by Ann Tatlock
“Yeah. Mom and Dad brought it last weekend. Guess you haven’t seen it.”
Jane shook her head. “Nice. Good idea. It’ll make it easier to stay in touch with them.”
“It’d be even easier if I could use the thing myself. I have to bother Sausalito here to come in and play secretary.”
The young Ugandan laughed again. Jane liked the way his whole face opened up with delight. “That’s all right, Mr. Seth,” he said. “I’d rather be typing your e-mail than emptying bedpans. Now, tell me again what you wanted your mother to bring.”
“The Nikes. They’re in the hall closet.”
“Okay. Please bring the—rats!”
“Bring the rats?” Seth echoed.
“Where’d it go?” Sausalito’s hands flew up from the keyboard as he stared at the screen in disbelief. “It’s gone! The computer sent the e-mail, and I wasn’t finished!”
Seth sighed heavily, but Jane was relieved to see that he was trying to suppress a smile. “Sausalito, my man, what kind of secretary are you? You’re fired. Get Hoboken in here. He can do a better job.”
Sausalito shook his head. “He’s not working today. You’re stuck with me. You will have to dock my pay.”
“I’ll do that. And I’m taking away your Christmas bonus too.”
“All right, Mr. Seth, but you are a cruel taskmaster. I ought to quit.”
“You ought to, but you won’t.”
“That’s right. I’m too dedicated.”
“No. You just know no one else will hire you.”
Sausalito threw his head back and howled in amusement. “Oh, Mr. Seth, you are right! No one else would be so stupid . . . I mean, so kind as to hire me as his secretary. I had better throw in my lot with you rather than try to find riches elsewhere.”
Seth nodded. The smile he’d been trying to suppress broke through. “Okay, then, shall we try this again?”
Sausalito was already staring intently at the screen. “Hi Mom and Dad . . .”
“No, no, they got that part. Just pick up where you left off.”
Sausalito, without moving his head, lifted his eyes to look at Seth. “I will tell them your clumsy secretary hit Send by mistake, and then we will go on from there.”
“Very good, Saus. I’m ready when you are.”
As Sausalito typed, Jane leaned over the bed rail and kissed Seth on the forehead. When she drew back, she felt a surge of joy to see Seth smiling at her.
“I didn’t see you yesterday,” he said quietly.
Jane nodded. “I came by, but you were asleep.”
“Why didn’t you wake me?”
“I don’t know. I thought maybe you needed the rest.”
“Next time wake me up.”
“Well, sure, but I—”
“I’ve kind of gotten used to seeing you. The day doesn’t seem right when you don’t come around.”
Jane reached out and touched his forehead, then curled her palm against his cheek. “I promise to wake you up next time.”
Seth nodded and leaned his head into the warmth of her hand.
“Mr. Seth?” Sausalito interrupted.
“Yeah, Saus?”
“I’m ready for your dictation.”
“All right. Read back to me what you have there.”
Sausalito cleared his throat. “‘My clumsy secretary hit Send by mistake. A thousand pardons—’”
“Wait, Saus, I wouldn’t say a thousand pardons.”
“You’re not. I’m the one saying a thousand pardons.”
“But this isn’t your e-mail. You’re just the scribe here. Scratch ‘a thousand pardons.’”
Sausalito sighed, highlighted the words, and hit the Delete key. “All right, Mr. Seth. A thousand pardons for the thousand pardons. It has been deleted. Now, to go on. ‘Please bring the Nikes. They’re in the hall closet.’” He looked up expectantly. “What do you want to say next, Mr. Seth?”
“Let’s see.” Seth thought a moment, staring up at the ceiling.
When a full minute had passed, Sausalito leaned forward. “Mr. Seth?”
“I’m . . .” Seth didn’t finish.
“Seth?” Jane leaned over the railing. “Seth, what’s the matter?”
Seth’s eyes widened with fear. He moved his head from side to side. “I don’t know. All of a sudden my heart started pounding in my chest. I can feel it. And my head—”
“What’s wrong?”
