Julio
 by: Miguel Sanchez

© 2005 by the author

The author retains all rights. No reproductions are allowed without the author's consent. Comments are appreciated at...

"What do you mean Doctor?" he asked.

"You were told he was to have nothing for pain and you went against my orders and asked the hospital for orders."

"The child is in pain. He needs something to make him comfortable." The paramedic said.

"At the cost of masking symptoms? I don't like seeing children in pain either but sometimes it is necessary. I'm a pediatric surgeon and that vile of blood will tell us what we need. If you are going to make this a career, you have to learn when and when not to give medication. Do I make myself clear?"

"Yes, sir. Well then doctor, what do you think it is?" The paramedic asked.

Chapter 15

 
I was getting pissed at his attitude and said "I think it is his appendix. That's why the blood sample for the CBC."

We arrived at the emergency room and the paramedic took the blood to the lab and waited for the results. Paul was waiting for us when we arrived as was Jack Williams, the ER attending, I had Nurse Betty Cruz (no relation) start another large bore IV in Jay's other arm.

The paramedic came back with the lab report and we looked at the numbers. "Are you sure this is from the blood sample you took from your pocket?" I asked.

"Yes sir," the paramedic responded.

I looked at Paul and said, "This can't be right. The white cell count should be much higher than that."

Paul read the report. "I want to draw another sample and have it repeated." Paul went into Jay's cubicle and took the blood sample himself and handed it to Betty. "Take this to the lab and watch them run the test then call me and give me the results while you're at the lab." Paul walked over to the phone and called the OR nurse. "Book me a room for an Exploratory Laparoscopy. The patient's name is Jay Sanchez and Dr. Miguel Sanchez will be assisting."

While Paul was doing this, I went and had Nurse Linda Cruz (Betty's sister) remove all of Jay's clothes so I could better examine him. This was weird. His symptoms and lab report didn't make any sense. I re-took his temp and it was up another .5 degrees. It was now 103.5. "Linda, put cool cloths on him to start lowering his temp. If we have to go in, I want his temperature no higher than 101."

Linda went to work. "May I give him a Tylenol suppository?"

"Yes, go ahead." I replied. Paul tapped me on the shoulder and we went to the changing room to get into our scrubs so we would be ready when the lab report came back.

Back at home, Steven was still crying. Ronnie was carrying the boy trying to clam him down. He went to his room and laid down with Steven in hopes he would fall asleep. Steven took Ronnie's hand and placed it between his legs. Ronnie wasn't in the mood for fun and games but if it would get to boy to quit crying, he would rub him. As he began to rub his brother's little manhood, Steven began to quiet. After a few minutes of this, he felt Steven go soft so he looked at his little brother and he was sound asleep. Ronnie soon drifted off to dreamland himself. The two of them sletp soundly until well after 8 AM.

Betty called down to the ER and spoke with Paul. Jay's CBC numbers were correct. He just stood scratching his head. After he hung up he was even more confused than before.

I had just left Jay's cubicle and say Paul shaking his head. "What's wrong?"

"These numbers." Paul replied. "They just don't make any sense. His WBC (white blood cells) should be in orbit, but they're only mildly elevated."

I went back into Jay's cubicle. Linda was still cooling him off. I took the cool cloth's off him and looked at him from head to toe. I couldn't see anything wrong. "What's his temp now?" I asked Linda.

She rolled Jay onto his side and inserted the thermometer into his rectum. A minute later it beeped. She removed it and read the number. "102.3," she said.

"Keep cooling him down. I want his temp 101 or lower so we can get him into the OR fast.

It was now 2:30 AM and his temp was down to 100.3 so we could safely operate. Paul and I went to scrub for Jay's exploratory laparoscopy while Betty and Linda wheeled him up to the operating room. At 3 AM we were ready to proceed. I was drying my hands just as a tech was getting ready to drape him. I don't know what made me look but my eyes went to his scrotum. I noticed he was bigger that I last remember. A nurse stretched the cuff of a sterile glove and I rammed my right hand into it. I walked over and felt his testicles. I felt his left first, then his right. The right was twice the size of his left. "Holy shit!"

