by Heidi Willis
My phone rings, and I know the word is already spreading across the small town.
It's Gloria from church. "We heard about Ashley. Is she gonna be all right?"
I want to ask how she heard, and who we is, but I just say I'm sure she'll be fine, but the medics want to take her to the hospital to make sure. No use in giving her and the other gossip gals at First Baptist more to talk about.
"A few of us will get together to pray for her. How should we pray?"
I know the tactic because I done it enough myself. Cloak your own need for information in a prayer request. But as I know they will genuinely pray for her, and since I want God on my side and I'm not that good at praying myself, I ask her to pray that Ashley will get good treatment at the hospital, and that she'll get a good doctor, because I'm not too trusting of doctors myself.
"Oh, don't I know it! Eduardo went in for a cough and caught the strep from a doctor who didn't wash his hands. The doctor poked around in him, told him to sit in the bathroom with a hot shower running, and then sent him home sicker than he was to begin with. He had to go back for antibiotics later. He almost didn't go cause he was scared of getting something even worse. Hospitals are just teeming with germs, and doctors don't know more about medicine than a monkey. Almost everybody I know comes out worse than they went in." She paused, and then added, "But I'm sure Ashley will be fine."
"Yes," I say shortly, and hang up.
By the time I park by the emergency entrance of St. Joseph's I've lost the feeling in my fingertips, and a gripping headache is spreading from my clenched jaw to the back of my neck. I grab my phone and stuff it in my purse and leave the clothes and the food.
I've only been in St. Joseph's three times before. Once each for the births of Logan and Ashley, in which I walked through the front doors, and once when Logan fell out of the oak tree in the back yard and needed twelve stitches in the back of his head. We came through emergency on that one, bath towel pressed to his scalp, blood already seeping through it. They put Logan on an examining table, and when the doctor took the towel off I passed out, and when I woke up, Logan was in a chair and I was lying on the table.
I pass off the church sick visitations on the other women. I hate hospitals.
St. Joseph's isn't like the TV hospitals, where attractive young interns wander the halls making eyes at each other, interrupted by sudden chaos when fifty people are brought in after a train wreck or bridge collapses and all hands on deck have to rip open bloody shirts and slice the chest open to get a heart beating again. Although when Logan came, there was a man who got his arm chewed off by a combine, and that was rather bloody. But even then, there weren't no great commotion.
Today, the ER is empty. Elevator music is playing on the sound system, some synthesized version of a Reba song, and no one's even at the information desk. I look outside to see if the ambulance is in the bay, but it's empty too. I have this frantic feeling I've gone to the wrong hospital, as if there were more than one within fifty miles. I see a bell on the desk and I ring it.
"I'm looking for my daughter, Ashley Babcock," I say to the white-haired lady who appears from nowhere. "An ambulance should have brought her in."
She nods and opens a door next to the desk and beckons me back. I follow her through a maze of curtains to the single room with a door. Inside, Ashley is on the bed, her eyes open, watching the two distinctly not-TV-type doctors buzzing around her. One is poking at her veins, cussing under his breath.
"I need a smaller needle, Park. The veins are collapsed."
I see Ashley wince each time he pierces her, and already blood is gathering beneath her translucent skin. This is why I hate doctors.
"Can't you be more gentle?" When my jaw unclenches I realize I've been gritting my teeth. The doctors ignore me, and I see her thick, dark blood finally filling a test tube. Ashley's eyes wander to me, but they are glazed and unfocused. She don't smile at me, and though she smiles less at me since she turned twelve, I find this a bad sign.
"Can someone tell me what's going on with my daughter? What's wrong?"
I am still expecting someone to say maybe she's anemic and needs to eat more bacon for breakfast, but instead he says, "Your daughter has diabetes."
Just like that. He don't even turn to look at me. He finishes drawing the blood and marks the tube with a black pen. "Christ, it's thick as finger-paint." He shakes the tube but the blood barely sloshes. "Up the fluids and give her a shot of humalog," he says to the man named Park. "Start with four units and add a drip line as well. I don't want her seizing again."
