I felt scared. I'd never heard of anything like this before, a baby turning bright red and screaming constantly. I didn't trust this intern, who seemed far too young to be competent. He couldn't be experienced; he didn't even look as if he shaved yet. I was jittery, shifting my weight from one foot to the other. I was beginning to feel slightly crazy, because my daughter had never stopped screaming once in the last hour. It was wearing me down. The intern ignored it. I didn't know how he could.
"She has no fever," he said, making notes in a chart, "but in a child this age that doesn't mean anything. Under a year, they may not run fevers at all, even with severe infections."
"Is that what this is?" I said. "An infection?"
"I don't know. I'm presuming a virus because of that rash. But we should have the preliminary blood work back in-ah, good." A passing nurse handed him a slip of paper. "Uhh… hmmm…" He paused. "Well…"
"Well what?" I said, shifting my weight anxiously.
He was shaking his head as he stared at the paper. He didn't answer.
"Well what?"
"It's not an infection," he said. "White cells counts all normal, protein fractions normal. She's got no immune mobilization at all."
"What does that mean?"
He was very calm, standing there, frowning and thinking. I wondered if perhaps he was just dumb. The best people weren't going into medicine anymore, not with the HMOs running everything. This kid might be one of the new breed of dumb doctor. "We have to widen the diagnostic net," he said. "I'm going to order a surgical consult, a neurological consult, we have a dermo coming, we have infectious coming. That'll mean a lot of people to talk to you about your daughter, asking the same questions over again, but-"
"That's okay," I said. "I don't mind. Just… what do you think is wrong with her?"
"I don't know, Mr. Forman. If it's not infectious, we look for other reasons for this skin response. She hasn't traveled out of the country?"
"No." I shook my head.
"No recent exposures to heavy metals or toxins?"
"Like what?"
"Dump sites, industrial plants, chemical exposure…"
"No, no."
"Can you think of anything at all that might have caused this reaction?"
"No, nothing… wait, she had vaccinations yesterday."
"What vaccinations?"
"I don't know, whatever she gets for her age…"
"You don't know what vaccinations?" he said. His notebook was open, his pen poised over the page.
"No, for Christ's sake," I said irritably, "I don't know what vaccinations. Every time she goes there, she gets another shot. You're the goddamned doctor-"
"That's okay, Mr. Forman," he said soothingly. "I know it's stressful. If you just tell me the name of your pediatrician, I'll call him, how is that?"
I nodded. I wiped my hand across my forehead. I was sweating. I spelled the pediatrician's name for him while he wrote it down in his notebook. I tried to calm down. I tried to think clearly.
And all the time, my baby just screamed. …
Half an hour later, she went into convulsions.
They started while one of the white-coated consultants was bent over her, examining her. Her little body wrenched and twisted. She made retching sounds as if she was trying to vomit. Her legs jerked spastically. She began to wheeze. Her eyes rolled up into her head. I don't remember what I said or did then, but a big orderly the size of a football player came in and pushed me to one side of the cubicle and held my arms. I looked past his huge shoulder as six people clustered around my daughter; a nurse wearing a Bart Simpson T-shirt was sticking a needle into her forehead. I began to shout and struggle. The orderly was yelling, "Scowvane, scowvane, scowvane," over and over. Finally I realized he was saying "Scalp vein." He explained it was just to start an IV, that the baby had become dehydrated. That was why she was convulsing. I heard talk of electrolytes, magnesium, potassium. Anyway, the convulsions stopped in a few seconds. But she continued to scream.
I called Julia. She was awake. "How is she?"
"The same."
"Still crying? Is that her?"
"Yes." She could hear Amanda in the background.
"Oh God." She groaned. "What are they saying it is?"
"They don't know yet."
"Oh, the poor baby."
"There have been about fifty doctors in here to look at her."
"Is there anything I can do?"
"I don't think so."
"Okay. Let me know."
"Okay."
"I'm not sleeping."
"Okay." …
Shortly before dawn the huddled consultants announced that she either had an intestinal obstruction or a brain tumor, they couldn't decide which, and they ordered an MRI. The sky was beginning to lighten when she was finally wheeled to the imaging room. The big white machine stood in the center of the room. The nurse told me it would calm the baby if I helped her prepare her, and she took the needle out of her scalp because there couldn't be any metal during the MRI reading. Blood squirted down Amanda's face, into her eye. The nurse wiped it away.
Now Amanda was strapped onto the white board that rolled into the depths of the machine. My daughter was staring up at the MRI in terror, still screaming. The nurse told me I could wait in the next room with the technician. I went into a room with a glass window that looked in on the MRI machine.
The technician was foreign, dark. "How old is she? Is it a she?"
"Yes, she. Nine months."
"Quite a set of lungs on her."
"Yes."
"Here we go." He was fiddling at his knobs and dials, hardly looking at my daughter. Amanda was completely inside the machine. Her sobs sounded tinny over the microphone. The technician flicked a switch and the pump began to chatter; it made a lot of noise. But I could still hear my daughter screaming.
And then, abruptly, she stopped.
She was completely silent.
"Uh-oh," I said. I looked at the technician and the nurse. Their faces registered shock. We all thought the same thing, that something terrible had happened. My heart began to pound. The technician hastily shut down the pumps and we hurried back into the room. My daughter was lying there, still strapped down, breathing heavily, but apparently fine. She blinked her eyes slowly, as if dazed. Already her skin was noticeably a lighter shade of pink, with patches of normal color. The rash was fading right before our eyes. "I'll be damned," the technician said. …
Back in the emergency room, they wouldn't let Amanda go home. The surgeons still thought she had a tumor or a bowel emergency, and they wanted to keep her in the hospital for observation. But the rash continued to clear steadily. Over the next hour, the pink color faded, and vanished. No one could understand what had happened, and the doctors were uneasy. The scalp vein IV was back in on the other side of her forehead. But Amanda took a bottle of formula, guzzling it down hungrily while I held her. She was staring up at me with her usual hypnotic feeding stare. She really seemed to be fine. She fell asleep in my arms.
I sat there for another hour, then began to make noises about how I had to get back to my kids, I had to get them to school. And not long afterward, the doctors announced another victory for modern medicine and sent me home with her. Amanda slept soundly all the way, and didn't wake when I got her out of her car seat. The night sky was turning gray when I carried her up the driveway and into the house.
DAY 3
6:07 A.M.
The house was silent. The kids were still asleep. I found Julia standing in the dining room, looking out the window at the backyard. The sprinklers were on, hissing and clicking. Julia held a cup of coffee and stared out the window, unmoving.