Kim thanked her, washed his hands in a restroom, and went back out to his car.
As he neared the hospital, Kim became increasingly anxious. He started trembling as he parked his car; the tremors grew worse as he rose up in the elevator. Preferring to face Tracy after checking on Becky, he used a back route to the ICU to avoid the ICU waiting room. As he passed through the halls, people eyed him with curiosity. Kim could well understand, considering his appearance. Besides his soiled attire, he needed a shower and a shave and his hair needed combing.
Within the ICU. Kim nodded to the ward clerk but didn't offer any explanation. Approaching Becky's cubicle. he found himself making a pact with God. If only Becky could be spared…
Kim slipped in by Becky's bedside. A nurse was changing her IV bottle. Her back was to him. Kim gazed at his daughter. Any faint sliver of hope of improvement he had entertained instantly vanished. Becky was obviously still in a coma. Her eyelids were taped shut and she was still intubated and being respired. What was new were large, deep-purple patches of subcutaneous bleeding under the skin of her face that made her look cadaverous.
"Oh, my goodness, you frightened me," the nurse said when she caught sight of Kim. She put a hand to her chest. "I didn't hear you."
"She doesn't look good," Kim said. He kept his voice even in an attempt to hide the grief, anger, and humiliating impotence he felt.
"I'm afraid not," the nurse said, eyeing Kim with some misgivings. "The poor little angel has been having a terrible time."
Kim's trained ear drew his attention to the cardiac monitor screen. The beeping was irregular as were the blips of the cursor.
"She has an arrhythmia! When did this develop?"
"Relatively recently," the nurse said. "It started last night. She developed a cardiac effusion which quickly brought on symptoms of tamponade. She had to be tapped."
"When?" Kim asked. Now he felt even more guilty for not having been available. Dealing with a cardiac effusion was something he knew about.
"Just after four this morning," the nurse said.
"Are any of her doctors still here?" Kim asked.
"I believe so," the nurse said. "I think they're talking to the patient's mother in the waiting room."
Kim fled. He couldn't stand to see his daughter in such a condition. Out in the corridor, he paused to catch his breath and regain some composure. Then he walked down to the waiting room. He found Tracy talking with Claire Stevens and Kathleen Morgan. As soon as they saw Kim, their conversation stopped.
For a moment there was silence.
Tracy was clearly distraught. Her mouth was a grim line. She had her knees pressed together and her hands clasped. She gazed at Kim with a sad, confused expression reflecting both concern and contempt. She shook her head. "You're in the same clothes. You're a mess. Where on earth have you been?"
"My visit to the Onion Ring took a lot longer than I thought it would." He looked at Claire. "So Becky has now developed pericarditis."
"I'm afraid so," Claire said.
"My God!" Kim exclaimed. "What next?"
"At this stage, just about anything," Kathleen said.
"We've confirmed that this is a particularly pathogenic strain of E. coli that produces not one but two extraordinarily potent toxins. What we're seeing is full-blown HUS."
"What about the plasmaphoresis?" Kim asked.
"Dr. Ohanesian made an impassioned plea to the AmeriCare Review Board chairman," Claire said. "But as we warned, the committee probably will not give the okay."
"Why not?" Kim demanded. "We've got to do something, and I said I'll be willing to pay for it."
"Your being willing to pay doesn't matter," Claire said. "From their point of view, it would set a dangerous precedent. They could then be forced to offer it to families that couldn't or wouldn't pay."
"Then let's get Becky to someplace where it is offered," Kim snapped.
"Dr. Reggis," Claire said sympathetically. "Becky is in worse condition today than she was yesterday, and yesterday she was in no condition to be transferred. But plasmaphoresis is not totally out of the question. There's still hope they could give the green light. We'll just have to wait."
"Wait and do nothing," Kim said with a scowl.
"That's not true," Claire said hotly. Then she caught herself and sighed; talking with Kim was a chore she did not relish. "We're supporting her every way possible."
"Meaning you're sitting on your hands and treating complications," Kim spat.
Claire stood up and looked at Tracy and Kathleen. "I think it's time for me to see the rest of my inpatients. But I'll be available if needed: just page me."
Tracy nodded. Kathleen responded that she'd be doing the same thing in a few minutes. Claire left.
Kim collapsed into the chair vacated by Claire and buried his head in his hands. He was struggling with a roller coaster of emotions: first anger and then sadness, then back to anger. Now sadness returned. He fought back tears. He knew he should be seeing his own inpatients, but for the moment he was incapable.
"Why did your visit to the Onion Ring take so long?" Tracy asked. As irritated as she was by his behavior, she couldn't help but be concerned about him. He looked pitiful.
"Actually, I was in jail," Kim admitted.
"Jail!"
"If you want me to tell you that you were right, you were right," Kim said. "I should have calmed down before I went."
"Why were you in jail?" Tracy asked.
"I lost my temper," Kim said. "I went there to find out about the possibility of tainted meat. The manager's self-righteous denial drove me up the wall."
"I don't think it's the fast-food industry's fault," Kathleen offered. "With this E. coli problem the fast-food restaurants are as much a victim as the patrons who are infected. They get contaminated hamburger."
"I figured as much," Kim said, with his face still buried in his hands. "My next visit will be to Mercer Meats."
"With Becky's condition, it's hard for me to think," Tracy said. "But how can there be contaminated meat? Aren't these places continually inspected? I mean, doesn't the USDA certify the meat?"
"They certify it," Kathleen said. "But in this day and age, it's an unfortunate assumption to believe that it's not contaminated."
"How can that be?" Tracy asked.
"For a lot of reasons," Kathleen said, "chief of which is that the USDA has an inherent conflict of interest."
Kim lifted his head out of his hands. "How so?"
"It's because of the USDA's mandate," Kathleen said. "On the one hand, the agency is the official advocate for U.S. agriculture, which includes the powerful beef industry. That's actually the USDA's main job. On the other hand, it has inspectional obligations. Obviously the two roles don't mix. It's a genuine case of asking the fox to guard the henhouse."
"This sounds incredible," Kim said. "Is this something you know for a fact, or is it something you've heard and are just passing it along?"
"I'm afraid it's something I know about firsthand," Kathleen said. "I've been looking into the problem of food contamination for over a year. I've gotten active through a couple of consumer groups who are fighting an uphill battle to do something about it."
"How did you get involved?" Tracy asked.
"It would have been hard for me not to," Kathleen said. "Food contamination and the illness it causes have become a major part of my practice. People in general seem to want to keep their heads in the sand about all this. But it's a problem that is getting worse by the day."
"This is unbelievable!" Kim exclaimed as anger again overcame his sadness.
"There's more," Kathleen said. "Not only is there a conflict of interest with the USDA, but from what I've seen, the USDA and the beef industry are much too close."
"What are you implying?" Kim asked.
"Exactly what I said," Kathleen added. "Particularly in middle-management positions, there's a kind of musical chairs with people moving back and forth to make sure the industry is interfered with as little as possible."