Providence (The Velvet Series Book 2)

by Diana Kane

  I pull out my phone as I step into consult room one and close the door. I select Catherine’s name from my contacts list and listen as the ringing stops on the fourth ring, intercepted by voice mail. It’s after midnight. I know that the three of them have long since called it a night. I redial Catherine’s number, determined to make her answer. Again her voice mail takes the call. This time I leave a message telling her I need her to call me as soon as possible. Not wanting to leave it at that, I redial her number a third time. A breathless Catherine answers on the third ring. I immediately know I’ve interrupted her quality time with Alex.

  “Sara?”

  “Sorry to interrupt, but I need a favor.” I briefly explain the situation to Catherine and ask if she can come in.

  “That man is an ass, a good surgeon, but an ass. Hold on just a second.” I can hear the noise as Catherine attempts to cover the microphone. I hear Alex groan in the background and ask if everything is ok. The sound of the microphone being uncovered comes through again. “I’ll be there in half an hour.”

  “Thank you. I’m going to owe you one.” A modicum of relief surges through me as I disconnect the call and exit consult one to rejoin Katrina.

  True to her word, Catherine is in the lounge 25 minutes later. As she pulls me in for a welcoming hug she whispers, “Sorry, had to freshen up.” I chuckle softly as we pull away from one another.

  “I figured I interrupted. Sorry again.” Catherine shifts her glance to Katrina and then to me. I nod to confirm that’s who I need her to speak with. Without missing a beat, Catherine makes her way over to Katrina.

  “Hello. I’m Dr. Waters.” Catherine extends her hand and shakes Katrina’s. “May I sit for a moment?” Katrina nods, and Catherine takes the seat on her right. “Sara has briefly explained the situation to me. I’m sorry Dr. Hastings was so unclear. If you’d like, I can take a look at Jill’s chart, her scans, and any notes to try to clear some things up for you.”

  “Would you please?” Katrina’s voice is a whispered plea, her demeanor that of a broken woman.

  “Absolutely. Give me a few minutes to see what I can learn, then we can talk.” Catherine rises from the chair and heads to the computer behind the desk.

  “Your close friend?” Katrina eyes me; I know what she is thinking. I can’t help but laugh a little.

  “Not that close. Catherine is madly in love with her partner.” I glance in her direction and see the small grin play over Catherine’s lips.

  A few minutes later Catherine calls over the counter, “Katrina, would you come here please?” I join them to find that Catherine has Jill’s first CT scan pulled up. “This is the CT that they took when Jill was brought in.” Catherine manipulates the mouse over the scan and begins circling it around an area of the skull. “If you look here you can see part of the skull over the left frontal lobe had been shattered.” Catherine scrolls down a few images and stops, circling the same area on a new image. “Some of those bone fragments were displaced into Jill’s left frontal lobe. They would have damaged the tissue and likely caused a great deal of bleeding. The common course of action would be to perform a lobectomy, or to remove a portion of the brain. Your frontal lobe controls a lot of emotions, memories, motor functions, impulse control and a variety of other things. While you do have two frontal lobes, damage to one can lead to changes in a person’s typical behavior. We really have no way of predicting the extent to which these changes will occur. Questions so far?”

  “Not yet, thank you.”

  Catherine switches to a slightly deeper view, this time of the brain’s surface. “If you look here, this is the midline of the brain. Ideally, you would see this align down the middle of the skull. As you can see, Jill has what we call a midline shift of 9 millimeters. This shift indicates how much pressure is on the brain. The higher the pressure, the greater the need for surgical intervention. With a midline shift of 9 millimeters, Jill would have absolutely needed a craniectomy to attempt to alleviate some of that pressure.” Catherine scans further, the damaged brain tissue of the frontal lobe is easy to identify. “This is the brain tissue that would have been below the point of impact. As you can see it is bright white, which indicates that it’s severely damaged. I’m unsure how familiar you are with anatomy, but Jill’s ventricles aren’t visible due to the large shift and the high pressure.” Catherine switches the scan to bring up Jill’s post-op images. “These images were taken after surgery. If you look at this scan, you can see that Dr. Hastings was able to remove a majority of the damaged brain tissue. It isn’t necessary to remove it, but with the bone fragments involved, I’m going to guess he had to in order to establish some level of control over blood loss. You can also see that the midline shift is still at 6 millimeters, which is still higher than we would like it to be. However, you can begin to see her right ventricle again, which is a positive.” Catherine shifts the view from deep to superficial and stops on what looks like half a skull. “This image shows what bone structure was removed and frozen. As you can see a majority of the frontal bone, as well as the anterior two-thirds of the parietal bone, are gone. Given the severity of the shift and the location of the injury, I would have done the same thing. When you see Jill, she is going to have a great deal of bandaging around her head as well as something indicating that she is missing a bone flap.” Catherine turns to Katrina and looks at her.

  “Please just tell me,” Katrina whispers her plea.

