When Mike arrived to make morning rounds, the nurses greeted him warmly, too warmly, he thought, as they smiled knowingly at each other.
“Where’s Lisa?” He asked.
“Lisa—Lisa who?” Sharon joked.
“All right, you guys. Have your fun.”
“She’s on break in the lounge. You remember where that is, don’t you?”
Mike shook his head, and walked to the back of the NICU.
When he entered the lounge, Lisa was sitting with a nurse and an aid. Suddenly, Lisa stood. “Good morning, Dr. Cooper.”
“Not you, too,” he said, laughing. “You’ve been hanging around with these nut cases too long.”
He kissed her on the cheek, and then said, “I’ll start rounds. I’ll check on your patients when you’re finished with your break. I’ve got to get moving. I have a busy day.”
“And a busy night ahead, too,” she whispered in his ear.
Mike smiled, and left the room.
One afternoon, about six weeks later, Mike’s secretary said, “I have the county hospital for you, Mike.”
He pushed the button on the speaker phone. “Mike, it’s Rebecca Levy at county. We have a case for you.”
“Hey, Rebecca, how’s it going?”
“To tell you the truth, Mike, I can’t wait to finish my training and get out of this hell hole.” She paused, and then continued. “I hear you’re out of circulation.”
“For a month or so now, and I love it.”
“Good luck, Mike. You’re a good guy, and I wish you the best.”
“What do you have?”
“Our NICU is full, and I have a thirty-week preemie to send to Brier. Baby girl Sanchez came into the world yesterday, and so for, so good. Her parents are undocumented, but not to worry, the county will foot the bill.”
“How’s the baby?”
“Mild respiratory distress, but otherwise, okay. I don’t anticipate other than the usual in her care.”
“Send her over. I’ll tell the unit to get ready.”
The transport team with a nurse and respiratory tech wheeled the incubator into Brier’s NICU. A small Hispanic woman followed in a wheelchair.
“This is Maria Sanchez,” the nurse said to Mike.
“Mucho gusto, Doctor,” she said, reaching for Mike’s hand.
“Mucho gusto,” Mike replied. “That’s about a quarter of my Spanish vocabulary, but we have many Spanish-speaking people at Brier.”
“She has a little English,” said the nurse.
“Un poquito,” said Maria.
Mike introduced Sharon Bridges, who’d be caring for the baby.
“Mucho gusto,” Maria said with a timid smile.
“Get her squared away, Sharon,” Mike said. “I’m going to review the baby’s records. Get some fresh lab tests and a portable chest x-ray by protocol.”
When Mike finished looking through the chart, he asked the ward clerk, Lucy Rivera, to translate. “Ask her if she’s named the baby.”
“Si, se llama, Ella.”
“Ella?” Mike asked.
After a brief speedy conversation, Lucy said, “She wanted an American name.”
Mike went on to have Lucy tell Maria about the baby’s prematurity, the low birth weight, and the mild respiratory distress. He finished by reassuring her that everything was likely to go well.
When Lucy finished, Maria grabbed Mike’s hand, and kissed it.
Mike felt embarrassed, but smiled.
Mike told Lisa about the baby that night as they sipped wine before dinner. “She’s tiny, but perfectly formed, and really cute for a preemie. You’ll get to see her tomorrow.”
“It’s such a thrill for me to see these tiny ones. She’s going to do okay?”
“You never know for sure, but I think so.”
They’d ordered in pizza for dinner, but it was cold by the time that they returned hungrily to the family room. Lisa reheated the pizza. Mike pulled two icy cold beers from the refrigerator, and they sat watching television.
“Let’s watch a Medium rerun,” Lisa said. “I love that show.”
“That’s the one where she can see and talk with ghosts, and has dreams that foretell future events?”
“Yes. It’s great, and you know, there really are people like that in the world.”
“Right,” he snorted, “and you believe in the tooth fairy, too.”
