by Dianne Drake
A seizure?
Sarah was immediately at his bedside, trying to turn him on his side in case he vomited up his stomach contents, but what she saw wasn’t a seizure. The man was so cold his body was shaking as hard as a body could shake. And he was literally going stiff.
Rigor? “I need help in here!” she called, as the man frantically grabbed at her hand. His hand was icy. So were his cheeks, she found as she laid her hand on his face. His body was literally in the throes of what happened when someone froze to death, and it was hard to hear his heart beating as she pushed her stethoscope to his chest, he was thrashing and shaking so badly.
She listened for a moment, heard his heart beating rapidly, but not critically so.
“What do you need?” Ina asked, rushing in. She took one look at Captain Regard and ran right back out of the room.
“You’re going to be fine,” Sarah said, wrapping a blood-pressure cuff around the man’s arm. “As soon as I make an assessment, we’ll get you warmed right up.” But what was making him so cold? That was the question she couldn’t answer yet.
“What the hell?” Michael sputtered, running into the room. “Fifteen minutes ago, when I admitted him, his temperature was spiking to four degrees above normal.”
“And now it’s dropped,” Sarah said, stepping back as Ina shoved her way in to take Captain Regard’s temperature. “To the point of rigors. What was your admitting diagnosis?” she whispered, pushing Michael out into the hall.
“Didn’t have one. He’s like the other twenty-five people we’ve admitted now, and I’m pretty damned sure it’s not norovirus.”
“Too bad,” Sarah said. “With noro we know what to do.” She breathed out an exasperated sigh. “Look, I know you’re in charge here, but I think we need to set up an isolation ward until we can figure it out. Keep these people separated from everybody else, get the lab work started, treat the symptoms until we know what we’re dealing with.”
“His temperature’s rising,” Ina called out.
“Start an IV, normal saline for now. And get him on oxygen.” Michael ran a frustrated hand through his hair. “And do the same for everybody else who’s come in with the captain’s symptoms.”
“He’s the captain?” Sarah asked.
Michael nodded. “Between us, I’m worried about how many of the crew are going to come down with this.”
“What about medical supplies?”
“We’re OK for now. Hope it stays that way until help arrives.”
“Which will be when?”
He shrugged. “They’re telling me soon, but not saying what that means. I have a suspicion the company is looking at its reputation, and sending in medical reinforcements to a ship with a couple of dozen patients with an undiagnosed illness is just bad publicity. They’ll take care of us, but let’s just say they’ll be careful at first.” He squeezed her arm. “I’m sorry I got you into this, Sarah.”
“I’m not,” she said, as one of the nurses ran by, carrying an IV set-up. “Look, Michael. Can you spare me for a few minutes? I have an idea.”
“Dr Sloan, the patient in number three is spiking a fever,” the other nurse called from down the corridor. “And we have an ankle sprain in Emergency.”
Before Michael could answer Sarah, she bolted out the door and ran straight to the elevator. Minutes later, she crashed through the doors to the photography class and ran toward the front of the room. Looking out over the group, she saw a sea of purple hats. “Martha,” she called out, spotting her friend in the crowd. “I need your help. Now.” Then she turned her attention to the rest of the ladies, who were whispering among themselves, wondering what was going on as the photography instructor assumed an angry frown over the intrusion. As Martha came forward, she whispered, “I don’t have time to explain, and I don’t want to cause a panic, but we need medical personnel in the hospital. Now!”
Martha acknowledged with a quick nod, then followed Sarah to the back of the room and waited until she had left before she looked around to see who in the class also had a medical background. Fifteen minutes later, after she’d discreetly called out four more purple hatters, the little troop of retired nurses marched their way into the ship’s hospital, ready for duty.
“We’re not going to put you in the ward where we’re isolating the ones with the undiagnosed illness,” she told Martha, who was wiggling her ample body into a pair of blue surgical scrubs. “We don’t know what we’re dealing with and I don’t want to put any of you at risk, but what I’d like you to do is manage everything else that’s coming in, which will allow Michael and me and the nurses already exposed to tend to the others.” Which now numbered thirty-two.
