Arrhythmia

  They tore into the ER with the typical urgency of a serious accident. From a distance, I could already hear the racing pulse of the injured patient, who was attached to a monitor. The heart rate was far above that of normal excitement; this patient’s circulation was about to fail.

  One of the paramedics called out the initial information.

  “Traffic accident. Patient was trapped in the vehicle for almost an hour. Stabilized, open fracture of the lower leg with massive loss of blood. Other injuries not clear. When we arrived, he was still responsive and his circulation stable. Just now, he’s starting to lose consciousness and his pressure is sinking.”

  That explained the high pulse rate. The heart was trying to compensate for the volume depletion by pumping faster. The patient urgently needed a transfusion.

  I held open the door to the trauma room for the group and looked at the patient for the first time. My eyes got wide and the rest of my body froze.

  The dark-haired man looked painfully familiar.

  “My God,” I heard Heimer call. “Is that DiCastello?”

  I reeled and had to steady myself on the doorframe.

  Was it possible? Was that really Desiderio or just somebody who looked like him?

  The EMT destroyed my hopes. “Yes, he told us he worked here.”

  Oh my God.

  Completely incapable of forming a clear thought and as if in a trance, I watched the frantic bustle in front of me.

  Seven people helped heave Desiderio from the stretcher to our emergency gurney. As the EMTs stepped aside, I was able to see the extent of the injuries.

  His cervical spine was being stabilized with a collar that covered most of his face. The visible part was covered in stripes of dried blood that had trickled out of several small wounds presumably caused by a shattered windshield.

  Small cuts covered his entire upper body. His shirt had been cut away to allow access to his chest. Distinct bruises caused by the seat belt were already visible.

  His left pant leg had been cut open up to the hip. Despite the temporary splint and the thick bandage, an unnatural bulge on his shin showed where part of the bone had broken through the skin.

  The frantic beeping of the EKG machine screamed in my ears.

  I became ill.

  While all the others performed their tasks in a routine manner, all I could do was stand there and try not to faint.

  “Dr. DiCastello? Can you hear me?” Graml, the anesthesiologist, said loudly while the resident skillfully found a vein and drew blood.

  Desiderio tried several times to open his eyes, but he kept losing consciousness.

  “You’re at the hospital,” the anesthesiologist continued, regardless of whether he was being heard or not. “You’ve had an accident. Everything will be all right now. We’re going to take care of you.” He turned to the male nurse. “We need a volume replacement. Give him a liter right away. Then he urgently needs several units of blood.”

  Heimer did an ultrasound on Desiderio’s abdomen to check for internal hemorrhages. Meanwhile, he barked terse instructions. “Two units at once, and have another four ready. No indication of a ruptured spleen or the like for the time being. Lisa, let the OR know that as soon as we’re done with the CT, we’ll be over there. Dr. Graml, please go ahead and intubate.”

  Lisa pressed the blood samples into my hand while she called the OR team.

  I did not react.

  She snapped her fingers in front of my face and shouted, “Lena! Pull yourself together and get this to the lab!”

  I awoke from my coma only when she gave me a little shove. I ran off at once.

  The hallway to the lab seemed twice as long as usual. I flew across the ugly green linoleum floor with long steps and listened to the rhythmic clacking of my soles. There was something soothing about that. Breathless, I reached the lab. The lab technician had been expecting the samples and immediately placed the little plastic tubes into her mysterious machines.

  “I need two units in the OR right now,” I said. “And four more at call.”

  The technician nodded. “I’ll call with the Hb level as soon as the centrifuge is finished.”

  With that, she disappeared to do her work. The way I should have been doing mine. After all, it wasn’t my first time dealing with a seriously injured patient.

  But it was the first time that this patient was someone I loved.

  Fear and panic welled up in me.

  Desiderio could die just from the massive amount of blood he’d lost. That wasn’t even accounting for the fact that he might have suffered a severe head injury that could lead to a brain hemorrhage.

  I was completely beside myself as I headed back to the ER.

  As I turned the corner, I caught a glimpse of the team wheeling Desiderio into the CT room. By now, he had been anesthetized, and a thick plastic tube attached to a mobile breathing apparatus protruded out of his mouth.

  I quickened my pace in order to go into the exam room, but Lisa blocked my path. “No. Not a good idea.”

  She slammed the door in my face. I stood rooted to the spot, looking at the wood with its light green lacquer until Dr. Heimer came out.

  He gently took my forearm and led me to the outpatient department. Once there, he carefully pressed me into a chair in the kitchen.

  “Have a cup of coffee, Lena. I’ll be back as soon as I know something,” he said in a calm tone. He left the room with a compassionate look.

  I sat there and looked out the window.

  The whole time, I felt like I was trapped in a bad dream. I hoped that I could finally wake up.

  That I would wake up, turn over, and find Desiderio lying next to me.

  Oh God. He can’t die. No, he just can’t.

  After a while, Heimer returned as promised.

