“It’s a hard thing to predict,” Nikki said as she unscrewed one of the pill bottle caps. One of the pills tumbled out into her palm, and she walked into the adjoining bathroom. Matthew gave Kathleen one more squeeze before letting go and following her. He watched as Nikki used one of the guest room cups to crush the pill.
“Do you have any water?” she asked without looking up.
Matthew nodded and fetched some, handing her a fresh bottle. She took off the cap and used it to sprinkle some water on the crushed pill, turning it into a paste on the edge of the sink. Then she used the cap to put the paste into the cup and poured a minimal amount of water into it. The water turned a cloudy white and seemed to have the consistency of orange juice with heavy pulp. Definitely drinkable, but chunky.
She walked by Matthew and said to him, “Help me hold him up.”
Matthew nodded, and he and Kathleen lifted David’s shoulders and neck into a somewhat upright position. David’s head lolled against Matthew’s shoulder. Matthew’s own heart wanted to break seeing his father this way. Nikki gently eased the concoction into David’s mouth, stroking his throat to help him swallow the medicine. It took a long time before the cup was empty and even then, Nikki swirled more water around in it to make sure he’d gotten everything. By the time she was finished, Matthew’s arms were aching again, and he saw the same strain reflected on Kathleen’s face.
“Okay, that’s it,” Nikki said, and she reached out to help Matthew and Kathleen ease David back on the mattress.
Ruth took up her position beside him and took David’s hands. “Do you think the medicine will help?”
Nikki shrugged even as her face looked bleak. “It can’t hurt,” she said. “Honestly, many of these medicines are mostly preventative, but they won’t do anything to worsen his condition. That being said, there’s a possibility that they might not be enough to help him at this point.”
Matthew sighed and helped plump the pillow David rested on. Beside him, his mother was still once more, as if she was trying to withstand the storm. Too still, really, but he knew that she was digesting information and would most likely need to be alone to vent her grief. “What else can we do?” Matthew asked.
“I assume that the stress of the last few weeks didn’t help his condition any,” Nikki said, running her hands through her auburn hair. “That, plus one of you had a gunshot wound, so I don’t think you’ve been living an easy life since everything went to hell.” She looked at Matthew. “What have you guys been eating? What did his diet look like?”
“Lucky Charms,” Ruth said flatly. “Lots of protein bars.”
“Manufactured foods,” Nikki said with a nod. “A survival diet for the century. I feel you, I’ve been doing the same. That probably didn’t do his arteries any favors, either. All that fat and carbs and protein, plus the processed sugars.” Nikki waved her hand in front of her as if cutting herself off. “It doesn’t matter. What matters is that he probably hasn’t eaten a lot of fresh foods, right?”
Matthew let out a breath. “Yeah,” he said. “We didn’t really have a choice.”
“I can’t blame you,” Nikki said. “I was in the same boat. You can’t really be picky when it’s a choice between eating crap or eating nothing at all. That being said, I have no way of knowing the extent of the damage done to him. Honestly, I don’t even know if this is a real heart attack or something that mimics an attack. Does he have a history of anxiety or panic attacks?”
Ruth shook her head. “No, not that I’m aware of.”
“Okay,” Nikki said and put her hands back on her hips. “I just hate making a diagnosis without knowing more.”
“Nik, you’re thinking too hard,” Wyatt said. “What’s the easiest solution?”
“Probably a second heart attack.”
“Okay then, what do we need to do for that?”
Nikki went silent for a moment. “It’s not that easy, Wyatt. Providing medical care for a patient that has internal injuries or trauma without electronic monitors is near impossible. I was trained to figure this all out with X-rays and scopes and electricity. Without it, I can’t get a clear picture of what’s happening inside his body.”
“If it is a clogged artery, wouldn’t it be worth it to find that out and clear it out? Or even clear out the partially obstructed artery?” Matthew asked.
Nikki looked agonized. “Surgery is risky even in a safe environment. Exploratory surgery on a patient without anesthesia would likely cause him go into shock from the pain. Cracking his chest open and messing with his heart is a good way for him to get infected. Infections could mean that he’d get worse even if I was successful at removing the blockages or putting in a stent. Plus, they are especially likely without a sterile environment. I’m limited. I’m so sorry, but I’m limited in what I can tell you and do for him.”
