She grimaced and raised her hand. “Kiss it,” she said of her hand. “Make it better.”
Thaddeus took her hand and pressed it against his face. Then he kissed it and gently placed it on the light blanket. “Love you, Biscuit.”
“Let me update you, Katy,” said Dr. Sewell. Your back is broken in several places. They’ve told you that. Your hip is broken. The plan is to put a plate in there.”
“What about the back, doc?” asked Thaddeus.
“For now, no surgery. The treatment of metastatic spinal tumors usually involves a team of surgeons, radiation oncologists, medical oncologists plus diagnostic and interventional radiologists and on and on. The goal would be to manage the pain. In general, extensive surgical procedures involving open surgery are avoided with metastatic spinal tumors.”
“Why is that?”
“Because open surgery increases the risk of systemic complications.”
The doctor looked at Katy, whose eyes were closed and whose breathing was shallow as if sleeping. He whispered, “It hasn’t been proven that survival is extended with aggressive treatment. Especially where expected survival is less than six months.”
Thaddeus turned away and looked out the window. He folded his arms across his chest and hung his head, not wishing to turn back around and face Dr. Sewell.
“But here’s what we can do. Radiation therapy is effective in shrinking tumors. This can alleviate pain by relieving pressure on nerve roots and the spinal cord. This is what I would recommend when the treating physician lists out your options.”
“But that doesn’t help her to even sit up does it? I mean, what about it—will she ever have any mobility again?” Thaddeus turned and spread his arms wide as if pleading.
“There’s a procedure that involves inserting a needle through a small incision in the back so that a bone cement can be inserted into a fractured vertebra to fill in the empty spaces. This helps stabilize the bone.”
“What’s that called?”
“Vertebroplasty. It can alleviate pain up to seventy percent if nothing else. Which is dramatic and very helpful in your wife’s case.”
“So she’s never going to walk again. Is that what I’m hearing?”
“Thad, she’s paralyzed. I know you know that.”
“I know. I’m just—I’m just—” He slumped in his chair. It was more than he could even begin to contemplate. His incredible wife was fading right in front of him and he was powerless to stop it! A moment of panic swept over him and he fought to keep it down so she wouldn’t see.
“You just don’t want to accept it. That will come too.”
“Will she be able to sit up if I help her?”
“Somewhat. No one can say for certain at this point.”
Katy’s eyes fluttered and she reached for the plastic drinking cup. She was able to raise her head with Thaddeus’ help and take two swallows. Then she abruptly fell back asleep.
“We can talk more,” said the doctor, “but we don’t need to do it here.”
He motioned at Katy with his head, and Thaddeus understood.
“Thanks, Doc. You know what? I think I’m just going to sit here with her for awhile. You don’t have to stick around.”
“No, I need to be getting back to San Diego.”
“Well, thanks for coming over. I have a much better grasp of the facts of your case now. And thanks for the help with Katy out there on the mountain.”
“You handled that very well yourself, Thad. I was glad to do what I could.”
“We’ll talk in a week or so.”
“Don’t hesitate to call me with any questions. Day or night, I’m available to talk.”
“Okay. Thank you.”
Thaddeus stood and extended his hand and the men shook hands. The doctor gave Thaddeus a warm look. Thaddeus turned away and collapsed into the chair. When he looked up, Dr. Sewell was gone.
Ten minutes later, Thaddeus had dozed off. Suddenly he was awakened by someone shaking his shoulder. He opened his eyes.
“Turquoise!” he exclaimed.
“How is she, Dad?” said his daughter. Her lips were trembling. She handed Thaddeus a thermos of coffee and bent to her mother. “Oh, she looks so innocent.”
“She’s pretty banged up.”
“They said she fell off Charley?”
“Yes. She heard a rattler and the next thing she knew she was on her back looking at the sky.”
“Poor baby,” said Turquoise, and took her mother’s hand. She massaged the palm and fingers, all the time studying her mother’s face. “Thanks for sending the plane, Dad.”
“What about school? Is this going to mess you up?”
“No,” said Turquoise, shaking her head. Her hair lay on her shoulders in two braids and they swung as she moved her head back and forth. “I’m ahead in everything. Besides, I don’t really give a damn if it does cause problems. This is my mom and I want to be with her.”
“Agree. You can always go to school.”
“Exactly. Now tell me about her injuries. Someone said she fractured four vertebrae?”
“They’re not exactly sure. They’re having trouble getting clear images and don’t want to move her much to do it. But she’s in a lot of pain, which they’re managing with meds. Right now she’s either asleep or passed out. Maybe both, I don’t know. I think the dose is pretty high.”
“The kids are all at home? Who’s with them?”
“Katrina from the office picked up her little girl and she’s out at the ranch keeping an eye on things.”
“Her little one’s Celena’s age? Eight or nine?”
“I guess. I just know Celena idolizes her. So does Sarai, for that matter.”
“What about Parkus? Does he have anyone?”
Thaddeus smiled. “Now he does. You.”
“You want me to go out there now?”
“How’d you get here from the airport?”
“Taxi.”