  “The CT is complete,” he explained in a matter-of-fact tone. “The skull is intact. The fracture of the lower leg is clear. In addition, there is a small crack in the pelvic ring—which is stable, however—and multiple rib fractures on the right. The lungs are well ventilated and intact. He’s being brought into the OR so we can reduce the fracture of the tibia. Don’t worry; he’s young and physically fit. We’ll soon compensate for the loss of blood, and then it will only be a question of time until he is completely recovered.”

  I listened to his account in silence. Of course, I was tremendously relieved to hear his words. Still, though, I was fully aware that Desiderio was not quite out of danger. His circulation was unstable, and the anesthesia would put additional strain on his already-stressed heart.

  It was truly a curse to know all the risks in a situation like this.

  I folded my arms and placed my chin on them in exhaustion. The doctor patted me on the shoulder to encourage me and hurried back to the OR.

  Lisa came by with the empty stretcher. As she passed the kitchen, I jumped to help her. She stopped me in the doorway.

  “No, no,” she said gently. “Stay here. I’ve got this. You’re useless right now anyway. Besides, there’s only one other patient here, and I’ll manage perfectly well. If things escalate, I’ll come and get you.”

  I nodded weakly and sank back into the chair.

  Lisa scratched her ear a little sheepishly. “I’m sorry I yelled at you earlier.”

  “That’s all right,” I croaked. “I needed that.”

  She gave me a timid smile before she left the kitchen.

  The large ER was directly next door, so I could clearly hear her puttering around in there. And I could also hear that one of the EMTs had returned because he needed some information or other on Desiderio. Lisa gave it to him and then asked what exactly had happened. I listened intently to the ambulance driver’s account.

  “He must have been on his way home. Presumably, he was either inattentive or tired or both. In any case, he somehow
drifted out of his lane and went into a skid. It was his bad luck that, just at that moment, a truck was coming in the other direction. He hit it head-on with full force. You should see his car! Incredible. By the time we got there, I was pretty sure there wasn’t much we could do for him. It’s hard to believe that it’s possible to survive in such a heap of metal. The whole engine had been pushed into the passenger cabin. That’s why his leg was caught and we couldn’t stop the bleeding for the longest time. When we finally got him out, there was really no time to waste!”

  Everything began to spin around me.

  He was tired and inattentive . . .

  Because of me.

  It was my fault that he was in critical condition.

  And I would never be able to forgive myself for that.

  Chapter 34

  It was getting dark outside, and I was still motionless in the kitchen.

  Lisa came in and told me that she had just spoken to the police on the phone.

  “At the accident site, Desiderio gave the police the phone number of a Ms. Bauer. Any idea who that is?”

  I shook my head.

  I began to realize there was a lot I didn’t know about Desiderio. I didn’t even know when his birthday was!

  “Oh well. It doesn’t matter,” Lisa said, having noticed how depressed I looked. “In any case, she’s on her way over.”

  I didn’t react, so she disappeared again.

  Heavy raindrops fell against the window and completed the gloom of the whole situation. Time and again, my hand slid into my pocket and felt for the folded letter inside. I didn’t dare read it again. Nor the missed text messages from him. His words would only rob me of the last bit of composure I had left.

  Every time the automatic door opened, I jumped up, hoping Heimer would come out of the OR.

  This happened at least ten times before the attending physician at last came striding down the hallway. His exhausted but satisfied expression already spoke volumes. Still, I nervously cracked my knuckles as I rushed up to him.

  “Everything went well,” he told me cheerfully. “The lower leg is back to being the way it should, and his condition has stabilized well enough that we no longer have to ventilate him. But he will have to spend the night in intensive care. Just as a precaution.”

  I began to make a move to go to Desiderio, but Heimer held me back.

  “Take it easy, Nurse Lena. Give the staff some time to take proper care of our young doctor. They’ll call here when they’re ready.”

  “Thank you,” I said quietly. At that moment, it was the best I could do.

  “Don’t mention it.” Heimer gave me a mock salute and disappeared into the doctors’ lounge.

  I began impatiently pacing the hallway.

  Everything was OK. His circulation was stable. He was out of the woods.

  But I would only really believe it once I had seen him with my own eyes.

  It was late now, and the night nurse came in to start her shift. By the shocked looks she gave me, I could tell Lisa had headed her off and filled her in. Eventually, she rushed past me into the locker room, greeting me only briefly to avoid having to find some sort of encouraging words. I didn’t mind. I, too, hated having to come up with empty phrases for distraught friends and loved ones.

  The outpatient clinic phone rang. I whirled around and looked at Lisa, who answered. She nodded at me, and I was gone.

  For the first time, I entered the intensive care unit not as a nurse but as a friend.

  Had the sounds of the many machines always been so frightening?

  I hesitantly stepped up to the nurses’ desk.

  An older, stern-looking nurse I knew only fleetingly looked up.

  “He’s in one.” She pointed with her chin and then returned to looking at her paperwork.

  I timidly walked along the dark hallway.

  I passed two patient rooms, each occupied by two patients on ventilators. Desiderio’s was the last, and it was a single room.

  I stopped briefly outside the door to compose myself.

  He was not likely to look great. At least I knew he would no longer have a tube in his throat, and that was sure to make the sight less frightening.