She punched Mike playfully in the arm. “Don’t be such a putz—that’s the right word, isn’t it?”
“Are you sure that you want to call the love of your life a putz? I think you’ve been hanging around Phoebe too long.”
“All those things you dismiss, such as spirituality, Tarot, Astrology, have persisted for thousands of years because there’s an element of truth to each of them. Sure, most of it is crap, but don’t you think that they all would have disappeared if they were baseless?”
“I think that humans try to find the easy way out, and would rather blame fate or whatever, than accept responsibility for their lives. If you want to go for some of this stuff for its entertainment value, great, but don’t think it’s real.”
“Mark my words, sweetie. Someday you’ll come to understand that there’s more to the world that what you can see, touch, and smell.”
“And don’t forget taste,” Mike said, kissing her lips.
Chapter Eighteen
“They want to what?” Asked Mike Cooper, as he sat before the desk of Bruce Bryant, the CEO of Brier Hospital.
“Hear me out, Mike, before you have a stroke.”
“I’m not allowing a TV crew into the NICU. Think of the disruption, the risk of infection, and the violation of privacy.”
“Whether we like it or not, a hospital is a business, and one component of any successful business is to protect and expand its market share. That’s what this is all about.”
“We don’t need to advertise. We get our referrals through professional channels from physicians who respect our work.”
“What’s our occupancy?”
“About 80 percent, but at times we’re closer to 90 to 92 percent.”
“We don’t have to reinvent the wheel, Mike. We’re a referral center, and, like Mayo or Ochsner, we all benefit by marketing. I’ll show you the data.”
“Find some other way.”
“We have the same objectives, Michael. Success breeds success. That means more space, better equipment, better staffing, and more participation in prestigious studies.” Bruce pulled a folder from his desk. “This is your contract, Dr. Cooper. Part of your obligation is to help Brier Hospital promote our NICU.”
Mike laughed. “It’s Dr. Cooper, is it? You’re threatening me with the terms of my contract?”
“Don’t be ridiculous. We all take on obligations when we sign a contract. Mine says that we should, within reason, do what will improve our hospital, and the patients it serves.”
“Did your marketing people give you that line? I think I heard it on a promo, somewhere. Look, Bruce, we’ll cooperate, but I won’t put us, or our patients, at risk. If they want to film through the viewing windows at times that we think are appropriate, then we can talk. If not, then we have a problem.”
Bryant rose and extended his hand. “I’ll get back to you, Mike.”
Three weeks later, in the anteroom of the NICU, Mike sat with Sam Patterson, the twenty-seven year old hyperkinetic producer.
While Mike understood the pressure to succeed, he didn’t get the single-mindedness of these media people; a herd willing to trample anything in their way.
“Please, Doc,” Sam said, “shooting through those windows is like having sex while wearing a condom.”
“Sam, if any member of your crew steps into the NICU, he or she won’t have to worry about having sex, anymore.”
“Mike, you better take this,” said the charge nurse, handing him the phone.
Mike listened, shook his head, and then said, “Send her up.”
“What
is it?” Asked Sam as he ran his tongue over his lower lip.
“Set up outside, take your pictures, and Sam—this is the last of it.”
Mike turned to the charge nurse and said, “Who’s up for a sick one?”
“Lisa. Is that okay, Mike?”
“Of course.” He caught Lisa’s eye, and gestured that she should join him.
“What’s up, Mike?” she asked.
“They delivered a woman right off the street with—no prenatal care. She just delivered a 34-week baby with hydrops.”
“Hydrox?” Sam asked.
Mike shook his head, and then turned to Sam. “Listen closely. This is all I have to say for now, and when that baby gets here, I don’t want to hear another word.”
Sam nodded.
“Hydrops is part of what we call hemolytic disease of the newborn, and it’s due to a blood mismatch between the mother and her baby. It’s mostly due to the Rh factor, where the mother’s body attacks the baby’s red blood cells. We rarely see it, anymore because, given half a chance, we can prevent it.”