“My head hurts and . . .”
Jane laid a hand on his forehead again. It was slick with perspiration. She looked at Sausalito. “What’s happening?” she asked.
The young Ugandan lifted the laptop to the hospital table and stood. His jaw went slack as his eyes swept over Seth’s face and down his inert body. “I don’t know, Miss Jane,” he said, his voice trembling. “I don’t know.”
“My head . . .” Seth moaned. “My head.”
Sausalito reached for the call button and pushed it. A light flashed on over the door, but he didn’t wait. “I’m going to get help,” he said as he rushed from the room.
“Jane,” Seth whispered. “What’s happening to me?”
“I don’t know. Sausalito’s gone to get help.” Her own heart hammered in her chest as she absently laid her hand over his. His fingers were cold, like meat packed in ice. She recoiled, clutching the railing instead as she willed herself not to panic.
Where was Sausalito? Where was the nurse, the doctor? Several agonizing seconds passed. When she didn’t hear the expected footfalls in the hall, she hurried to the door. At the same time a familiar figure exited a room two doors down.
“Truman!”
“Jane.” He raised a hand. “How are you?”
“Truman, please hurry. There’s something wrong with Seth.”
Frowning, he quickened his pace. “What is it?”
“I don’t know. Just all of a sudden he said his head hurts and his heart is pounding.”
Before Jane finished speaking, they were by Seth’s bed. Seth moaned as his head rocked from side to side. Truman touched his forehead, then fingered his wrist to feel for his pulse. “It looks like dysreflexia,” he muttered. He reached for the bed control and raised the head of the bed.
“What?” Jane asked.
Truman didn’t answer. He winced as he eased himself down into a squatting position by the bed. He was obviously looking for something.
“Truman, please. What is it?” Her words were edged with panic.
But still Truman ignored her as he unhooked Seth’s catheter bag and lifted it up toward the light. “Just as I thought.”
“Please, Truman . . .”
“His urine isn’t draining properly. His bladder is overdistended. He’s—”
Truman was interrupted when Sausalito rushed into the room, shadowed by a nurse.
“Dr. Rockaway?” the nurse said, surprise in her voice.
“It’s possible dysreflexia. We’re probably looking at a mucus plug somewhere in the tubing.” Grunting, Truman stood. “What’s his BP?”
The nurse unwound the stethoscope from her neck and pulled the blood pressure cuff out of its steel holder on the wall. She quickly positioned the cuff around Seth’s upper arm and started pumping. Jane and Truman waited anxiously as she listened through the stethoscope. When she’d got the reading, she let go of the pump, and the remaining air quickly sighed out of the cuff. “One-sixty over one hundred.”
“Just as I thought,” Truman said. “Who’s on call?”
“Dr. Harrington.”
“Call him.” As the nurse reached for the phone, Truman turned to Sausalito in the doorway. “Get Jane out of the room,” he ordered. “Go on. Both of you.”
Jane looked frantically from Truman to Seth and back again. “But, Truman—”
“Go on, Jane. You’re just in the way here.” He had pushed back the linens on the bed and was examining the site where the catheter tubing entered Seth’s groin through a small incision. He glanced up at Jane, h
is brow furrowed. “He’ll be all right. Wait for me in the hall.”
Sausalito moved to Jane’s side and cupped her elbow with one large hand. “Don’t worry, Miss Jane,” he said gently, guiding her out of the room. “Dr. Truman will take care of everything.”
Jane wanted to bury her face in the young Ugandan’s shoulder and cry out her fear. But before she could so much as speak, the nurse appeared in the doorway and barked at Sausalito, “Go to the supply closet and get a new catheter. Quickly.”
Sausalito disappeared and Jane was alone. In another moment, a young doctor she didn’t recognize rushed by her and into the room. She could hear him speaking to Truman, but she couldn’t understand the words.
Please, God, she thought, let Seth be all right.
The voices inside sounded serious but calm. Sausalito came down the hall with a coil of tubing in a plastic wrapper. He nodded as he reached her. “Don’t worry, Miss Jane,” he said again. “Everything will soon be all right.”
