“Wait for what? You’ve had all the time you deserve.”
“I just thought of something. If the antibiotics I gave him started to work, if they started to subdue the staph and strep—”
“Which we have absolutely no reason to assume will—”
“Matt’s temperature wouldn’t start to rise when I expected.”
“It won’t rise at all!”
“You don’t understand how strong the infection was.”
“Was? You mean how strong you think the infection might be.”
“Will be. The schedule’s been delayed,” David said. “Give me fifteen minutes more. Just to put me at ease before—”
“You’ve had all the leeway you’ll get!”
“I just took his temperature again,” a nurse said.
The doctor stared toward the numbers on the box.
“His temperature’s up.”
14
The ensuing events were so rapid the doctor didn’t have time to call the authorities. He and his staff were too busy working.
“My stomach,” Matt said. “It feels worse. I’m going to—”
Matt vomited. Not just vomited. Spewed.
The contents of his stomach shot to the end of the bed.
“My God,” Sarie said.
A nurse scrambled for a plastic basin. Another nurse grabbed for towels to clean away the vomit. Donna rushed to help her.
A doctor lunged for the cart beside the bed. Grabbing the syringes marked Gentamicin and carbenicillin, he injected them through Matt’s IV line.
“He’s already getting the Vancomycin,” the doctor in charge of the ward said. “With these others, we ought to be able to attack whatever infection he’s got.” He frowned toward David. “How the hell you knew this would happen …”
“The Vancomycin’s the important one. Keep giving it to him.”
“We have been! You forced us to inject it on a regular schedule since you gave it to him last night! How did you know … ?”
Matthew vomited again.
Explosively. A white fluid streaked with red.
The nurse holding the plastic basin didn’t catch all of it. Donna and the other nurse kept wiping the vomit from Matthew’s sheets. Sarie rushed to help.
“Blood cultures,” the doctor in charge of the ward said. “The lab. Find out what kind of infection he’s got.”
An assistant was already in motion. Inserting an IV needle into Matthew’s left arm, he filled several vials with blood.
“Staph and strep,” David said. “That’s what the lab’ll tell you.”
The doctor frowned again toward David. “Not likely, since he’s already covered for that. It could be any number of other bacteria. We don’t know what the lab’ll tell us. This is all a coincidence. The fever just happened to start when you said it would.”
“Believe what you want. Just save my son!”
Matt vomited again.
“Another basin! Get another basin!” a nurse yelled.
David grabbed for one off a shelf.
The color of Matthew’s skin was alarming, no longer pale but red, speckled with crimson spots: tiny hemorrhages beneath his skin.
With dull swollen eyes, Matt squinted toward the contents of the basin the nurse held. “White?” He groaned. “Why am I vomiting white?”
“That’s the medication we’ve been giving you to coat your stomach.” A doctor tried to sound reassuring but wasn’t successful. “To help prevent ulcers from the chemotherapy.”
“But it’s streaked with … red.” Matt gasped. “Am I throwing up blood?”
No one dared to answer.
David handed the nurse the empty basin, hurrying to remove the one Matt had filled. The exchange occurred just in time. Matt vomited again.
A doctor pivoted toward one of Matthew’s IV stands, pressing buttons on a pump, increasing the flow of saline solution into Matt’s body. “He’s losing too much fluid. We’ve got to keep him hydrated.”
Urgent voices overlapped.
“Blood pressure.”
“Check it again.”
“What’s his temp now?”
The nurse who was helping Donna and Sarie clean the vomit from the sheets quickly reached for the computerized thermometer. At once she realized she couldn’t put anything into Matthew’s mouth. She groped into a pocket of her uniform, pulled out a standard thermometer, shook it, and wedged it under Matthew’s right armpit.
Just then, the smell and sound unmistakable, Matthew’s bowels let go.
David’s arms and legs rippled with hot and cold rushes. His lungs heaved, making his mind spin. No, please. Not now. I can’t have another attack. Matt needs me.
Added to his symptoms was a dizzying sense of déjà vu. In theory, he was witnessing these terrifying events for the first time, and yet he saw the chaos around him in double focus, as if this was the second time he’d been here. Each horror was occurring after he sensed it would. He’d seen it all before, endured it all before. From an impossible perspective, forty years from now on his deathbed, he relived hell.
15
Even before Matthew’s bowels lost control, David reacted as if they already had. He grabbed towels off a shelf and raised Matthew’s sheets. When what he expected to happen did happen, he experienced another eerie shift in time, not from the future into the present, but from the present into the past. For while he used a towel to wipe the excrement from Matthew, he couldn’t ignore that what he did now for his fifteen-year-old son was exactly what he’d been accustomed to doing when his son was newly born. David’s soul almost burst with love as he performed without disgust this most intimate of acts.
“I’m sorry, Dad.”
“You don’t need to apologize. You’ve no idea how glad I am to help you. I’ll do anything to get you through this, to make you feel better. In fact, if there’s a God, I started to do that, to help you, last night.”
Matt’s red face dotted with crimson formed a weak smile, almost the boyish grin David had seen on Matt in better times.
