by Laura Iding
“Maybe.” Holly didn’t sound convinced.
Their conversation was interrupted when the nurse brought JT back to his room. Once he was reconnected to the bedside monitor, Holly came forward.
“I’ll need to examine him.”
Gabe stood back, allowing Holly to do her job. He felt sick all over again when he realized JT was still pretty lethargic. If JT’s responsiveness didn’t improve, he’d end up getting intubated in order to protect his airway. Remembering Mark’s mother’s traumatic reaction to watching her son be intubated, he suddenly understood exactly how she’d felt.
Swallowing hard, he watched Holly go through her in-depth exam. When she’d finished, she turned toward him.
“Has JT always been afraid of wild animals?” she asked.
“No.” He didn’t understand what she was getting at.
She hesitated, then said, “I think we should test him for rabies.”
Rabies? Gabe stared at her. “Why? There’s no way JT could have been exposed to rabies.”
“Yesterday morning, JT told me wild animals bite. Then he said he saw a raccoon at the cemetery, and I’m assuming that was probably during Claire’s funeral.” When he nodded, she continued, “Four to six weeks is the typical incubation period for rabies. What if he saw a rabid raccoon and it bit him? I don’t want to ignore any possibilities.”
Gabe had trouble wrapping his mind around the implications. “But he hasn’t been given the vaccination for rabies.”
Holly didn’t say anything. She didn’t have to. Once a patient showed clinical signs of rabies, the mortality rate was very high.
The tightness in his chest intensified. If JT had really been exposed to rabies six weeks ago, there was a very good chance he would die.
CHAPTER TEN
HOLLY cradled the phone receiver between her ear and her shoulder, listening to the dreadful music as she waited for the lab tech at the Center for Disease Control to put her in touch with the physician who specialized in rabies. As soon as Gabe had admitted there was a possibility JT had been bitten by a raccoon, she’d called to get their recommendations.
Rabies wasn’t very common. Treatment after known rabies contact had become so good there had been little recent research on the subject. Local labs didn’t even run tests for rabies. If infection was suspected, the patient was simply treated no matter what any blood tests showed.
“Dr. Davidson? This is Dr. Lois Whitney at the CDC. I was told you have a case of suspected rabies?”
“Yes.” Holly explained the potential raccoon bite and then described JT’s symptoms. She’d noticed JT’s right side was convulsing and he was salivating more than normal, which was one of the symptoms of rabies. In reading up on the disease, she’d discovered some patients had literally drowned in their own secretions.
“Send us some blood and cerebral spinal fluid samples immediately,” Dr. Whitney told her. “Put them on dry ice and ship them as fast as possible.” Lois Whitney hesitated, and then added, “From what you described, you’d better treat him as if he is positive for rabies.”
“I understand.” Holly hung up the phone, feeling sick. She’d hoped she’d been wrong about JT having contracted rabies.
Without immediate post-exposure vaccinations, the disease was highly fatal.
She took several deep breaths, trying to hold panic at bay. They had the best medical experts in the country here at the Children’s Medical Center. If anyone could get JT through this, they could.
Poor Gabe. She knew how devastated she’d been after losing Kayla. Losing JT would be worse. Much worse.
Stop it. She mentally gave herself a hard shake. They weren’t going to lose him.
Somehow they were going to find a way to successfully treat him.
Turning blindly from the desk, she bumped into Dr. Jeff Konen, the neuro specialist assigned to JT’s case. He’d come in to examine JT right after she’d broached the possibility of rabies.
“According to the CDC, we need to treat JT Martin as if he has rabies. And we need to get some blood and cerebral spinal fluid samples sent to Atlanta immediately.”
The older man blew out a heavy breath. “Okay, so if your theory is correct and he was bitten almost six weeks ago, then the virus has already begun its attack on his central nervous system. The typical rabies vaccine injections are used to prevent the virus from attacking the nervous system. In JT’s case, it’s too late to prevent that. Which means we have to try to minimize the damage.”