Paul looked at me like I lost my mind. "What's up?"

All I said was, "feel this."

Paul walked over and looked. "Jesus" was all he could say.

"You start on the exploratory lap and I'll explore his skrotum. Get me a sterile cup, nurse."

I changed my gloves, as did Paul, and began our procedures. Since Paul was right handed and I was a lefty, this made things easier when we worked. While we were changing our gloves, one of the nurses had prepped Jay's groin for the surgery. What little hair he had managed to grow in twelve years was quickly removed and I really felt sorry for him. He was proud of his long awaited hair, now it was gone.

I stepped up to the table and said "scalpel." I received the knife and made my incision. At the same time, Paul was working on Jay's abdomen. Paul looked over Jay's insides thoroughly and could find nothing wrong. He checked his appendix and it was pink and healthy. I, on the other hand, found a fluid filled mass. I asked for a syringe with a 14 gague needle and withdrew a small amount of fluid. I had one of the nurses take it to pathology so it could be tested for cancer. I couldn't proceed until I had the results of the biopsy so I assisted Paul in closing Jay's belly. As Paul clipped the last stitch, the pathology department called and said everything was negative. It was just a hydrocelle.

I carefully drained the cyst then took a quick look inside to make sure there wasn't anything else that could crop up later. I noticed where the infection was coming from and I had him put on antibiotics to clear that up. I made another quick check of the area and I closed his scrotum.

It was now 5 AM and Jay was in his room and coming out of the sedation. I, on the other hand, was trying not to fall asleep. I called the house and filled Luiz in on what transpired and I heard Ronnie gasp on the extension. I told Ronnie not to worry and Jay would be home in a couple of days. He asked if he was coming home with everything he left with and I assured him he was. Paul cleaned up and went to get some sleep in the residents "on call room." I told the nurse not to wake him for any reason and that I would handle his calls. Tomorrow was Saturday so he didn't have to go to the office and I would sleep at home after I checked on his patients.

Jay slept until 7. "Ungh. What happened?" were the first words out of his mouth.

I sat up and looked at him saying. "You gave us quite a scare. How do you feel?"

Jay groaned saying, "my gut hurts and my balls are sore."

I looked at him and said. "Son, why didn't you tell me your right nut was swolen?"

He looked at his covers and said "scared."

"You didn't have to be. Haven't I taken care of you before and gotten things worked out? Ah hell don't sweat it son, here's what happened. Dr. Paul and I thought you had a bad appendix, like Steven so we had to take a look inside. Then I found your swollen testicle and was afraid of something much worse. Thank God I was wrong. You had a cyst and an infection in your right testicle. I drained it and you are on antibiotics for the infection. You should be able to go home Monday if you do well. Anything else you need to know?"

Jay shook his head no and fell back to sleep. I kissed him goodnight and wrote his orders on my way out. I checked on Paul's patients then went home.

I walked in at 10:30 and was greeted by two eager boys. I had a cup of coffee while telling Ronnie and Steven about their brother. After I gulped down my coffee, I went to bed. I had been up over 24 hours. The boys came in and kissed me before I went to sleep and I asked them to make sure I was up and awake at 4 PM.

At 4, Ronnie and Steven were waking me. I shook the cob webs from me head and went to take a shower. I soon had two boys joining me. "What's this all about, you two?"

"We've missed you, daddy." Steven said looking up at me with those big puppy dog eyes of his.

"Ronnie, you may not like what you see the next time you look at Jay." I said. "We had to shave off his hair before we could operate."

"Is that all? Y..You d..d..didn't have to c..c..cut it off did you?" Ronnie asked stammering.

I hugged him as I whispered "no" into his ear. He looked up and smiled as he snuggled his head into my stomach. We washed quickly so I could get something to eat. Although I had been up for 24 hours, it had been quite some time since I last ate and I was hungry.

