Trapped (5 page)

Chapter Six

When Mike had first arrived at Brier, the hospital had only a nursery with one corner designated for intensive care babies. State and Federal regulation regarding NICUs had become strict, so the choices were to either get into the business of intensive care big time, or get out. Brier decided to become a regional center for neonates. They recruited a board-certified neonatologist, Mike Cooper, and together they built a first-rate NICU. Each time Mike entered the unit, he felt the satisfaction and pride of having been part of that process.

Lisa Cooke was in the midst of changing one of her baby’s diapers when Mike arrived for rounds. “Let me clean up, Dr. Cooper. I’ll be right with you.”

“No problem. When you’re done, I’d like you to come with me while I talk with the Kramers about their daughter
, Amanda.”

“I want to apologize to you, Dr. Cooper. I was rude the other day,” she said with a smile that made him blush.

He hesitated for a moment, fixed like a deer in the headlights, and then looked into her soft green eyes. “It was nothing,” he sputtered, “I should have waited until you were through with your Yoga. After all, you were on a break.”

“No, it was something else…”

“Something else?”

“You reminded me of someone, and too many unpleasant experiences
, but,” she paused, “I can see that you’re not that way, at all.”

Unpleasant experiences? What way?
He thought.

She removed her gloves
, and washed her hands before coming to his side.

“This isn’t going to be easy, Lisa. I need to bring Ted and Karen Kramer up to date on baby Amanda’s condition.”

Lisa felt sick.

The Kramers sat side-by-side on the faded sofa in the waiting room. They grasped each other’s hands
, and rose as one when Mike and Lisa entered.

“What is it?” Karen cried.

“Please have a seat,” Mike said as he grabbed a footstool and slid it over to sit before them. While sitting, he remained at their eye level, and looked directly at each of them as he spoke.

“I wish I had better news.”

Karen gasped, and then she started to cry.

Mike clasped his huge hands over
Karen’s. “Please,” he begged, hear me out.” He hesitated before meeting and holding their gazes. “It's a struggle for premature babies; they’re not ready for life outside the womb. Amanda’s problem, respiratory distress syndrome, is simply due to her immature lungs, which struggle to provide her body with enough oxygen.”

Lisa moved to the couch
, and sat next to Karen.

Ted loosened his tie, and said, “I thought the cortisone and the stuff you’re putting into her windpipe…”

“Surfactant,” Mike said.

“Yes, the surfactant. You said that they designed that medicine to head off these problems.”

“It was helping, but today she had another lung collapse. I removed the air in her chest to re-expand her lung, but I’d be lying if I didn’t tell you that I’m concerned.”

“Can’t you do anything else?” Karen asked. “What about another consultant?”

“If you want another opinion, I’ll arrange for someone I trust to see her.”

“It’s not that we don’t trust you, Dr.…”

“Don’t apologize, Ted. I understand. Let me outline where we are. We’ve given Amanda the best available therapy. We’re a referral center for high-risk premature infants, so we’re up on the latest treatments. You’ll discover, if you inquire, that we’re caring for Amanda exactly as they would if she was at the University of California Medical Center in San Francisco, or at Stanford.”

“I’m sorry,” Ted said. “We’re not questioning you
, or what you’re doing for Amanda. We’re upset. We trust you. If you think an outside consultant might help, then let’s get one.”

Mike moved his eyes between the two. “How about this
, I’ll discuss Amanda’s case with Dr. Ira Greenfield, the chief of neonatology, at UC. He’s been caring for preemies for thirty years, and he taught me everything I know about babies like Amanda. Let’s see if he has any other suggestions.”

“It’s okay if we stay here?” Karen asked, “We want to be near her.”

“Of course,” Lisa said.

Mike stood, started for the door
, and then turned to face the Kramers. “It’s difficult to talk about Amanda. I want you to understand what’s happening with your daughter, though I know it’s frightening to hear the details about someone so small and helpless being this sick. Don’t let my cautionary words rob you of hope. That’s not my intention. I believe that she’ll come through this, and you should, too.”

