Mark waited for her to speak, his eyes flitting back and forth between her and Jonah, still sprawled on his side on the bed with a terrible vacancy on his face. “Can you open the shades?” she managed finally, gesturing at the heavy blackout drapes.
“Of course,” he said, moving smoothly to the window. In an instant, natural light flooded the room, subsuming the ugly brilliance of the track LEDs. Mark moved back to her. “Tell me,” he said.
“Acetaminophen poisoning is . . . bad,” she said, forcing herself to speak. “It’s especially bad when combined with alcohol.”
He gestured to Jonah. “Tylenol did this to him?”
“It didn’t make him unconscious. The benzos and the booze did that,” she said, trying to calculate the maximum length of time that could have passed since Jonah had taken the pills. At some point he’d likely have been vomiting profusely; he was lucky he hadn’t choked and died in his sleep. She heaved herself out of the S&M chair and crossed to Jonah, peeling up one of his eyelids. The sclera—the white part of the eye—was bloodshot but still white; not yellow, thank God. Next she pried open his mouth and lifted his tongue, inspecting the bottom of the mouth. Pink, not yellow. She felt herself sag in relief: maybe he hadn’t been this way for long.
“What are you doing?”
“Checking for jaundice,” she said. She closed Jonah’s mouth, but kept her hand on his face, stroking along the angle of his jaw up to his cheekbone. He did not respond. “Tylenol eats your liver. It’s a slow, nasty death, and once it reaches a certain point, it’s irreversible.”
“There’s nothing they can do? They can’t pump his stomach?”
They both startled as the wail of a siren reached them. “Not unless he just took it, and even then . . . There’s an antidote, but it’s time- and dose-dependent. If he took too much too long ago . . .”
She could not bring herself to finish the sentence. If he’d taken too much too long ago, there was no way to save him. He’d die.
Jonah would die.
“He’ll be okay.” Mark crossed to her and took her in his arms, wiping away a deluge of tears she hadn’t known were there. “He’ll be okay, Georgia.”
* * *
—
The family space adjacent to the ICU was standard-issue Hospital Waiting Room; crammed with fusty people, it contained angular pleather couches and a whole host of AARP magazines from the early 2000s, along with the mandatory wall-mounted television set tuned to Fox News. With bleary incomprehension, Georgia stared at the TV; a Barbie-esque blond woman stared heatedly back, her mouth moving and moving and moving.
They’d been in this room for hours, in a big downtown Charleston hospital less than an hour away from the hospital where Georgia and Jonah worked. She buzzed the ICU nurse yet again, and this time she was told someone would be out to talk with them shortly. She returned to Mark, who looked at her with new energy. “Did she say anything?”
She shook her head. “But soon, I hope.”
They waited. Neither of them wanted to eat, but every hour or so Mark had gone on a coffee run, traipsing down to the cafeteria and returning with yet another steaming cardboard cup. Georgia hadn’t been able to bring herself to leave the waiting area for a bathroom break, fearful she’d miss an update, so by now she was nearing a state of profound discomfort.
Doubling over, she made her way out of the room in a gait that could only be described as a speedy hobble. She flung herself out into the hall and into the doorway of the nearest restroom. It turned out to be a men’s bathroom, with several startled men standing at urinals, but no matter. This was an emergency.
When she emerged from the stall, feeling infinitely more comfortable, the men had fled. She washed her hands at length, splashing water onto her face in an attempt to ward off the desire to curl up and weep. She rubbed the cold water into her skin until her hands had gone numb and her cheeks stung. Looking in the mirror, she saw the face of a stranger staring back. She had Georgia’s dark red hair and her arched eyebrows and her stubby nose, but her eyes were hollow coals set in a mottled patchwork of pink and white, with nothing recognizable behind them. For a moment reality had suspended itself; Georgia had the impression she didn’t exist anymore, that she’d been replaced by someone else.
This—this feeling of extreme disorientation—had happened to her before. Her dad died in a hospital when she was seventeen, hardly more than a child. After her mother disappeared, Georgia and her father had forged their own little family unit of two, just her and him, preparing the food they liked, reading their books together at night by a fire, working on projects together in their workshop out back. After he died and she’d moved to Charleston, she’d worked for weeks to re-create their workshop in her little backyard, designing and building and curating the structure to match the original as best she could from her memories and the one photo she had of their backyard in Kentucky. All her dad’s things, including his tools and books, had been sold by her guardian at an auction to raise money for her care; it was one of her greatest regrets that she hadn’t had the foresight to snag and hide a few of his favorite items for herself. She’d give anything to be able to hold his beloved old calculator, to turn it over in her hands and see the numbers, encased in blurry circles from the oil of his fingerprints. Or the one ancient army jacket he’d worn every day in the fall, winter, and early spring; she could picture herself wrapped in it, inhaling his scent, resurrecting a momentary feeling of safety, of being loved by someone above all others.
Perhaps it was her special burden, her particular doom, that everyone she ever loved would leave her.
