He tried to remember the patients from his pediatric ICU rotation during medical school. What kinds of trouble could happen to a kid with meningitis, especially after going on the ventilator? Bleeding? Not likely. Increased intracranial pressure? Possibly. Maybe the neurosurgeons wanted permission to insert an intracranial bolt. That was an ugly thought—a trocar shoved through his baby’s skull.
His fingers trembled as he unhooked the pager from the waistband of his scrub pants. The overhead lights reflected off its ghost-blue screen and dimmed the message. He tilted the pager and squinted his eyes. “Call 79100, Dr. Dunwoody’s office.”
The chief of orthopedic surgery. Now what?
He stopped at a hallway phone.
“Good afternoon, Dr. Dunwoody’s office.” The secretary spoke in a singsongy, flight-attendant voice. Didn’t she understand that, at this moment, some people in this building were critically ill? Some were dying. Some were already dead. Don’t give me an empty-headed, chirpy greeting, he thought.
“Campbell,” he said. “Someone paged.”
“Oh, yes, Dr. Campbell. Dr. Dunwoody would like to see you. In his office.”
Three junior residents walked down the hall toward him, two men and a woman. They were laughing. One guy patted the other on the back. Jake didn’t want to see them. He turned his face toward the wall.
“Okay,” he told the secretary. What the hell does the Old Man want? He shook his head in disbelief.
“Is now a good time?” she asked.
A good time? Is there ever a good time to be summoned to the chief’s office? Had any time been good for anything in the last two days?
“Yes,” he said.
He replaced the receiver and glanced at his watch. Four o’clock in the afternoon. He wanted to go home. He didn’t want to deal with this . . . whatever it was. He stuffed his hands deep into the pockets of his clinical coat and headed toward the elevator.
This was the office of one of the most powerful men in the hospital—the chairman of the Orthopedic Surgery Department, the vice president of the Medical Center. Jake had been there several times in the past: when he interviewed for his residency position, when he signed his annual evaluation papers. Those were easy visits. He was sure this one—no matter what it was about—wouldn’t be easy.
“I’m Dr. Campbell.” He took a deep breath. “Dr. Dunwoody wants to see me.”
“Oh, yes.” The secretary peered over the rims of her reading glasses and then looked down at the phone console on her desk. “Dr. Dunwoody is on a long-distance call. He’ll be with you in a moment.”
Jake took a seat. Maybe someone had complained, possibly one of the clinic staff, likely Olivia, the extremely unpleasant head nurse. She had no sense of humor and took everything far too seriously. When the doctors remarked among themselves about a patient’s weight—“so and so’s eating herself into a knee replacement”—or about a patient’s lack of intelligence—“so and so’s dumb as a brick”—Olivia would get huffy. Maybe she had filed an incident report.
Or maybe one of the attending physicians didn’t like his work. That didn’t seem possible. Just two weeks earlier he met with the residency program director and his evaluations were in the four to five out of five range. Maybe one of the patients had had misplaced expectations or an unfortunate experience or a bad outcome and had filed a lawsuit. Just what he needed—Eddie in the ICU, Anna worried sick, and now this, whatever it was.
He stared at the covey of framed documents—there must have been at least forty of them—hanging on the wall. The Gothic letters on the yellowing parchments mapped the road to Dr. Dunwoody’s professional success: Teacher of the Year, the Murphy Award, Master of the Order of the Bone, The Hammer and the Saw Award. Transparent as ice, a crystal statue of a twisted femur balanced awkwardly on a waist-high oak pedestal. Its brass plaque, dimmed with tarnish and dust, read DR. DAVID DUNWOODY, PRESIDENT, AMERICAN COLLEGE OF ORTHOPEDIC SURGEONS, 1994–96.
Jake scratched his neck, realized that he needed a haircut. His stomach rumbled. When had he last eaten? Not today. Sometime yesterday. Sometime before Anna had called last night.
He didn’t want to think about that phone call. What was Eddie really like last night, lying there, sick, in Anna’s arms? She should have told him how ill Eddie was. He would have told her to take him to the ER immediately. Eddie could have gotten the antibiotics earlier. Why didn’t she realize he was so sick? If Anna didn’t panic about every little thing, he would have taken her call more seriously.
