The most activity was in one of the small, separate rooms off to the side. Within its confines was a group of doctors and nurses attending to an acute situation. Kim walked over and stood in the doorway. He saw the respirator and heard its rhythmical cycling.
Judy Carlson, a nurse Kim knew, caught sight of him. She called out his name and all the people surrounding Becky’s bed silently stepped back to afford Kim a view. Becky had been intubated. A large tube stuck out of her mouth and was taped to her cheek. She was being breathed by a respirator.
Kim rushed to the bedside. Becky looked up at him with terrified eyes. She’d been sedated but she was still conscious. Her arms were restrained to keep her from pulling out the endotracheal tube.
Kim felt a crushing feeling in his chest. He was revisiting the dream that he’d had the night before; only this time it was real.
“It’s okay, Pumpkin, Daddy’s here,” Kim said, struggling to control his emotions. He was desperate to say something to reassure her. He gripped her arm. She tried to speak but couldn’t because of the tube in her throat.
Kim looked around at the people present. He centered his attention on Claire Stevens.
“What happened?” he asked, keeping his voice calm.
“Perhaps we should go outside,” Claire said.
Kim nodded. He gave Becky’s hand a squeeze and told her he’d be right back. Becky tried to speak but couldn’t.
The doctors filed out into the ICU proper and formed a group off to the side. Kim folded his arms to hide his trembling.
“Talk to me!” Kim commanded.
“First let me introduce everyone,” Claire said. “Of course you know Kathleen Morgan. We have Dr. Arthur Horowitz, nephrologist; Dr. Walter Ohanesian, hematologist; and Kevin Blanchard, respiratory therapist.”
Claire had pointed out each person in turn. All had nodded to Kim, who nodded in return.
“What’s the story?” Kim asked impatiently.
“First I have to tell you we’re definitely dealing with E. coli 0157:H7,” Claire said. “We’ll have an idea of the particular strain tomorrow after pulse field electrophores’s.”
“Why is she intubated?” Kim asked.
“The toxemia is affecting her lungs,” Claire said. “Her blood gases suddenly deteriorated.”
“She’s also in kidney failure,” Arthur said. “We’ve started peritoneal dialysis.” The kidney specialist was a completely bald man with a full beard.
“Why not a dialysis machine?” Kim questioned. “Aren’t they more effective?”
“She should do fine with the peritoneal dialysis,” Arthur said.
“But she just had surgery for a perforation,” Kim said.
“That was taken into consideration,” Arthur said. “But the problem is AmeriCare only offers dialysis machines at Suburban Hospital. We’d have to transfer the patient there, which we surely don’t recommend.”
“The other major problem is her platelet count,” Walter said. The blood specialist was a gray-haired older man who Kim guessed was in his seventies. “Her platelets have fallen precipitously to the point where we feel they must be replenished despite the inherent risks. Otherwise, we might have a bleeding problem on our hands.”
“There’s also the problem with her liver,” Claire said. “Liver enzymes have risen remarkably, suggesting. .”
Kim’s mind was on overload. He was stunned to the extent that he was no longer absorbing the information being presented to him. He could see the doctors talking, but he didn’t hear. It was the nightmare all over again, with Becky floundering in the dangerous, surging sea.
A half hour later, Kim stumbled out of the ICU into the ICU waiting room. Tracy got up the moment she saw him. He looked like a broken man.
For a moment they stared into each others eyes. Now it was Kim’s turn for tears. Tracy reached out, and they locked in a hug of fear and grief.
ELEVEN
Friday, January 23rd
Kim paused for a moment to get his breath. He glanced up at the institutional clock on the tiled OR wall. It was nearly two o’clock in the afternoon. He was making good progress. This was the last of three cases.
Kim looked back into the depths of the wound. The heart was fully exposed. He was in the process of putting the patient on cardiopulmonary bypass. As soon as he was finished, the heart could be stopped and opened. At that point he would replace the damaged valve.