by Melissa Yi
21
"We better not be late," I whispered to Tucker, as we squeezed on the bus after some school kids.
"Worth it," he said back, kissing my cheek.
I laughed and almost told him about the Becker notes right then, but decided to wait until we were alone.
Tucker looked like he was eavesdropping on the middle-aged man who'd let us go in front of him so he could chat on his cell phone. Cell Phone Man wore a white scarf held in place by a black circle of rope, which my mom calls a Lawrence of Arabia headdress, but this one looked authentic.
I raised my eyebrows at Tucker to ask whassup.
He rubbed his thumb and middle fingers together in a way that meant Cell Phone Man was loaded.
Hmph. Well, why would he bother taking a bus then?
Scratch that. I'd take a bus even if I were a billionaire. Except maybe not after a too-close encounter with an IED.
I held onto a pole and used my free hand to look up the headdress. Then I moved on to "Carnarvon," another item from Becker's list.
"We should be okay," said Tucker.
I shoved my phone in my pocket. "What?"
"Wow, are you ever jumpy today." He leaned closer. "Maybe I need to relax you all over again."
I emitted a jagged little laugh, but he didn't notice. He checked his watch. "If we run into too much traffic, maybe we should take an Uber-Careem. Or run."
Crap. The ER chief would hate me even more if I seemed to leave early and come in late. Sweat itched my armpits.
"Why were you reading about Lord Carnarvon?" said Tucker.
"Huh?" I tried to change the subject. "I looked up the headdress. It's called a ghutra or keffiyeh. I wonder if our ER chief wears one."
"No, he doesn't. Not at work yesterday, anyway. What does that have to do with Lord Carnarvon?"
My jaw tightened. "Um. Well. His name came up." Technically true. Gizelda had said Carnarvon in passing, although it had meant nothing to me until it reappeared on Becker's list. "It turns out that Lord Carnarvon was the man who backed Harold Carter's archeology expeditions."
"And the man who supposedly died from the mummy's curse."
The bus chatter around us shrivelled with Tucker's words. But that must've been my imagination. How many of them even spoke English?
I glanced around at people's averted faces and muttered, "Mummy's curse?"
"Yeah! The curse of the pharaoh!" Tucker thrust his free hand in the air, making the rock and roll sign.
I had to laugh. "Shh. I've heard of that, but so far, all I saw was that Lord Carnarvon married rich and funded Harold Carter's archaeological digs. Carter found the tomb of King Tut."
"Right. And on the day that Howard Carter opened the tomb, on the 29th of November in 1922, a cobra broke into Carter's own home and killed his pet canary."
I shook my head. Did I hear him wrong? "His canary?"
"Yes, a messenger heard the canary cry out before it died. He said it almost sounded human."
"Aww." That poor, tiny, delicate yellow bird. "On the other hand, a canary would look like lunch to a cobra."
"Right, but think symbolically. The cobra represents the Egyptian monarchy. That cobra eating Carter's canary looked like retribution for opening the tomb."
"Poor birdie. I'd call that more than symbolic. And didn't you say Lord Carnarvon died too?"
"He died on April fifth, 1923. About four months later. He got a mosquito bite on his left cheek which turned into cellulitis, sepsis, and pneumonia."
I counted up the months as I squeezed against people's knees to allow more riders on the bus. Four months and six days. "Hmm. That's a bit of a time lag."
"Yeah, a bit. Sir Arthur Conan Doyle theorized that Carnarvon could have been killed by 'elementals' that King Tut's priests had sequestered to guard the royal tombs."
I made a mental note to look that up. I hadn't realized Sherlock Holmes's creator had any connection to Egypt. "Did anyone else die?"
Tucker grinned and scanned his phone. "Well, considering that this all happened a century ago, all of them. But you're asking if any of them were felled by the curse sometime close to 1922, right? One man died with a fever on the French Riviera in May 1923. A member of the excavation team was poisoned with arsenic in 1928. Carter's secretary died in 1929—they think someone smothered him."
"Good God!"