Karen stood, walked to Mike
, and placed a soft kiss on his cheek. “Thank you. It means so much to us that you care about Amanda.”

Lisa felt her eyes welling as the first tear streamed down her cheek.

Mike and Lisa stood outside the waiting room. Lisa blew her nose
, and wiped her tears away. “You were great with them, Dr. Cooper.”

“Please, if you’re comfortable, call me Mike. Everyone does.”

“Thanks, Mike, but I’m more embarrassed now about how I treated you the other day.”

“Forget it. I’d give anything to take back some of the things that came out of my mouth.”

He looked at her as she glanced through the windows over the bay. The grey-black western clouds billowing over the horizon, obscuring the setting sun, befitted her mood.

“I still feel the need to say more,” she said. “To explain.”

Be careful,
he thought.
Sharon told me what Lisa said. She’s already on record as disliking me. All I need now is a sexual harassment charge
.

“I’m
around. We can talk anytime.”

She again gazed through the window for a moment, and then turned to face him with the warmest smile. “Why don’t you buy me a drink after work?”

Be still, my heart,
he thought, inwardly laughing at himself for the corny line. Then, thinking twice, he said, “Don’t take this the wrong way, Lisa, but I don’t think that would be a good idea at this time.”

Mike’s flat rejection shocked Lisa.
Not a good idea?

Chapter Seven

Mike Cooper
awoke with a start at five-thirty in the morning. His arm flailed out, grasping for the phone to silence the piercing ring.

“Mike,
it’s Leona Lee in NICU. It’s baby Kramer. You’d better get over here, ASAP.”

“What?”

“Mike, wake up. It’s baby Amanda.”

“Amanda,” he repeated, shaking off the cloud of sleep. “What’s wrong?”

“I think she’s septic. You need to get over here—now.”

“Are the Kramers there?”

“Yes, and they’re freaking.”

“I don’t blame them,” he said. “I’ll be right over.”

Mike rolled out of the bed in the on-call room. He stumbled to the bathroom, quickly brushed his teeth, and combed his thinning brown hair, which stood upright. He put his lab coat over his scrubs, and headed for the NICU.

Even in the midst of an emergency, at least one short of a Code Blue resuscitation, the NICU evoked the sense of calm control. Leona Lee and the respiratory care technician stood at the side of Amanda’s incubator. Their drawn looks told Mike that this baby was again in deep trouble. He looked through the plate glass window of the unit. The Kramers were staring at him.

“I’ll be there in a moment,” he said, exaggerating the words so
that they could read his lips.

They nodded
in understanding.

Mike redirected his attention back to the incubator. “Leona, what have you done so far?”

“I followed protocol and had the lab draw a blood count, electrolytes, and several blood cultures. They completed the chest x-ray a moment ago. We should have everything back soon.”

Mike reached into the incubator
, and exposed the tiny body. The baby’s skin was red, and paper thin with little fat. That allowed him to see each rib, as if examining a skeleton. Amanda’s respirations had increased, and, in spite of support from the ventilator, she struggled to breathe. Through his latex gloves, Mike could feel the baby’s fiery hot skin.

“Get me a spinal tap set,” he said
. “We need to see if the infection’s spread into the central nervous system.”

With so little subcutaneous tissue, the landmarks for the spinal tap were obvious
, and, in a minute, he held a small test tube full of clear spinal fluid.

Thank God it’s clear
, he thought. The tension in his abdomen eased a bit.

Mike ordered
broad spectrum antibiotics, and then sat at the nursing station viewing the chest x-ray image on the monitor. It showed changes consistent with the respiratory distress syndrome, but no other new infections. The lab data reflected an ongoing severe infection of the blood stream, which they called sepsis.