Luiz had fixed dinner early. Spaghetti and meat balls with Italian sausage, garlic bread and iced tea. While he was fixing the plates, Ronnie asked if they could come with me while I went to check on Jay in the hospital. I agreed as I gave my middle child that look as if to say "you better not do what you did the last time you visited the hospital." Ronnie got the meaning of my look and nodded his head in agreement.

Luiz agreed to take care of the dishes himself instead of having the boys help. We were at the hospital by 6 PM. When we entered Jay's room, he was surprised to see his brothers with me. The both gave him hugs and kisses.

I asked Jay, "how do feel and did you eat dinner yet?"

"I still hurt and the food is worse than dog chow." Jay replied.

I sent the boys down to the cafeteria to get Jay something decent to eat. While they were gone I took a look at him. All in all, he wasn't that bad. I told him I would get him something for pain after he ate. Jay was pleased with that.

The boys returned with enough food to feed a small army or one growing 12 year old. While he was eating, I went to the nurses station and prepared Jay's pain medication. When I went back into the room, Steven was conducting his own physical exam on Jay. I took the syringe and set in down on the night stand and proceeded to have a talk with Steven. "What were my words to you before we left home?"

Steven hung his head and started to cry. "I only wanted to see what he looked like, Daddy."

"Why did you have to do that with your hand? You don't have a choice. A spanking when you get home plus you will not be allowed to come back to visit Jay. I will not have a nurse reporting you to the nursing supervisor. I thought I made myself clear before we left. Now, do you understand me?"

Steven came over and said he did then sat in the chair and didn't move until it was time to leave. I gave Jay is pain medication and kissed him good night. Ronnie gave him a kiss on the cheek and Steven hugged him. Jay looked at me as if to say "Dad, do you really have to spank him?" My look said it all. He knew I was not going to put up with this kind of behavior remembering what happened when Steven was in the hospital.

I said "Jay, you know I hate having to spank any of you."

Jay looked at me glassy eyed and said "yes sir, I know. I should have just lifted the covers. This was partly my fault."

"You didn't pull his hand there, did you?" I asked.

Jay just shook his head no before falling asleep. I kissed him and turned off the light. Ronnie took Steven by the hand and we went to the elevator. Steven looked up at me as if to say he was prepared for what was going to happen when we returned home. I looked down at him and he slipped his hand into mine. He squeezed it slightly telling me he knew what he did was wrong and was ready to meet his fate.

On the way home, Ronnie asked if it was true that Jay's hair should grow back thicker and heavier than before. I told him it was and that it should be growing in fast for him. Ronnie laughed. Since he never really had that much to begin with, anything more was bound to be an improvement.

When we entered the house, Luiz was standing there with my evening Bailey's. Ronnie headed to his room to get some clean clothes so he could take a shower. Steven just hung his head as he wandered towards his room.

"Something wrong with Steven?" Luiz asked. Very little escaped his eyes. He never interfered with the boys but was always there if they needed anything.

"Steven let his hormones get higher than his IQ at the hospital, my friend. I hate using corporal punishment but what choice to I have. Yes, I laid down the ground rules before we got there so he can't say he didn't know what was expected of him. Besides, if I hadn't said anything, he still knows how to act in public."

"Why not just sit back and listen to what he has to say?" Luiz said just as Steven came into the room in his underwear and robe.

"Daddy, I'm ready." Steven said.

I couldn't do it. As upset as I was when I saw him with his hand on Jay's groin, I just couldn't bring myself to spank him. I leaned down and picked him up into my arms and just held him.

Steven knew he was wrong for what he did and he started crying as he whispered "I'm sorry Daddy. I was wrong for not listening."

All I could do was say "I know son, I know. Please don't let that happen again."

This was the first time I ever failed to punish one of the boys. For some strange reason, I just could not bring myself to spank him. I set him down and he went to join his brother in the shower and took my drink from Luiz.

Luiz just stood there and smiled at me. "You did listen, didn't you?" he asked.