“Tell us what we can do,” Wyatt said. “You’re the one with all the knowledge. Give us some hope.”
Nikki rubbed her face with her hands. “For acute angina episodes, he probably needs a higher dose of nitroglycerin. Most likely, his doctor put him on a low dosage to see how he reacted. You said he was still full of fire, but would get winded?”
“He’d get tired and would have to rest. He’d sweat sometimes. But most of the time I think he avoided his meds as much as possible,” Matthew said. “In fact, I’m not even sure he was taking that preventative one.” Indeed, the bottle seemed mostly full.
“So adherence is going to be the most important thing.” Nikki looked out the window and the sunlight highlighted the green in her hazel eyes. “We’ll have to keep him on an aspirin regimen at a minimum, but there are a number of other medications that could help him—a higher dosage of beta blockers, an ACE inhibitor, even statins.”
“Sorry, what?” Matthew asked.
“Medicine for heart failure. They relax the blood vessels. Lower blood pressure or cholesterol. All things that put less strain on the heart,” Nikki said.
“Where do we find that kind of stuff?” Matthew asked.
Nikki took a deep breath. “The hospital,” she said. “While I’m making a shopping list it would be great to have some IV antibiotics in case he did get infected. Might as well go all out and get medical supplies for other injuries like suture kits, sterile gloves, and oh, can Santa please bring me some bandages while we’re asking for miracles?”
“Maybe we need to make a trip, then,” Matthew said, ignoring her sarcasm. “I might not be able to bring you miracles, but Galena does have a hospital. It’s about time we go down there and see what we can do. We’ll need those things regardless at some point. Why not get them now?”
Nikki stared at him even as a smile of appreciation spread across her lips. “I like how you think. Problem-solver, huh? Okay. Let’s figure this out. How do we get to the hospital?”
4
A surge of decisiveness ran through Matthew at Nikki’s question.
She dangled a purpose in front of him, and he was eager to pursue it. Going to the hospital would mean he could help his father. He wouldn’t have to be stuck in this newly-created sickroom. He could make up for doing poor CPR on David earlier. He could be useful. He could bring back the items that would save David’s life. Nikki’s question wasn’t just a purpose, it was also a plan.
“It will need to be calculated,” Matthew began, warming to the subject. “We’ll need a list of what you need, probably ranked by importance and where it would be in the hospital so we don’t get sidetracked.”
“That’s easy,” Nikki said with a wave of her hand. “Get me a pen and paper.”
“We’ll have to be careful, though, and bring weapons for protection. We have no idea who might already have taken over the hospital. Guarding its supplies. Maybe even selling them or trading for them. We should bring some food in the event that is the case.” Matthew steepled his hands in front of his chin, his mind whirring with the plan, and turned to see his mother still sitting on the edge of the bed.
> Silent tears covered Ruth’s face. Her mouth was pinched and tucked in at the corners, as if she were holding her grief inside and it was a difficult task. Both of her hands were cupped around one of David’s, and she was stroking the back of his hand carefully, as if memorizing every wrinkle and liver spot.
Matthew’s next sentence died in his mouth. He took in the sight of his mother and knew that this time would be much different than David’s first heart attack. They weren’t surrounded by people who knew what needed to be done. They didn’t have medical support or beeping machines giving an array of vitals. They didn’t have nurses coming to check in on him. They only had a very limited subset of knowledge that hinged on Nikki, and he knew that underneath it all, his mother was terrified.
She was terrified that David might not make it through the night.
If Matthew was being honest with himself, he was terrified of that thought as well.
How could he lead a mission to Galena’s hospital and leave his mother alone? He wanted to go to the hospital with every fiber of his being. It was his father’s health and life on the line, after all. He wanted to be involved in anything that would help save his life. Yet that burning flame of purpose was snuffed out in the face of his mother’s fear and sadness. He knew he had to be here. For her. She would need someone to be the rock, and that duty fell to him.
