Authors: Hannah Alexander
“Jarvis?” The voice was Estelle's. He heard her footsteps draw near, and the echo of them pounded in his head, which he could not raise from the desk for the moment. She laid a hand on his right shoulder.
He forced his eyes open. His whole body trembled as he made himself straighten in the chair.
“How are you feeling now, Dr. George?”
“I'm okay,” he heard his own voice croak. He blinked and glanced around the room. “Have they taken Tedi to CT?”
“They did that ten minutes ago. Jarvis, you're sick. Dr. Bower is here now, and I've asked him to check you out.”
“I told you I've been checked out,” he growled, sudden irritation giving him momentary energy. “I don't want him touching me.” He struggled to his feet, then walked unsteadily past her out the door toward the central desk. He knew she was following, but he didn't care. “Claudia, have you heard anything about Dwayne yet?” he asked.
The nurse turned and looked up at him, then glanced at Estelle.
“Go ahead and tell him, Claudia,” Estelle said.
“Yes, Dr. George. I called Cox South as soon as I made sure Tedi was going to be okay.”
“How is he?”
Estelle laid a hand on his shoulder. “Dwayne coded about five minutes out, Dr. George. They did a hot offload, but they couldn't get him back. I'm sorry. He died.”
Jarvis could not respond. He stared at Estelle for a long moment. Then the room went black. He felt himself topple forward.
“Help me, Claudia!” Estelle cried as she caught Jarvis and eased him to the floor.
A full-body spasm caught Jarvis in its relentless grip.
“Where's Dr. Bower?” Estelle demanded.
“He's in room six,” Claudia said.
“Get him now!”
L
ukas heard Mrs. Pinkley cry out, and he rushed out of exam room six to find Jarvis on the floor, his hands and legs flailing in a classic seizure. Mrs. Pinkley knelt before him, watching helplessly, but wisely not restraining him.
“What happened?” Lukas asked.
“He just passed out and started seizing. What should I do?”
“Make sure he doesn't hit his head against the desk.” Lukas walked over and grabbed a cot. “Claudia, get out the Ativan.”
The severity of the convulsions slowed, and in thirty seconds they stopped. “Did he hit his head when he fell?” he asked.
“No,” Mrs. Pinkley said. “I was able to break his fall.”
“Good.” Lukas reached beneath the doctor's arms, lifted him from the floor and manhandled him onto the cot. “Claudia, is that Ativan ready?” He pushed the cot into exam room two.
“Coming.”
“Good. Grab a gram of Dilantin on your way. Put it in 100 CCs of normal saline. We want to get this in by IV if possible. We'll need extension tubing. I don't want him pulling the IV out if he seizes again. You concentrate on the IV. I'll take care of the rest.”
He had Jarvis hooked to oxygen and had padded the bed rails with blankets by the time Claudia walked into the room.
“Do you want blood drawn?” she asked.
“Yes, but do it fast. We want to be able to break the next seizure if there is one.” He applied monitor patches and attached the leads.
“How fast do you want me to give it?” she asked.
“Fifty milligrams per minute. You're just in time,” he said as he watched her secure the IV with tape. He stepped to the door and called out to Carol for stat blood work. Jarvis's arms and legs had begun to tense for another round. “Claudia, hold the Dilantin. Give the Ativanâ2 milligrams per minute should break it.”
Jarvis jerked violently and it started again. Claudia pushed the drug Lukas ordered, and the length of extra tubing prevented the IV from being pulled out. Within two minutes the seizure broke.
“It's working.” Lukas watched as the spasms once again grew less intense. “That's enough Ativan. I think we can start the Dilantin now.”
“Gotcha.” Claudia switched the medications quickly. She shot Lukas a broad grin. “Good to have you back. I can't tell you how much I've missed you.”
Lukas reached over and straightened Jarvis's oxygen mask, which had slipped sideways during the seizure. “I haven't even been gone a whole day.”
“It's been a rough day.” She lowered her voice. “We've
lost two patients already. Sweet old Mr. Verris had an MI, and he had a DNR sheet, so we couldn't code.”
Lukas felt a swift rush of pain. “Frankie?”
“Sorry, Dr. Bower. I know you really liked him.”
Frankie had been looking forward to his reunion with his wife, and he was ready. That knowledge brought Lukas peace. It must have upset Dr. George to lose a patient, especially considering the mental state he'd been in recently.