The large knot in her stomach tightened. She knew the mechanism of disease as well as he did. This long after the time of infection, there wasn’t much that could be done to stop the progression of the virus.
“We need to talk to Gabe, to include him in this discussion,” she said firmly. Gabe was a physician as well as being JT’s uncle. He’d want to be included in all aspects of JT’s care.
Jeff hesitated and nodded, turning toward JT’s room. She followed close behind.
While she’d been in touch with the CDC, the nurses had placed JT in isolation. Both she and Jeff donned a face mask, gown and gloves before entering the room.
Gabe wasn’t wearing any isolation gear, as if he could care less if he was contaminated by the virus. From her research she knew that person-to-person transmission of the virus was rare. Still, infectious disease literature said that it was better to be safe by placing patients in isolation.
Gabe sat on JT’s bed, holding the boy in his arms. His face was pale and drawn, his eyes bleak with grief.
“The CDC would like samples of JT’s blood and cerebral spinal fluid,” she told him. “They recommended we treat JT as if he’s already tested positive for rabies.”
Gabe gave a slight nod. She wasn’t sure if he was agreeing to send blood to the CDC or to the proposed treatment plan. Hopefully both.
Jeff stepped forward. “Gabe, I propose we get JT intubated and sent up to the PICU. I think if we paralyze and sedate him, putting him into a barbiturate coma, we’ll have a chance to protect his brain while it fights the virus.”
Holly raised a brow. The neurologist’s proposal was intriguing. And somewhat experimental. Similar treatment plans had been tried but not all of them had been successful. There were so many variables, especially as there were at least eleven different strains of the rabies virus.
When Gabe didn’t say anything right away, she spoke up. “Gabe, I’ve done some research on rabies, and there has been limited success with this approach. I have to agree with Jeff’s treatment plan. I’d also add another possibility. Ketamine, a drug used primarily for anesthesia, has been shown to decrease the rabies virus in mice. It hasn’t been tested on humans, but if we use a combination of ketamine and Versed to decrease the toxic effects on JT’s brain, we may have a chance to beat the virus.”
There were no guarantees. As a physician Gabe had to understand that more than anyone. Yet Holly firmly believed that if doctors did not try, they would not succeed. If the chances were high that JT might die, there was no reason not to try this radical treatment option.
Gabe gazed so intently down at JT she wondered if he’d heard anything they’d said. But then he slowly nodded.
“Do whatever you have to do to save my son.”
His son. Tears burned the back of her eyes and she had to look away, biting her lip behind the face mask.
Once they had paralyzed and sedated JT, they could ensure he wouldn’t feel any more pain or discomfort.
Gabe’s suffering, for the son he might never get to formally adopt, would be much harder to bear.
Gabe didn’t leave JT’s bedside except to eat and to use the bathroom. Eating wasn’t exactly high on his priority list. He wasn’t hungry but knew he needed to keep up his strength, in order to support JT.
His mother insisted on staying in Minneapolis, despite the fact that he encouraged her to go home to her husband. Clearly he no longer needed her to watch JT while he was at work.
There was no reason for he
r to sit here with him. JT’s recovery would likely take weeks. Maybe even months.
He refused to consider the alternative. The physician part of him understood the risks, but as a parent he chose to ignore them.
JT would pull through this. He’d make sure of it.
The hours merged into days. He lost track of time, sleeping on the parent bed next to JT in the PICU.
He couldn’t complain about JT’s care. Everyone bent over backward to take excellent care of his son. Within twenty-four hours of sending blood and cerebral spinal fluid samples to Atlanta, the CDC had confirmed the diagnosis of rabies.
Holly had been right after all.
He couldn’t hold JT in his lap anymore now that he was intubated and breathing with the help of a ventilator. There were so many tubes and wires in JT he was almost afraid to touch him. All JT’s nutrition came through a feeding tube, not to mention myriad IV medications he was receiving. He knew that despite the radical combination of medications Jeff and Holly had ordered for JT, it was possible the treatments might not work.