The balding businessman in front of me glanced up from his phone to check that I was okay. I gave a pained smile.
Tucker half-hugged me, still eyeing his screen. "It's not that bad. Carter didn't die until 1939. On average, the 25 Europeans who attended the official opening lived a normal lifespan. Lord Carnarvon's daughter held on for another 57 years."
"Right. The timeline is suspect. But if two people in the party were murdered, that seems high."
"Yeah, and check this!"
I nearly laughed at his excitement and translated expression. Québecois people sometimes yell "Check ça!", which rubs off on English Quebecers.
Tucker tapped his phone. "Carter gave his friend, Sir Bruce Ingram, a paperweight made of a mummified hand."
"Ew."
"Wait, there's more! The hand had a bracelet inscribed 'Cursed be he who moves my body. To him shall come fire, water, and pestilence.'"
I stared at him. "And did he get fire, water, and pestilence?"
"Apparently Sir Bruce Ingram's house burned down right after he received the hand. He rebuilt the house, and then it flooded."
"Ugh. Did Ingram end up with pestilence, too?"
"Wikipedia didn't mention it, but he probably had mice. Remember how cats are supposed to be sacred in Egypt because they were so good at killing the mice that ate the grain?"
"Let's stick to one story for now." I sighed. The businessman in front of me popped open his briefcase and tried not to react to either of us. "So the curses probably don't work. And yet, for the rest of the month, I promise I'll stay away from King Tut and mummy hands."
"It's a deal." Tucker smacked a kiss on my cheek, and then gave a low whistle at his phone.
"What is it?"
"Just got a notice. Someone thinks they recognize the guy from the ICU."
The guy with Phillip Becker's cobra bag. We exchanged a long look, and then I murmured in Tucker's ear, "The game is afoot. I have something to tell you later, too."
22
I kept an eye out for the chief as we walked into the ER together at precisely 0800. My turn on the acute side today, and I was looking forward to it, although the number of patients in the hallway made me uneasy.
Anyone stuck in the hallway in Montreal gets a stretcher, at least. In this case, I saw families surrounding patients on chairs. One woman seemed to nurse a baby while she was sitting on the floor.
Rudy greeted Tucker with a complicated handshake that made both of them grin.
"You good?" said Rudy.
"I'm good, man. Ready to rock and roll."
As if on cue, a man's voice cried out behind us, and a woman's voice raised in alarm.
I spun around to watch the door from the waiting room burst open. While a nurse yelled at them in Arabic, the man ported a child into the hallway.
The boy's head bobbed in a way that made me clench my teeth.
Tucker and I rushed to their side. I couldn't follow the language, so I focused on the boy, who looked maybe four. Sand clotted his hair, his nostrils, and lips. His eyes were closed, his body limp. He looked grey under his melanin.
"How old is he?" I asked Rudy, who'd been talking to the grey-haired dad.
"Five years."
I added the age to my pediatric phone app. It automatically calculates the correct medication doses per weight, so I can concentrate on other stuff like the ABC's.
"What happened to him?" I said, eyeballing the Airway and Breathing (A and B). No obvious choking or snoring in dad's arms, but he was breathing fast and shallow, with that odd colour.
Rudy struggled to translate in real time. "He was … playin
g underground. We pulled him out of the sand. We thought he might get better, but—"
The dad called out, frantic.
We needed the kid on a stretcher, with oxygen, an IV, a cardiac monitor, and a glucose check to start.
The black-clad woman behind them, probably mom, pointed at a bloody smear on the boy's sandy left ankle. I wasn't sure what to make of that. It looked like the least of his problems.
The grandmother added something I couldn't understand.
"He can't breathe!" A pretty, dark-haired girl, maybe seven, rushed up to my side. "Can you help him?"
"We'll try." I turned to direct them to the resuscitation bay, one of four glass-walled rooms on the right side of the hallway, but Rudy stopped us. "They have to register."
I whipped around to stare at him.
Rudy said, in a flat voice, "Those are the rules. They need to register and pay. Security should have stopped them from coming in."
Two men in dark uniforms nodded back at him from behind the family.
