The doors to the elevator opened and Kim was dismayed to join a group of happy staffers leaving the hospital at the end of the day shift. He knew it was unreasonable of him, but he couldn't help but be annoyed by their cheerful babble.
Getting off the elevator, Kim started down the hall. The closer he got to the ICU, the more nervous he became. He was almost beginning to feel a premonition.
He paused at the waiting-room threshold to see if Tracy was there. He knew she'd planned on going home to clean up and change clothes.
Kim saw her sitting in a chair near the window. She spotted him at almost the same moment and stood up. As she approached, Kim could see there'd been fresh tears. They streaked the side of her face.
"What's wrong now?" he asked with dismay. "Has there been a change?"
For a moment Tracy could not speak. Kim's question brought forth new tears that she had to choke back. "She's worse," Tracy managed. "Dr. Stevens talked about a cascading pattern of major organ failure. It was so much mumbo-jumbo to me, but she said that we should prepare ourselves. I think she was saying that Becky may die!"
"Becky's not going to die!" Kim said with vehemence that bordered on anger. "What happened to make her suggest such a thing?"
"Becky has had a stroke," Tracy said. "They think she's blind."
Kim shut his eyes hard. The idea of his ten-year-old daughter having a stroke seemed beyond any realm of possibility. Yet Kim well understood that her clinical course had been spiraling downward from the outset. That she may have reached the point of no return was not entirely surprising.
Leaving Tracy in the waiting room, Kim strode across the hall and entered the ICU. Mirroring the previous afternoon, a gaggle of doctors were pressed into Becky's cubicle. Kim pushed his way in. He saw a new face: Dr. Sidney Hampton, neurology.
"Dr. Reggis," Claire called.
Kim ignored the pediatrician. He muscled his way to the bedside and looked at his daughter. She was a pitiful shadow of her former self, lost within the wires and tubes, and the technology. Liquid crystal displays and monitor screens flashed their information in the form of digital readouts and tracing cursors.
Becky's eyes were closed. Her skin was a translucent bluish white.
"Becky, it's me, Dad," Kim whispered into her ear. He studied her frozen face. She didn't register any sign of hearing him.
"Unfortunately she's unresponsive," Claire said.
Kim straightened up. His breaths were shallow and rapid. "You think she's had a stroke?"
"Every indication suggests as much," Sidney said.
Kim had to remind himself not to blame the messenger.
"The basic problem is that the toxin seems to be destroying her platelets as fast as we give them," Walter said.
"It's true," Sidney said. "There's no way to know if this was an intracranial hemorrhage or a platelet embolus."
"Or a combination of the two," Walter suggested.
"That's a possibility," Sidney admitted.
"One way or another," Walter added, "the rapid destruction of her platelets must be forming a sludge in her microcirculation. We're into that cascading major organ failure situation that we hate to see.
"Kidney and liver function is definitely going down," Arthur said. "The peritoneal dialysis is not keeping up."
Kim had to steel himself to curtail his anger at this self-serving dialectic. It certainly wasn't helping his daughter. He tried to think and remain rational.
"If the peritoneal dialysis is not working," Kim said in a deceptively calm voice, "perhaps we should transfer her to the Suburban Hospital and get her on a dialysis machine."
"That's out of the question," Claire said. "She's too critical to be transferred."
"Well, it seems to me we-have to do something," Kim shot back, his anger bubbling to the surface.
"I think we are doing all we can," Claire said. "We're actively supporting her respiratory and kidney functions, and replacing her platelets."
"What about plasmaphoresis?" Kim said.
Claire looked at Walter.
"AmeriCare is reluctant to authorize it," Walter said.
"Screw AmeriCare," Kim spat. "If there's a chance you think it could help, let's do it."
"Hold on, Dr. Reggis," Walter said. The gray-haired man shifted his weight. He was obviously uncomfortable about this issue. "AmeriCare owns this hospital. We can't just go thumbing our noses at their rules. Plasmaphoresis is expensive and experimental. With lay families, I'm not even supposed to bring it up."
"How do we go about getting them to authorize it?" Kim questioned. "I'll pay for it myself if it can help."
"I'd have to call Dr. Norman Shapiro," Walter said. "He's the chairman of the AmeriCare Review Board."
"Call him!" Kim barked. "Right now!"
Walter looked at Claire. Claire shrugged. "I suppose a call can't hurt."
"Okay by me," Walter said. He left the room to use the phone at the ICU desk.
"Dr. Reggis, plasmaphoresis is grasping at straws," Claire said. "I think it's only fair to tell you and your former wife that you should be preparing yourselves for all eventualities."
Kim saw red. He was in no frame of mind to "prepare himself" as Claire euphemistically suggested. Instead he wanted to strike out at the people responsible for Becky's sorry state, and at that moment his nearest targets were the doctors in that very room.
"You do understand what I'm saying, don't you?" Claire asked gently.
Kim didn't answer. In a suddenly clairvoyant moment, he comprehended the absurdity of blaming these doctors for Becky's plight, especially when he knew where the fault lay.
Without warning, Kim broke away from Claire and rushed out of the ICU. He was beside himself with anger, frustration, and his humiliating sense of impotence. He started down the hall.
Tracy was still in the waiting room. She spotted Kim's hasty exit and immediately knew he was in a rage. When he passed by without a glance, she ran to catch up to him. She was afraid of what he might do.
"Kim. stop! Where are you going?" She pulled on his sleeve.
"Out," he said, breaking away.
"Where?"
Tracy had to run merely to keep up with Kim's determined stride. The look on his face frightened her. For the moment she forgot her own grief.
"I've got to do something," he said. "I can't just sit here and wring my hands. Right now I can't help Becky medically, but by God I'm going to find out how she got sick."
"How are you going to find out?" Tracy asked. "Kim, you have to calm down."
"Kathleen told me the E. coli problem is mainly a problem with ground meat," Kim said.
"Everybody knows that," Tracy said.
"Yeah, well, I guess I didn't," Kim said. "And remember when I told you that a week ago I took Becky to the Onion Ring on Prairie Highway? She had a burger, and it was rare. That had to have been when she got sick."
"So you mean to tell me you're going to the Onion Ring restaurant now?" Tracy asked incredulously.
"Obviously," Kim said. "If that's where Becky got sick, that's where I'm going."
"Right now, it doesn't matter where Becky got sick," Tracy said. "What matters is she is sick. We can worry about the how and the why some other time."
"It might not matter to you," Kim said. "But it matters to me."
"Kim, you're out of control," Tracy said with exasperation. "Just once can't you think of someone else besides yourself?"
"What the hell do you mean?" Kim snapped, feeling even more enraged.
"This is about you, not about Becky. It's about you and your doctor ego."
"The hell it is," Kim growled. "I'm in no mood to listen to any of your psychological nonsense. Not now!"