“We don’t need five nurses in the ER clinic,” Martha stated. “So I’m coming with you.”
“But we don’t know what we’re dealing with yet,” Sarah argued.
“And if you get yourself too rundown, you won’t be in any condition to find out. I know what I’m doing, Sarah. I spent my life working at a doctor’s side, being in the thick of it, and that’s what I do best.”
Sarah gave the woman a big hug. “I think this is called getting involved,” she said.
“In more ways than one.” Martha chuckled. Backing away from Sarah, she grabbed an IV set-up from Ina, who was on her way into Dr Allen’s room, and hurried to get to work.
“Where the hell did all those ladies out there come from?” Michael asked, minutes later, on his way back to the captain’s bedside. Tom Regard’s fever was on the rise again, and if the pattern repeated, he was about to drop to a nearly life-threatening cold shortly after.
“Purple hats, every last one of them. Desperate times call for desperate measures, and as you already had permission to find qualified help on board, that’s exactly what I did.”
“Well, I’ll be damned,” he said, as he swabbed the captain’s arm, readying himself to take a blood sample. “We wouldn’t happen to have a lab tech in the bunch, would we? Once I get the blood samples, I need someone to run them. My lab tech just checked herself into the hospital.”
“Let me go and ask Martha.”
Nine hours later, the crisis had not let up, and the slow trickle of patients into the emergency clinic continued. The cruise line was concerned now, and everything they needed was en route. Of course, with nine purple-hat nurses, two purple-hat lab technicians, and a retired purple-hat doctor who’d been called in by Martha and had subsequently taken total charge of all non-essential medical care, the hospital was functioning pretty well.
Captain Regard was doing better, after a simple prescription of acetaminophen, but he wasn’t out of the woods. And unfortunately, Dr Allen had taken a critical turn. Michael hadn’t left his side for the last hour as the man seemed to be suffering a serious cardiac crisis. Of the sixty-three patients they had in isolation now, seven were considered critical, nine were serious, and Dr Reese Allen, a man much too young and vital to be in his condition, was in a critical condition.
“Mike needs to take a break,” Ina confided to Sarah. “He’s not helping anybody, wearing himself out the way he is. But he won’t listen to me.”
“He’s dedicated,” Sarah said wearily. She’d been off her feet ten minutes, and was allowing herself twenty more, barring an emergency.
“Dedicated to the point of being foolish,” Ina snorted. “Loosely translated to mean stubborn as hell.”
“You’ve known him a long time, haven’t you?” Sarah asked.
“I was the first face he saw the first time he stepped foot in a hospital. He was…different from the other medical students. They all huddled together, scared, timid, not sure which end of the thermometer to use. But Mike…he stepped right out, distinguished himself.” She chuckled. “All full of big plans for his life.”
“He was materialistic?”
“Not at all. Mike was about as altruistic as anybody I’d ever met. He always wanted to make a difference. Wanted to do something good with his life. Had so many goals, so
many things he wanted to do as a doctor.”
And he’d ended up here on a cruise ship? It wasn’t a bad thing, and cruise ships did need medical personnel. But she seriously doubted that working on a cruise ship had been one of his goals, so what had happened to change him? His leg?
Sarah wondered about that, and she wanted to ask. She might have, but Ina dashed off in pursuit of an IV refill, leaving Sarah alone for the remainder of her break. At least, she’d thought she was going to be alone, but no sooner had Ina gone than Michael wandered into the doctors’ lounge, and dropped his lanky body onto a sofa there, letting out a weary groan as he lifted his legs up over the armrest. “If I weren’t so damned tired, I’d complain about how uncomfortable this sofa is,” he said, as his eyes shut. “Oh, and don’t let me sleep. I’m better off sleep-deprived than I am grabbing a quick nap.”