The elevator door pinged open. A nurse and respiratory tech pushed the incubator out, and into the NICU.
Mike pointed for Sam to leave.
They moved the incubator with the large blue tag, labeled, ‘Baby Boy Johnson’, to the level three areas, for the sickest babies. After attaching the power cords, the monitoring devices and the oxygen, Mike took his first look, and felt sick. The tiny baby’s yellow face had the shape of a Buddha. It was almost perfectly round, due to fluid swelling. White tape surrounded the skull below the nose, and held the small tube into the baby’s trachea. All extremities, as well as the abdomen were similarly bloated by accumulated water.
“Get me the umbilical tray,” Mike said to Sharon Bridges. “We’ll use the umbilical vein for an IV line, and we can use it for the exchange transfusions.”
Mike sweated under the radiant warmer. He finished inserting the plastic catheter into the baby’s umbilical vein, when he felt the heat of the camera flood lights over his left shoulder.
What the fuck!
He tied the last suture in place to anchor the catheter, removed his hands from the incubator, and turned to face the camera.
Enraged, he lifted the cameraman and camera into the air, rushed them through the doorway, and then threw both against the wall. The camera crashed against the floor with an expensive crack.
“What are you doing?” Sam screamed, pushing his way toward Mike.
Mike stretched his enormous hand in a ‘stop’ gesture. “Come closer, and you may live to regret it. You fucking bastards don’t give a damn about who you hurt! I’m holding you and your station responsible for any contamination of the NICU and for any infection that baby gets. Get out, or I’ll have security throw you out.”
As they left, Michael said, “Get your checkbook ready, it's gonna cost you big to disinfect the NICU.”
When Mike returned to the NICU, his pulse was still bounding with anger. He changed his gown, washed his hands, splashed cold water into his face, took a deep breath, and returned to the incubator.
Sharon stared at Mike. Her face was that of Leonardo da Vinci’s Mona Lisa.
“What?”
Sharon smiled. “You let him off easy. I would have killed the son-of-a-bitch!”
They performed several exchange transfusions, replacing the baby’s damaged red cells with fresh, donated blood.
By the next morning, the baby was yam-yellow, and flaccid. Signs of brain damage increased hourly until noon, when ‘Baby Boy Johnson’ took his last breath.
Chapter Nineteen
The next few weeks sped by in a blur for both Mike and Lisa.
Phoebe was happy for her friend, but complained, “I never see you, anymore. Why don’t you move in with Mike?”
“I’m sorry, Phoebe.”
“Don’t be. You’re a lucky woman, and I’m jealous.”
“I won’t let anything interfere with our friendship. Next to Mike, I’ve never been so close to another human being.”
“Tell him to find me a nice Jewish doctor. My mother would be eternally grateful.”
“Mike’s your biggest fan, Phoebe, and he tells me that he has several candidates in mind.”
Phoebe smiled. “Bring ‘em on!”
By the end of the second week, everyone was in love with Ella Sanchez.
They used Maria’s breast milk, but had to supplement it with tube feedings.
When Mike entered at eight a.m., Lisa greeted him. “Ella doesn’t look so good, this morning.”
“What is it?”
“Her belly is a bit swollen, and she spit up twice this morning.”
Mike’s pulse raced as he approached the incubator. There was some redness around the baby’s belly button. His hand covered the baby’s entire abdomen, and he noted the swelling, and he thought that he felt a swollen loop of bowel in the right lower quadrant.
“Shit,” he said. “Put a syringe on that feeding tube, Lisa. Let’s see how much residue she has in her stomach. Then get blood cultures, a routine blood count, and electrolytes, and a stat portable x-ray of her abdomen. Stop the tube feedings. I hope I’m wrong, but I think it’s Necrotizing Enterocolitis, NEC. I need to talk with Maria.”