"What's going on?" I think I sound angry and this is better than worried, which is what I am. I don't like that they are putting drugs into Ashley's veins.
"Your daughter's nearly DKA, ma'am. It's lucky the EMTs had it figured or we'd still be running tests. Her glucose doesn't even measure on our meters here in the ER, so there's not much doubt, but we're running the labs anyway."
"What's DKA?" I have no idea of half what he said.
"Diabetic Ketoacidosis. Coma," he says, and then I wish I hadn't asked.
He begins to walk out, his hands full of my daughter's finger-paint blood, then turns and says, "We called the helicopter in. We're going to medevac her out to Children's Hospital in Austin. She needs immediate attention, and they're more equipped to deal with this than us. You need to keep her awake. It's still possible for her to go into coma, and that would be bad."
I stand looking at the door that's swung shut behind him. Bad doesn't even begin to cover it.
"How can she have diabetes?" I say to the man at the IV. "It's not like she's fat or anything. She doesn't even eat sweets that much." I think of the Sunny D loaded with corn syrup and a sliver of guilt creeps in. The man at the IV shrugs and leaves. I make a mental note to write the director of the hospital and demand he provide a seminar on bedside manners.
I spot a swivel stool in the corner and pull it over to Ashley's side. I take her hand. It's hot and dry. I think of when I was a kid and my dog dragged around like he had worms and my brother told me to test his nose. "If it's cold and wet, he's okay. If it's hot and dry, he's sick." Despite the ridiculousness of it, I reach out and touch Ashley's nose. She opens her eyes.
"Hi sweetie." I move my hand to her forehead as if I'm testing for fever instead of hiding the fact that I'm treating her like my childhood pet. "The doctors say you need to stay awake. Can you do that?"
She looks like she might want to answer, but then changes her mind. She swallows hard, then whispers, "Water."
Now I feel like rolling my eyes. "Dang it, Ash, is that all you can think about?"
Suddenly she vomits. It's mostly just water, I suspect because that's about all that's in her. Still, the sight of it makes me queasy, and I jump up, letting go of her hand and sending the swivel chair crashing into the metal cabinets against the wall.
"I need a doctor," I yell.
One appears almost instantly, a different one, and I wonder how many doctors a small town like Collier Springs can hold. It's not as if people are lined up in the waiting room.
This one, though, I like instantly. He immediately lifts the back of Ashley's bed, grabbing a pink plastic tub at the same time and handing it to her with a smile. "That'll wake you up, won't it?" He strips the blankets off her as a nurse rushes in.
"I'll do that, Doctor Benton," she tells him, smiling in that way that actors in the TV shows smile at each other when they're in love. He doesn't notice. She takes the sheets away and returns with clean ones and a washcloth for Ashley's mouth. I notice Ashley trying to suck the water from it as the nurse passes it over her face, and I throw her a scowl she doesn't catch.
Dr. Benton rests his hand on Ashley's head the way I was doing before she threw up. "You're a pretty sick little girl, aren't you?" He doesn't say it in the kind of condescending way someone educated might talk to a twelve-year old, but in a grown-up, compassionate way. He recovers the stool and holds it out to me. He sits on the end of
the bed and opens the clipboard Dr. Park had with him. I like that he don't seem scared she will hurl again.
"Ashley's got diabetes," he says to me. "Do you know what that is?"
I nod, but I really don't. I've heard the commercials for the blood test machines. It's on the news a lot lately too, what with America being so fat now they say. I don't know what it is for sure, but I know the people who get it are old, or have behinds wide as a bus, and end up blind and amputated. It has something to do with eating sugar, and I'm sure Ashley doesn't have it.
"There are two types of diabetes. We used to call them juvenile and adult-onset, but now we're seeing kids as young as six and seven getting the adult-onset, and adults can get the juvenile, so we differentiate now by calling them type 1 and type 2." He winks at me. "We in the medical profession pride ourselves on our creativity."
"What's the difference, then, if age don't matter?"
