Seth had poor nutrition. He was clinically depressed. He had a history of heavy drinking and arteriosclerotic vascular disease. He had received a trauma resulting in an open wound, and a foreign body that could not be removed. Seth, according to Dr. Cabel, was immunosuppressed, and was losing approximately a pound of flesh per hour. This did not include layers lost by surgeons file ting to the next level of healthy, bleeding tissue, which soon after turned black and green, despite all efforts and prayers. Hammer was motionless in her chair, reliving every word she'd ever spoken to her husband, every deed that had been angry or unkind. None of his flaws would come to her now.
This was all her fault. It had been her. 38 special, her Remington hollowpoint +P cartridge. It had been her order that he root under the sheets for that gun and hand it over to her this minute. It had been Hammer giving him the ultimatum about his weight, and she halfway believed that what he suffered from now was no coincidence, but a functional illness. Seth was melting before her eyes, an inch smaller every hour, slabs lighter after every surgery. This was not the weight-loss plan she would have wished for him. He was punishing her for all those years he had lived in her shadow, the wind beneath her wings, her inspiration and biggest fan.
"Chief Hammer?"
She realized someone was speaking, and her eyes focused on Dr. Cabel, in surgical greens, cap, mask, gloves, and shoe covers. He was no older than Jude. God help me, Hammer thought with a deep, quiet breath as, once again, she got out of her chair.
If you'll give me a minute with him," Dr. Cabel said to her.
Hammer went out into the antiseptic, bright corridor. She watched nurses, doctors, family members, and friends alight on different rooms where more suffering lay tethered to narrow hydraulic beds, and machines monitored the life force as it struggled on. She stood, in a daze, until Dr. Cabel returned, slipping Seth's chart in the envelope on the back of the door.
"How is he?" Hammer asked the same question, pulling her mask down around her neck.
Dr. Cabel left his mask on. He took no chances, and didn't even shower at home anymore without lathering from head to toe with antibacterial soap. He shut Seth's door, eyes troubled. Hammer was shrewd, and not interested in further euphemisms, convolutions, and evasions. If this young infectious disease doctor thought he could hide the truth from her, she was about to add to his education.
"We're going to take him back into surgery," Seth's doctor said.
"Which is fairly typical at this point."
"And which point is this point, exactly?" Hammer wanted to know.
"Day two of progressive streptococcal gangrene and necrotizing fasciitis," he replied.
"The necrosis is visibly beyond the margins of the original debridement."
While Dr. Cabel respected Chief Hammer, he did not want to deal with her. He cast about for a nurse. Shit. All were busy elsewhere.
"I need to get started," he said.
"No so fast," Hammer let him know.
"Exactly what are you going to do in surgery?"
"We'll know better when we go in."
"How about hazarding a guess." She might slap him.
"Generally, at this stage, the wound is debrided again down to bleeding, healthy tissue. We'll probably irrigate with saline and pack the wound with Nu-Gauze. We'll continue with hyperbaric oxygen therapy twice a day, and I recommend total parenteral nutrition."
"Multivitamins then," she said.
"Well, yes." He was mildly surprised by her ability to connect the dots.
Hammer had been buying vitamins for years and failed to see anything special about the suggestion. Dr. Cabel started to walk off. She snatched him back by his greens.
"Let's cut to the chase," she said.
"Seth has had strep throat a dozen times in his life. Why has it turned into this now?
Aside from his lousy immune system. "
"It's not exactly the same thing as the strep that causes a sore throat."
"Clearly."
This lady was not going to let him go. Dr. Cabel felt sorry for Seth in a different way, now. Living with this woman would wear out anybody.
Imagine asking her to fetch coffee or take your word for it? When all else failed, Dr. Cabel switched to the language that only his super race understood.
"It's quite possible strep has acquired new genetic information, picked up genes. This can happen through infection by abacteriophage," Dr. Cabel informed her.
"What's abacteriophage?" She wouldn't give up.
"Uh, a virus that can incorporate its DNA into abacterial host," he said.
"The hypothesis is, that some Ml strain of group A strep, in approximately forty percent of recent invasive infections, seems to have acquired genetic material from a phage. This is according to WHO. "
"Whoi' Hammer frowned.
"Exactly." He looked at his watch long enough to give her a broad hint.
"Who the hell is wboY She would get an answer.
"World Health Organization. They have a strep reference laboratory.
The long and short of it, this may all be connected to a gene that encodes a toxin called super antigen which is widely believed to be connected to toxic-shock syndrome. "
"My husband has the same thing you get from a tampon?" Hammer raised her voice.
"A distant cousin."
"And since when do you amputate for that?" she demanded as passerbys glanced curiously at the two people in greens arguing in the spotless, well-lit corridor.
"No, no." He had to get away from this woman, so he, the English major, threw Shakespeare at her.
"Ma'am, with what your husband's got, surgery remains the most effective treatment.
"Be bloody, bold and resolute," he quoted.
"King Lear."
"Macbeth," Hammer, who loved the theater, said as Dr. Cabel hurried off.
She lingered long enough to see her husband wheeled back to the OR, then Hammer went home. By nine o'clock, she had collapsed in bed, too exhausted and distressed to remain in a conscious state effectively.
She and her deputy chief, in their respective homes, one with a pet, one without, slept fitfully the rest of the night.
Brazil tossed and yanked sheets this way and that, over his feet, under them, back over them again, on his side, on his belly. Finally, he lay on his back, staring up into the dark, listening to the TV murmur through the wall as his mother lay passed out on the couch again.
He kept thinking about what West had said. He should move out, find an apartment. Yet whenever he followed this scary, exciting path a few steps further, he always ran slam into the same scarecrow that sent him fleeing the other way. What was he supposed to do about his mother? What would happen to her if he left her alone? He supposed he could still bring by groceries, stop in to check on her, fix things, and run errands. Brazil worried as he thrashed in bed, listening to the eerie strains of what must have been some three a. m. half-a-star horror flick. He thought about West and felt depressed again.
Brazil decided that he did not like West in the least.
She was not the kind, enlightened woman that Hammer was. One day, Brazil would find someone like Hammer. They would enjoy and respect each other, and play tennis, run, work out with weights, cook, fix the cars, go to the beach, read good fiction and poetry, and do everything together, except when they needed space. What did West know about any of this? She built fences. She cut her own grass with a rider mower because she was too lazy to use a push one, and her yard was barely half an acre. She had disgusting eating habits. She smoked. Brazil turned over again, hanging his arms off either side of the mattress, miserable.
At five, he gave up and went back to the track to run again. He clipped off eight more miles and could have gone farther, but he got bored and wanted to get downtown. It was strange. He'd gone from exhaustion to hyperactivity in a matter of days. Brazil could remember no other time in his life when his chemistry had swung him around like this. One minute he was dragging, the next he was high and excited with no explanation. He contemplated the possibility that his hormones were going through a phase, which he expected would be normal for one his age. It was true that if the male did not give in to his drives between the ages of sixteen and twenty, biology would punish him.
His primary care physician had told him exactly that. Dr. Rush, whose family practice was in Cornelius, had warned Brazil about this very phenomenon when Brazil had a team check-up his freshman year at Davidson. Dr. Rush, recognizing that Brazil had no father and needed guidance, said many young men made tragic mistakes because their bodies were in a procreation mode. This, said Dr. Rush, was nothing more than a throwback to colonial times when sixteen was more than half of the male's life expectancy, assuming Indians or neighbors didn't get him first. When viewed in this fashion, sexual urges, albeit primitive, made perfect sense, and Brazil was to do his best not to act on them.