Panacea

by F. Paul Wilson

  Rick caught up to her then, stopping beside her but saying nothing.

  “You don’t have to come in,” she told him. “In fact, I’d rather you wouldn’t.”

  His expression was grim. “Tell you the truth, I’d rather not myself. But I’ve got a feeling you’re gonna need me.”

  “You keep saying that.”

  “I’ll stop as soon as I’m proven wrong.” As she started forward, she felt his hand grip her shoulder. “Give me a signal when you’re ready to make your move.”

  “What?”

  “They’ll most likely have CCTV in there. If so, put yourself between Marissa and the camera. I’ll make sure no one’s watching.”

  A camera … that hadn’t occurred to her.

  With Rick close behind, she pushed through the doors into the beeping, blinking, wheezing cocoon of an ICU. She didn’t have to ask which bed was Marissa’s because she immediately spotted Steven’s blue-and-red Rangers jacket draped over a chair to the right of a bed holding a child she barely recognized.

  So pale, eyes closed with lids so dark and sunken.

  A woman in scrubs bustled toward her. “Can I help you?”

  Laura continued forward. She tried to answer but words wouldn’t come.

  “Ma’am, you just can’t come in here.” Her name plate read H. Sayers, RN.

  “I-I’m Marissa’s mother.”

  “Doctor Fanning? I spoke to you before. We—”

  “What level?”

  “Six—she’s down to one on eye response. I’m so glad you made it.”

  “Swallow reflex?”

  “Still there the last time we swabbed her mouth.” She pointed to a man and woman in scrubs behind the nursing station. “The intubation team is here.”

  Laura froze. For the first time she noticed the ventilator on Marissa’s left, next to the bed on the far side from Steven. If she was going to do this, she had to act now.

  She glanced around for the camera and found it—up near the ceiling and angled toward the side of the bed opposite the still dozing Steven. She caught Rick’s eye and gave him a quick nod.

  He winked and ducked behind the nursing station where he began pulling open random drawers.

  “Where’s the good stuff?” he shouted. “Show me the good stuff!”

  Nurse Sayers made a beeline for Rick. “Sir! Sir! What do you think you’re doing?”

  Laura moved in the opposite direction, unstoppering the vial as she neared the bed.

  Sayers’s voice well behind her now: “Wait! Stop! You can’t go in there!” Other protesting voices joined her. “Help! Call security!”

  “Just want a little taste!” Rick shouted.

  Squeezing between the silent ventilator and the bed, placing her back to the camera to block her hands and Marissa’s head, she tilted her daughter’s chin up and parted her jaw. She then tipped the vial and poured its contents into Marissa’s mouth, then sealed her lips.

  Marissa made a choking sound, then coughed, but not before swallowing.

  “Laura!” Steven said, looking confused and concerned as he came up behind her. “You’re back!”

  “Finally. In time, I hope.”

  She turned to see Rick watching her as he struggled with Sayers and two other nurses, one male. She gave him another nod. Smiling, he wrenched free and headed for the doors.

  “You people are no fun. I’m outta here.”

  Watching him go, she realized she could love a man like that.

  Steven looked baffled as he tried to grasp the situation by the nursing station, then he turned to Laura. “You’ve got a hell of a lot of explaining to do.”

  “You don’t know the half of it.”

  Nurse Sayers hurried over to her. “Do you know him?”

  “He followed me in.”

  Steven was turning in a slow circle. “What just happened here?”

  “I wish I knew,” Laura said. “I wish I knew.”

  THE IKHAR

  1

  12:16 A.M.

  “I still don’t understand about the phones and the texts,” Steven said.

  She’d spent the rest of Saturday afternoon and much of the evening trying to explain it as best she could. Why wouldn’t he just drop it for now?

  Midnight had come and gone and now on Sunday morning they were seated on either side of Marissa’s bed, each holding a hand. Activity in the twilit PICU had dropped to sleep-time level. Laura had convinced a very reluctant Dr. Lerner to hold off on the ventilator a little longer.