"Well, they're really two entirely different beasts. Type 2 is an insulin resistance, where a person's body might make enough insulin, even an excess, but not be able to use it. The body resists it. But type 1, which is most likely what Ashley has, is an autoimmune disease. Has she been sick recently with a cold?"
"She had the flu last week."
He nods, as though this explains it. "For most people, a virus, or the flu, is just an illness their body can fight off. In Ashley's case, though, the virus triggered her immune system to attack the pancreas and destroy the part that makes the insulin."
I don't know what insulin is, or what the pancreas does, but I nod because I don't want to open my mouth and look stupid. "So it's not because she's fat or eats bad?"
He laughs, and I like his laugh. It's honest and not patronizing. Patronizing is a big fancy word that means you think you know more than someone else. I learned it from one of Logan's school books.
"No. Type 1 has nothing to do with weight, or with what she eats. Even people with type 2 aren't always overweight, although being overweight does increase your likelihood of being insulin resistant. What Ashley has, the genetics have probably been dormant in her since she was born. It just took this particular virus, at this time, to set it off."
He looks past me at the door, and I turn to see Travis standing there, pale as a Pilsner. At the same time, Ashley begins to heave again, except nothing comes out. Dr. Benton jumps up and grabs the bowl and sticks it under her chin, but Ashley throws her arms out, knocking it to the floor. I scold her, but her eyes, which are wide open now, are wild and foreign. She pulls at the IVs, ripping the tape off her hand before Travis can get to her and wrap his arms around her, tying them to her sides. She struggles against it a moment before sinking back against his chest and sighing deeply. Her eyes close again.
"What the hell?" I've never heard Travis swear before.
"Is she in DAK?" I say to Dr. Benton, rushing to Ashley's side to take her hand and shake it.
"It's DKA," says Dr. Park, the rude note-taking doctor, who is now pushing me and Travis out of the way along with the two others who have come with him, steering a stretcher like the one from the ambulance. We are all crammed in this tiny room like clowns in a circus car, but I am not about to be the one to back out first.
"The Life Flight helicopter is here."
"Why the Sam Hill do we need a helicopter?" asks Travis.
Dr. Park doesn't even bother to explain. He flings a look my way that says it's my job to explain while it's his job to save. "Ashley needs to go to the Children's Hospital in Austin," Dr. Benton says, moving aside so the stretcher can line flush with the bed. "We just aren't equipped to help her the way she needs, and you as well. This affects your entire family. They'll make sure you get the best care, and that you are all ready to make the changes that need to be made before Ashley comes home."
"Changes?" I can tell Travis is not excited about that word. Lord a mercy, you'd have thought he'd had his arm cut off when I stopped making gravy every morning. He's been sitting in the same lazy chair since we've been married, driving the same dilapidated Ford truck, listening to the same Willie Nelson tape since I met him. Change is not his thing.
I stick my elbow hard into his ribs and glare at him. He shushes up. I glance at Dr. Benton, who is holding Ashley's head as they transfer her to the stretcher.
They are now pushing against us again, wheeling her out through the door and down the deserted hallway. "I'm going with her," I call over their shoulders.
"You get scared on a step ladder," Travis says, which I think is plain rude to say in front of everybody.
"I'll be fine. You need to pick up Logan and grab us some clothes and some sandwich stuff from the house in case there's no food places near the hospital. I'm not eating hospital food for supper. And call the church and let them know I can't come to the church today to help with the rally. And ask Janise if she will feed the goldfish until we get back. And call the flute teacher. I don't think we'll be home in time for lessons today."
I stop to think if there is anything else he needs to do when he says, "If there's that much on your list, why don't I go and you pick up Logan?"
"I'm sorry," Dr. Benton says, looking for all the world like he really is. "There's not enough room for you. Only Ashley and the emergency personnel are allowed. You can both drive and meet them there."
"We'll drive separate cars, then," I decide. "I'll go from here, you go get Logan."
"Why don't we all go together?"
"Because someone should be at the hospital when she gets there."
"You're not going to beat a helicopter, Babs."
I cannot believe we're standing in some hick hospital arguing over who's going to drive.
