Silent Fear, a Medical Mystery (7 page)

“What’s sep tic, Doc?” Troy asked between breaths. “That other doctor told me but hell if I knew what he was talking about.” He pointed at his abdomen like he was going to vomit, but then coughed and spit out phlegm into a tissue.

“It means you have an infection in your blood stream.” It didn’t make an impression, so Danny added, “It can be a serious medical condition.”

“Should’ve told someone my butt was in trouble, right?”

“Yes, Mr. Troy. Now you get some sleep.” Danny dimmed the light as he left.

After Danny saw a few more patients, he looked over Michael Johnson’s chart. A normal postop fever should be gone for him as well. He thumbed to the nurse’s notes, although no one had called him with any new developments. An entry from the last shift nurse mentioned Michael complaining of a headache again, or maybe it had never left. Danny shook his head - kids weren’t always the best historians. Another note mentioned copious mucous or expectorant and several entries said ‘patient sleeping.’

Danny made his way to the room farthest down the hallway with Linda following. Inside the darkened room, the long teen stared hazily at the TV. Danny stood right beside him, but the teen seemed half asleep. Michael pushed his tongue out to his lips stirring the secretions all around his mouth. “Michael?” Danny said. He received no response. Danny picked up the bedside chart. Last temp recorded - 101.8 Fahrenheit.

“Linda, have his parents been by today? I haven’t seen them in a day or two.”

“No, Dr. Tilson. Actually, I was told they went on a two day trip. They should have been back, but the charge nurse couldn’t reach them this morning.”

With Linda’s assistance, Danny removed Michael’s head wrap and found nothing amiss. “Let’s get him to C.T. for head imaging, please, as soon as possible.”

When Danny left, he ran up two steps at a time to the medical fifth floor to see Harold. He swung open the heavy door as three medical employees, a crash cart, and an anesthesiologist whizzed by. Danny made a right turn for room 525 down the hall. Visitors and a nurse putting pills into little patient cups from a cart cleared the way for all the commotion. A doc’s worried face poked out from room 525 and signaled to the group of personnel heading his way. It was Bill Patogue, the internist. “In here,” he said loudly.

Danny ran. Harold must be in a single patient room. It had to be Harold who was getting all the attention. He carried up the rear of emergency medical workers as they swarmed on Harold. Through the hands and bodies putting on EKG patches and suctioning secretions, the anesthesiologist pushed himself between the wall and the head of the bed. Dr. Patogue threw him some rubber gloves. Harold’s lifeless-like body wasn’t dead when it came to an overabundance of wet, clear, sticky secretions over his mouth, down his chin, and flowing to his ears and hair.

The anesthesiologist leaned over to the top of the red cart, grabbed a laryngoscope and an adult-sized endotracheal tube and then opened Harold’s mouth. With trembling hands, the respiratory therapist handed him the suction catheter. The anesthesiologist interrupted trying to intubate him, moved the tip all around Harold’s mouth, and advanced it further into the back of his throat. The continuous slurping sound made everyone’s heart quicken. He switched what he had in his hands again. As fast as possible using the laryngoscope, he made his way through the secretions with the tube and into Harold’s trachea. The endotracheal tube and the ventilator were now going to do Harold’s breathing for him.

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The sun hadn’t sunk all the way down past the horizon when Danny pulled into the driveway. As Casey pumped insect repellant onto a small Japanese Maple on the front lawn, Dakota ran to the car and anxiously waited for the door to open. Danny stepped out and gave Dakota a spirited greeting.

“Look at this,” Casey said after putting the spray bottle next to his sneakers. He turned over a purple leaf. “Japanese beetles everywhere.”

Danny’s finger flicked off one of the copper-colored, hard insects. “Great. What about the maples in the back?”

“Not as many, but I’ll spray those, too.”

Danny pointed over to the front step. “Mind sitting for a minute?”

Casey brought the canister over with them and Dakota followed. When they sat, Danny picked up a tennis ball alongside the path, and threw it. Dakota’s eyes tracked it while his body raced across the lawn.

“Good boy,” Casey yelled. “At least you inherited a winner, Danny.”

Danny’s eyes sparkled. “That dog has drilled a spot in my heart.”