  “There is no way to predict outcomes correctly 100% of the time. Jill’s Glasgow Coma Scale rating was a 3. That is admittedly low. If a patient can score an 8 or above, they have a very strong likelihood of making a full recovery. I’ve seen people make full recoveries from GCS 6. I’ve also seen people with GCS 6 not recover. I’ve seen patients make partial recoveries from a GCS 3 score before.” Catherine’s words hit Katrina hard.

  “So you’re saying?” Catherine exhales slowly. I know she is trying to break the terrible news as gently as she can.

  “In my professional opinion?” Katrina nods. “I would advise you to be cautiously optimistic. Honestly, it isn’t an exact science. The human body tricks us all the time. You can see a healthy 40 year old who exercises every day suddenly die from a heart attack or an aneurysm. Likewise, there have been instances where individuals smoke a pack of cigarettes a day and drink heavily and live into their 90’s. This is no different. A GCS 3 is low, but I’ve seen partial recoveries from it. Should you hope for a full recovery? Absolutely. I would caution you though to be prepared for less, much less, unfortunately. Sadly this is something that’s just going to require time.” Catherine pauses to give Katrina a moment to process. She looks up at me and shakes her head slowly. I know then that there is little to no hope for Jill making any type of recovery. “Can I answer any questions for you?”

  “Can I see her? Am I allowed to see her?”

  “Of course. Come, Sara and I will walk you up there.”

  A few minutes later Katrina, Catherine and I stand in neuro ICU 7 around Jill’s bed. Visitors are limited to two in the ICU but given I’m still in my work attire and Catherine’s presence is familiar on this floor, so no one objects. As we stand there watching Katrina holding Jill’s hand and crying, I see Catherine grow visibly uncomfortable.

  “Still difficult to think about?” I put my hand on Catherine’s shoulder as I mutter the question under my breath.

  “Even after all this time. It reminds me of when it was Alex. How scared I was that I lost her. Maybe that’s part of the reason our bond is so strong. I know how it feels to almost lose her. I don’t ever want to let anything go unsaid or undone.” Catherine shakes her head slightly; like the movement will clear away her emotional cobwebs.

  “Understandable. Katrina, would you like to ask Dr. Waters anything else?”

  “No. Thank you very much for taking the time to help me understand. I’m sure Sara pulled you out of bed just to come here.” Catherine manages to stifle the grin that threatens to spread across her
face, but not the gleam in her eye as she remembers whatever she and Alex were doing when I interrupted.

  “No problem. Would it be alright if I check in with you tomorrow?”

  “Yes.”

  “Do you need anything before I go?”

  “No, I think I just want to be alone with Jill for a while, if that’s alright.” I nod my head that it is and write my phone number down for her.

  “Call me if you need anything, no matter the time.” Katrina nods that she will. Catherine and I take that as our cue and make our exit. “Thanks again. I really do owe you one.”

  “What are friends for? No bill for this one,” she tells me as she throws me a quick wink.

  “She won’t recover will she?” I press the button for the elevator, the doors opening immediately.

  “It’s highly unlikely. Right now she isn’t even breathing on her own. That would be the first step. Never say never though, I guess. Are you ok to drive?”

  “I’m fine. I just feel bad for Jill and Katrina.”

  “I don’t think I’ve met them. How do you know them?”

  “Jill was a patient.” I shake my head, unable to believe how one person can go through so much in the span of a few short years.

  “Are you close to them?”

  “Not super close, but I work with my patients for quite a while. You get to know them.” Catherine nods her understanding.

  “I’m going home to wrap my arms around Alex extra tight. If you need anything or if she has any more questions, I’m only a phone call away.”

  “Or three.” We both laugh as we get into our cars. I switch on the heat against the mid-February chill and wave to Catherine as she pulls out of her parking space.

  Chapter 2

  I wake up just after 5 am, despite getting to bed much later than I’m accustomed to. I guess some habits are not so easily broken. I try to go back to sleep, but give up after 15 minutes, figuring that I’ll be able to get to bed early tonight. The sound of sleet steadily tapping against the window makes it clear that I won’t be running outside this morning. I check my phone as I head downstairs to the gym I’ve set up in the basement. No messages from Catherine or Katrina wait for me, and I leave the rest to deal with later. I switch on Netflix and hop on the rowing machine to warm up my core. 15 minutes on the rowing machine, 15 minutes on the treadmill and then arms and shoulders with the free weights. I make it through two episodes of Grace and Frankie in the time it takes to complete my routine.

  Sweaty and high on endorphins, I push my burning muscles up the stairs and head toward the kitchen to see what I can throw together for breakfast. I put together a grocery list and clean up my mess while I eat, my habit of being as efficient as possible ruling my actions, even on a day off.

  My phone rings as I’m pushing the cart to my car. “Morning Abby.”

  “Good morning. I just wanted to get an update on Jill and Katrina.” I take a deep breath and exhale before giving Abby a quick summary of the situation. “That doesn’t sound good.”

  “Catherine said she very likely won’t recover, and if she makes any recovery at all, it won’t be a full one.”

  “When did Catherine get involved?”

  “I called her last night and asked for a favor. Hastings’s bedside skills are unimpressive, and Katrina had questions. Catherine was kind enough to come in.”