Slowly he shook his head. Food. He should focus on food.
Maybe his son had gotten sicker and sicker while he and Anna chatted on the phone last night. How was Eddie breathing then? Smooth as usual? Gasping? Maybe he should have asked her more questions, should have insisted she call the pediatrician. Why didn’t she do that on her own? She seemed to walk away from her responsibility as a mother. Not him. Physicians didn’t walk away from sick people.
But Anna was a good mother. Yes, she worried about the boys. That was normal. Admirable. She hadn’t neglected Eddie. She got him to the ER as soon as she could. In fact, if she had called 911 and waited for the EMS team, Eddie may have been even sicker by the time he arrived in the ER. What would Dr. Elliott have done if she had called him last night? Maybe nothing except tell her to do what she already did. Maybe he would have told her to take Eddie to the ER then. So many unanswerable questions.
His stomach grumbled again. His last meal was that Snickers bar at noon yesterday. Hungry as he was, he couldn’t imagine putting anything into his churning gut.
He glanced at his watch. He’d been waiting in Dunwoody’s reception area only a few minutes. Seemed like an hour. He stared across the room. In the center of the wall hung a huge aerial photograph of the Medical Center, its authoritative white stone exterior aglow against a backdrop of roiling, blue-green thunder clouds. Looks like today, he thought as he stared at the picture. Gloomy.
Wait. In truth, although it felt like a stormy day, the weather had been beautiful—clear and warm and cloudless—when he drove Chris to Rose Marie’s. His gaze rested on the upper-left corner of the building in the photo. The PICU. That’s where Eddie was, on the other side of the third or fourth window on the fifth floor.
“Dr. Dunwoody can see you now, Dr. Campbell.” The secretary rose from her chair and opened the door to the chairman’s office.
The afternoon sunlight shone through the Venetian blinds, casting stripes on Dunwoody’s silver hair, along the shoulders of his white coat, and over the papers scattered across his massive desk. As he pulled himself to his feet, the chairman waved his open hand toward the sofa. “Please sit.”
Jake sat. Dunwoody shuffled around the desk and took a seat beside him. The chairman had a limp. Who would do the hip replacement on the Old Man? Who’d have the courage? Jake wondered.
“Jake,” he said. “Heard about your son.” Dunwoody settled into the sofa’s cushions and adjusted his pant leg. His socks didn’t match. Both were brown but one had a faint herringbone pattern and was darker than the other.
“Terrible,” the chairman added.
“Yes, sir, it is,” Jake said. Maybe Olivia hadn’t issued a complaint after all. Maybe this wasn’t a dressing down in any way.
“Tell me what happened and how he’s doing.”
“Um . . .” It would be difficult to tell their story to this imposing man with steel blue eyes and strong hands tempered by thousands of surgical scrub brushes. “Well, Eddie has bacterial meningitis, probably Strep pneumo. At least that’s what the Gram stain suggests. The culture hasn’t grown anything yet, but it’s only been seven or eight hours since it went to the lab.” Tears began to blur his vision. Oh, God, no, he thought. Not here. He took a deep breath, held it until his lips ceased quivering. Then he continued speaking.
“They couldn’t control his seizures, even with Ativan and phenobarb, so they intubated him in the ER. He’s on the vent with pretty heavy pressor support. I t
hink his systolic pressure is now in the fifties, which is okay for a kid his age.” As long as he stuck to the medical stuff, he’d be all right.
“I haven’t thought about meningitis for many years, but he sounds pretty sick,” said Dunwoody.
“Yes, sir. It’s not good.”
“How’s your wife holding up?”
“She’s upset, naturally. And tired. And feeling guilty.” Lots of guilt, he thought. Hers. His. Yet, no one was really to blame. Bad things happen to good people, like Anna. Like him.
He felt the tears rise up again. He took another deep breath and blinked hard to keep them from spilling over his lids.
The Life Flight helicopter landed on the roof of the adjacent wing of the building and the whap-whap-whap of propeller blades filled the room. He stared at the floor. The sound of the helicopter faded, replaced by the hum of a fan.
“Jake, I know how miserable this is for you.” Dunwoody crossed his legs, lifting his left knee with both hands. “My oldest son drowned when he was three years old.”