So he prayed, like he’d never prayed before.
On Friday, his mother came into JT’s room with a pile of mail she’d brought from his house. Gabe hadn’t been home since meeting JT and his mother at the hospital, and he found it difficult to care about mundane things like phone bills and bank statements.
One of the letters snagged his attention because it was from the DNA lab in the Minnesota State Lab in Minneapolis. He stared at the envelope for a long time. The DNA results declaring the identity of JT’s biological father were inside. This was what he’d been waiting for, in order to move forward with JT’s adoption.
He almost threw the envelope away. JT’s life hung in the balance—what difference did it make who his biological father was?
Except that maybe JT’s biological father deserved to know the truth. Especially now that JT was so sick.
Especially when there was a possibility JT might not survive.
He stared at the letter for a long time, struggling with what to do. If the situation were reversed and he’d fathered a child that no one had told him about, he’d want to know the truth.
“Gabe? Are you all right?” his mother asked.
“Yeah, I’m fine.” He opened the letter and scanned the results. Rising to his feet, he glanced down at JT, still motionless in the barbiturate coma. He knew what he had to do. “Will you stay here with JT for a few minutes?”
His mother glanced at him in surprise. “Of course I will.”
Gabe nodded and left the room, pulling his cellphone out of his pocket. Then he swore when he realized the battery was dead. He hadn’t recharged his phone over the past few days.
He turned and headed to the PICU waiting room. There was a phone in there he could use. If the operator would give him an outside line.
He had a long-distance phone call to make.
Holly checked on JT and Gabe as often as her schedule allowed. Sometimes she came and sat with him at the end of the day, but Gabe didn’t say much.
She knew he blamed himself for the seriousness of JT’s illness. And maybe a small part of him blamed her as well.
What could she say? There were no words to make him feel better. They were doing everything possible to save JT’s life.
All they could do was wait.
On Friday evening she headed into the PICU to find Gabe walking out from the waiting room. She was surprised to see him outside the PICU when he’d been practically living at JT’s bedside.
“Hey,” he greeted her weakly.
“Hi, Gabe.” She longed to put her arms around him, to hold him close. Sometimes she wondered if she’d imagined those stolen hours they’d spent together at her house the night before JT had become so sick. The only evidence she had to prove it wasn’t her imagination was the fact that her sheets still carried a hint of Gabe’s musky scent.
Gabe stared at her for a long moment, before glancing away. “I need to thank you,” he said slowly. “If you hadn’t brought up the possibility of rabies when you did, it would have been too late.”
She hoped it wasn’t too late. So far, she knew JT’s vital signs were good, but they wouldn’t know about his level of brain function until they brought him out of the coma.
“You don’t have to thank me. I wish there was more I could do. I care about you, Gabe. I care about both of you.”
“I know.” At that moment his stoic expression cracked, revealing the vulnerable man beneath. Unable to ignore his pain, she closed the gap between them and wrapped her arms around his waist, determined to offer comfort even if he did push her away.
He didn’t.
Instead, his arms came up to crush her close, his face buried in her hair as he murmured, “I can’t lose him, Holly. I just can’t.”
“I know.” She battled tears, holding on to him tightly. She wasn’t one to offer false hope but in this case they needed to think positively. “You won’t. I’ll be here for you. We have to believe you won’t lose him.”
“I’ve been a lousy father so far,” Gabe whispered.
What? She pulled back to look into his eyes. “That’s not true. Compared to Tom, you’ve been wonderful. Stop blaming yourself, Gabe. How could you know JT had been bitten by a raccoon? The bite would have been so small it was barely noticeable. And how could you know that the raccoon carried rabies?”
“I don’t know. I just don’t want to lose him.” The self-reproach in his eyes made her draw him close, give him another tight hug. His grip tightened, too, as if he needed the support as much as she needed to give it.
