“I fainted this morning.”
“Fainted?”
“I went out running. I came back, started to drink a glass of water, and …”
“You ran in this heat and fainted?” the resident said. “You’re probably dehydrated.”
“No! I drank plenty of water after I woke up!”
“Electrolytes,” the neurologist said. “They must be off-balance.”
“No!” David said.
He understood about electrolytes. They were elements in a person’s blood that allowed the body’s “electricity” to flow efficiently through vital organs. But if these elements weren’t present, the “electricity” couldn’t flow, and the vital organs went into shock. The principal electrolytes were potassium and sodium.
“No!” David repeated. “I swallowed a potassium pill. I put salt on my palm and licked it.”
“Have you had medical training?”
“Sarie, get back to Donna and Matt!”
“His pulse is up again,” the resident said. “A hundred and fifty.”
“Pressure,” the neurologist said.
“A hundred and sixty over—”
David felt such swelling in his chest and head, such heaving in his lungs that—
“I’m going to die,” he said.
“Code blue?” the resident asked.
Despite his delirium, David recognized the hospital’s signal for summoning maximum help in case of imminent death.
“Code blue? Should I call it in?” the resident repeated.
The neurologist opened her mouth, her lips forming “yes.”
“Wait, his pulse is coming down,” the resident said. “A hundred and forty.”
The neurologist rubbed her forehead. “Pressure?”
“Down. A hundred and fifty. Code blue?”
“Not yet.”
“His pulse is down again,” the resident said. “A hundred and thirty.”
“Pressure?”
“Down. A hundred and forty.”
The room became silent. In David’s swirling mind, the walls seemed to narrow.
“His pulse is down to a hundred,” the resident said. “His pressure’s a hundred and thirty.”
David’s delirium began to clear. He stared at the cabinet to his right and managed to steady his vision.
“Pulse?”
“Ninety.”
“The same as when he came in here. Pressure?”
“A hundred and twenty. Almost what he says is normal for him.” The resident shook his head. “This thing’s like a roller coaster, suddenly up, then down.”
The neurologist rubbed the back of her neck. “I don’t know. Labyrinthitis maybe.” She referred to an infection of the inner ear that affected a person’s ability to balance, making the patient dizzy.
“No,” the neurologist corrected herself, “that wouldn’t explain the pressure on his chest. Mr. Morrell, apart from your fainting spell after running this morning, has anything else happened to change your medical condition?”
“The last six months have been the same.”
“I don’t understand.” She responded to a sudden thought. “When did you eat last?”
“This morning. Or maybe last night. I don’t remember.”
“You don’t remember?”
“There isn’t always time. It’s been mostly hospital food, and …”
“Hospital food?”
“Dad”—Sarie clutched David’s arm—“tell them.”
“Tell us what?”
“About Matthew,” Sarie said.
“Who’s … ?”
“My son.” Despite his dizziness, David told them everything.
In hesitating gasps.
All of it.
A breathless babble.
The turmoil of the last six months.
Every fear-filled instant.
“Mr. Morrell,” the neurologist said, “you’ve just had a panic attack.
DÉJÀ VU
1
“Of course, I feel panicked! Didn’t you listen! My son has cancer! Six months of chemotherapy! I watched him lose his hair! I held him while he vomited!”
“Take it easy,” the resident said.
“I watched him get weaker, watched him stagger, watched him get thinner! They tried every goddamned chemical they thought would work! He lost four ribs … a third of his lung! He had a bone marrow transplant! Three weeks ago, I didn’t even know what a bone marrow transplant was! They … !”
“Try to relax,” the neurologist said.
“If I don’t do something, Matt’s going to die!”
The nurse who’d rushed off with samples of David’s blood pulled open the curtain, entering the room. “His tests came back.”
The neurologist reached for the computer printout and scanned it. The resident peered over her shoulder.
“Look at those numbers,” the resident said, amazed.
“You found it?” David asked. “You know what’s wrong with—”
“These numbers indicate you’ve got—”
The neurologist interrupted. “The healthiest blood I’ve seen tested this year. Cholesterol—one hundred and seventy-nine. Well below the danger level. Creatinine—point nine.”
David had never heard of creatinine. He was sure the term was unfamiliar to him. And yet …
He recalled his seizure on the kitchen floor this morning. A shudder aggravated his tingling.
Creatinine, he understood suddenly, was an element in blood that indicated how well a patient’s kidneys were functioning. The lower the number, the more efficiently the kidneys were filtering poisons from the body.
How do I know this? David thought.
His 0.9 was excellent, David realized, as if he’d been taught it many years before. An average person had a creatinine level between 0.1 and 1.1. Over 1.1 meant the kidneys weren’t working as hard as they should. Over 3.0 meant the kidneys were failing. Over 4.0 meant the kidneys weren’t working at all. Unless emergency procedures were taken, the body’s toxins would accumulate to a fatal level.