Silence, huge and throbbing, filled the room.
“He fell into a pond. But those details don’t matter now. It’s the worst thing that ever happened to me. The absolute worst.”
Jake looked at Dunwoody, at the tilt of his lips, at the wrinkles beside his eyes. In a near whisper, he said, “I’m sorry, sir.”
“Michael didn’t die right away. After several months in the hospital, we took him home. He aspirated about a year later and then died.”
The room was silent again. Dunwoody rubbed his hands together impatiently, as if washing out a stain. “I didn’t intend to be so morbid, Jake. Hopefully, your son will come through this just fine. But it might be a long, tough, unpleasant journey.”
“Yes. Thank you, sir.”
“Has . . . What’s his name? . . . The chief resident . . . Hanson. Has Hanson been able to work with the schedule so you can have a little time with your family?”
“Well, I was on call last night so my next call night will be Wednesday . . .”
“I’ll tell him to give you a break. You look as if you haven’t slept for a month.”
“Yeah, this’s pretty exhausting.”
“Hanson and I will figure something out.”
“Thank you, sir.” He stood up.
“One more thing, Jake.” Dunwoody’s eyes had softened. They looked almost gentle. “Physicians usually do very badly as patients and even worse as parents of patients. They can’t keep their hands off the throttle, so to speak.”
His voice had softened as well. “Your son has many fine doctors here who will make the right medical decisions, but he has only one father. Don’t neglect being the dad.”
Chapter 14
Anna
If time could speak, it would be a backward, then forward twisting sound that roared like thunder at some moments, shrank into a sigh at others. As the hours stretched before her, they seemed an endless highway running for miles and miles into the unknown. And yet, sometimes those hours piled on top of each other, becoming stacks of important events—lab results, proclamations from the doctors, vital sign changes, new X-ray findings—that crowded at the top of the pile, crushing those that languished beneath.
Sometimes the hours twirled and roiled in nauseating swells. Sometimes they sailed onward as smooth as glass. No, she corrected her thought. They were rarely smooth, never slick as glass. She could hardly remember back when time had been normal, when days had mornings, noons, afternoons, and evenings, when night was night—the quiet, sacred time of sleep that gently folded itself around her and carried her to a peaceful place. When had they come to the hospital? A month ago? A week ago? She thought for a moment. Only a day ago. Yesterday.
Now, the only time that mattered was the fifteen minutes out of every hour she was allowed at Eddie’s bedside. Expectantly, cautiously, she clung to the brief moments when the doctors explained Eddie’s progress—or lack of progress. Her son’s blood pressure went up, his blood pressure went down. He breathed on his own for a short while, he no longer breathed on his own. His temperature was 38.8° C, his temperature was 36.1° C. His sodium was 128 and they slowed down his IV, his sodium was 141 and they turned up his IV. They lightened his paralyzing meds and he had a seizure; they increased his anti-convulsants and ordered a CT scan. She didn’t understand what it all meant, when it would end, how it would end.
Anna had staked her territory in one corner of the lounge. To her, the room was a refugee camp, teeming with others who were also displaced from their regular lives. Even now, during the daytime, some of the other parents slept on the shabby sofas. Their bodies were wrapped in flannel sheets, their scuffed shoes dangling from one end, their drawn faces and oily hair protruding from the other. A sea of remains—paper cups, crumpled Wendy’s sacks, French fry cartons, sandwich wrappers—spilled from the wastebasket.
This was her home now, her base of operations. A blanket, the gray scratchy one Jake had brought from the backseat of his car, lay folded over the arm of the chair. A pillow in a polka-dotted case was wedged against its back. The bruised banana and a foam cup half full of cold coffee—the detritus of lunch—rested on the table beside her. She settled into the chair and waited for . . . She wasn’t sure what she was waiting for, other than a miracle.
Somebody’s diaper bag sagged open, at ankle level, to her right. Inside she could see talismans—security deposits on promises that the sick babies would be well again, soon: a rattle to scare off evil karma, lotion to erase a witch’s spell, powder to sprinkle like moon dust, wipes to remove the dirt. It was all about hope, she concluded. Would that hope be rewarded or would it be dashed? Who could believe in such empty magic?