  “I can’t believe you got her to answer the phone,” Abby manages through her peel of laughter.

  It’s my turn to laugh now. “Only took three back to back calls.” Abby laughs again. “I’m going to go up there in a little bit to see how Katrina is holding up. I need to take care of my groceries but can meet you outside of the Biggby in the lobby in about half an hour.”

  “Sounds like a plan. I’ll see you then.”

  “See you then.” I disconnect the call. Abby learned a long time ago that I never end calls with the typical good bye. Good bye just seems too final, so I don’t use it.

  Half an hour later I’ve put in an order at the coffee shop and am waiting for the lattes and Abby’s Chai tea. I see Abby coming towards me as the barista places the three drinks in a carrier for me. Unlike last night, the cups are labeled with their contents. As Abby draws near, I extract her tea from the carrier and greet her with it.

  “Thank you! What a dreary day.” She takes a tentative sip of her tea. “This is perfect.”

  “Shall we?” Abby tilts her head towards the elevator as she takes another sip of her tea. We board the elevator and head upstairs to the ICU. “Did you guys have a good time last night?”

  “We did, thanks again. Catherine insists we try again when you can make it.”

  “Absolutely.” The ding of the elevator alerts us to the fact that we have arrived at our destination. We knock to announce ourselves and wait to be told to come in. Katrina looks back at us as we enter, her eyes puffy and red.

  “Sara, Abby. Thank you for coming.” Abby, always a hugger, pulls Katrina into her arms. I see Katrina struggle to keep it together as Abby offers her the typical platitudes and comforts you hear in these situations. Katrina gives me a small smile as she pulls away from Abby. I move towards her and extend the drink carrier, allowing her to take her pick. “I’m going to owe you a franchise at this rate.” She takes the carrier from my hand and sets our drinks on the small tray table found in every patient room. She pulls me in for a hug and surprises me as she continues to fight off her emotions.

  “You won’t owe me anything. Do you need anything else?” I whisper to her. Abby gives me a small smile of approval before turning to make her own assessment of Jill.

  “No, thank you. Thanks for coming back.”

  “Of course. You could have asked me to come back at any point, and I would have. You don’t have to face this alone.”

  “Thanks. I plan to let our friends know what happened later today. I’m just not ready for the inevitable traffic and the questions that will come along with it. I’m not ready to explain this time and again.”

  “So don’t. Take the time you need. Ask for some privacy. The only people you need to be strong for right now are yourself and Jill. Abby and I can leave if you’d like. We just wanted to check in.” Katrina pulls away from me and looks me in the eye.

  “No, you can stay. I wasn’t throwing you out. I don’t know, it feels easier with you. You know the situation, I don’t have to explain it to you, try to answer your questions, or deal with your emotions instead of worrying about mine.” Katrina looks back and forth between us before settling her gaze back on Jill. “Does that sound terrible?”

  “Not at all. Why don’t you sit back down? Did you sleep at all after I left?”

  “Not really. I might have dozed for a few minutes here and there, but if I got an hour, I’d be surprised.” I figured as much. I pick up her latte and hand it to her. She accepts the offered cup and takes a sip. Abby and Katrina start to talk a little, and it becomes clear to me how much closer Abby allows herself to get to our patients than I do. I enjoy my latte as I silently watch their interaction, not hearing a single word they are saying. A slight pang of jealousy hits me as I wish that I possessed the social ease that Abby does. I’ve never seen her struggle when conversing with a stranger, nor does her self-confidence ever seem to waiver. Suddenly I realize that Abby is staring at me. Katrina turns to look at me seconds later. I have no idea how long I’ve been lost in watching them, criticizing my own inability to be more like Abby. I gauge the fullness of the cup in my hand; as if I could measure time by how much of the rejuvenating beverage I’ve consumed. My cup is almost empty, and Abby and Katrina continue to stare at me.

  “Sorry, I zoned out.” Abby simply shakes her head, a knowing grin plastered on her lips.

  “Typical. I have to get going so I can get to the shelter for my volunteer shift. Are you leaving with me?” Am I? I have no idea if I should leave or if Katrina would rather I sat with her for a while. I look at Katrina, searching for an answer. Her eyes quickly s
hift to the vacant chair and then back to me.

  “I’ll probably stay a little longer.” A little of the tension eases out of Katrina’s shoulders when she hears my answer.

  “Ok.” Abby gives Katrina another hug and writes down her phone number. “Feel free to call me if you need anything.”

  “I will. Thank you for visiting.” Abby says goodbye and makes her way out the door. I take the seat that Katrina indicated moments ago.

  “Did you want me to go? I will if that’s what you want, I wasn’t sure.”

  “No, please stay.” Katrina never takes her eyes off of Jill. We sit there in silence, and I find myself once again tuned out as I stare off into space. The sound of Katrina’s chair sliding over the tiled floor pulls me out of my trance. “Do you want to go for a walk? I’ve been sitting in this chair since we got here last night.” I think about this for a second and realize that this means Katrina hasn’t eaten.