He disappeared into the room. Jane stared at the floor, not wanting to make eye contact with anyone passing by in the hall. She squeezed her hands together. Please, God . . .
She waited. Several tension-filled minutes ticked by. Jane felt light-headed with fear and her stomach turned. Finally Truman stepped out into the hall and laid a reassuring hand on her shoulder. “He’ll be all right, Jane. Dr. Harrington’s got everything under control.”
She let out a breath she didn’t even know she was holding. “Thank God,” she said.
“Yes. He’s been given something for pain, and he’s resting more comfortably now. They’ll be monitoring him closely for the next few hours, just to make sure.”
“What exactly happened in there, Truman?”
Truman lifted his hand from her shoulder and wiped at the beads of perspiration that had sprouted along his brow. “There was a mucus plug in the tubing that wouldn’t allow his bladder to empty. Basically, when something like that happens, the body rebels in an effort to let you know something’s not right.”
“You mean, your body pulls a major stunt over something so minor?”
Truman smiled patiently. “Well, to you and me, it’s a minor deal. When our bladder’s full, we know it and we do something about it. But it’s not that way for Seth. He doesn’t know when his bladder’s full, so the catheter is supposed to be taking care of all that for him. Since it was plugged, it wasn’t working. We just now emptied about 1000 cc’s of urine out of Seth’s bladder. Normally, we’d be looking for a bathroom at 350 cc’s.”
Jane studied Truman’s face for a moment. “So that made his blood pressure skyrocket?”
“Yes. It’s a condition called autonomic dysreflexia.”
“But did it happen because the catheter tubing is going directly into his groin?”
“Oh no.” Truman shook his head. “Nothing like that.”
“Well, why is it? Going into his groin, I mean. I didn’t know he had an incision like that.”
“It’s just a different kind of catheter. It’s used for long-term situations, when the tubing won’t be removed after a day or two. Less chance of infection that way. Though obviously there’s still the possibility of mucus plugs. At any rate, there are many causes of dysreflexia, not just a problem with the catheter. The larger problem is that many doctors don’t recognize the signs when it happens.”
“But you did.”
Truman nodded. “I’ve seen it a few times in my career.”
Jane moved her head slowly from side to side. “What if you hadn’t been there? What if no one had reached him in time? Could he have . . .”
She didn’t finish her sentence.
Truman wiped at his brow again. “I could use a drink,” he said, sighing wearily. “Can I buy you some chocolate milk?”
16
For several long minutes as they sipped chocolate milk from pint-sized cartons, neither of them spoke. They seemed first to need time to come down from the panic, to travel from the frenzied episode on the fifth floor to the quiet, sweet normalcy of the canteen.
Jane breathed deeply, savoring the sense of relief. Then she said, “If his blood pressure had kept going up, couldn’t he have had a stroke?”
Truman nodded. “Almost certainly he’d have had a stroke.”
“An episode like that could kill him.”
“Yes.”
Jane thought about that a moment. “Thank you for saving his life, Truman,” she said quietly.
Truman took another swig of milk and settled the carton on the table. “Dr. Harrington saved his life. I don’t practice medicine here.”
“Oh. Okay.” Jane nodded her understanding. “But I’m glad you were there.”
“I am too.”
Another silence followed. Then, “Truman?”
“Yes?”
“I’ve done a lot of reading about spinal cord injuries, but I had no idea anything like this could happen. I mean, one minute he was fine, even joking with Sausalito, and the next . . .”
“It’s insidious, Jane. The body suddenly revolts without warning.”
Jane finished her milk and closed up the lip of the carton. “It makes me realize how vulnerable he is. And about how ignorant I am when it comes to his condition. What else don’t I know? What else could happen to him at any time?”
Truman frowned and looked down at his hands, as though he didn’t want to answer. “Lots can happen that you’ll have to be prepared for.”
“Like another episode of this . . . whatever you called it?”