Matthew stepped forward and put a hand on his mother’s shoulder. Ruth turned to look up at him with reddened eyes. She didn’t wipe the tears from her face. “I’ll stay here, Mom,” he said.
“Oh,” Ruth said, “would you? Matt, that would mean so much to me.”
Matthew nodded and looked over to Wyatt, who still sat in the accent chair across the room. “Would you be willing to go to Galena in my stead?”
He hated asking. Wyatt had done so much for them already. The Marine had helped retrieve Patton, had even put his life on the line by getting involved in a gunfight with the cartel. He had called on Nikki to help them. Matthew’s family was full of mistakes and accidents, and it seemed like Wyatt had no skin in this game. Matthew expected Wyatt to pause, shake his head, and say he had business elsewhere.
Wyatt did pause. He looked over to Nikki and met her eyes. Matthew wondered how long they had known each other, or if she was just another member of the club who had sought sanctuary there when the world ended. “Yeah, I can go,” he said.
Relief filled Matthew. Nikki smiled slightly at Wyatt and said, “You’ll be going with me, Wyatt. No matter what, I’m heading down there. I need to see what’s available or even see if some of the second-tier meds are there that can work if the stuff I really want isn’t. I need to see the state of the hospital.”
“No one was arguing that,” Wyatt said.
Nikki nodded curtly. “Good. So me and Wyatt. Who else?”
“I’ll go.”
Matthew turned to the door to see Jade leaning against the doorframe. She wore a black tank top, and a lopsided bandage was wound around her arm and shoulder with a splotch of blood seeping through. Her arm seemed clean, though, and somewhat pinkened from scrubbing.
“I’ll go,” Jade repeated. “The Rileys need to stay here in case something happens to David. They all need to be together in case the worst happens. I don’t mind going into Galena to find what David needs. I’m a good shot, as Wyatt can attest. I can be the muscle.”
“Not sure you can shoot anything with that wound,” Wyatt drawled.
Jade grinned. “This old thing? It’s nothing.”
“Who bandaged you?” Nikki demanded, eyeing the wrapping with a critical eye. “A couple of raccoons?”
“A tween and a teenager, actually,” Jade said, shooting a crooked smile at Matthew.
Matthew couldn’t help himself. He smiled back at her.
“They’re good kids,” Jade said, as if realizing she was supposed to be defensive about the raccoon comment.
“I’m sure they are,” Nikki said.
“I mean it, though,” Jade said, looking back at Matthew. “I can go with them to the hospital.”
Matthew had so many things to say to her. He wanted to apologize. He wanted to tell her he was wrong in assuming she was a stone-cold murderer. Instead, Kathleen rushed forward and enveloped Jade in a strong hug. Over Kathleen’s shoulder, Jade made a meep sound and looked at Matthew with disbelief. Matthew shrugged at her, even though the warm feeling in his heart expanded and threatened to make tears prick at his eyes.
“Thank you,” Kathleen said, and if it were possible, she squeezed Jade tighter.
Jade patted her on the back and looked overwhelmed. “Of course. But watch it. I’m an injured woman.”
Kathleen pulled back with a tearful laugh. The two women looked at each other for a moment, and something passed between them. Matthew couldn’t put his finger on what, but he was happy to see that a new connection was forming. Not just a connection. A bond. It seemed the Riley family had added another member to their ranks they didn’t expect, and her name was Jade.
“We should have one more come with us,” Wyatt said. “Four is a good number. Two to defend. Two to search.”
“How about Max?” Jade suggested.
Collectively, they all turned to look at Kathleen’s brother, who stood against the wall, looking very much like he’d like to slink into the shadows. A bruise had formed under his jaw in the shape of a fist, and dark circles hollowed out his eyes. “Oh, I don’t know,” Max said, looking startled. “I’m actually not feeling that great after everything that’s happened.”
Matthew wanted to roll his eyes. Of course, Max was going to play it up that he was injured.
“Car wreck and two beatings take it out of a guy,” Max supplied again, his eyes skipping over all of them. He sounded somewhat panicked.
Kathleen’s mouth tightened, and she looked away as though ashamed of Max’s response. Max coughed, but didn’t say anything else.