I paused to check the family more carefully. This time, I noticed that the little boy's frayed pants had ripped at the knees. The dad's shaggy hair hung in his eyes. The mom was covered in what I think is called a niqab, with only her eyes showing through cloth that had faded to greyish-black.
These people were poor. They probably couldn't pay for their treatment. Which meant that the boy would die.
I wanted to grab Rudy and yell, "But this is Canada!" We treat life-threatening injuries first and ask questions later.
Except this wasn't Canada. We needed to play by Egyptian rules.
"Please. We will pay," his sister piped up in her little voice.
I shuddered. Even at her age, she already knew the game. She knew they needed money to buy her brother's life.
"Good enough for me," said Tucker. "We need a stretcher!" He raised his voice and repeated it in Arabic, using his hands to signal that he wanted the boy to lie down.
Slowly, two women who looked like nurses came forward, spoke to the family, and led them toward trauma bay #2.
Yes! Come on, come on, I mentally urged them as I trailed behind them. We usually run to resuscitate sick kids.
The boy moaned.
Well, at least that bought his Glasgow Coma Scale up another point.
The father barked something, his arms still full of his son, and the mother pulled a wallet out of the dad's back pocket.
One of the women must have been patient registration, because she tried to take Mom with her. Patient reg adds the patient to the record system and takes your health card, or in this case, your credit card or cash. Mom hesitated.
The father jerked his chin at her.
"We'll take care of him!" I called to Mom, and she nodded at me as if she understood.
The little daughter called out something reassuring too, and Mom slowly left her son.
"We need gloves," said Tucker, and I scanned the resus room. Normally they mount racks of gowns, gloves, and masks on walls in the resuscitation bay or just outside, in the hallway.
We did need gloves. Over six percent of the Egyptian population is infected with Hepatitis C, a rate ten times higher than in Canada.
Hep B and HIV are "only" about 1 percent each in Egypt, but yeah. I don't need my liver attacked or my immune system compromised for the rest of my life.
Where could we get gloves? Rudy hadn't followed us in. The remaining nurse quizzed Dad and sister.
Tucker spoke to the nurse, who shook her head and said something curt.
Tucker ran his hand through his hair and turned back to me, pale. "We should have brought our own gloves. We can go buy them at the pharmacy."
"Right now? But he's a code purple!" That's a pre-arrest.
He shook his head. "The patients and Rudy already spotted me yesterday. He said I'd have to get the next box. It's BYOG."
Bring Your Own Gloves. Unreal. "Damn it. The staff doctor covered me yesterday and didn't say anything. I forgot what you said about patients bringing their own cast material."
"Yeah. I was distracted yesterday too." He meant our "detective doctor" fight last night.
No time for that. "We can buy gloves, but not now."
"Agreed. They must have some. We can borrow them and pay them back."
I glanced at the boy. "And he probably doesn't have anything infectious." No one wants to do mouth-to-mouth resuscitation, but when kids are involved, we do.
Tucker raised his eyebrows.
I glanced from the boy's bloody foot to my own intact-looking hands. Should be okay. But no guarantees. I'd assessed a whole bunch of people yesterday. Theoretically, I could infect the boy. We both needed protection.
I felt like crying. I pushed that aside. "Well, the rest of the team will be here soon. They'll have gloves. Until then, I'll do the history, and you can translate."
Tucker opened his mouth, but I moved toward the kid, whom the father had laid on the stretcher. Then I realized the kid was unconscious, the dad and grandma probably didn't speak English, and the sister might be seven years old.
Awright. Moving on to physical exam.
"Airway and C-spine," I said to Tucker. The father tried to steady the boy without covering him up from my inspection. "Did he fall and hit his head and neck?"
"He was buried in sand. They had to dig him out," the sister volunteered. "My other brother called us to come get him."
"Okay. We should get a C-spine collar on him in case," I said.
"Does he have any health problems or allergies?" Tucker cut in.
The girl spoke to the dad a bit before she turned back to us. "No."