I just nodded as I held my youngest. After a few minutes of holding him , I carried him into the bathroom so he could take his shower.

There, in all his glory, was Ronnie fast asleep in the bath tub. I put Steven down and felt the water. It was cold. I lifted the drain and started running the water to rewarm the tub when he suddenly sat up.

"You startled me, Dad" he said looking down at his shrunken manhood.

Steven started giggling and pointing. "Look Daddy, Ronnie's smaller than me" he said through the laughter. He was trying to take off his underwear as he talked, but since he was laughing so hard he fell down on his butt.

That got Ronnie laughing and before long, we were all in tears from laughing so hard.

I helped Steven up off the floor and put him into the re-warmed tub. Ronnie had managed to control himself so he could stand without falling. It seemed everything someone did or said was funny and brought us all back into hysterics. The only thing I could do to bring this to an end was to leave the bathroom and that, I did. Before I closed the door I told the boys to get cleaned and dressed in a reasonable amount of time.

Luiz had a lite snack ready for us and we all ate. Ronnie and Steven cleared the table and went into their room. Ever since this round of problems with Jay, Steven seems to have reverted backwards to the insecure child I first knew.

"You seem lost in thought my friend?" Luiz said.

"That noticeable?" I replied.

"Very. Steven seems to have taken a step or two backwards. Have you thought of giving him a little extra attention. I know Ronnie and Jay would not get upset with you for this." Luiz added. "Steven is barely nine. He has never had the least little problem with his past unlike the other two. You gave Jay a lot of one on one while he was in the hospital in Recife. Then Ronnie had your attention. When Steven lost his mother, he seemed to take it in stride but never let his feelings be known."

"You are always the observant one, my friend. So tell me, how do I handle this?" I asked.

"Just be yourself. What allowed the boys to open up to you in the first place? Once you remember that, you will find the key." Luiz finished as he headed back to the kitchen.

I looked up and saw Steven coming in just a pair of underwear and no shirt. He climbed up on my lap as I turned on the television. I wrapped my arms around my youngest and realized that I had really missed this time with him. I occurred to me that I had been treating Steven like the older two and was expecting the same things from a nine year old. Luiz was observant, something I had forgotten. Steven took my hands and wrapped them around his belly. As soon as they torched his skin, I tickled him.

He started squirming and squealing. Ronnie came running into the room and when he saw what was happening, he just smiled and went back to his room. Ronnie seemed to have picked up on the fact that his little brother needed some special one on one attention. I felt a pair of lips on the back of my head and knew who it was.

Steven settled down as soon as I stopped tickling him. He started to say something and I just put my finger over his lips and said "you don't need to say a thing little one. I seem to forgotten that your only nine."

He looked up at me and gave me that smile I first fell in love with as if to say, "that's OK Dad."

It was hard not to start crying then but I managed to hold back the tears as I pulled him closer to my chest.

As Steven settled himself on my lap, I couldn't help notice that he had a bulge in his underwear.

"Am I to small for my age, Dad?" Steven asked as he lifted underwear.

I looked at him and replied saying "you are just the right size for you. A man isn't judged by the size of his penis, my son."

"I know but I am smaller than everyone else." Steven answered.

I pulled him close to me and answered him saying "that is only because of your age. You are the youngest child. Sometime soon, you will start growing there and begin to look like Jay. Do you understand?"

Steven let his underwear go and he nodded his head letting me know he did understand what I was saying then asked "but when will I be able to do squirt like Jay and Ronnie?"

I held him close and said "in a year or two."

His body went totally relaxed against my chest and I heard him sigh as he exhaled. It was hard to keep from laughing at Steven's innocent questions but I think I finally had gotten the point across to my youngest.

Steven had nodded off to sleep when I saw the 11 o'clock news coming on the television. I decided to watch the news and then carry my little one into my room and let him sleep with me. After I had Steven safely in bed, I did my nightly ministrations then went to call the hospital to see how Jay was doing.