“I love you, son.” David’s throat ached so much it strangled him. He threw a soiled towel into a trash container and used another to continue wiping excrement from Matthew’s hips.
“His temperature’s up again.” The nurse read a Celsius number, which David knew from experience was the Fahrenheit equivalent of a hundred and five.
More overlapping voices.
“Get that temp down.”
“Ice. Wet towels.”
“Compazine. Settle his nausea.”
“Increase his saline IV. More fluid.”
“Blood pressure?”
“A hundred and thirty over ninety.”
“A little high.”
“But not alarming. Easily explained.”
“Yes, the trauma of his vomiting.”
David threw a second soiled towel into a waste container. “You’re right,” he told the doctors. “A hundred and thirty over ninety isn’t a problem. His blood pressure won’t go any higher. But it’ll go lower.”
“What?”
David glanced toward a swirling clock on the wall. Somehow, more than an hour had passed. It was now 4:12.
“It’ll go lower,” David said. “I predicted the septic shock would hit at four-thirty-six. But the Vancomycin I gave him changed the schedule. His temperature rose five minutes later than I expected. So the shock will hit—”
“Five minutes later?” the doctor David had argued with at noon asked. “God help me, I almost believe you.”
“Four-forty-one? Less than a half an hour from now? Is that what you’re saying?” The doctor in charge of the ward stepped close. “For the record, I want to hear this. How low will his blood pressure drop?”
“Forty over twenty.”
“Down from a hundred and thirty over ninety? In less than thirty minutes! Improbable!”
“How I pray you’re right.”
The doctor studied Matthew. “His vomiting’s under cont
rol. His bowels have stopped voiding. I think we’ve checked whatever’s wrong with him.”
David leaned against the wall. “With due respect, you’re mistaken. But just in case, will you phone Intensive Care? Tell them you might have to send down—”
“No!”
“Why not?”
“They’d want a reason, and I can’t give them one! They don’t just jump into action because an anxious father has hunches!”
“Then I’ll phone them myself.”
“You don’t have authority.”
“But what if I’m right?”
“Intensive Care is always ready!”
David stroked Matthew’s feverish forehead. “So. With no other options, I guess we have to wait. Son, I know this is all confusing. Trust me?”
“You, Dad?” Matt grinned sickly. “When didn’t I trust you?”
“When I told you not to ride your skateboard down a hill toward traffic.”
Matthew breathed. “I could stop that skateboard on a dime.”
“You listened, though. We never had to find out. So listen again. If something bad happens to you in the next half hour, don’t be afraid.”
“I won’t need to?”
“You’ll want to. But I’ll be here to hold your hand. Depend on it. I’ll do everything I can to help.”
“Of course. You’re my dad.”
“Just don’t be afraid. That’s your job, the most important way you can help.”
“Hang tough, right?”
“Yeah. Hang tough.” David turned so Matthew wouldn’t see him crying.
16
“It’s four-thirty-six.” A doctor turned toward David.
“Temp?” another doctor asked.
“Slightly down. A point above normal,” a nurse said.
“Blood pressure?”
“Down. A hundred and twenty over eighty.”
“Perfect.”
“Not for him. He tends to run a little lower,” the nurse said.
“The difference is too slight to be bothered about.”
“Oh, there’ll be a difference,” David said.
“But your deadline’s come and gone,” another doctor said. “I told you, the first time was just a coincidence. He just happened to spike a fever when you said he would.”
“And I told you, the Vancomycin I gave him delayed the schedule.”
“I’ve had enough of this. We controlled his infection.”
“No!”
“Everything’s back to normal,” the doctor said. “Now I’ve got rounds to make.”
“Well, maybe we ought to …” The doctor from the Pediatrics Ward cleared his throat. “It wouldn’t hurt. Just wait a few more minutes.”
“And reinforce this man’s delusion?”
“He’s been right so far.”
“Coincidence!”
“Just in case, though.”
“Something’s happening,” a nurse said.
“What?”
“His pressure’s down to a hundred.”
“Now will you believe me?” David asked.
“Check it again,” a doctor said.
“Down to ninety.”
“No.”
“I told you,” David said.
“Eighty.”
Matt vomited again.
“No!”
“Don’t wait,” David said. “Give him the dopamine.”
“Dopamine? How did you know that’s the drug we’d use to—”
“Raise his pressure? You wouldn’t believe me! Give him the—!”
“Seventy.”
“Do it!” David yelled.
“Can’t you see we already are?”
Matt’s body shuddered, convulsing.
“Sixty.”
An intern injected the contents of a syringe into one of Matt’s IV lines.
David exhaled. Panicked, he slumped against a wall.
“And now we wait,” he said. “And pray.”
17
In David’s nightmare, Matthew’s plummeting blood pressure had not responded to the dopamine. The pressure had bottomed at forty over twenty, almost as low as it can get and still allow the body to maintain vital functions. Repeated injections of dopamine hadn’t raised the pressure.
David had watched a frantic nurse crank up the end of Matthew’s bed, raising his feet, helping his blood to circulate, trying to compensate for the devastating decrease in arterial pressure.