"Okay. Let's get him some oxygen already," I said. We didn't have any vital signs, but the kid looked "like ass," as one of the St. Joe's nurses would say.
I caught the Cairo nurse's eye and pretended to string nasal prongs up my nose and hook them around my ears.
She shook her head at me, even though she was already wearing gloves.
"He needs oxygen." I mimed a face mask this time and pointed to the oxygen dial mounted on the wall.
Tucker began speaking in a low, calm voice. Maybe because he was a white, male, foreign M.D., or possibly because he spoke Arabic, or all of the above, she crossed to the wall and unwrapped some nasal prongs.
"O2, BP, monitor," I said to Tucker, but there was only one nurse. The hospital could be short-staffed, or holding off until the family paid. Or both.
"I can do the monitor," said Tucker.
He spoke to the dad, asking permission before lifting the boy's shirt.
"It's better if you leave it for someone with gloves," I said.
"Hope." Tucker's lips pressed together.
"I'm sorry, but it is." I glanced at Tucker's abdomen, knowing the exact surgical scars hidden by his shirt.
Tucker loathed when I brought that up. He shook his head at me and reached for the electrodes.
"It's just … be careful. I love you," I added, under my breath.
Tucker's face flashed between anger and pleasure. He closed his eyes in acknowledgement.
I'd never said ILY over a resuscitation before. I was losing it.
I turned back to the boy and located an adult-sized oxygen saturation probe that fell off the end of his finger. We needed to clip one on his ear, or tape one to his fingertip.
Meanwhile, the nurse slowly, slowly attached the cardiac leads to stickers on the boy's bare chest, revealing a sinus tachycardia at 179. Kids can go fast, but this was pretty fast. We still didn't have a blood pressure.
"Glucose," said Tucker.
Yep. Kids (well, more infants) can go hypoglycemic during a resuscitation. Better keep an eye on all his electrolytes.
With a rip of Velcro, the nurse attached a blood pressure cuff to the boy's arm, which slid down to his elbow. She shook her head.
Right. This wasn't a pediatric hospital. We'd have to approximate his BP by taking his carotid, femoral, and radial pulses. If we could touch him.
&nb
sp; "What is going on here?" called a dark-skinned man in a lab coat, surrounded by a bevy of med students and residents. He glared at me and Tucker, but the important part was that he spoke English and he probably had gloves.
The nurse took a step back. She wanted no part of this.
"I have a five-year-old who was buried in sand and at least partially suffocated," I said, not turning a hair. As far as I'm concerned, a sick kid trumps everything. "You can see he's tachycardic, we need a C-spine collar, a pediatric BP cuff, a glucose, and a full set of labs. He needs a CT head and C spine with a decreased level of consciousness, GCS—"
"Who are you?" The doctor barely glanced at the child. His gaze lodged on my left ear.
"I'm Dr. Hope Sze, a resident doctor from Canada."
He jerked a thumb at the doorway.
He couldn't kick me out. I glanced at a second nurse frozen in the doorway, with a glucometer in her hand.
He's joking, right?
She wouldn't make eye contact with me, but after a beat, she moved aside to let me through, the beige curtain swaying behind her.
Tucker opened his mouth. "Dr. Sharif—"
Damn it. Perfect way to meet the Chief of ER: him booting me out of a pediatric resus.
"Please, Dr. Sharif," I added quietly.
Medicine is a hierarchy. As the new female Canadian resident doctor in the Middle East who couldn't speak Arabic and had no gloves, I could hardly claim status as an essential member of the resuscitation team.
Tucker tried again. "Dr. Sharif, Dr. Sze and I can tell you all about this previously healthy five-year-old boy, no medications, no allergies—"
Dr. Sharif shook his head. "Get her out of here. Now. Has this patient been registered?" he asked, as a third woman in a white head scarf urged me and Tucker toward the door, away from the boy.
Uh oh. If they stopped the resus to get official documents and payment, this kid could die.
"At least get the glucose," I pleaded with the second nurse, as we glided past her and her glucometer in the doorway. "If it ends up being hypoglycaemia, we could treat that."