“Perfect.”
“Not for him. He tends to run a little lower,” the nurse said.
“The difference is too slight to be bothered about.”
“Oh, there’ll be a difference,” David said.
“But your deadline’s come and gone,” another doctor said. “I told you, the first time was just a coincidence. He just happened to spike a fever when you said he would.”
“And I told you, the Vancomycin I gave him delayed the schedule.”
“I’ve had enough of this. We controlled his infection.”
“No!”
“Everything’s back to normal,” the doctor said. “Now I’ve got rounds to make.”
“Well, maybe we ought to…” The doctor from the Pediatrics Ward cleared his throat. “It wouldn’t hurt. Just wait a few more minutes.”
“And reinforce this man’s delusion?”
“He’s been right so far.”
“Coincidence!”
“Just in case, though.”
“Something’s happening,” a nurse said.
“What?”
“His pressure’s down to a hundred.”
“Now will you believe me?” David asked.
“Check it again,” a doctor said.
“Down to ninety.”
“No.”
“I told you,” David said.
“Eighty.”
Matt vomited again.
“No!”
“Don’t wait,” David said. “Give him the dopamine.”
“Dopamine? How did you know that’s the drug we’d use to-”
“Raise his pressure? You wouldn’t believe me! Give him the-!”
“Seventy.”
“Do it!” David yelled.
“Can’t you see we already are?”
Matt’s body shuddered, convulsing.
“Sixty.”
An intern injected the contents of a syringe into one of Matt’s IV lines.
David exhaled. Panicked, he slumped against a wall.
“And now we wait,” he said. “And pray.”
17
In David’s nightmare, Matthew’s plummeting blood pressure had not responded to the dopamine. The pressure had bottomed at forty over twenty, almost as low as it can get and still allow the body to maintain vital functions. Repeated injections of dopamine hadn’t raised the pressure.
David had watched a frantic nurse crank up the end of Matthew’s bed, raising his feet, helping his blood to circulate, trying to compensate for the devastating decrease in arterial pressure.
David had watched the doctor in charge of the ward phone Intensive Care. David, Donna, Sarie, a nurse, and a doctor had rushed Matthew’s bed down hallways, into an elevator. Two floors below, they’d scurried with the bed down other hallways, into the ward that made the Emergency Ward seem primitive. As the document David had signed when Matt went into the Bone Marrow Ward so vividly put it, You have a life-threatening disease. Within a year, you will surely die unless you receive exceptional treatment. A bone marrow transplant has serious risks, including infection.
And, David mentally added, they don’t rush you down to Intensive Care just to try out the machines.
In David’s nightmare, higher doses of dopamine finally raised Matthew’s blood pressure to a barely acceptable level of eighty over sixty. A team of trauma specialists waited in Intensive Care, and as soon as he arrived, the team snapped instantly into motion. David recalled no fewer than eight IV stands with two pumps on each injecting fluids and medications into his son.
But dopamine has plus and minus effects. It raises critically low blood pressure. However, to do so, it must stem the flow of blood to such crucial organs as the kidneys.
Matthew’s kidneys shut down, stopped filtering poisons into the bladder. He needed a hole cut into his abdomen. A tube was inserted, through which fluid was poured in and an hour later drained out-to vent the poisons.
But now he was also on oxygen. If given long enough, oxygen poisons the lungs. Fluid accumulates. That fluid puts pressure on the heart.
Three organs in trouble. And that’s not counting the remnant of the tumor in his chest, four missing ribs, and…
In David’s nightmare, Matthew struggled against an oxygen tube crammed down his throat. Finally morphine had to be given, to put him to sleep, so he wouldn’t yank the tube from his mouth.
Just before the tube was inserted and the morphine injected, the director of Intensive Care told David, Donna, and Sarie, “If you need to tell him something, now’s the time. He might not come off the respirator.”
Next to David, Sarie paled. “What does he mean, Matt might not come off the respirator?”
“It means”-David couldn’t believe he was saying this-“Matt might die.”
“Jesus.”
18
What do you say to your son when the ultimate reality kicks him and you in the teeth? You’ve got five minutes to tell him the last words he might ever hear. Then, whether you said the right thing or not, you don’t get another chance.
Your character, your upbringing, your self take charge.
Sarie chose to say, “I love you, Matt.”
David chose to be practical. “Don’t get panicked. Fear will increase your shock. Trust the system. I’ll push these doctors to their limit. I promise, they’ll do everything they possibly can.”
Donna said… wise Donna… “Matt, you’re a perfect boy.”
A priest in the background said, “No, a perfect man.”
Donna kissed her son.
The tube was inserted, the morphine given.
And that was the final communication.
Except… before drifting into a morphine stupor, Matt (unable to speak because of the oxygen tube crammed down his throat) pointed with determination toward letters on an alphabet board. His trembling finger wavered, spelling. The gist was clear.
Take this tube out. Need a root beer.
And then… Die? he spelled.
“We’re doing our best,” a doctor said.
Matt nodded. His eyelids fluttered. He slept.
The final communication.
Five days later, his injured lung collapsed.
But it reinflated, giving cause for hope.
Three days later, his heart became infected. His blood pressure plummeted, and this time nothing on earth or in heaven, no medicine, no prayers, would help.
19
In David’s nightmare. But now, heartbroken, desperate for a second chance, David stared at the nurse taking Matthew’s temperature.
“It’s back to normal.”
“Blood pressure?” a doctor asked.
“Up. Ninety over sixty-five.”
“He’s coming around,” another doctor said.
“There.” The doctor in charge of the ward turned to David. “A false alarm.”
“Pressure-a hundred over seventy.”
“I repeat,” the doctor said.
“A false alarm? I watched you,” David said. “You were afraid. But believe me, you couldn’t have been as terrified as I was. What I did last night when I gave him the Vancomycin…”
“Was irresponsible.”
“I saved my son’s life!”
20
In David’s nightmare, one of the bitterest ironies had been that as Matthew had worsened in Intensive Care, his recently transplanted bone marrow had started to multiply, producing healthy blood. Four days after the onset of his septic shock, Matt’s white-blood count rose from zero to eight hundred. Not strong enough to fight infection but, under other circumstances, encouraging. As a rule, a white count of one thousand is considered the minimum safety level. The next time Matt’s white count was tested, it had risen to sixteen hundred. And the next time, thirty-two hundred. When he died from heart arrest, his white count was over six thousand. If he hadn’t contracted septic shock, his healthy blood would have permitted him to be released from the hospital the day of his death.
To be sure, there would still have been dangers. The devastating chemotherapy had temporarily destroyed his immune system. For several months, he’d have been susceptible to such normally nonlethal diseases as chicken pox, which he’d already had and acquired an immunity to, but which in his present weakened, nonimmune condition could have killed him. To guard against that danger, he’d have been forced to stay at home, his visitors restricted to those who had no illness and hadn’t been exposed to any illness. Even then, his visitors would have been required to put on hospital face masks, just in case. When school started in the fall, Matt couldn’t have attended but instead would have studied through correspondence courses.