“Let me call the ranch. I’ll have Emanuel bring the truck and pick you up.”
“So you’re staying here?” She saw the look on her father’s face. “Dumb question. Okay, Dad.”
He reached and pulled her down and kissed her forehead.
“I’m just glad you’re here,” said Thaddeus. His voice was husky and low.
“Me too.”
Thaddeus was on his cell phone a minute later, making arrangements.
Turquoise went to the end of the bed and grasped her mother’s toes beneath the blanket. She slowly shook her head and tears formed and streaked down her cheeks.
“Why did you have to ride Charley? Now, of all times?”
“Because that’s who she is. Fiercely independent even if it kills her.”
Turquoise looked at her father.
There was no taking back the words and they both knew it.
27
The pain told her that she was dying. She could actually feel the tumors that had metastasized from the breast cancer and spread in her body. The thoracic spine tumors were the worst: she could find no possible position to get comfortable and sleep. Sleep only came when she was heavily medicated and then it would overtake her and leave her dreamless for a few hours until she would awaken drowsy, drugged, and feeling like she hadn’t slept at all.
One afternoon in the hospital she was waiting for the nurse to come around and increase the dosage of the pain meds hanging above and behind her. She clicked the button again. She was angry that help hadn’t appeared immediately and now it was five minutes and still no response.
So she shut her eyes and began counting. It was all she had left, counting. Her body could offer no further resistance to the disease that was killing her. Her psyche could spend no more time dwelling on her impending death and dealing with the terror. Her mental state had deteriorated to the point where she no longer cared; she only wanted out of the body that was failing her, the body that had turned her over to the tumors.
So she counted some more. It was
a useless act: there was nothing she was counting. She was just counting because there was nothing else.
She shut her eyes.
However much later it was, she didn’t know. Maybe a minute, maybe ten. She honestly didn’t know.
When she opened her eyes she was at the water’s edge, kneeling on the beach, digging with the sand shovel, building a sand castle. She stood up and her belly protruded. Like a child’s belly, the belly of a little girl. She felt her arms. They felt like taut rubber; the arms of a little girl. She held out her hand. Yes, said her mind, it was a child’s hand.
Which was good.
So she turned back to digging. Every so often she would wade into the surf and fill her bucket. It was her favorite bucket, the one with the bubbly whale on the side. Half-full of ocean water, the bucket was then poured into the trench she had dug around her castle. She had seen something like it on TV. She knew that people with castles kept water around them.
A man came up to her. He looked familiar.
But she didn’t know him.
“Hello, Biscuit,” he said to her.
Someone had called her “Biscuit” before. But she didn’t know who.
She looked up at him and smiled.
“Want to walk?” he asked and held out his hand.
She nodded. More than anything else, she wanted to go with the man.
Together they strolled off down the beach. She cast a long look back over her shoulder. There was no one else to be seen. It didn’t occur to her there were no other people. Nor was she worried.
In fact, she felt a great joy come over her as she walked along with the man.
In celebration, she pulled free of him and ran into the surf. Her feet kicked up fleece and foam with each pattering step. The man followed. He rolled his trouser legs up to his knees and began trotting after her. He caught up and seized her by the hand. Together they walked into the deeper water. She lay out in the water and he pushed her by her feet. Then she folded in half and came up laughing. Now the surf was breaking just beyond them and the water was swirling up to her chest. The man’s pants were wet and baggy.
“Hungry?” he asked.
She nodded.
They left the water and walked further up the beach to the hamburger shop. It was a square green structure with exterior shutters that were pinned up and open because it was doing business.
She stepped up to the counter and smelled the cooking food. Suddenly she wanted one of each.
“—and a daylong sucker,” she finished, after relaying a long list of what she wanted.
The man behind the counter looked at the man who brought her there. He shrugged. “Give her whatever she wants.”
She tossed her head and did somersaults across the hot sand. Then she took the man’s hand and ran around him, making him spin and laugh with her. Faster and faster they went, spinning and laughing. Then she stepped inside the imaginary circle and gave him a hug. She felt his strong hand in the middle of her back. He was patting her.
The food came and they loaded up with carry trays and headed back toward the sand castle.
* * *
The light rose in the sky. The sand was quite hot on her feet. She spread her towel and leaned back on her elbows. The man sat down beside her, she on the towel, he in the sand. His pants were still rolled up and wet up to his waist. He seemed not to mind in the least, which was different from how she knew most adults to behave. Then she realized, she couldn’t remember any of their names. But they spoke to her.
“One thousand and four,” she said in a strange voice.
“One thousand and four what?” the man said. “Are you counting?”
“—Thousand and eight—“
“You must like to count very much.”
The light was just over the ocean and going down.
The man scooted closer to her and took her hand. He looked at the tiny lines in her palm.
“What are you doing?” she asked.
“Committing to memory,” he said and continued looking at her hand.
“Do you have a dog?” she asked.
He shook his head. “No dog.”
“I have a cocker spaniel. His name is Woofers.”
“Woofers. I like that.”
“One thousand and thirty-five—“
“There you go again.”
The light was setting behind the ocean.