She shuddered, realizing that she, too, had made such promises. She’d said to a deity she didn’t believe in, “I’ll stay awake all night; I’ll keep Eddie’s teddy bear—the one with the blue M on the maize sweater and the missing left eye—nearby; I’ll be the most attentive, adoring, even-tempered, responsible, prepared mother of all times, if you’ll let Eddie be healthy again.”
But these deals were fleeting and she knew deep in her soul that such promises wouldn’t do any good.
The room was too hot. The light was too stark. Her neck itched. The skin on her legs had become scaly. A mix of odors—dirty socks, hamburger grease, stale sweat, ketchup—seemed to float past the lamp shades and coatracks to her chair. The muggy and fetid air was beginning to suffocate her. Every time she inhaled, she felt a germy puff sweep into her nose and spread, like a tea stain, across her throat and deep into her chest. Every square inch of the air in this room had flowed in and out of other people’s lungs—down into their insides, then out, and down into her insides.
The painting on the far wall mocked their children. It was obscene in this place. None of the parents here would want to stare at the dewy face of a toddler who giggled as she blew the fuzz off a dandelion head. The sign on the door commanded, in foreboding, black letters, NO CELLULAR PHONES. Beneath, an apology in smaller, light blue letters read THEY MAY INTERFERE WITH THE ELECTRONIC EQUIPMENT. She hated the carpet, the windows, the pale urine color of the ceiling tiles. This is what prison must be like, she decided. Mindless restrictions. Arbitrary schedules. Absence of privacy. Lights on all night.
“Anna, I’m headed to the cafeteria. Want something?”
She turned toward Charlotte, toward the sad and tattered face that wore an eternal smile. It was the mask of serenity, the façade of contentment. Charlotte was the mother of a seventeen-year-old cheerleader with brain cancer. “Thanks. I’m not hungry.”
“You sure?” Charlotte’s daughter had had her third operation yesterday. “I could bring coffee from the Starbucks stand?”
This was the sixth week of the daughter’s stay in the ICU. Charlotte had appointed herself dorm mother to the rest of the parents, had earned the position by dint of longevity. She explained the rules, gave directions to the chapel, loaned quarters for the vending machin
es, interpreted the routines.
Slowly Anna shook her head. She wasn’t thirsty, wasn’t hungry. She wanted nothing, at least nothing to eat.
“Maybe a latte?” Charlotte’s lips, thin and cracked, moved in a pained, crooked curl when she spoke. They were determined lips that belonged to a woman committed to making life better for people in the lounge. Maybe Charlotte thought her service to the others would be rewarded by miracles for her daughter.
“No, thanks. Maybe later.”
Anna settled into her chair and closed her eyes. Her swollen breasts ached. Her head hurt. She listened to the hum of conversation around her and opened her eyes to the stirring of the room. Sleep was impossible.
She paged through a Cosmopolitan magazine, pausing at an article about older men who marry younger women. She scanned the first column. “. . . second and third marriages . . . midlife crisis . . . sense of stability . . . fatherhood at fifty (or sixty) . . .”
Men. She knew about men, at least a couple of them. Jake, for one. Her father, for another. And little men, like Chris. Like Eddie. She shut the magazine. Half the people in the room were men, fathers of the patients. The twenty-something-year-old beside her, with a white buffalo tattooed on one arm and a blue chameleon on the other, had spent the last two hours cradling his head in his hands. The man across the room, in the UAW jacket that smelled of stale cigarettes and heating oil, picked at a scratch on his forehead as he pleaded with his wife to quit worrying.
“Just forget about it,” he said.
“I can’t,” she sobbed. “He’s my son.”
“He’s my son, too. You’re making yourself sick.”
“I don’t care.”
The jowly man with a salt-and-pepper pompadour and emerald green jogging suit held hands with a woman about a third his age. Maybe he had a sick-child crisis on top of a midlife crisis.
She picked up another magazine—last December’s issue of House Beautiful. A blue Christmas tree with silver balls sparkled on the cover. Christmas. What would next Christmas be like? Two days ago she had expected Eddie to be walking by mid-December, to be pulling the decorations off the lowest branches of the tree and tearing the wrapping paper off the gifts. Now she couldn’t imagine what their next Christmas would be like. She tossed the magazine back onto the table.
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