“Work with me, Lucy,” Mike said to the translator as they sat in the waiting room. “I need Maria to understand what’s going on.”
“NEC is a disease of some premature babies that affects the intestines. Tell her that it’s an infection that can be serious. We’re running some tests, and starting her on treatment.”
Mike watched as Maria listened. Her face became ashen as his meaning came through. She looked at Mike with pleading, wet eyes.
“Is there a Mr. Sanchez?” Mike asked.
“Yes,” said Lucy, “but he’s frightened of the Immigration Service.”
“Nobody’s calling the INS,” Mike said.
As he rose to leave, Maria again grasped his hand. Looking up into his eyes, she said, “Por favor, Doctor. Por favor.”
“You know how we work here, Lucy. Tell her.”
An hour later, Mike stood before the x-ray digital display with Bernie Myers, an experienced radiologist.
“Don’t like the looks of this, Mike.” He pulled a chrome pointer from his shirt pocket, extended it to its full length, and then used it to indicate areas of interest on the films. “Look at the distention, the stacked loops of bowel.” He pointed to a small area on one film, and continued, “that’s air in the bowel wall. I don’t see any free air, yet, that would indicate a perforation, but it wouldn’t surprise me to see that, soon. It’s classical NEC. How’s the baby doing?”
“It’s too soon to tell. We’ve just started treatment.”
Bernie shook his head. “I’d get films two or three times a day. If she perforates, the sooner you get her to surgery, the better.”
Chapter Twenty
When she looked at Mike, Lisa felt warm all over. It wasn’t his individual parts that had her—not that anything was wrong with his parts—it was the whole. A man of his size might easily evoke fear in some, but Lisa felt his bigness was a good match to the size of his easygoing nature.
She often just watched him.
“What are you looking at?” He asked that morning as he brushed his thinning hair across his scalp.
“I’m looking at you. Can’t I look at the man I love?”
“Looking’s okay, but I sense an element of appraisal, like when we dress to go out, and you say, ‘you’re not leaving the house wearing that, are you?’”
“Well, now that you mention it, it’s time to do something about your hair.”
“There’s not much to do with someone as follically-challenged as I. I’m not getting a transplant, nor will I use medications to repopulate this barren land.”
“I have something a lot simpler in mind.”
“I’m listening.”
“The curls in the back are okay, but the comb-over’s got
to go.”
“What comb-over?”
“You’re kidding, right?”
“It’s the way I comb my hair—I guess as I lost more in front, it naturally spread over the impoverished territory. I don’t see what’s wrong with it.”
“It looks like what it is, a vain attempt to hide the fact that you’re follically challenged, you know, pardon the word, bald.”
“I’m not bald, Lisa.”
“Of course not, sweetie, nature has malapportioned your hair. We simply need to do some redistricting.”
“You want to Gerrymander my head?”
“Exactly, and I’ve contracted the right person to do it. Phoebe will be over tonight after dinner, scissors in hand.”
“Great,” he said shaking his head. “I can’t wait.”
That evening, Mike sat on a chair in the middle of the kitchen, while Phoebe and Lisa circled, critiqued his head, and discussed their strategy.
“Are you sure this is necessary?” Mike asked.
“Without a doubt,” Phoebe said, as she approached with scissors and comb in hand. “You’re about to become three pounds lighter, Samson. You’ll survive.”
Phoebe went to work with gusto. Lisa watched, smiling and pointing here and there.
When Phoebe was aiming for the curls in the back, Lisa said, “Don’t take them all. I love those curls.”
Mike shook his head as long strands fell to the floor, and said, “Are you done?”
“A few more tiny snips, and then I’ll be through.”
After the last cut, Lisa grabbed Mike’s brush, and swept it backwards over his scalp. “Done.”
Phoebe held the mirror, and Mike looked. He was shocked at first by the magnitude of the exposed frontal plane, but he finally said, “It’s okay—better than the comb-over.”
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