In David’s nightmare on his kitchen floor—or in his memory, floating over his deathbed—when Matthew had contracted septic shock, one of the major consequences had been kidney damage. The kidneys had shut down totally (though temporarily, David had been told). Matthew’s urine had stopped completely. He’d been put on dialysis to vent excess fluid and filter toxins from his blood. But despite the dialysis, Matthew’s creatinine had risen to—dear God!—the lethal level of 4.5.
And even that hadn’t been what killed him!
2
Had?
Would?
But none of these disasters had happened! They were only from David’s nightmare! And yet he knew, tomorrow afternoon Matt’s unexpected septic shock would set them in motion!
Have to get up there! Have to save … !
The neurologist kept reading the results of David’s blood tests. “Sodium, potassium, chloride … electrolytes all normal. No sugar problem. Mr. Morrell, I repeat, you’ve had a panic attack.”
She raised her hands. “Yes, I understand you’re worried about your son. You’re afraid for him. But that’s not the kind of fear I’m talking about.”
Sarie spoke quickly, “What do you mean?”
The neurologist continued to stare at David. “For the past six months, you’ve been in a constant state of increasing crisis. Each stage of your son’s treatment has been more prolonged and more extreme.”
“Extreme? Every time the damned phone rings …”
“You jump? Your knees get weak? Of course. You’re afraid you’ll hear more unnerving news about your son’s condition, a worse diagnosis of …”
“His pain, his horrible pain. I don’t know how he bears it. We tell him he’s been through the worst, and then something else goes wrong, and he needs some other kind of treatment, and the worst turns out to be nothing compared to … ! I don’t know how he keeps up his strength! How can he be so brave? He nev
er complains! He … !”
The pressure behind David’s eyes broke. Tears streamed down his face. “Matt’s just a kid! How can he be so strong?”
“You’re proving my point,” the neurologist said. “After six months of constant chaos, your body finally told you it reached its limit. Imagine if you’d almost been in a traffic accident. A truck veers toward you, forcing your car off the road. You manage to stop an instant before you hit a tree. What’s your reaction? Your stomach feels on fire. Your heart races. You can’t catch your breath. In effect, you’ve been having that near-accident for the past six months. I could give you a lot of technical words about neurotransmitters in your arteries and the nucleus locus ceruleus in your brain, but basically what it comes down to is, your crisis glands have been working constantly, to the maximum. And you’ve become used to it. You think it’s normal, because for the last six months, it’s all you’ve known. You’re so saturated with adrenaline your body can’t deal with the chemical effects any longer. You’re hyperventilating, and that makes your heart pump faster, and that makes you dizzy. Of course the dizziness makes you more afraid. That in turn makes you hyperventilate more extremely, and that in turn makes your heart pound faster and … you’re trapped in a terrifying, worsening, self-perpetuating circle. The more your crisis glands pump, the more they will pump because they’re reinforced by fear. A panic attack. And if the cycle isn’t stopped, the ultimate consequence is total physical collapse and possible catatonia.”
The neurologist paused. “One more thing. In a panic attack, the patient usually feels tingling only in his hands, but you described tingling in your feet as well, and that makes this one of the most extreme examples of a panic attack I’ve ever diagnosed. You need rest. A lot of it. Now.”
“But my son …”
“Is under constant professional care. In the four hours you’ve been down here …”
What? David thought, pulse rising. Four hours? It seemed as if he’d been in the Emergency Ward for only forty-five minutes.
“In the four hours you’ve been down here,” the neurologist continued, “I’ve asked for several reports on your son’s condition. His physicians tell me he’s doing fine. He’s weak, but that’s to be expected, given what he’s been through. The main thing is, he’s stable, and his treatment seems to be effective.”
“No! He’s going to die!”
“Should I call for help?” the resident asked.
The neurologist studied David.
“Maybe we ought to sedate him,” the resident added.
“No,” David said. “No, please, don’t sedate me. Don’t put me to sleep. My son …”
The neurologist scribbled on a prescription pad. “But sleep’s exactly what you need. Your daughter can have this filled at the hospital pharmacy. I’m prescribing Valium for you.”
“Valium?”
“Whatever you’ve heard about the drug, don’t let the name shock you,” the neurologist said. “Don’t give yourself another attack. These pills won’t knock you out. But they will make you groggy. You’ll feel like taking a nap. You’ll wake up calmer, rested. After your daughter gets this prescription filled, I want her to take you home and put you to bed. And to make sure you take the medication.”
“But my son … !”
“Two days from now, you’ll adjust to the medication. You’ll feel a little slow perhaps, but much less excited, and you’ll be able to function. By then, you can come back and visit your son, as long as you don’t try to drive. In the meantime, your wife will be with your son. The doctors will supervise him constantly. He’s in good hands. There’s nothing to worry about.”
Two days from now? David thought.
Two days from now?
But that’ll be too late!
3
The glass doors hissed open. A nurse pushed David in a wheelchair from the Emergency Ward. Beneath a concrete canopy, in a curve of the driveway where hours earlier David had seen attendants unloading a patient from an ambulance, Sarie was waiting in her yellow Fiesta.
The nurse stopped the wheelchair, opened the Fiesta’s passenger door, and eased David inside.