* * *
—
When she made it back to the waiting room, a slender woman with lustrous black hair stood with her back to the door, talking to Mark. From the confidence of her stance, Georgia immediately pegged her as the admitting ICU doctor, or possibly a toxicologist. She used her hands for emphasis, fluttering them in front of her like two brown birds as she spoke. Georgia rushed up, catching the tail end of her sentence: “. . . perhaps by tomorrow.”
“Georgia Brown. Like the song,” Georgia said, thrusting her hand toward the woman and then retracting it when she remembered that for obvious reasons ICU docs weren’t big on shaking hands. She nodded instead. “I’m Jonah’s friend, the one who brought him in.”
“Of course,” she said. She had a lovely accent, as if she were speaking in cursive. “I’m Stephanie Levin. Thank you for the information you provided to the ER doctors. Do you know how to reach Dr. Tsukada’s family?”
“Jonah isn’t close with his family; I don’t know how to contact them. I’ll work on it.” She hesitated. “But I can help you. I’m Jonah’s healthcare power of attorney.”
She and Jonah had each designated the other to make medical decisions on their behalf if the worst happened; as every doctor could attest, you wanted someone who knew you extremely well to do that.
“Thank you for everything you’re doing for him.” Georgia could barely contain her anxiety. “How is he?”
“I was just telling your friend here”—Dr. Levin nodded to Mark—“that it’s going to be a while before we know.” She angled the tablet she was carrying so Georgia could see it. “You’re a doctor at another hospital, correct?”
“Yes. A urologist.”
Dr. Levin tapped on the screen of the tablet. “Do you remember what this is?”
Georgia looked at the screen. It contained a graph with a horizontal axis plotting the plasma concentration of the drug and a vertical axis for the time elapsed since ingestion.
“It’s been a while,” she admitted. “But I think I remember you use this to determine how effective the acetaminophen antidote might be?”
“You’re close,” said Dr. Levin. “The name of the antidote is N-acetylcysteine, but we call it NAC. In certain situations, the nomogram allows us to figure out if liver tox
icity is likely; in this case, however, it’s not as useful because we don’t know the time of ingestion.”
Georgia slumped. “Jonah is still unconscious, then.”
“Yes,” Dr. Levin said. “We’ve had to intubate him to protect his airway from aspiration.”
Georgia nodded, and then, remembering Mark was likely to be bewildered, she translated. “She’s worried he’ll throw up and suck the vomit into his lungs. So they put in a breathing tube.”
“I got that much,” he said. “But does that mean he can’t wake up? Or you’re giving him more medicine to keep him unconscious?”
“It’s a good question. Right now we are not giving him any additional sedation, so we’re certainly hoping he’ll wake up once the drugs and alcohol wear off.” A tiny frown puckered Dr. Levin’s lips as she turned to Georgia. “What can you tell me about his drinking habits?”
Georgia knew where she was going with this. Chronic alcohol use and acute acetaminophen could be a bad mix. Not so much in the short term, but heavy consumers of alcohol faced more of a problem when their livers were suddenly called upon to detoxify large quantities of poison: they’d already depleted their stores of natural antioxidants, meaning a smaller amount of acetaminophen could take them down. She couldn’t suppress a wince. Jonah had always been a social drinker, but he’d upped his game in the wake of his firing, occasionally even to the point of slurring words. To Dr. Levin she said simply, “I think he’s been drinking more than usual lately. He’s been facing some difficulties.”
She could tell from Dr. Levin’s expression that she was aware of Jonah’s specific difficulties. Before she could even formulate an internal worry that Dr. Levin would find him distasteful because of them, she placed a gentle hand on Georgia’s forearm. “I can see how much he means to you,” she said.
“You need to know—he doesn’t regularly use drugs,” Georgia said. She could feel a flush warm her cheeks at the thought of Amsterdam. “He drinks and he had that benzo prescription, I know, but he didn’t steal drugs, like you’ve probably heard. Test him.”
“We already sent a tox screen and we’ll follow up,” she promised.
“His other labs,” she asked. “What do they show?”
“Since we don’t know what time he did this, or even what day, we’re assuming the worst-case scenario based on the timeline you gave us.” Georgia nodded again; she’d added four and a half hours of drive time to estimate the earliest possible time Jonah could have overdosed if he’d sped home and immediately chugged an entire bottle of Tylenol after talking to the Airbnb woman. But now it struck her: Jonah could have taken the Tylenol while still in the mountains. She struggled to contain her expression.
“Liver enzyme levels don’t correlate with the severity of a Tylenol overdose,” the doctor went on, “but we have to consider the possibility of significant, possibly even fatal, liver damage. But at this point we don’t really know. We’re also waiting on our second blood draw to retest his level.”
“How do his liver function tests look?”
Dr. Levin clicked on the screen and a different image came up: a list of Jonah’s labs. She took Georgia and Mark through them one by one, patiently explaining to Mark what each of them meant. Georgia tried to focus on her words, but it had taken only one glance to know: they were bad.
Dr. Levin read Georgia’s expression correctly, again placing a strong, slim-fingered hand on her arm. “You should go home and rest,” she said softly. “It will be a long time before we know how he’ll do. Go home and sleep and pray or meditate—or whatever you can do to gain strength—and come back tomorrow. I promise I’ll call you if anything changes, and I’ll make sure the next physician does too. We’ll take care of him, just like you would.”