Jade’s face was unmasked, disdain written on her features. “Seriously?” she said and cast him a judgmental look.
“Wyatt is way more capable than I am,” Max spluttered. “I don’t know how to shoot my way through packs of bad guys like he can. Three is better than four by a long shot.”
“Oh my god,” Jade said. “Nikki and I can look after ourselves, too, you know. It’s not just about having a big strong man to back us up. Take a moment and think. Some of those cartel members we fought got away. I watched two of them run down the road. You’re the person who would best be able to recognize them if we came face to face with them again. Without you with us, there would be a very good chance of us walking up to them saying, ‘Excuse me, sir, can you direct us to the antibacterial spray?’ before he takes us hostage!”
Max swallowed hard. “I see,” he said.
“I’m glad you see. What I see is that there are two people out there who we shot at and who got away. If they’re hanging around, thinking about getting revenge on us, I wouldn’t be able to pick them out of a crowd. You, on the other hand, are in with the cartel. You’ve seen their faces. Are you telling me that you’d still let us go into Galena without you, now?” Jade put her hands on her hips. Her green eyes glittered with anger.
Max let out a shaky sigh, and he seemed to wither under Jade’s rage. “Of course not. I’ll come with you.”
“That’s right, you will,” Jade said and turned back to Kathleen. Kathleen didn’t say anything and didn’t look up. Max lowered his head and studied the floor.
“We should get a move on,” Wyatt said, “I want to make it back before dark.”
Nikki nodded and beckoned Jade over to her. As she poked and prodded at Jade’s bandage, she started talking to Matthew. “Now, I know I might be telling you things you already know, but in the event that something does happen while we are gone, you need to keep David hydrated. Sprinkle a little water into his mouth and make sure he swallows it. Being dehydrated would be detrimental to his healing, and it’s one of the easiest things to fix. If we can give hi
s body that, then it won’t have to worry about seeking out a water source on top of dealing with a heart attack.”
“Of course,” Matthew said. “We have enough water that we can do that.”
“Don’t give him anything but bottled water,” Nikki cautioned as she unraveled Jade’s bandage and peered at the wound. Jade’s face screwed up in pain. “I don’t trust other water sources. Bottled water should be clean and fresh, if not sanitized. The worst thing that could happen would be if he drank contaminated water and it caused a septic infection. I’m not sure he would recover from that.”
Matthew nodded. Even though Nikki’s instructions were helpful, they also made him feel a bit overwhelmed. All the possible ways he could accidentally make his father sicker flashed through his mind.
Nikki made a satisfied sound as she rebandaged Jade’s shoulder. This time, the material was tight and methodical around Jade’s arm and shoulder. “Now, if for some reason, David stops breathing—”
Ruth made a choked-off sound and Matthew walked over to her, putting his arm around her for support.
“—and you need to do CPR, make sure he is lying on his back. A firm surface would be best. Place the heel of your hand in the center of his chest. I think that’s why you were having difficulties getting deep enough pressure earlier.”
“I know,” Matthew said tightly.
“I’m not trying to make you uncomfortable,” Nikki said. “Just reminding you. You want to interlock your fingers but don’t have your fingers falling down to touch the rib cage. You want to lean forward so your shoulders are directly over his chest and press down about two inches. Release the pressure and let his chest come back up. Rule of thumb is thirty compressions for every two rescue breaths. Should I go over rescue breaths?”
“Yes, please,” Kathleen cut in.
Matthew raised an eyebrow at her.
“What? I don’t know all this,” Kathleen murmured.
“Okay,” Nikki continued. “You want to tilt his head back so that his neck is somewhat lean and long. But not so much that its overextended. Natural. You want to pinch his nostrils closed with one hand that rests on the forehead while the other tilts his mouth open at the chin. Take a normal breath—you don’t need to gasp or fill your lungs huge or anything—and put your mouth over his and blow until you see his chest rise. You want to check and see if his chest is falling and that he’s not breathing on his own before doing it again. After two breaths, repeat the cycle.”
EMP Catastrophe | Book 3 | Erupting Chaos Page 3