The head nurse filled me in and I told her I would see him in the morning. She told me that Jay was sleeping most of the evening because of his pain medication.

I turned off the light and crawled in beside my boy and drifted off to sleep.

The next thing I knew, I had small streaks of sun light breaking through the curtains and the phone was ringing. Still half asleep I answered it saying "hello?"

"Dad?" The voice said. "Daddy, please come get me."

I suddenly realized who it was. "Jay, what's wrong?"

"Dad, I wanna come home. Please?" He was in tears and close to totally losing it.

"OK, son." I said trying to clam him down. I had to yell at him so he could hear me over his crying.

A nurse took the phone and asked, "who is this?

I was awake now and said "Jay's father. Dr. Sanchez. Push the call bell and get me the charge nurse NOW!"

I heard another voice and then it was on the phone. "Dr. Sanchez, Jay has had a very rough night and didn't sleep well at all. He wouldn't let us medicate him and I can tell he is in quite a lot of pain."

I gave the nurse my orders to medicate him and that I would be in directly and bring him home. It seems Jay may be taking a step backward like Steven.

I got up and went into the bathroom to drain my very full bladder. I quickly got dressed and headed for the door when I saw Luiz holding my cell phone. I took it from his hand and headed for the garage. Saturday morning traffic was light and it only took me twenty minutes to get to the hospital. I parked in the doctor's lot and headed inside.

It took a couple of minutes to get an elevator but I did get lucky and have a non-stop trip to the fourth floor. I stopped at the nurses station and wrote Jay's discharge orders then went to have a talk with my boy. As I opened the door, Jay was sitting up and dressed ready to go. I sat on the bed and he gingerly eased up onto my lap.

He wrapped his arms tight around my neck just as he had done back in Recife. Jay looked just like the innocent child I first saw in that dark alley. "Daddy, take me home." Jay said into my ear.

I picked him up and carried him downstairs to the Navigator. He slid in the back seat and lied down as I made the thirty minute trip home.

I eased the Lincoln into the garage and as soon as the engine was off, out came Ronnie and Steven. I picked Jay up and carried him into the house and set him down at the kitchen table.

Luiz, our mother hen, was asking him what he wanted for breakfast while trying to do what seemed like fifty other things all at the same time.

When Jay had given Luiz his food order, sausage and scrambled eggs with cheese, Steven came over to Jay and whispered something into his ear. I couldn't hear what was said but Steven was crying and hugging Jay at the same time. Jay was saying something to Steven and soon both boys where hugging and crying.

I got both boys calmed down and Jay whispered to me that Steven apologized for what he did in the hospital. Jay told him not to worry about it because it had all been forgotten.

Ronnie, who was sitting quietly beside Jay waiting for his chance to talk to his brother, was startled when he turned and received a wet lip lock from the oldest brother. I almost needed to get a bucket of cold water for these two as they were getting quite involved. Suddenly Jay's condition reminded him that that had not been the wisest of things to do.

Jay stood up and had his hand down his shorts holding himself and wincing in pain. I started to say something but Jay beat me to it saying "I know Dad, this wasn't the brightest move I ever made but it was worth it to kiss my love."

Luiz turned his head so fast I thought it would go flying off his shoulders. "What was that?"

I looked at Luiz and said "Why are you acting so surprised? You haven't seen the signs or are you looking for them to make a public statement to everyone?"

The two looked at each other and shrugged their shoulders and said "OK, Uncle Luiz. We love each other and want it to be like this for ever. Are you happy now?"

Luiz was not expecting the boys to call his bluff but after they did, he was standing there with his foot on his tongue and egg on his face. "I guess this will teach me when to keep my mouth closed."

Both boys went over to Luiz and kissed him on the cheek and said. "That's OK we still love you and always will."

Jay was still holding himself so Ronnie got him a pillow so he could sit on that while he ate. After breakfast, I gave him something for the pain and he was soon sound asleep.

Steven went in to make sure Jay was alright then he came and sat beside Ronnie. "Dad?" Steven started. "When are we going to get enrolled in school?"