Dakota leaped three feet into the air, caught the ball on the fly, and sprang back to Danny for more. “I’m sorry to say if you needed help around here this weekend, I’m out of the loop. I feel bad about it, too. Half the time I think I should be out of my Mom and Dad’s house anyway. Mary has more rights over it than I do. You two…”

Casey cut him off. “We’ve been through that before, so shut up about it. You getting your own place still doesn’t make sense. This place is huge. And plus, we want Dakota here as much as you.”

Danny grimaced. “All right, but after your wedding, we better talk about it again.” Danny threw Dakota the ball again, higher and farther, but the yellow fuzz was getting harder for Danny to see in the fading light.

“Harold not only was admitted today,” Danny said, “but he’s in the unit on a ventilator. I don’t have a clue what’s happened to him. And as you know, Julia was coming this weekend. I had to call Rachel and postpone because I’m going to take Harold’s call.”

Casey stretched his legs forward and leaned back on the palms of his hands. “How’d that go over?”

“She’s a trip. Julia’s worth ten times the mother.”

“Have you told Annabel and Nancy?”

“No, but they love being with you two anyway. Maybe they can come next Saturday, too. I’ve rearranged Julia’s visit for then.”

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From the moment she woke after nodding off to sleep after her alarm sounded, Rachel scrambled to make up lost time. Her one freaking day to work and she almost blew it. She threw scrubs on so she wouldn’t have to change into them at the hospital; she did the basic changing with Julia; and she ran every yellow, almost red, traffic light in her CRV’s path. During the drive, she regretted that she hadn’t had enough time to give Julia her morning bottle. When she got to work, she rushed to the OR, ready to pass instruments to her present hospital’s demanding and uninteresting surgeons.

Rachel had left hours ago when Leo cracked open his eyes. The tee-shirt and cotton bottom she wore to sleep were tossed on the bedspread and a skirt and blouse still hung on the doorknob. He figured she’d left in scrubs. He also knew her baby was crying.

After a visit to the bathroom, he went to the kitchen where the bawling baby sounded a lot louder. On the counter, he found an elegantly written note from Rachel.

Leo, I didn’t have time before I left. Would you please make Julia a bottle as soon as you get up? I would really appreciate that.

Hell
, he thought. She doesn’t even take care of her own kid. Blood ran faster in his veins while he made coffee. He found a clean bottle near the sink and
tapped it on the counter with annoyance, then ripped open a new pack of cigarettes. Julia’s crying picked up, slowed into sobbing while she caught her breath, and then pitched back into a frenzy.

Leo jerked open a cabinet, grabbed a mug, and substituted it under the dripping coffee instead of the pot. It diverted him from going in there and ripping her apart. He gulped down a second cup, which wasn’t hot enough for him, especially since he was hotter than hell. After he lit his first smoke, he tucked the pack between his ripped bare abdomen and jockey short’s waistband. Several puffs later, he downed more coffee. Julia’s distress could be heard by deaf ears through most of the house.

The Columbian blend tasted rich and smooth. He deserved this. A day where he didn’t run off to read unintelligible doctor scrawls all day and count pills like a child. But what the hell was he doing putting up with a little human being who couldn’t talk, yet could scream like the backdrop for a horror movie? That’s what he had allowed to happen in his own place. The wailing from his guest bedroom was analogous to screeching from some species living on the forest floor.

“Crap,” he shouted. He stormed across the kitchen, threw the bedroom door further open, smashing it into the wall, and ended beside the crib. Shut up, he silently said as he grabbed Julia’s arm. But she didn’t. His temper swallowed his thoughts as he went for her arm. His hand encircled her soft puffy baby arm and he shook. But that wasn’t enough for him as her eyes registered shock. The veins around Leo’s temples bulged and his biceps stiffened as he jerked again and again on the arm of the baby that had done nothing wrong.

Chapter 6

On Saturday morning Danny arrived at the hospital with plenty of time to spare. Dakota had demanded bedside attention a half hour earlier than normal, making Danny think Dakota needed to go out, so he relented and got up. It wasn’t such a bad day to be on call after all. A late summer rain made for a dreary morning and clouds began stacking up with malicious intent.

To Danny’s pleasant surprise, he still had only two surgeries booked as well as the group’s in-house patients to see. His first case was one of Harold’s back patients who couldn’t wait for Harold’s return to work. Danny did the fewest in his group, but he could put people back on their feet without sciatica as well as his colleagues. He sat in the doctor’s lounge with a bowl of cereal and coffee. As he turned a page in The Tennessean, he heard a familiar voice.