The Kramers remained at the window
. Mike could feel their eyes tracking his every move. He looked up again as Lisa approaching them with a broad smile as she arrived for her shift. Her smile evaporated as they exchanged the first few words. Karen gesticulated wildly as she pointed toward her daughter’s incubator. Lisa stared at Mike through the window. A moment later, she was at his side.

Leona gave Lisa a quick
, but thorough, report on Amanda’s condition, and what they’d done.

“Do you want me to talk with the Kramers, Mike?” Leona asked.

“No, I’ll do it. Let me finish writing my notes and the new orders, first.”

As Mike prepared to leave the unit, Lisa
asked, “Do you want me with you?”

“I’d love it, Lisa, but I need you here with Amanda. Come get me the second you see anything alarming. I’ll be right outside in the waiting room.” He started to walk away,
but hesitated. Turning to Lisa with a face fixed with determination, Mike said, “I won’t let this baby die! I can’t let her die!”

Mike’s ferocity both alarmed and touched Lisa as he struggled to hold together the barriers of Amanda’s failing defenses.

When Mike left the NICU, the Kramers approached him, clutching each other for support. Ted’s face was stone. Karen’s was red and tear stained. She blew her nose repeatedly, and twisted the frayed handkerchief between her hands.

“Please, come into the waiting room,” Mike said.

Both parents wouldn’t look into Mike’s eyes as they sat on the sofa, terrified by what might come.

Mike sat next to them. “I never get used to this,
yet I do it all the time. Babies like Amanda get sick in a blink of the eye, and they get better just as quickly.”

“What’s wrong?” Karen asked.

“Amanda has an infection in her blood stream. It’s serious—anything that happens to her now can change her condition from serious to critical. I’ve started her on antibiotics.”

Karen turned to Ted, placed her face against his chest
, and cried.

“What are her chances?” Ted whispered.

“I’m going to do everything possible to get her through this.”

“The tension is overwhelming,” Karen said, pushing Ted away
, and beginning to pace. “I feel like I’m on a tightrope, swaying, shaking in the anticipation of the fall. I can’t stand it.”

“I understand,” Mike said. “I must get back to Amanda. I’ll let you know the moment
that anything changes.”

Mike returned to the incubator. “Anything new?”

“No,” Lisa said. “She looks so sick. She’s fighting so hard to live
—it breaks my heart.”

Mike picked up the phone
, and dialed his office. “Cancel my office appointments for the day. I’m staying here with a sick baby. Get Dr. Dillard to cover my patients.”

Mike and Lisa worked together through the day. Caring for Amanda was like stepping on a newly frozen lake, listening for the first cracks of the ice
, foretelling a fall into the freezing waters. Lisa stayed one-on-one with Amanda, and continued her routine chores in caring for the baby. Mike tried to keep out of her way, but felt a tingling warmth whenever they accidentally touched. Mike never left the side of the incubator, except for a restroom break, and to get a snack. He continually adjusted the intravenous fluids, blood pressure support medications, and worked with the respiratory therapist to maximize the effectiveness of the ventilator.

“It’s near the end of your shift, Lisa. I appreciate your help. You’ve been great.”

Lisa reddened. “Thanks, Mike. It’s been an experience.”

Just then, the intercom sounded, “Lisa Cooke, line three.”

Lisa picked up the phone, listened, and then said a few words. When she returned to the incubator, she said, “You’re stuck with me for another eight hours. I have to do a double.”

As they continued to work together, Mike took the opportunity to watch Lisa. Except for periods of extreme stress or intense concentration, she always
wore a smile. Seeing that smile made him smile, too.

This is someone
special,
he thought…m
aybe we should
…

She interrupted his fantasy. “Amanda’s breathing
more easily, now. Her temp’s down.”

Mike examined the baby
, again. “I agree. The worst may be over. I’m going to talk with Ted and Karen,” he hesitated…and then, if you have the strength, maybe we can get that drink after you finish your shift.”

She smiled at him. “I might have enough energy left for that.”