His every movement remained an effort. His vision continued to swirl. Nonetheless he noticed Sarie move a small white paper bag—a pharmacist’s green bill was stapled to it—off the passenger seat so he could get in.
The nurse shut the door. “Get some rest now, Mr. Morrell.” She added to Sarie, “Make sure he takes those pills. Put him to bed as soon as he gets home.”
“Don’t worry,” Sarie said. “I guarantee my Dad’ll be a model patient.”
Sarie put the Fiesta in gear, then steered around the curved driveway, heading toward the Emergency Ward’s parking lot. The pivot of the car made David’s mind reel. He wanted to clutch his skull, but given what he planned to do, he didn’t dare alarm his daughter.
She turned right, onto a road that passed several university dormitories and a recreation building. Students thronged the sidewalks. The warm June sun was low in the sky, casting shadows. David raised his watch, squinting at its hands. Seven-thirty in the evening, and as near as he could tell, he’d entered the Emergency Ward shortly after two o’clock.
He couldn’t understand how the time had passed so quickly.
Time! He didn’t have much time!
“I’m sorry I took so long coming back,” Sarie said. “The hospital pharmacy closes at six, but I managed to get them to stay open long enough to fill the prescription. Then I wanted to go back upstairs and see Matt.”
“I hope you didn’t tell him what happened to me.” When David had collapsed, he’d been in a conference room with two doctors. In theory, Matthew didn’t know about the panic attack.
“No. Mom didn’t tell him either.”
“Good. I wouldn’t want to upset him.”
“But I took Mom aside and told her what the neurologist said was wrong with you. Mom’s worried. She says you have to take care of yourself.”
David nodded, the effort painful.
“Mom says she can stay with Matthew. I’m supposed to ask a neighbor to bring up a change of clothes for her. When we get a chance, Mom and I will trade places. She’ll come home and see if you’re okay.”
“Oh, I’m okay,” David said with effort. “You heard the neurologist. I’m in perfect physical shape.” He stifled the bitterness in his voice. “Except I’m terrified.”
“But Matthew’s doing fine.”
“No! He going to—!”
Stop! David thought. You can’t alarm her! You need her help!
“Matt’s going to what?” Sarie asked.
“He’s sicker than he’s ever been before.”
“But that’s because the chemotherapy this time was stronger than he’s ever received.”
David pressed her hand. “Of course. He’s bound to be sicker this time. Forgive me. I’m just a little confused.”
Fireflies.
Power chords.
4
Sarie turned right again (more swirling in David’s head), proceeding down a main road toward an intersection, where if they turned left they’d be heading home.
But if they turned right, they’d go back to the hospital, not to the Emergency entrance in the rear but to one of the entrances along the front that David always used when he went up to stay with Matthew.
“Sarie, don’t ask questions. Turn right.”
“But …”
“Don’t ask questions, I said. I know it’s the wrong direction. It’ll take us back to the hospital. Just turn right.”
“But I’m supposed to … What about the pills you were ordered to … ?”
“I’ll swallow them. I promise. I’ve got something I have to do first. If it works, I promise I’ll take the pills. I’ll go to bed.”
“But what do you want to do?”
“I can’t explain it now. Just do what I say. Listen to me. I’m begging. Turn to the right.”
Sarie stared at him. “You’r
e sure you know what you’re doing?”
“So sure you can’t imagine.”
Devotion made her acquiesce. “Okay, Dad. I don’t want to get you more upset, but I don’t want to be irresponsible.”
“Trust me.”
“Didn’t you tell me never to trust anyone who says that?”
“This is different.”
“Why?”
“Because I’m your father.”
Sarie had almost passed through the intersection. “And I’m your puzzled daughter. I hope I’m not making a mistake. Trust you? Okay, then, Dad, hang on. Here we go.” She jerked the steering wheel toward the right (David’s skull came close to exploding) and drove down the lane that would take them to …
5
The ramp, where David had parked early in the afternoon. Now the family had three cars at the hospital: David’s Porsche, Donna’s Voyager, and Sarie’s Fiesta. The gang’s all here, David thought bleakly.
“Dad, that neurologist is going to be pissed at me.”
“But I’m going to love you more. That’s a wonderful trade-off, don’t you think? And believe me, no matter if you think I’m going crazy, just keep trusting me. I’ve never been more sure of anything. I know I’m right.”
David staggered from the Fiesta, Sarie holding him up as he wavered from the parking ramp. Strangers frowned at them.
“But what are we doing?” Sarie asked. “Where are we going? Tell me. Explain.”
“I can’t. You wouldn’t believe me. It’s too complicated. But maybe forty years from now we’ll talk about it.”
“Forty years from now? You’re scaring me, Dad.”
“With a lot of help from you”—or God, or I don’t know what, David thought—“we’re going to save Matt.”
Sarie frowned.
Again David went through the entrance he always used. Again he went down the corridor that early this afternoon had seemed so familiar and yet so distant in time. With Sarie holding his arm, he did his best to keep from wavering, to keep from attracting attention.