“Does that kind of complication occur often?” persisted Susan.
“No,” said Bellows, “rare as hell, maybe one in a hundred thousand.”
“One hundred percent for her, though,” added Susan with an edge on the tips of her words.
Bellows looked up at Susan without any idea of what she was driving at. The human element in Nancy Greenly’s case had ceased to be a part of his concern. Bellows was intent on keeping the ions at the right level, keeping the urine output up, and keeping the bacteria at bay. He did not want Nancy Greenly to die while she was on his service because if she did, it would reflect on the kind of care he was capable of providing, and Stark would have some choice comments for him. He remembered all too well what Stark had said to Johnston after a similar case had resulted in death while Johnston was on the service.
It wasn’t that Bellows didn’t care about the human element, it was just that he didn’t have time for it. Besides the sheer number of cases he had been and was involved with provided a, cushion or a numbness associated with anything done repeatedly. Bellows did not make the association between Susan’s and Nancy Greenly’s ages, nor did he remember the emotional susceptibility associated with an individual’s initial clinical experiences in the hospital environment.
“Now for the hundredth time, let’s get back to work,” said Bellows, pulling his chair in closer to the desk and running his hand nervously through his hair. “He looked at his watch before going back to his calculations. “OK, if we use 1/4 normal saline, let’s see how many milliequivalents well get in 2500 cc.”
Susan was totally detached from the conversation, almost in a fugue. Following some inner curiosity, she moved around the desk and approached Nancy Greenly. She moved slowly, warily, as if she were approaching something dangerous, and absorbing all the details of the scene as they came available. Nancy Greenly’s eyes were only half closed and the lower edges of her blue irises were visible. Her face was a marble white, which contrasted sharply with the sable brown of her hair. Her lips were dried and cracked, her mourn held open with a plastic mouthpiece so she wouldn’t bite the endo-tracheal tube. Brownish material had crusted and hardened on her front teeth; it was old blood.
Feeling slightly giddy, Susan looked away for a moment and then back. The harshness of the image of the previously normal young woman made her tremble with undirected emotion. It wasn’t sadness per se. It was another kind of inner pain, a sense of mortality, a sense of the meaningless of life which could be so easily disrupted, a sense of hopelessness, and a sense of helplessness. All these thoughts cascaded into the center of Susan’s mind, bringing unaccustomed moisture to the palms of her hands.
As if reaching for a delicate piece of porcelain, Susan lifted one of Nancy Greenly’s hands. It was surprisingly cold and totally limp. Was she alive or dead? The thought crossed Susan’s mind. But there directly above was the cardiac monitor with its reassuring electronic blip tracing excitedly its pattern.
“I shall assume you are a whiz at fluid balance, Miss Wheeler,” said Bellows at Susan’s side. His voice broke the semitrance Susan had assumed and she replaced carefully Nancy Greenly’s hand. To Susan’s surprise the whole group had moved over to the bedside.
“This, everybody, is the CVP line, the central venous pressure,” said Bellows holding up the plastic tube whose tip snaked into Nancy Greenly’s neck. “We just keep that open for now. The I.V. goes in the other side, and that’s where we’ll hang our 1/4 normal saline with the 25 milliequivalents of potassium to run at 125 cc per hour.”
“Now then,” continued Bellows after a slight pause, obviously thinking while looking vacantly at Nancy Greenly, “Cartwright, be sure to order electrolytes on her urine today but leave the standing order for daily serum electrolytes. Oh yeah, include magnesium levels too, OK.”
Cartwright was madly writing these orders down on the index card he had for Nancy Greenly. Bellows took his reflex hammer and absently tried for deep tendon reflexes on Nancy Greenly’s legs. There were none.