“Dysreflexia. Yes. That and blot clots, pneumonia, bedsores that turn septic. And on and on. Virtually every system in his body has been left compromised by the injury and the resulting paralysis.”
“So you’re saying he could die at any time.”
“Well . . .” Their eyes met briefly, but they both looked away. “Chances are that Seth will live a long time. Just in the past few decades we’ve gotten very good at keeping people like him alive.”
“People like him?”
“People with spinal cord injuries at or above C-5. Still, the higher the injury, the lower the life expectancy.”
Silence again. Then, “What does that mean in terms of years, Truman?”
“If you’re asking me how old Seth will be when he dies, I can’t answer that. If I could, I’d be God.”
Jane tried to smile.
Truman went on, “But it’s possible he’ll live into old age.”
“And it’s possible he’ll die tomorrow.”
“Any one of us could die tomorrow, Jane.”
Jane breathed deeply, let it out. “I suddenly realize the uncertainty of life, and I don’t like it very much.”
“None of us does, but we have no choice. This is the story we find ourselves in, and we have to see it through.”
“I suppose you’re right.” She shrugged. “That reminds me of what Laney used to say—”
She was interrupted when a young woman with a small boy in tow moved quickly across the canteen and stopped in front of one of the vending machines. “Make it fast, Jeffrey, we’ve got a bus to catch,” she said, digging around in her wallet for some change.
The little boy pressed one plump finger against the glass. “I want . . . I want . . . I want . . .” His finger moved from pretzels to peanuts to candy bars.
“Sometime in this century, please, Jeffrey,” the mother said with barely restrained patience.
“Umm . . . .”
“Come on, kiddo, choose. Or I’ll choose for you.”
“These!”
The woman dropped the coins in the slot, pushed the appropriate button, and claimed the bag of chips. “Here you are. Now let’s go.”
She grabbed the boy’s hand, passed by Jane, unsmiling, and rolled her eyes.
She doesn’t know what she has, Jane thought. Jane would give anything to have a little boy or girl to buy potato chips for, even if it meant waiting for a later bus.
“What were you say
ing, Jane?” Truman asked.
“What?” She looked back across the table at Truman. “Oh, I don’t know. Nothing, I guess.”
“You’re deep in thought, though.”
Jane nodded. “I can’t help thinking that I have a wedding dress hanging up in my closet at home. I’ve chosen the invitations. I’ve got four friends lined up as bridesmaids, just waiting for me to decide on a color scheme so they can order their dresses. And . . .”
“And?” Truman prodded.
She held up her hand and touched her forefinger to her thumb. “I was this close to my dream coming true.”
Truman leaned forward over the table. “Who’s to say it won’t still come true?”
“I think—” She stopped and sighed heavily. “Maybe I should just accept the fact that it isn’t going to happen. I mean, I suppose there are worse things than never getting married.”
“Oh yes, I’m sure. But listen, Jane, you’re so young. You’re far too young to say you’ll never be married. If you don’t marry Seth—and who knows but maybe you will—but if you don’t, there will be someone else. I know it’s hard to imagine that now, but I believe I’m right. Most people marry, after all.”
“Did you, Truman?”
Truman laughed lightly. “Well now, I guess I’m the exception to my own rule. No, I never married.”
“But why not?”
“I almost did once. But—” He looked down at his hands and shrugged.
“Tell me about her, Truman.”
“It was a long time ago.”
“What was her name?”
Truman looked up, looked resigned. “Magdalene,” he said. “Her name was Magdalene Hearne. Everyone called her Maggie.”
“Pretty name.”
“Pretty girl. She was beautiful and sweet. Smart too. As they used to say, she was quite a catch.”
“So what happened?”
Truman frowned, sticking out his lower lip so that the fleshy inner pink was visible. He took a deep breath. “Someday I’ll tell you, Jane. But not today.”
Jane nodded. “All right. But soon, okay?”
Truman stood and threw away the milk cartons. “Well, back to rounds,” he said.
“I thought you didn’t work here.”
Truman put a finger to his lips and winked as he moved toward the door.