“Let's check for vitals since we didn't get a chance to do so earlier.” Lukas reached for an ophthalmoscope and shined the light into Jarvis's eyes. They were equal and reactive, and thanks to the seizure, there would be no question about the movement of all four extremities. “You say we lost two?” he studied the patient. “Jarvis? Dr. George? Can you hear me yet?”
No reply.
“The other one was Dwayne Little,” Claudia said softly.
Lukas jerked around and stared at her. “What? How?”
“He came seeking drugs again, and he got them this time, then drove away while we were busy with Mr. Verris. Wrecked his car. Jarvis seized when he got the news about Dwayne.”
Lukas felt another rush of pain, and no peace followed this one. Another human life, a human soul, lost.
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Mercy pushed through the emergency room doors and saw Mrs. Pinkley coming forward from the desk to meet her. “Thanks for calling me, Estelle. Where's Tedi?”
“She's in CT right now.” The administrator's deep, familiar voice conveyed a sense of calm as she laid an arm across Mercy's shoulders and walked with her, keeping up the brisk pace without apparent effort. “She was awake
and talking when they took her over, so it looks as if the worst has passed.”
Mercy took a deep breath and willed herself to slow down. She headed toward radiology. “What happened?”
Estelle pressed her lips together thoughtfully. “She doesn't remember it yet. Her father says she fell and hit her head against a wooden bookcase.”
Mercy raised a brow at the older woman. Estelle caught the look and returned it. “I'm glad Carol was able to reach you. I'd been trying for some time.”
“Oh? Why?”
“Dr. George has fallen ill, and I needed someone to fill in for him. Dr. Bower came in just a few moments ago.”
“Good. Where's Theodore?”
“I left him in the private waiting room.”
“Has he been drinking?”
Mrs. Pinkley nodded.
Mercy didn't say another word. She would deal with Theodore later. Right now Tedi needed her.
When she stepped into the CT room, she caught sight of her daughter's brave expression where she lay in the center of the shooting match. It made Mercy want to cry. The technician completed her final orders and gave Tedi some encouraging words. The press of a button slid Tedi out from beneath the X-ray cameras.
“Can I talk now?” Tedi asked.
“Yes, go ahead. We're finished here,” the tech said, nodding to Mercy. “You can come and get her if you want, Dr. Richmond.”
Mercy stepped around the lead-lined partition and bent down to kiss Tedi, taking care not to move her any more than necessary. She still wore the c-collar. Mercy studied
Tedi's skin for signs of abuse and found nothing. No marks. Still, children often failed to show signs of trauma.
“How are you feeling, honey?”
Tedi blinked and yawned, then raised her hand and touched the collar. “My throat hurts.”
Mercy's interest sharpened. “You have a sore throat?”
“No.” Tedi tapped the collar with her fingers. “It's my neck, right here.” She indicated the left side of the collar.
Mercy gestured toward the tech. “Ann, has she shown any physical changes since they brought her in?”
Ann shook her head. “She's been perfect. She did everything I told her to do, didn't cry, didn't complain. I wish all my patients were so good. Time to get her to the plain film room so we can clear that c-collar. Maybe her neck will feel better then.”
Fifteen minutes later, Tedi continued to pick at the c-collar with her fingers. “This thing really hurts, Mom.” The X-ray tech had just finished with the final shot, and Mercy stood brushing the hair from her daughter's eyes and watching her face.
Something didn't seem right. Tedi did not seem to feel as well as she had earlier. She should be getting more alert, not less alert.
“Mom, that machine's still buzzing in my ear. It's too loud.”
Mercy frowned and glanced at the tech. “Buzzing? I don't hear anything.”
Tedi looked around and pointed toward her left. “It's coming from over there.”
“Are you hurting anywhere besides your neck?”
Tedi yawned. “My head hurts.” She raised her hand toward the right back side of her head and blinked sleepily.
Mercy checked the movement of her daughter's pupils.
They were fine. Mercy turned to the tech. “Please have Dr. Bower come over here for a stat exam. Something's wrong.”
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The tech brought Dr. George's lab printouts to the exam room. Lukas studied them, frowning. “I don't see an obvious explanation here. We'll have to do a CT of his head.” He stepped toward the door to give Carol the order.