Ronnie shot a look at him that if his eyes were laser beams, Steven would be dead.

I had totally forgot all about that. The boys birthday's, the relaxation and then Jay's emergency had made this totally slip my mind. "Well boy's, I guess this is something we can do on Monday. How does that sound?"

Steven thought that was cool but Ronnie had other ideas on the subject until Steven reminded him about football (soccer to those in the US). Soon Ronnie's attitude towards school had changed. The next thing I knew, two boys were out the door looking for their soccer gear.

Jay woke around one when his stomach started growling and his bladder was hitting over flow. I heard the toilet flush and Jay came in and crawled up on my lap. "Where is everybody?" Jay asked still somewhat asleep.

"Your brothers are outside playing with their soccer balls." I answered. "You will be able to play soon enough. I don't think you can run very well right now, can you?"

He just placed his head on my chest and closed his eyes. I laid back in my recliner and dozed off for a few minutes until Hurricanes Ronnie and Steven came into the house announcing to the entire neighborhood they were hungry.

Luiz appeared from the kitchen and glared as the two future Pele's were still bouncing their balls on his clean floor. Needless to say, they were now on Luiz's list.

I walked past them into the kitchen and said. "Don't look at me. You two should know how to act in the house." I went over and sat down and fixed a sandwich while Ronnie and Steven removed their feet from their mouths. They went and washed up and quietly sat at the table. Those two, this was not their day. But it was amusing watching things go wrong for someone else for a change.

The rest of the weekend went by very quickly and Jay went almost all day Sunday without needing any pain medication until he tried to return a kick from Ronnie and he misjudged the speed and direction of the ball. He took a direct hit into his stomach but the jarring caused his groin to begin hurting again. I gave Jay his medicine and told him no more soccer until he is totaly healed. My oldest was in to much pain to argue this with me.

On Monday, I gathered my crew and headed off to the school to get them enrolled. We met with the principle and she looked at their transcripts from Recefe. She thought that Jay would do better if he repeated the 6th grade.

He began to protest until he learned that Ronnie would be in the same class. He got very quiet because he hadn't listened to everything the principle had say before getting upset. He looked up at her and said. "Sorry, man. I should have let you finish first."

The principle just smiled. She was an older woman but was very in tune to today's children. It seemed that she was also a substitute teacher and the kids new not to try to pull anything over on this lady. She reminded me of a teacher I once had when I was about Steven's age.

I stood and shook her hand and told her I looked forward to the boys getting their education here and to call me anytime there was a problem. I was suddenly being stared at by three pair of very wide eyes. You would have thought I just sent them to meet the devil rather than enroll them in school. I think they realized for the very first time that I really was Dad.

We returned home in time for lunch. While Ronnie and Steven were getting lunch, Jay came in and said he really needed to speak to me after lunch.

I took Jay into my office and sat him on my exam table thinking he was having a problem from his surgery.

I walked over to him and he said. "No, Dad. It's not that. Friday is Ronnie's birthday."

I stood there with my mouth hanging open until I felt Jay's finger push my jaw closed. "Damn. I've done it again. I have forgotten all three of your birthdays. Steven reminded me of yours and Ronnie reminded me of Steven's. Now you remind me of Ronnie's. I'm some father."

Jay pinched my chin and said. "Your our father and the only father we want. Every time a birthday came up, one of us had been sick and it was you who were taking care of us. You took care of me in the hospital not once but twice and Steven had to have his appendix out. I would say that you had a few more important things on your mind than our birthdays. I'm glad to be around to have another birthday and so is Steven. I go into the hospital again and need another operation right before Ronnie's birthday. I need not to get sick like this again."

I looked at him saying. "As if that was really your fault. You made your point though. What do you want to do for Ronnie's birthday?"

Jay looked very serious and said. "Dad, we need to sit and talk about this, just you and me. OK?"

When Jay gets this serious, I know it is something really big.

To be continued...

Posted: 06/06/08