Through rubbery lips Georgia said, “I will, but first . . . can I see him?”
Dr. Levin increased the pressure of her grasp on Georgia’s arm, her gaze soft and strong at once. “Come with me,” she said.
* * *
—
She’d seen a billion people in a state of unconsciousness before, including, at the end of his life, her own father; but nothing could have prepared her for the sight of Jonah in the ICU. He looked so small and helpless; a child caught in some monstrous alien contraption.
All physicians employ some degree of dissociation when viewing their most vulnerable patients; you had to master the trick of simultaneously thinking of them as fully human but also as a kind of disembodied technical challenge to master. This trick didn’t negate compassion or empathy, but it smoothed over your reaction, allowing you to process the worst of it later.
Here, though, Georgia couldn’t think of Jonah as a patient to be fixed, or as anything other than Jonah. Even with all the gadgets and tubes, even with the dull, insentient face of unconsciousness, he was so fully himself. His features were dear; his shock of black hair was dear; his thin, wiry shoulders and scrawny chest were dear. She wanted so badly to kiss him, to rattle him awake, that it caused actual physical pain: a searing sensation in her chest.
She gulped in air and looked away. By force of habit, her eyes drifted to the monitor above Jonah’s bed: his vital signs were normal and his ventilator-regulated breaths were measured and even. By machine standards, he was doing fine.
She picked up his hand, gripping it tightly, and leaned down to his ear.
“Come back,” she whispered. “Please come back.”
23
VINDICATION
MARK
The next day—Sunday—passed without much change. Mark had been scheduled to go to Raleigh for a meeting, but he quietly canceled, opting to stay another day or two in Charleston with Georgia. He couldn’t bring himself to leave her in the midst of her terror for her friend. The more time he had spent with her, the more he’d begun to admire her character. She was so honest, so authentic and open; even though she’d made it clear she cared a thousand times more about what happened to Jonah than she did about her budding relationship with him, it only served to deepen his respect for her. That kind of integrity was uncommon.
The word about Jonah leaked out: Georgia had told Stewart, who told the police, who told the clinic administrators, who told the press, who, naturally, told the entire world. Not the details, not that Jonah had overdosed. But within a day, everyone in Charleston had access to the knowledge that he’d been hospitalized for something serious enough to land him in the ICU.
As the long, torturous hours of Sunday bled into Monday, he remained by Georgia’s side. She refused to leave the hospital, so they spent the night in the waiting room. He couldn’t sleep, of course, sitting upright in a hard chair. Moonlight sliced into the room, falling through the blinds and across the floors in silvery stripes. Across the room, a discarded white hospital blanket on a chair trembled as air blew up from vents in the floor, its edges ghostly and ephemeral. An image of Mark’s mother appeared in his mind, her face eternally young and kind and full of comfort. He often did this when he was stressed or concerned: conjured up his mother’s features and held them as long as he could, allowing the unconditional acceptance in her gaze to warm him. Perhaps this was juvenile and maudlin, but he didn’t care. If you didn’t have anyone in the world to offer you unconditional love, the next best thing was the memory of someone who had once done so.
He would’ve sworn he hadn’t slept at all, but the next thing he knew the room was bright with sunlight. Fragments of the night returned to him: restless shifting in his chair; his attempts to bore himself to sleep by naming, in alphabetical order, all the states in America, then all the state capitals, and then, in desperation when that hadn’t worked, all the countries in Africa and Asia. (He’d always been a bit of a geography buff.) He thought he’d gotten through them all, but at some point in the process he must have drifted off.
Beside him Georgia still slept, her full lips parted enough to reveal the glint of her top two
teeth, her hair tumbling all over the back of the seat like a paint spill. Perhaps she sensed his stare in her sleep, because suddenly she opened her eyes. For a glorious moment there was pleasure in her gaze at the sight of him. Then the pleasure turned to confusion as she caught sight of her surroundings, and then, horribly, her face contorted in pain as she remembered why she was here.
They spent the day at Jonah’s bedside, whenever they were allowed. His condition did not improve.
In the afternoon, Georgia began to obsess about whether or not they’d locked the door to Jonah’s house after the departure of the EMTs, and he agreed to drive her back to check. As he drove, Mark registered the glowing cloudless sky and the ever-present lure of the sea, casting its brisk winds into the city. It was a gorgeous afternoon, almost evening.
They sailed through the city in her quiet car, the only sound the whooshing of the wheels on the road. Mark reached for the dial of the radio, flipping through the preset stations until he landed on NPR. Keeping the volume low, he drifted in the cultured murmur of the voices, a comforting and reassuring background sound even though for all he knew, they could have been discussing a massacre in South Sudan or the corruption of a treasury cabinet member or the erosion of the Arctic ice. As a single person, he often used the radio as a reminder of human connection, a way of eating silence, even when he didn’t want to know the news. He’d almost forgotten the radio was on when Georgia suddenly tensed and reached for the dial.
The Antidote for Everything Page 25