“Danny, can I join you?”

Danny looked up at Bill Patogue’s wide grin and thick glasses. At forty-two and natty in a bow tie, the internist looked a decade younger.

“Sure, Bill,” Danny said. He pointed to the scarlet red tie. “You must be a Louisville Cardinals fan. You’re not wearing Tennessee orange.”

Bill shook his head. “My tie colors don’t make sport’s statements unless we’re in March madness or it’s a holiday.”

Danny laughed. “I could use some color, Bill. What color stands for ‘stay out of trouble’?”

Bill put down a small plate, waved off the comment dismissively, and pulled in his chair. “I’m rounding soon on Harold and my growing list of consults. Did you know that hospital bed admissions are almost full?”

“Really? That means I could have a quiet day on call. If they get full, they’d have to divert emergencies to other hospitals.”

“The growing admissions seem to be medical.” Bill buttered his toast and opened a packet of marmalade. “Anyway, I never got back to you about Harold.” He shook his head and leaned in closer to Danny so he could be heard over the blaring TV. “He’s unconscious. The blood and urine results aren’t conclusive and nothing’s amiss with x-rays of his chest. Blood and sputum cultures are pending. I don’t want to waste any time, so what do you think about getting a brain MRI?”

Danny sighed. In reflective thought, he stayed quiet for a moment and stared at his cereal. This seemed so unreal. Harold had been fine and he had no health issues which would have made him susceptible to a unique malady. Danny snapped out of his pensive look. “Sure. Let’s do it. When it’s done, I’ll take a look with you.”

“All right. Even though it’s a Saturday, I’m going to stick around a bit. I’ll call you when it’s finished, it may be this afternoon.”

Danny fiddled with the spoon in his raisin bran and glanced at his watch. “It’s discomforting that one of our own is sick. As we know, medical people have the worst luck and outcomes.”

“I hear you. My consult to see this morning works here in the OR. She’s apparently confused, with a headache and muscle weakness. It’s not even flu season.”

“What’s her name?”

“Dotty Jackson, do you know her?”

“She’s one of the OR nurses. I haven’t seen her most of the week. It may have been Monday or last week when I had cases with her.”

On the table, Bill’s pager vibrated, causing it to slightly scurry along as Danny and Bill watched. “Let me get this,” Bill said, pushing away from the table.

Danny reheated his coffee in the microwave while Bill answered his page. When he made it back to the table, Bill patted him on the shoulder. “Guess I’ll go downstairs to the ER first. The doc says it’s a hospital scrub nurse they just intubated and put on a ventilator. His mother found him unresponsive after he ran a fever all night. I’ll call you later.”

As Bill turned, Danny hurriedly asked, “What’s his name?”

“James something.”

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The patient on the operating room table was turned prone. Danny had good exposure into the man’s back to work around the lumbar nerve roots and musculature. Considering every surgery Danny had seen through residency or knew about, back surgery most reminded him of butcher’s work - like splayed cattle meat on a table, red and raw. Things weren’t going so well, either. The man had a platelet disorder which made him bleed more profusely.

Getting good visualization of his landmarks became increasingly difficult. At least he had Dean in the room, who had more of a challenge with the patient’s hematologic disorder than giving him anesthesia. Dean asked for two bags of platelets from the blood bank while he infused more IV fluids to compensate for the blood loss. Danny slowed down his pace so that the platelets could arrive and be transfused. They had to make headway in stopping the oozing.

Danny kept the suction tip in the open gap while waiting. Slow, steady blood was sucked into the canister. He watched Dean, who stood so tall that the IV height was easily in reach.

“I’ve never worked with you on a back before,” Dean said, glancing at Danny.

“I do them, but rarely. The head cases pile up for me, so I do backs less and less. Actually, this is Harold’s patient.”

“What’s going on with Harold? You were going to see him in the ER the other day.”

“He’s in a coma,” Danny said, concern buttering his words.

Under his mask, Dean’s expression registered alarm. His eyes widened. “No way.”

Danny moved the tip away from the patient’s back for a moment. “Dr. Patogue is taking care of him. We’re getting an MRI of his head today.”