TOXIN BY ROBIN COOK

The woman disappeared for a moment. She returned wearing latex gloves. She took the meat and put each sample into a separate container. Then she took the billing details. Kim used his office account.

“How long will it take?” Kim asked.

“We’ll have a final reading in forty-eight hours,” she replied.

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.”

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