“Do you think she will survive?”
“I hope. At least she didn’t crash the first day like two others. She’s gradually getting worse, but slowly enough that I hope she will turn this around soon.”
Brian’s hand trembled as he scratched his ear, and he felt his heart in his chest. “We didn’t think this epidemic was going to amount to much, and now it has become historic. Somebody said we could have two million deaths.”
“I hope we don’t get to that.”
“What about Faith terrifies you?”
“She has almost no lymphocytes,” Peggy said. “In non-pregnant patients, low lymphocytes and high D-dimer is a bad combination. The problem with D-dimer is that it is sky high in pregnancy anyway, so the significance in pregnancy is obscure in my mind.”
“Crap.” Brian sat for a moment. “What if she dies?”
“Many of our spirits will be broken, including this team, her family, and especially Josh. I’m not sure some aren’t broken already that we don’t know about.”
“I heard you saved a baby.”
“Yes. Ricky and Ann did. He’s one that I am worried might be particularly fragile.”
“I’m surprised. He seems more resilient. I haven’t seen a soft side.”
“This is where you could use more interaction with the team. Let them talk. Let them verbalize about things besides patients, medicines and blood tests.”
“I don’t want to hear that,” Brian said. “I don’t need to hear their stories. Just like NA meetings, and some of the literature that the NA leader passes out. It doesn’t help me to hear or read about someone else’s problems. I just don’t need the darkness now.”
“Don’t you need the light side also? Ricky is often hilarious.”
“I don’t want the rest of the story.”
“How do I help you open your eyes. What are some of the NA survivors telling you about life?”
“Crap. Then more crap. All they can think about is using again. There is one lady in my group who says she has been clean for a decade, and she still thinks about it every damned day.”
“My brother-in-law quit smoking twenty years ago and says he doesn’t go a day without thinking about a cigarette. I don’t have any personal experience like that, but I think I hear what you are saying.”
“They never manage to tell me how they avoid falling off the wagon,” Brian said. “It sounds like it never ends.”
“What has Pain Management said about it?”
“That it’s something that will be with me for the rest of my life.”
“Like cancer of the pancreas and lymphoma.”
“Why do you always come back to that?”
“Because we are talking about the same kind of disease. Like diabetes. Once you have it, you have it. Unfortunately, this is not like appendicitis or bladder infection. You don’t get cured.”
“But lymphoma patients sometimes get a bone marrow transplant and never hear about it again.”
Peggy raised her index finger, “But they have to watch for it around every corner. I bet they think about it every single day, worry about every visit to the oncologist, dread every CT scan, and deal with the effects of the transplant.”
Brian felt defeated. He didn’t like the idea that this was a serious illness, especially a chronic illness that could be terminal. “The real kicker is the stigma. It’s not like cancer of the pancreas or lymphoma in that people looked at those patients differently. I get the sense that people think of me as causing this illness and choosing not to get well.”
“What do you think about lung cancer and smoking?”
“Smoking causes lung cancer.”
“So, are those patients responsible for their illness?”
“I guess so,” Brian said. “More and more, people recognize that they brought this on themselves.”
“My brother-in-law, Skip, is certainly in that situation with his lung disease. We don’t talk about it in the family, but everyone knows that his smoking was the problem. Don’t you think this is sort of the same?”
“I hadn’t thought of that, but it’s a valid point.”
“Both cancer of the lung and obstructive lung disease are consequences of smoking, which is a substance abuse. They don’t die of overdose, I don’t think, but they die of heart disease, stroke, lung disease, and a lot of cancers.”
Brian scratched his ear again, “Those are physical diseases that seem more tangible than substance abuse with lethal potential. I think of it differently, and I can’t help but think others think of it differently too.”
“We can’t control what others think,” Peggy said. “But you can control what you think about it. If you approach it like cancer of the lung or obstructive lung disease, since you don’t want me to go back to cancer of the pancreas and lymphoma, it might lead you to a better outcome.”
“Man, oh man.” Brian stood and turned away from Peggy, sauntered toward the door, then turned and briskly returned to the desk. “I need to thank you. You are always here late in the morning, I can come without an appointment, you don’t set rigid time limits, and you have been insightful. I need to thank you for that.”
Peggy, totally taken aback, stood and shook Brian’s hand.
“I’ll see you later.”
The window gently affirmed Brian’s progress. Brian had to look back at the door he had just closed. Was this the first time he had heard it rattle?
Chapter 37
“I’m getting worse, Josh. I can feel it.”
It was not the greeting he expected. It shook him to the core. She had now been here four days. “What makes you think so?”
“It’s really getting harder to breathe, like before the CPAP. And they keep increasing my oxygen to keep my pulse ox up. Look, right now it’s only eighty-nine percent.” She was using a makeup mirror to look at the numbers on the monitor.
He sat and held her hand. Aspirin was keeping his fever away. Luckily for him, no cough, trouble breathing, or muscle aches had appeared, but food had lost its taste. Showered, dressed, and in good spirits, he had come to spend the night with her and to help the exhausted Labor and Delivery staff. The ride over had been through an uplifting sunset and a warm breeze. This revelation spoiled the pudding.
“We need to check this probe out,” he offered, looking at its pristine appearance and perfect placement. The truth was repulsive. It wasn’t the probe. His heartthrob was becoming critically ill. She was going to need a ventilator. What if we didn’t have one? In the guise of needing the bathroom, he left the area, found a stall, sat, and cried.
In less than an hour, Peggy sat with Josh at the side of Faith’s bed. Ricky appeared in PPE. Josh knew what was coming and didn’t like it a bit.
“We were thinking we should intubate you, Faith, since you are getting worse, and we don’t want this to become an emergency.”
“I was thinking I was getting worse. It’s now hard to breathe even with my CPAP.”
“So, I’ll tell Ann we agree with her,” Ricky said and disappeared as stealthily as he had appeared.
“Will you put me to sleep?” Faith asked.
“Yes. You won’t know a thing,” Peggy said.
“Josh.” She coughed again. “Kiss me. What if I don’t see you again?”
“Don’t talk like that. I’ll see you later. Get well quick.” He kissed her. “Go back to Sandia Peak.” It sounded lame this time.
Ann appeared, Josh held her hand, and Peggy emptied one full syringe of milky white propofol and one clear syringe of vecuronium into her IV. Faith’s body relaxed, she stopped breathing, Peggy slipped the endotracheal tube in, and hooked the tube up to the ventilator. With each breath it gave her, she listened to Faith’s lungs, then applied the stabilizing device between her teeth.