She stood and put her hand on the man’s shoulder. He didn’t move. Then she smiled and nodded. She turned and began walking toward the sea.
When she felt the water on her feet, the light blinked on and off and on. She continued walking into the sea.
“Oooooh, Did I overdose you?” a voice said.
She struggled to open her eyes.
“What?”
The nurse flicked her index finger against the plastic bag. “This thing isn’t feeding. Wait here and I’ll grab a new one.”
Katy looked at the woman’s back as she hurried out the door.
There was no pain. There were no drugs in the line threaded into her hand, either.
“Two thousand,” she said, and dropped her head onto the pillow.
She was no longer afraid.
28
After visiting with Katy, Dr. Sewell left Thaddeus alone with Katy.
Dr. Sewell stepped into the hallway and looked both ways. Then he walked down four doors and entered. The patient was Nadia Turkenov.
There was no one else in the room. The doctor studied her at the bedside. She looked frail and, since he had first visited her many weeks ago, her skin had turned ashen, a sure sign, to his eye, that she was not thriving. And, he thought with a shake of his head, who would be? He reviewed her chart quickly; he set it back down, shaking his head.
The ventilator was attached, of course. It was breathing for her, the familiar “Shush-shush-shush of the machine as it delivered oxygen to her lungs. Without the machine, she would die. He knew this and, in studying her and watching, he made a decision.
Taking her left hand in his—he was on the far side of her bed, next to the monitors and pumps—he felt her pulse. It was regular and strong. He lightly stroked the back of her hand with his fingers.
Then he closed his eyes and did not move, still holding her hand. This continued for several minutes.
Finally, he opened his eyes and lay her hand back down beside her on the bed.
At the Medical Center, mechanical ventilators were designed to generate alarms when patients became disconnected or experienced other critical ventilator events. However, those alarms could blend in with other common sounds of the ICU. Ventilator alarms that went unnoticed long enough would result in permanent harm to the patient or death. So FMC had developed a system to monitor critical ventilator events through the hospital network. Whenever an event was identified, the new system took control of every computer in the patient’s ICU unit and generated an enhanced audio and visual alert that there was a critical ventilator event and identified the room number. Knowing this, and knowing what would happen if the ventilator failed or were shut off, Dr. Sewell proceeded otherwise.
With his surgeon’s skilled hands, he removed the dressing and unplugged the ventilator coupling from the throat of Nadia Turkenov. With his hand, he then mimicked the back pressure against the hose that would exist were the ventilator actually attached to the patient.
Five minutes later, he again felt for Nadia’s pulse. It was much weaker.
He repeated another five minutes.
As this was going on, Nurse Charlotte Mendoza approached Nadia’s room. She came up to the door and was about to enter when, feeling instinctively at her neck, she realized she had left her stethoscope in the previous patient’s room when she had helped a child listen to her mother’s heart. Nurse Mendoza turned on her heel just before entering Nadia’s room and circled back down one door.
Dr. Sewell sensed someone about to enter, but still he manipulated the ventilator hose so that no alarms fired.
&nbs
p; Several minutes later, Nurse Mendoza came barreling into the room. She paused when she saw the doctor there.
“Family?”
Dr. Sewell shook his head. “Just a friend.”
“I’ve seen you here before.”
“I have two friends in this hospital. Plus, I am a physician.”
As Mendoza’s eyes passed from the doctor to the patient, she then realized the ventilator was detached from the patient. She screamed and pushed the doctor aside. Tearing the free end of the hose out of his hands, she reconnected the patient’s life support. The doctor backed away and went to the foot of the bed. He watched as the nurse checked vitals. There was no pulse and no measurable blood pressure. That monitor had been shut down, Mendoza realized.
She screamed and re-armed the monitor then hit the panic alarm on the monitor board.
“You did this!” she screamed at the doctor.
“I did. But she’s free now. She asked me to set her free! You’ll just have to trust me.”
She screamed again.
“She’s free now.”
Security, nurses, and two duty physicians came crowding into the room.
“He did this!” Nurse Mendoza screamed. “This man unhooked this patient from her life support!”
Security grabbed the doctor from behind and handcuffed him. He offered no resistance.
As they surrounded him and checked for weapons, he said to the blue-shirted officers.
“Please. Let me speak with your supervisor. I can explain where she’s gone.”
“Sir!” said the youngest officer. “She’s on that bed!”
The doctor smiled. “No, that’s only what your eyes are telling you. Nadia Turkenov is actually gone from here, gone from this room, gone from this hospital. I can explain!”
29
They put him in an isolation cell. They wanted to evaluate him before introducing him into the general jail population. They explained there was blood testing to be done to make certain he wasn’t a threat to the other prisoners: AIDS/HIV and Hepatitis-C. What they didn’t tell him was they wanted the jail psychiatrist to evaluate him. As the arresting detective phrased it, he had given some “Pretty damn off-the-wall explanations for what he’s done,” in unhooking Nadia Turkenov from life support. There was a legal duty to protect the other inmates from a crazy one, and the jailers were taking no chances.
The Near Death Experience (Thaddeus Murfee Legal Thriller Series Book 10) Page 13