“No.”
Dr. George's sudden, gruff voice startled Lukas and Claudia. Lukas turned back toward the bed. The lids of Jarvis's eyes were half-open in a struggle for more complete consciousness.
“Dr. George, you've had a seizure,” Lukas explained. “The blood work shows no obvious cause for it, so a CT scan is the next step.”
“Done it,” Jarvis growled.
Lukas blinked at him in surprise. “When?”
“Monday.” His eyes opened farther, and he turned his head to glare at Lukas.
“What did it show?”
“Nothing.”
“Then we'll need a lumbar puncture. You're in trouble, Dr. George. We've got to find out whatâ”
“Not here, and not by you.” Jarvis struggled to sit up. Lukas laid a hand on his shoulder to stop him, and Jarvis knocked it away. “Get me to Springfield!”
“Jarvis, you're already seizing, so you know time could beâ”
“Dr. Bower.” Carol rushed into the room. “Sorry to interrupt, but Dr. Mercy's calling for you over in radiology. She thinks there's something wrong with Tedi.”
Jarvis lay back against his pillow. “Get over there and take care of that little girl, and get me an ambulance.”
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Theo was slumped at the end of the sofa in the private waiting room. His head hurt so badly he could barely hold it up, so he sat with his face buried in his hands, tears dripping between his fingers. He heard the door open and heard footsteps on the carpet, but he didn't look up. If it was Mercy, he'd rather not see the attack coming.
Nobody hit him, but someone sat down beside him, then reached down and patted his knee. He opened his eyes and looked at the hand without raising his head. The hand had deep veins and liver marks and wrinkles. It was feminine, but not Mercy.
“How are you feeling, Theodore?”
He recognized Estelle Pinkley's voice. “How's Tedi?”
“Not doing too well at the moment, I'm afraid.”
He raised his head, sniffed and wiped the moisture from his face with his sleeve. “What's wrong with her? What's happening? They said she was conscious. Is Mercy here yet?”
“Yes, she came in a few moments ago. Tedi isn't feeling as well as she was when she first woke up.”
Theo's head didn't swim now, but his stomach churned with nausea and fresh fear. What had he done?
Estelle grabbed some tissues from the box beside the sofa. She laid them in Theo's lap. “Here you go. I know that sleeve's awfully handy, but it's already a mess.”
He took the tissues and wiped his face with them. “What're they doing with Tedi?”
“All they can do. You know, Theodore, although I've been blessed these past forty-five years to be married to a strong man who knows how to be tender, I grew up with three testosterone-ridden brothers and I know the hazards of male pride. Some men would rather die than
admit they have a problem. But what if it kills someone they love?”
The words struck him like a railroad tie in the gut. He sucked in his breath as he looked into her all-seeing eyes.
“Tedi is still going through some tests. But, Theodore, tests are subjective,” she said quietly. She held his gaze.
He blinked at her.
“We've got good doctors here, but they aren't God. They x-ray what they think might be damaged, just as they run blood tests for particular needs. They can't find every little thing if they don't know what to look for.”
Slowly Theo realized what she was saying.
She continued to watch him, as if studying every move of his face for signs of weakness. “I've worked with people a lot of years, Theodore. I've learned to depend on my ability to read people, and I think I've become quite good at it. Can you honestly tell me that Tedi is suffering from a simple bump on the head?”
He looked away, looked down, then buried his face once more in his hands.
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Tedi sighed with relief when they finally took that big, hard collar from her neck. She tried to concentrate as Mom talked to the radiologist and to Dr. Bower. The CT was normal, whatever that meant. They said she had a large contuâ¦something on the back of her head. What in the world were bone windows? Anyway, they were normal, too. Why did doctors have to speak a different language from other people? Didn't it just confuse things worse?
With another yawn, Tedi closed her eyes and tried to sleep. Her neck still hurt, though, and that buzzing still bothered her, even though Mom said she couldn't
hear anything. Maybe something was wrong with Mom's hearing.
The radiologist left, and Tedi listened to her mother's worried voice float over her.
“Something else is going on, Lukas. I don't like this.”
Gentle hands touched her face, and she opened her eyes to find Dr. Bower bent over her.
“Tedi, how are you feeling?”
“Weird.”
“Describe that feeling to me.”