She held Gabe for a long time, offering him a little of her strength. When he finally lifted his head and loosened his arms, he brushed a light kiss over her mouth, as if offering silent thanks. “I know you’re scheduled to work this weekend, but will you stay, at least for a little while?”
Thrilled and humbled that he’d realized he couldn’t do this alone without help and support, she nodded. “Of course. I’ll stay for as long as you need me.”
“Thanks.” Gabe took a deep breath and let it out slowly. He offered a crooked smile and held out his hand. “Let’s go.”
She took his hand and walked with him into the PICU. Their clasped hands drew a couple of curious glances from the PICU nurses but Holly couldn’t bring herself to care. What did a few whispers matter in the big scheme of things?
The only thing that mattered was the fact that Gabe and JT needed her. And if she was honest, she needed them too.
Gabe’s mother greeted her with a wide smile. She got the distinct impression his mother approved of Holly’s new yet tenuous relationship with her son.
That night, Holly stretched out next to Gabe on the narrow parent bed in JT’s room. He held her close, her head resting on his shoulder, their embrace cozily intimate despite the fact that they were both fully clothed. Gabe had changed into a pair of comfortable sweats and a T-shirt, while she’d borrowed a pair of scrubs to wear.
Still, Holly was poignantly aware of the message her actions sent to anyone who walked into the room to care for JT.
She and Gabe were a couple. Together they were supporting JT and each other.
She loved him. The shocking realization made her eyes fly open. Her chest felt tight, as if she couldn’t breathe.
Love? How could this have happened? For a moment panic swelled as she stared blindly at the tile ceiling. Falling in love usually meant getting married. Having a family. Another child, hers and Gabe’s.
Could she have a family of her own? There was a tiny part of her that always thought she’d feel disloyal to Kayla if she had another child.
Yet being here, next to JT’s bedside while the boy fought for his life, she slowly realized nothing could be further from the truth.
Having Kayla had taught her to love. Loving one person didn’t mean you couldn’t love another. JT needed all the love and support he could get.
So did Gabe.
Nothing
else mattered.
The next morning, she awoke when Jeff Konen came into the room. Groggily, she swung her legs over the side of the bed, sitting next to Gabe who’d also just woken up. Jeff eyed her presence beside Gabe curiously, but didn’t comment.
“How long do we need to keep JT in a coma?” Gabe asked, scrubbing a hand over his face.
“I’m not sure,” Jeff admitted. He glanced at Holly. “What do you think?”
Holly blinked and forced herself to focus. “A full week, to be safe.”
Jeff nodded. “Yeah, that’s what I was thinking too. We’ll start tapering off the medications early next week.”
“So there’s nothing more to do at this point but to wait,” Gabe said.
“I’m afraid so,” Jeff admitted.
Waiting was difficult. Holly knew where Gabe was coming from. As a physician he was accustomed to action. Not to the wait-and-see approach.
After Jeff left the room, Holly slowly rose to her feet. “I have to get ready for work,” she said, wishing she didn’t have to leave.
Gabe nodded, watching her as she gathered her things together. It was too late to run home for a change of clothes so she decided to find a call room to shower and change into a fresh set of scrubs. Scrubs paired with a lab coat would have to do.
“Thanks for staying,” Gabe said in a low voice.
She gave him another hug, knowing they’d need to talk but that this wasn’t the time. Not when JT’s fate was still largely unknown. “I’ll be back tonight, unless you decide you don’t want me here.”
Gabe reached up to cup the side of her face. “I do want you here,” he murmured, before bending his head down to kiss her.
His kiss was brief but potent. Her senses swam as she momentarily lost herself in his embrace. He broke off the kiss when one of JT’s nurses entered the room.
Holly stepped back, feeling a little self-conscious but not to the point where she regretted one second of their embrace. “I’ll see you later,” she promised, before picking up her clothes and leaving the room.