  I realized I’d forgotten to ask if he was responsive.

  Well, I was about to find out.

  If only I could finally bring myself to enter his room.

  I took a deep breath in and out. Then, with my hands shaking, I pushed back my hair and forced my legs to move forward.

  I was only halfway through the door when I stopped again and gazed into the room, thunderstruck.

  It wasn’t only Desiderio’s wretched appearance that made me stop in my tracks but also the attractive blonde sitting by his bedside and lovingly stroking his head.

  It was the woman from his dining room.

  Although her eyes and cheeks were red from crying, she was still gorgeous.

  The shaking in my hands rapidly spread to my entire body. My knees threatened to give in, and I could feel angry and desperate tears making their way to the outside.

  That was Ms. Bauer.

  Desiderio had given the first responders her number so she could come and support him.

  He hadn’t mentioned me. I wasn’t his emergency contact.

  But he knew you were here anyway, silly.

  Stupid inner voice of reason. I was not in any condition to think rationally.

  The blonde looked up because I’d made a slight snorting sound.

  I couldn’t stand to have her look at me. I had to get away.

  “Wait!” I heard her calling as I turned on my heel. “Lena?”

  Surprised, I stopped.

  How does this bimbo know my name?

  I slowly turned around. The blonde had followed me into the hallway.

  “So you’re Lena?” she wanted to know.

  I crossed my arms and haughtily raised one eyebrow. “Yes. And who the hell are you?”

  At first, she seemed startled by my hateful tone, but then she began to laugh.

  Was she nuts? What was so funny?

  “Desiderio wasn’t exaggerating when he told me about your temper.”

  Huh?

  My second eyebrow rose into a questioning frown.

  The blonde graciously extended her hand. “Hi, I’m Susi.”

  “Who?”

  “Susi,” she repeated patiently. “Desiderio’s cousin.”

  “Are you sure?” I asked in shock.

  “Uh, yes. Quite sure.”

  Oh. My. God.

  If I still had any color in my face, I now lost it completely.

  This was Cousin Susi? From Munich? Who was like a sister to him?

  My stomach tensed up, and I tasted bile.

  Desiderio was lying in intensive care, gravely injured, because I had been so incredibly bonkers that I had decided that he was having an affair. With his cousin.

  I groaned and tore at my hair.

  Susi lowered her hand and looked at me with concern. “What’s the matter?”

  “My God, Susi, I’m so sorry for everything!” I wailed.

  “What?” she asked, confused.

  “This! All of this!” I stammered and tried very hard not to scream. “It’s my fault that Desiderio even had this accident at all! Because I am a giant idiot. A hysterical asshole. A stupid cow!”

  “Now, now, calm down,” Susi soothed me. “Nobody is to blame for Desiderio’s accident. He wasn’t paying attention and drifted off the road.”

  “Yes, because of me! Because I was such a lunatic!”

  I tearfully recounted the whole story to her. That I had seen her. That I had thought he was cheating on me. That I had been too much of a coward to talk to him about it. That I was the biggest moron on earth.

 
Even though we didn’t know each other, she took me into her arms to console me. “That is dramatic, sure, but what’s done is done. And the accident isn’t all your fault. I’m sure Desiderio feels the same way.”

  Desiderio.

  I looked at the open door to his room. Susi noticed and released me.

  “Go to him. He’s very tired, but I’m sure there’s nothing he wants more than to see you now. Go on!”

  When I didn’t budge, she summarily pushed me into the room and quietly closed the door behind me so I couldn’t bolt.

  I stood there like an idiot and furtively wiped the tears from my face.

  Now that the blood had been washed off, Desiderio didn’t look quite so terrible, but it was still bad enough. The nurse in me had to check the readings on the small monitor showing his vital signs. Everything was perfectly normal.

  Still, his complexion in no way resembled his usual healthy tan. He had a gray sheen and looked terribly unwell. There were IVs in both his arms. The rest of his body was mostly covered, except for the toes of the broken leg, which peeked out from the cast. They still had some surgical disinfectant on them.

  I crept over to his bed as quietly as I could and sat down on the chair where Susi had been.

  Susi, his cousin.

  I still couldn’t grasp the damage I had done with my delusional ideas . . .

  “Hi,” Desiderio said softly. He had opened his eyes and was looking at me.

  Right away, those annoying tears began running down my cheeks again.

  “Hey,” I whispered, choking, and took his hand. It felt cold. “I . . . I don’t know where to start—”

  “You don’t need to,” he interrupted me hoarsely. “I heard everything.”

  “You did?”

  “Yes. Well actually, I think all of intensive care listened in.”

  “Oh.” Embarrassed, I wiped my eyes. “At least now you know what a stupid woman I am.”

  “You’re not. You’re just overly cautious.”

  “More like hysterical,” I said bitterly.

  “Nonsense.” He was exhausted. He shut his eyes and weakly closed his fingers around mine. “I’m glad you’re here.”

  I looked at his ashen face, which was still angelic. A strong wave of affection overtook me. I would never survive without this man.