  It hadn’t been easy. Her heart had quailed when he’d shown her the X-rays. The CMV pneumonia was steadily taking over her lungs. Most adults were immune to the virus, so chance of spread to others was low. But Marissa had never been exposed to it, and it had overwhelmed her compromised immune system, clogging her airways. Even on nasal oxygen, her pulse ox was running only 89 or 90 percent. Lerner told her when—Laura had noted that he didn’t say “if”—her oxygen saturation dropped to 88, he’d be obliged to intubate her and start the ventilator.

  “I barely understand it myself,” she told Steven, “but this isn’t the time or place to discuss it.”

  He shook his head, accepting the fact, but obviously not liking it.

  Really, Steven? Our daughter is slipping away before our eyes and you want to discuss phones?

  “I take it you didn’t find what you were sent for.”

  “What do you think?”

  She couldn’t tell him she’d dosed their daughter with—what had Rick called it?—worm juice.

  Right. Tell him that.

  A nurse came over and checked the pulse oximeter on Marissa’s index finger. She took it off, looked at it, frowned, then replaced it.

  “Something wrong?”

  “Just checking.”

  That hadn’t been a just-checking frown. Laura watched her return to her desk, lean over one of her monitors, and frown again. Laura had to go see.

  “What’s up?” she said when she reached the desk.

  She hoped her MD degree still carried some weight.

  “Oh, Doctor Fanning.” Her nameplate read J. Philips, RN. “I … I’m just wondering about the oximetry reading.”

  “There’s a problem?”

  “Her O-two sat appears to be rising.”

  Laura clutched the counter as the room seemed to sway.

  “What’s it reading?”

  “Ninety-two.”

  Okay. Not a dramatic jump. Just two or three points up from where she’d been running. Laura would not allow herself to step into that abyss called hope.

  She noticed a paper clip on the counter and grabbed it before she returned to Marissa’s side.

  “What’s going on?” Steven said.

  She considered her reply and decided it would be cruel to give him hope.

  “She seems to be holding her own. No ventilator yet.”

  “Yet,” he said with a sour expression. “Yet.”

  If he’d had hope in the past day or so, it had slipped through his fingers like a gambler’s savings.

  She straightened a loop of the paper clip and waited until no one was looking. Watching Marissa’s eyes, she dug the tip into the web between the child’s thumb and forefinger. The hand withdrew—still at level four on the motor scale—but the eyes remained closed.

  No change.

  Yes, best not to hope.

  1:07 A.M.

  For the fourth time in less than hour, Laura approached the nursing station.

  “Any change?”

  “Um, yes,” Nurse Philips said, her expression uncertain. “Pulse-ox jumped to ninety-four.”

  Up another two percentage points. That was with continuous oxygen flowing into her nose. She’d have nowhere near that on room air, but still … it meant her red cells were carrying more oxygen to her tissues.

  “This isn’t supposed to be happening,” the nurse muttered. “Doctor Lerner said—”

  “Yes. He told me too.”

  Laura
couldn’t trust herself to say more. She feared she’d break into hysterical laughter. Because this was insane. And yet it was happening. Hope was becoming insistent … insistent as all hell.

  “Ventilator time?” Steven said when she returned to the bedside.

  She shook her head. She had to tell him. “Her oxygen saturation has actually improved.”

  His eyes widened. “Could she be…?”

  “Don’t go there, Steven.”

  Not yet.

  As he slumped back in his chair on the far side of the bed, Laura dug the paper clip into Marissa’s hand again.

  She jerked her arm, moaned, and briefly opened her eyes.

  “Oh my god!” Steven said. “Did you see that? Oh my fucking god! Nurse! Nurse!”

  Marissa had just risen from a six to an eight on the coma scale.

  Was she coming out of it … really coming out of it?

  2:31 A.M.

  Marissa became the focus of all attention in the PICU. The third shift was much smaller than the first, but every nurse on duty kept stopping by to check on the little girl who was defying all the dire expectations.