“Medical school days,” Sarah commented casually, giving him the full scrutiny of her medical expertise, studying him from head to toe while he wasn’t looking. Such a handsome man. Better than handsome, actually. He was the kind of man who took away your breath at first glance. Rugged, even a little hard around the edges, he looked like a man who’d seen a lot of living. Of course, that was only conjecture, as she knew practically nothing about him. “Back then I was up for a quick nap anywhere, even standing up, if I had to.”
He chuckled, but didn’t open his eyes. “I remember once, I was so tired that I literally fell asleep sitting at a patient’s bedside. When I woke up, a full hour later, I was still sitting in the chair, but had tilted over, with my head actually on the bed. She said I snored.”
“And she didn’t wake you up?”
“She felt sorry for me. I think she also figured I’d be a better doctor if I were a little more rested. So she let me sleep there, and even kept other people out so I wouldn’t be disturbed.”
“I think my worst was the elevator. I got on, leaned back in the corner, and apparently rode up and down for fifteen minutes before somebody was kind enough to lead me off.” He looked none the worse for the wear, she thought, still trying to make a casual observation. In fact, for all the hours he’d put in, he looked rather amazing. “Can I get you something, Michael? To eat, or drink?”
“Damn it, Sarah! I can get it myself! What the hell makes you think I need or want you to wait on me? I mean, who the hell do you think you are to me?”
That was a mood swing she hadn’t expected out of Michael. His mood changed so drastically, so quickly, it took Sarah a moment to realize that it had actually happened, and when that finally sank in, she was left wondering why. What was so dark in Michael that made him so defensive? “I wasn’t suggesting that you couldn’t help yourself, Michael.” She struggled to tamp back her own flare of temper. “But I’m at the end of my break and you’re at the beginning of yours, so I thought I’d do the polite thing and—”
“And what?” he snapped again. “Save me steps? Poor Michael. Look at the way he limps. Is that it? My leg makes me incapable of taking care of myself? Is that how you see it, because if it is, save the pity, Sarah. I don’t need it. Not from anyone, and especially not from you!”
Well, this was certainly a little hotbed of something she’d stumbled into. Problem was, she couldn’t hang around and find out what it was about. Duty called and medical emergencies took precedent over bad moods. “Good thing I don’t generally give pity,” she said, standing up. “And just so you’ll know, Michael, I’d have made the same offer even if you didn’t limp. Call me crazy that way, but I do like helping people when I can, and whether or not you want to admit it, you looked like…and still do look like…you need some help. But not from me. I’m out of here. Back to work. If you want something, get it yourself!” She headed toward the door but stopped before she got there, then turned back to face him. “You know what, Michael? We all have problems right now, and while yours may legitimately be worse than most of the others, it’s not right to take it out on me…or anyone else who’s simply trying to be kind. I know you’re in charge here, but I’d suggest you get your bad mood under control before you come back to work because none of us needs to deal with that along with everything else going on.” Harsh words, but she was glad she’d said them because he needed to hear them. He could bask in his damn bad mood another time, but right now he had more important things to think about.
As Sarah stepped into the passage, Michael let out a frustrated sigh. “Don’t go,” he managed, pushing himself part way up to look at her.
“Why shouldn’t I?” she asked, without turning around. She had so many feelings swirling around…. anger, hurt, frustration. Confusion. They seemed to do so well together in so many ways, her and Michael, yet there was always an intense wariness between them, one that neither of them had penetrated yet, and she wasn’t sure what to do about it. Or if she even wanted to try doing something. He wasn’t the only one with problems and complications in his life, and if they hadn’t been in such close proximity, she would have left. Right then. Left the ship, no looking back. Well, that wasn’t an option, was it? She wasn’t going to jump overboard, and the doctor in her compelled her to be here, with Michael, to take care of these people. So that was it—no choices.
“Look, Sarah, I think I owe you an explanation,” he continued. “And an apology for being so bad-tempered with you just now.”
“No, you don’t owe me a thing,” she said. Finally, she turned to face him. “Except civility.”
“People patronize me. Treat me like I lost my intelligence with my leg.”
