“Yes. I don’t think what they told me is correct.”
“So, you have some soul searching to do.”
“Between you and my Pain Management crew, I am about to go nuts.”
“You realize that is half the battle, right? Once you honestly, in your deepest soul, are convinced that this is a problem, you can tackle it with vigor. Only you can enter and follow the treatment. Only you can allow yourself to be treated. Only you can climb this mountain.”
“But then what?”
“Take up life and enjoy it. Dive into your career.”
Brian didn’t say anything, visions of mountains, treatments, trials, and tribulations swirling in his head. How would this end? When would he be free of it? Brian stood. “Thanks.” With no more than that, he left the room.
The window didn’t rattle.
Chapter 30
Peggy was relaxing in the call room when her phone displayed Ann as the caller. “Peggy, the patient that Faith brought up from the Emergency Department, Melanie Forsythe, has become extremely difficult to ventilate as well as oxygenate. We’re using insanely high peak inspiratory pressures, insanely high PEEP, and one hundred percent oxygen. With that we only have about eighty percent pulse ox, and a blood gas shows a carbon dioxide too high for pregnancy. I’m about out of options.”
“Yes, Ann,” he replied.
“She has an insanely elevated d-dimer and almost no white blood cells, both terrible predictors. I’m meeting with the family in the main lobby. Do you think you could join us?”
“Absolutely. I’ll be right there. Are you insanely OK?”
“No.”
Sunny skies in the lobby atrium belied the gravity of the immediate problem. Two trips to this place for the same reason in four days was repugnant.
Ann introduced Peggy, “This is Greg Houston, father of the baby, Frank and Brenda Forsythe, Melanie’s parents.” The faces were grim. Brenda was seated with the others standing. Ann had masks on all of them.
Ann addressed the family, “Dr Valdez can help me.”
“What do we know so far?” Peggy opened the discussion.
Frank, the patient’s father, said, “Dr McCauley told us that her lungs have rapidly deteriorated, and that she might not survive.” Tears were running down his cheeks. “No one should outlive their child.” This yanked hard on Peggy’s heartstrings, as she thought of her wife, niece, and her extended family in Crystal Springs.
“Yes, no one should outlive their child. Coronavirus causes swelling and fluid in the tiniest airways in the lung. In her case it’s bad enough to occlude them. This prevents moving air in and out and keeps oxygen from getting into the blood.”
“Dr McCauley told my wife, Brenda, that there was nothing else to do.” He struggled with the rest of the thought, “If her heart stops, they won’t do anything because even if she restarts, it will stop again and again.”
Brenda was sitting in a chair holding her face in her hands.
“Yes. Sadly, we can’t fix the problem. She has run out of the kind of white blood cells she needs to fight the infection and her lungs are failing her.”
“Is this because of the pregnancy?” he asked.
“Well, it’s because of the virus. Pregnancy makes things worse.”
Frank was frustrated. “How did this happen? Where did she get this?”
“We don’t know,” Ann answered.
“How can we find out?”
Peggy let Ann continue, admiring the job he was doing. “She got it between two and eleven days ago, I expect the shorter because of how fast she has gotten sick. She must have come in close contact with someone who had it. We think it can be transmitted from someone before they know they are infected.”
“For her sake, it’s not important for us to know,” Peggy said.
Brenda stood and looked at the group. “Are you sure she will die today?”
Ann sounded bold. “Yes. Her pulse ox is down to sixty-five percent. It might be in the next hour.”
Frank’s mouth popped open. “The next hour?”
“Yes,” Peggy said. In the next few minutes.
“She started a little cough yesterday,” Brenda observed. “How can she die today?”
As Brenda wheezed out the words, Ann looked down at a text message, and told Peggy with eye contact.
“Brenda,” Peggy softly spoke to her, “She’s gone.”
“My little girl is gone,” she spoke, one word at a time between sobs. “My grand-baby is gone, too!”
“Yes,” Ann said, whispering because she had lost her voice. “I’m sorry.”
“You can sit here as long as you like,” Peggy offered.
Brenda looked up, “No. I want to go. You guys need the ventilator.”
“What?” Peggy gasped.
“I know you need the ventilator. I heard that last night on the news.” She was sobbing and moving toward the door.
“Not only couldn’t the family see their daughter, they couldn’t hold her hand as she died, and they can’t visit her now. That’s cruel.” Ann said.
“Yes.”
Peggy walked with Ann to the ICU where Faith was sitting on the bench outside the door, her face in her hands. As they approached, she looked up, sweat, PPE marks, freckles, and all. “I don’t know if I can stand this,” she said.
“I don’t want to suggest that any of this is easy or that this isn’t the scourge of the century,” she said, “but I know you better than to think you will succumb to this. Of all the people in this medical center, not only do you have the compassion, but you have the personal strength it takes to weather a storm like this. But I know exactly what you mean. Sometimes you want to wake up from a bad dream, which doesn’t happen.”
“That’s what this is, Peggy. A bad dream. Every time something bad happens to one of our patients, I can’t help but go into a tailspin worrying about Josh and Cori.”
“Cori?”
“My baby.”
“Cori.”
“I just wish I knew that this is going to turn out OK, Peggy. Do you think it will?”
“Yes.”
“How do you know?”
“You are strong. Josh is strong. Cori has everything going for her. We are seeing the worst of the worst. We aren’t seeing all the ones who don’t know they’re sick or who are only mildly ill. We see the ones that need serious intervention. We get a slanted view.”
“I’ve never seen someone die before,” Faith confessed. “It wasn’t ugly looking, but it was ugly feeling.”
“Yes.”
She stood from the bench. “I need to get some of this work done. Thanks for talking.” She disappeared into a bathroom.
The way she walked away exuded strength and determination hiding grief and the injury. Peggy admired her stamina, her honesty, and her fortitude. She was going to become a bastion of the profession.
Chapter 31
“Can you believe how fast she died?” Faith asked, sitting next to Josh at the charting station and leaning on his shoulder. “It was less than twenty-four hours from when she had symptoms to when we couldn’t oxygenate her. That’s amazing. What else does that so fast?”
Josh had no answer. “I don’t know. Bacterial sepsis doesn’t. Maybe some poisonings and chemical weapons. Botulism?”
“I can’t believe this. That means any one of us could be working today and in a casket tomorrow.”
“I try not to think of that, like I don’t think about the dump truck on I-40 with no brakes.”
“I suppose,” she said. “It’s just that this hammers it home. Then others come in, get a couple days of oxygen, and go home. And there are some who don’t even know they have it?”