  “She’s a real fighter, isn’t she,” said an older nurse who studied her from the foot of the bed.

  “You can’t imagine,” Steven said.

  Which was the expected response. Marissa really was a fighter. She’d fought through the pain and side effects of all the leukemia therapies that had failed without ever a hint of wanting to give up. But this was different. The CMV had dealt a death blow. Something else was bringing her back.

  With all the traffic around the bed, Laura hadn’t tried poking her again.

  “Call her name,” the nurse said.

  Laura leaned close. “Marissa? It’s Mommy. Can you hear? Marissa?”

  She opened her eyes.

  Laura balled her fists. That put her another point up the scale.

  Nurse Philips appeared at the bedside. “Pulse ox is up to ninety-six.” She sounded as if she’d just run around the building. “I called Doctor Lerner and he ordered a portable chest. He’s on his way in.”

  3:12 A.M.

  Laura stood behind Dr. Lerner where he sat at the nursing station. She stared at the monitor screen over his shoulder.

  “This is impossible,” he was saying. “I’ve never seen anything like it.”

  “Impossible is an opinion,” Laura muttered.

  Lerner turned to Nurse Philips. “You’re sure the film didn’t get mislabeled?”

  “No, look,” Laura said, pointing to the tube visible in her little chest. “The central line is in exactly the same place as the last film.”

  Dr. Lerner had yesterday’s portable and this morning’s side by side on the computer screen for comparison. Laura was no radiologist or pulmonologist, but the new film was definitely better.

  “She’s had fifty-percent clearing in less than twenty-four hours. That’s impossible, you know. Even a bacterial pneumonia that’s sensitive to an antibiotic won’t do anything like that. And this is viral. There has to be a mistake.”

  “Pulse ox just hit ninety-eight,” Philips said.

  “That goes with the X-ray.” Lerner shook his head. “I just … just…” He shook his head again.

  You just don’t get it, Laura thought. Well, neither do I. But I’m going with it. I’m—

  “She’s talking!” Steven cried from the bedside. “She’s not making any sense, but holy shit, she’s talking!”

  Laura rushed over. Marissa’s eyes were open and staring at the ceiling while she babbled in a hoarse voice.

  “… mayonnaise soup computer severe plate school spots lights night…”

  “Word salad,” Laura said.

  “Right,” said Lerner, stepping up beside her. “But it means her meningitis is abating as well. This is incredible. Just incredible.”

  4:19 A.M.

  Marissa’s oxygen saturation had passed 100 percent. She’d lapse into a sleeplike unconsciousness, then awaken and spew more word salad.

  Laura had found that hope wasn’t necessary now: Her little girl was getting better by the hour. Steven had fallen asleep in his chair and Laura felt herself slipping into that delicious presleep drowsiness when she heard Marissa start making sense.

  “Where’s Natasha? It’s time for math. She should be here by now.”

  Her head was propped on a pillow now but remained stationary. Only her eyes moved. She seemed disoriented, but she was making sense.

  “Do the Mets play tonight? No, it’s December. That’s silly.”

  Then she closed her eyes again.

  Laura could no longer fight the reality of what was happening. The ikhar … whatever was in it was working. She still could not accept the All-Mother or Rick’s vast intelligences, but she had to accept the ikhar. It was real and it was working.

  SUNRISE

  “Mom? Mommy!” The voice seemed to come from far away … from the other end of a tunnel. “Mom, wake up!”

  Laura forced her eyes open …

  … and found herself staring at Marissa’s face. She was sitting up in bed. She looked unsettled but fully alert.

  “Marissa? Honeybunch?”

  “What happened? How did I get here?”

  “You were sick.”

  “I was?”

  “Yes. Very.”

  “But I’m okay now. Can we go home?”

  Laura couldn’t answer. She was sobbing too hard.

  2

  The rest of Sunday became a series of parades, starting with a parade of inexplicables.