She wasn’t surprised, but that still wasn’t a good enough reason for his attitude toward her. Who the hell do you think you are to me? She’d thought she was his friend. Maybe a little more. Silly her. “Maybe they do, and I’m sorry for that, but I’m not like that, Michael, and you know it. And I resent being the one you pick on because you’re feeling bad.”
“Look, could we pretend that I never came into the room and made a total idiot of myself?”
She did want to. But the things he’d said had cut so deeply she needed time to figure it out. “The deed’s done, Michael. But go ahead and pretend anything you want to, if it’s easier for you.”
Propping his head up on the armrest, Michael studied Sarah from that position for a moment, without making any effort to get up. “You’re an odd woman, Sarah Collins.”
“In a good or a bad way?”
“I don’t think there’s anything about you that could be odd in a bad way.”
“So I should take that as a compliment, that I’m odd in a good way? A sincere compliment, I hope, seeing that you’re trying to redeem yourself from being a total idiot.”
“You’re straightforward,” he said. “More so than anybody else I know, except Ina. Most people won’t even mention my disability, yet you seem to have some insight. And some gall to ague with a cripple, which, I might add, most people won’t do.”
“In other words, you beat them up and they let you?”
“I don’t beat them up, as you think. Most of the time I get better results beating myself up.”
She wanted to ask. Dear God, she wanted to ask. But there wasn’t time. “You said I had insight into your disability? Remember, I had a husband with terminal melanoma, so I suppose that did give me some insight. Oh, and in case I hadn’t mentioned it before, after Kerry died I got myself engaged to a man with leukemia. More insight there.” Lots of it, for a very long time.
“Did he…?”
“He didn’t die, but we didn’t make it.” She forced a half-smile, then left the room. There would be time for talking later. If Michael wanted to talk. If she wanted to talk.
“I’m sorry,” he called after her. “Please, Sarah. Forgive me.”
She turned back to the room to accept his apology, just in time to see Michael nod off. No snoring, though. The patient whose bed he’d slept on all those years ago must have lied about that. Not that it mattered, because when would she and Michael ever share a bed?
CHAPTER NINE
“YOU let me sleep for two hours!” Michael said, as Sarah sailed past him to admit the next patient.
The toll had now risen to seventy-six, and even though most of them were a long way from being critical, she was past the point of being tired. Her feet hurt. So did her head, her shoulders, her back. As well as everything else. But she was running on pure adrenalin now, so wired that even if she’d had the chance to sleep, she probably couldn’t.
“You needed it, and we were slow. We’re keeping those patients with the minor symptoms to confined to their cabins with instructions to check back in with us if their symptoms get worse. And I’m not patronizing you because of your disability. Just giving you my medical opinion.” She flashed him a grin. “Which, in this case, was valid. You look better.”
“I don’t get you, Sarah. You didn’t want to practice medicine so you quit it, yet when you’re given the opportunity to work again you blossom.”
“Sometimes it’s not so much about what we want to do as what we have to do.” Before he could ask what that meant, she turned down a side corridor leading to the small lab area and disappeared into the cubbyhole where Helen Weinstein, a seventy-something retired lab technician, was busy examining blood samples. “Anything yet?” Sarah asked.
“It’s a nice lab, very modern, but limited in its scope. I’m seeing a run of elevated white cells, elevated blood sugars, but nothing really significant other than that. And I don’t have the equipment to test for many of the specific conditions I’d like to. But I’ve got some bacterial cultures incubating and maybe that will tell us more. Unfortunately, they take time.”
“Do you think it could be bacterial? All along we’ve been going on the assumption that it’s some kind of virus, but if it’s bacterial that would make the way we’re treating this entirely different.” She did a mental check of all the various symptoms they were seeing, and while there was some commonality, there wasn’t enough to be conclusive. But the possibility that this could be bacterial did raise some interesting questions, such as where was the point of origin? In a virus it didn’t matter. One person got it, they coughed or sneezed and spread it to another. It was contagious from person to person. Bacteria weren’t contagious like that, so if this mystery illness wasn’t being transmitted that way…