We're still following Ashley, though nobody now seems to notice us. Doors to a landing pad slide open, and we're greeted with a whoosh of air and the thwapping of the helicopter blades. "Make sure we got the paddles ready," one of them yells over the noise to the woman who is helping lift the stretcher and my baby in. "We may need them on this trip."
I am not educated. I do not know what DKA means and what a pancreas does, but I do watch ER and I know what paddles are. They are for people who die.
I whip back to Travis, whose slowly returning color has just drained again. "I'm driving myself – right now – because I drive faster than Jehu, and I'll get there before that dad-burned helicopter."
And that is the end of that.
~~~~
Chapter Four
Ashley was born screaming. I think she came out with her mouth open, her eyes scrunched into tearless cries, which no amount of bundling could soften until the nurses put her on my chest and I said, "Hi there, baby girl." And just like that, she stopped crying. She looked up at me with wide blue eyes, not even blinking, like she knew my voice from all those months inside me. The moment they took her away, she cried again until they brought her back.
We've been tight like that ever since. People told me when she grew up we'd fight like rattlesnakes. This is the nature of preteen daughter/ mother relationships, friends say. But this isn't so with Ashley. We are salt and pepper, sweet and sour, sun and moon. She is the blond to my brunette, the quiet to my loud. We are the opposites that attract. We need each other the way a bee needs the flower and the flower needs the bee.
I think about her first day of kindergarten, when we held each other's hand so tight it was hard to tell who was the most scared of letting go. I think about her birthday parties when I would invite her friends in and get the games started and be elbow-up with glue and paints and tissue paper crafts, and realize Ashley wasn't around. I'd find her in her room, reading a book, too shy to be the center of attention. I think of our fights in the grocery store over Doritos or Salt and Vinegar Chips. I think about her crying when she didn't make all-state choir and me baking her oatmeal cookies thinking that was all she needed to get over it.
I think about all this as I'm driving route 79 toward Austin. I wonder if she's crying now, needing me the way I need her. I want her to be. If she's
crying, then she's alive, and God knows how I need her to be alive.
My cell keeps ringing, a dancing little Martina ditty, but I don't want to talk. They are all people from the church, and I know the news about Ashley is spreading like poison oak all over town. I don't know what to say because I don't know anything, so I finally turn it off and pray Travis won't need to call me.
Then I try to pray about Ashley, only I can't think what to pray except, "Lord keep her alive." I finally decide this is about all I have to say anyways, so I fish for one of Ashley's favorite CDs and pop it in.
I press the pedal hard until I'm riding the tail of a muddy foreign car. She drifts over on the shoulder so I can pass, and I wave friendly-like even though I'm thinking she shouldn't be on the road at all if she can't keep up with the speed limits.
I turn up the music to drown out the fear. It's the David Crowder Band, a group Ashley learned about from friends at church. Once, when I came to the church to put up Christmas decorations, I saw her with them in the basement. They were sitting on the floor in the midst of other junior high kids, singing these songs along with the youth minister, strumming on his guitar. Red and green twinkle lights bounced off her hair and lit up her face in a warm glow that seemed to go right through her. Her voice rose above the others, high and sweet. I'm not the crying type, but I teared a bit and knew her life was taking a turn I might not be invited to travel.
I linger in the music before I turn it off again, preferring the company of the silence.
It takes a little over half an hour to get to Austin and longer than that to cross the city to the Children's Hospital. There are long moments when I'm stopped in traffic on the feeder roads, and I scan the sky for helicopters that might be heading the same direction. The skies are quiet today, blue and clear as a song. I hope she's there already.
In my mind, I planned to arrive, park, and be in the hospital before the helicopter can land. In reality, I can't find the visitor parking lot or where I should enter. The building is huge, and the parking spreads out forever, and I start to panic. I think I see three or four doors, and I break into a sweat trying to figure out which one is the one I need. This is an emergency so I should go in there, except the sign says ambulance only, and the front says visitors but I'm not a visitor. I am the mom. I park. I move. I park again. Shoot.