  Marissa’s second chest X-ray of the day showed no pneumonia—not a trace. Her white blood count had returned to normal—all her labs were normal.

  The second was a parade of the specialists and subspecialists who had treated her over the course of her stay, all coming to bear witness to the miracle in the PICU.

  Marissa was her normal precocious, gabby self, meeting them all for, what was to her, the first time.

  Laura sat back and watched the expressions on their faces as they listened to Marissa’s lungs and questioned her. Most of them had visited her at one time or another during the past thirty-six hours. None of them seemed able to reconcile the bright-eyed, vivacious little girl before them now with the obtundent child they’d seen before.

  Laura even heard one mutter that it was a trick—had to be a twin or something—no way was this the same kid.

  How human: When you don’t have an explanation for what you see, you make one up.

  While Marissa was basking in the spotlight—and Steven was home grabbing a shower—Laura had a chance to look around at the other PICU patients. A sandy-haired little boy about Marissa’s age caught her eye. He had the usual assortment of tubes running into him, but his color was terrible. She wandered over.

  “Hi.”

  He looked up. “Hi.” His voice was a puffy whisper. Clearly short of breath despite the oxygen cannula in his nose.

  “I’m the mother of that popular little girl over there. What brings you here?”

  “Heart (puff) went bad.”

  Nurse Sayers from yesterday arrived then and added, “Cory has a cardiomyopathy.”

  “Viral?” Laura said.

  “They think so. We’re getting ready to transfer him to Presbyterian for a new one.”

  Laura nodded. “Good place.” Columbia Pres had a renowned transplant center. “They have a match?”

  Sayers shook her head. “Not yet. We’re all hoping.”

  As the nurse bustled away, an idea—an insane idea—took hold.

  “Cory? You thirsty?”

  He nodded.

  “What kind of juice would you like?” She made a point of not mentioning water.

  “Apple?”

  “You got it.”

  Trying to look casual, Laura followed Sayers back to her station.

  “Cory says he’s thirsty. Looking for apple juice. Is he on fluid restriction?”

  “He is, but he can have
four ounces.”

  “I’ll give it to him.”

  She gave Laura a quizzical look. “You sure?”

  “I’m in a mothering mood and my own doesn’t seem to need much at the moment.”

  Sayers glanced toward Marissa and her pseudo press conference and smiled. “When I was here yesterday, the general opinion was no hope. Now look at her. It’s a miracle.”

  “It sure is.”

  “Well, she can spend the rest of her Sunday on a general peds floor—private room, of course.”

  Apparently they still considered her immune system fragile.

  “You’re transferring her?”

  “Yeah. We need the bed and Marissa no longer needs intensive care.”

  Sayers measured out four ounces into a plastic cup, tapped an entry into the computer, then handed it to Laura.

  “Let me know if he doesn’t drink it all so I can adjust the intake/output.”

  “Sure will.”

  Laura detoured to Marissa’s bed where she fished the third vial from her bag. Cory’s eyes were closed so she turned her back to the CCTV camera and quickly emptied it into the juice, giving it a good swirl.

  “Hey there,” she said, tapping him on the shoulder. “Got your juice.”

  He opened his eyes and took the cup without speaking.

  “The nurse wants you to drink it all.”

  He nodded and tossed it back. He made a face as he swallowed. “Tastes (puff) funny.”

  “I think it’s the fresh kind. Better for you.”

  He handed back the cup. “Thanks. So (puff) thirsty.” He looked past her. “There’s my (puff) mom.”

  Laura nodded to the frazzled, distracted looking woman approaching the bed and glided back toward Marissa.

  3

  With Marissa on the regular pediatric floor and Steven back on bedside duty, Laura took the keys to his Audi and headed for the parking lot. She needed a long hot shower.

  She found a familiar figure waiting.

  “Clotilde?”

  The older woman wore a baggy sweater and jeans and looked like she could be right at home at Walmart.

  “Your daughter is well.” A statement, not a question.

  “Yes. Thank you.”