minutes," is what I said.

The chart was thrown all over two desks. Good god, a small forest was hacked down to document all Johnson's care.

"I am going to go look at your chart." I pointed to the desk a few feet away - I mean spitting distance. I could hit the desk with my morning stream if you know what I mean.

"Ok," he replied meekly.

"Can I have my carmex?" Oh yeah, I forgot the Carmex. How could I forget the Carmex? I found the tube laying next to some meds I had pulled "just in case." The Carmex was probably the most essential item there.

As I walked out Johnson looked up at me again. "Do you need anything else?" I said.

Johnson looked around the room, his eyes roving to every surface. The move was more over the top than Mel Gibson in Conspiracy Theory.

"Close the curtain, I don't want them to watch," he said.

Freak. What an nut. I pulled the curtain partially closed. From my desk I could lean forward and see Johnson. Now satisfied to see him smearing more Carmex than Tammy Fae I walked over to the desk.

"CODE BLUE ICU, CODE BLUE ICU"

What the hell. I hadn't even sat down. There were 20 patients in our unit. We started scrambling to see who had tried to check out without paying the bills. I took a quick glance in at Johnson to make sure he wasn't freaked by the alarm.

"$#^@, it's Johnson," I said as I ran in the room. The Carmex was still in his hands but his paranoid eyes had changed into that distinctive fish look that I had seen so many times before.

An hour later I am sitting at the desk looking at the paperwork. Johnson was the first patient of mine who had ever died. Sure, I had seen dozens... maybe hundreds of people die but none of them on my watch. None of them under my care.

None of them ever said, "Close the curtain. I don't want them to watch" 20 seconds before they simply went asystole.

I had my own come to god moment that night. What the heck did he mean? Why did he have to say those words? Why do I get the feeling that this freaky young man knew that the valkeries had roosted upon his IV pole and were simply waiting for me to leave the room. If I had turned around would I have seen Brunhilde taking him by the hand and saying, "Your war is over troubled one. We have a seat for you next to Odin in the halls of Valhalla. You earned it."