David had watched the doctor in charge of the ward phone Intensive Care. David, Donna, Sarie, a nurse, and a doctor had rushed Matthew’s bed down hallways, into an elevator. Two floors below, they’d scurried with the bed down other hallways, into the ward that made the Emergency Ward seem primitive. As the document David had signed when Matt went into the Bone Marrow Ward so vividly put it, You have a life-threatening disease. Within a year, you will surely die unless you receive exceptional treatment. A bone marrow transplant has serious risks, including infection.
And, David mentally added, they don’t rush you down to Intensive Care just to try out the machines.
In David’s nightmare, higher doses of dopamine finally raised Matthew’s blood pressure to a barely acceptable level of eighty over sixty. A team of trauma specialists waited in Intensive Care, and as soon as he arrived, the team snapped instantly into motion. David recalled no fewer than eight IV stands with two pumps on each injecting fluids and medications into his son.
But dopamine has plus and minus effects. It raises critically low blood pressure. However, to do so, it must stem the flow of blood to such crucial organs as the kidneys.
Matthew’s kidneys shut down, stopped filtering poisons into the bladder. He needed a hole cut into his abdomen. A tube was inserted, through which fluid was poured in and an hour later drained out—to vent the poisons.
But now he was also on oxygen. If given long enough, oxygen poisons the lungs. Fluid accumulates. That fluid puts pressure on the heart.
Three organs in trouble. And that’s not counting the remnant of the tumor in his chest, four missing ribs, and …
In David’s nightmare, Matthew struggled against an oxygen tube crammed down his throat. Finally morphine had to be given, to put him to sleep, so he wouldn’t yank the tube from his mouth.
Just before the tube was inserted and the morphine injected, the director of Intensive Care told David, Donna, and Sarie, “If you need to tell him something, now’s the time. He might not come off the respirator.”
Next to David, Sarie paled. “What does he mean, Matt might not come off the respirator?”
“It means”—David couldn’t believe he was saying this—“Matt might die.”
“Jesus.”
18
What do you say to your son when the ultimate reality kicks him and you in the teeth? You’ve got five minutes to tell him the last words he might ever hear. Then, whether you said the right thing or not, you don’t get another chance.
Your character, your upbringing, your self take charge.
Sarie chose to say, “I love you, Matt.”
David chose to be practical. “Don’t get panicked. Fear will increase your shock. Trust the system. I’ll push these doctors to their limit. I promise, they’ll do everything they possibly can.”
Donna said … wise Donna … “Matt, you’re a perfect boy.”
A priest in the background said, “No, a perfect man.”
Donna kissed her son.
The tube was inserted, the morphine given.
And that was the final communication.
Except … before drifting into a morphine stupor, Matt (unable to speak because of the oxygen tube crammed down his throat) pointed with determination toward letters on an alphabet board. His trembling finger wavered, spelling. The gist was clear.
Take this tube out. Need a root beer.
And then … Die? he spelled.
“We’re doing our best,” a doctor said.
Matt nodded. His eyelids fluttered. He slept.
The final communication.
Five days later, his injured lung collapsed.
But it reinflated, giving cause for hope.
Three days later, his heart became infected. His blood pressure plummeted, and this time nothing on earth or in heaven, no medicine, no prayers, would help.
19
In David’s nightmare. But now, heartbroken, desperate for a second chance, David stared at the nurse taking Matthew’s temperature.
“It’s back to normal.”
“Blood pressure?” a doctor asked.
“Up. Ninety over sixty-five.”
“He’s coming around,” another doctor said.
“There.” The doctor in charge of the ward turned to David. “A false alarm.”
“Pressure—a hundred over seventy.”
“I repeat,” the doctor said.
“A false alarm? I watched you,” David said. “You were afraid. But believe me, you couldn’t have been as terrified as I was. What I did last night when I gave him the Vancomycin …”
“Was irresponsible.”
“I saved my son’s life!”
20
In David’s nightmare, one of the bitterest ironies had been that as Matthew had worsened in Intensive Care, his recently transplanted bone marrow had started to multiply, producing healthy blood. Four days after the onset of his septic shock, Matt’s white-blood count rose from zero to eight hundred. Not strong enough to fight infection but, under other circumstances, encouraging. As a rule, a white count of one thousand is considered the minimum safety level. The next time Matt’s white count was tested, it had risen to sixteen hundred. And the next time, thirty-two hundred. When he died from heart arrest, his white count was over six thousand. If he hadn’t contracted septic shock, his healthy blood would have permitted him to be released from the hospital the day of his death.
To be sure, there would still have been dangers. The devastating chemotherapy had temporarily destroyed his immune system. For several months, he’d have been susceptible to such normally nonlethal diseases as chicken pox, which he’d already had and acquired an immunity to, but which in his present weakened, nonimmune condition could have killed him. To guard against that danger, he’d have been forced to stay at home, his visitors restricted to those who had no illness and hadn’t been exposed to any illness. Even then, his visitors would have been required to put on hospital face masks, just in case. When school started in the fall, Matt couldn’t have attended but instead would have studied through correspondence courses.
Fireflies: A Father's Classic Tale of Love and Loss Page 13