Of Flesh and Blood (53 page)

Nikki had the sudden sense that his comment was born from personal experience. She was tempted to ask but instead she merely said, “No, I do not.”

“Are you saying Dr. McGrath explained all the potential risks to the Staffords?”

“I am saying that Nate was dying. There was only one drug left that might have helped him. And Dr. McGrath tried it.”

“So he decided for them, then?”

She stopped herself from blurting a reply. “I don’t want you to ever call me again, Mr. Rymer. Do you understand?” With that, she hung up the phone.

Nikki considered crawling back to bed, but she knew it would be hopeless. Instead, against her better judgment, she decided a shift on the SFU might provide a needed distraction from the turmoil raging inside her skull. She called the supervisor and agreed to come in for half the shift.

She arrived on the sixth floor in less than forty-five minutes. She had just finished taking her handover report at the nursing station when Tyler walked in. Spotting Nikki, he offered a slight wave and headed toward her.

Nikki was stunned by his appearance. In a stained, wrinkled T-shirt and jeans, he had at least two days’ worth of stubble on his cheeks. His hair stuck out in unruly spears. Instead of his usual soapy freshness, she picked up a whiff of stale sweat. And the bags under his eyes were so deep that his eyeballs appeared sunken in their sockets. More than simply exhausted, he looked traumatized.

She immediately assumed his appearance had something to do with the weasel of a reporter, Rymer. Anger rippled through her. She felt the urge to comfort him. “Tyler, what is it?”

He rolled up a chair beside her and slumped into it. “It’s Jill.”

“What happened?” Nikki said, trying to push away the twinge of hopefulness that Tyler’s marriage might be in deeper trouble.

“She’s sick.”

Nikki felt herself flushing, ashamed of her earlier selfish assumption. “It’s serious, isn’t it?”

He dropped his head and nodded. “She picked up
C. difficile
.”

“Oh, God, Tyler!” She reached her hand out to his shoulder, but something in his distant gaze stopped her. She let her hand drop to her lap. “I’m so sorry,” she mumbled.

“I spent the whole night in the ER with her.”

“Where is she now?”

“They moved her to the Henley Building. The surgical ICU.”

“The ICU?” Nikki remembered hearing rumors of several patients who had already died from the superbug.

“For infection control.” He sighed. “They’re pooling all of the
C. diff
victims in the surgical ICU.”

“Oh. Is she doing any better this morning?”

“The fluids have stabilized her blood pressure.” He shook his head. “But the pregnancy hasn’t helped at all.”

The news hit Nikki like a kick to her stomach. “Jill . . . and you . . . are pregnant?” she stuttered.

Tyler grinned, almost apologetically, and then looked away in embarrassment. “We only found out a few days ago. It was a huge surprise to both of us.” He shrugged minimally. “Jill assumed all her vomiting and GI symptoms were just part of her morning sickness. So the infection was really out of hand by the time we got her help.”

“How awful . . . but . . . um . . . congratulations.” Nikki had trouble focusing on his explanation. She had appreciated that there was little or no chance of a long-term romance between Tyler and her, but the fantasy had lingered. The news of Jill’s pregnancy wiped it all out with cold, harsh finality.

“Jill has been through hell, Nikki.” His voice was raw. “I’m not sure how much more she . . . or the baby . . . can stand.”

Nikki tried to shake off her personal disappointment. In a way, she was happy for Tyler. She had seen how he lit up around kids, and she knew he would make a great dad. “Jill strikes me as a strong person,” she said.

“Yeah, she is,” he said. “But what she has been through recently . . .”

She touched him lightly on the shoulder. “It’ll be okay, Tyler.”

He stared into her eyes and smiled gratefully.

“Why aren’t you with Jill now?” she asked.

“I’ve handed over all my patients to Alice Wright and Don Kitigawa. All except Keisha.” He shook his head. “I can’t abandon the Berrys now.”

“You still plan to give her the Vintazomab today?” She thought of Denny Rymer again and the hair on her neck stood on end.

Tyler read the concern in her eyes. “Nikki, I promised them.”

“But you’re probably not in the best . . . um . . . headspace to start it, with what Jill and you are going through and what happened to . . .”

“Nate.” There was no defensiveness in his tone. “I can’t do anything about the past, but Keisha needs that drug. There’s nothing else left for her.”

“Tyler, you look as though you haven’t slept in a week. You sure you’re up to performing a spinal tap today? Can’t someone else—”

“I have to do this, Nikki.” He touched his chest. “Not just for the Berrys. For me, too.”

She nodded. “Okay.”

“Will you help me?”

She grinned. “Try stopping me.”

“Thank you.” He reached over and brushed his hand across the back of hers. “Nikki, how about you? Are you feeling okay? You were in rough shape yesterday.”

She shrugged. “It was a tough night. Today is better.”

“You did it, though.” His lips cracked their first smile. “You made it over the hurdle.”

His touch felt so good on her arm that her heart ached at the lost possibilities. Reluctantly, she pulled her hand from his and rose from her seat. “If it were only just one hurdle to get over.”

As Tyler watched Nikki glide away from the nursing station, a pang of loss hit him. He knew that they would never share another evening like they’d had at O’Doole’s. And judging from the trace of hurt that colored her words, she understood it, too.

Despite her composed appearance, Tyler realized Nikki had to be going through hell, physically and emotionally, after falling off the wagon. And she had to suffer through it without the support of a partner or family member in town. The thought evoked a mix of guilt, sympathy, and affection for her. He wished he could do more, but Nikki didn’t seem to want that. Besides, Jill had to be his focus now.

It wasn’t just the pregnancy, or even her illness. Jill’s naked need for him had brought them closer than he would have thought possible a few weeks earlier.

In full mask, gown, and gloves, he had spent the night scrunched up in a chair by her bed. He dozed intermittently for short periods, but he was nowhere near comfortable or relaxed enough for real sleep. They went long stretches without sharing a word. However, they held hands throughout the night. Despite the latex, the minimal touch was as intimate as any contact in his memory.

He had opened his eyes at around two
A.M
. to find Jill staring at him. Although she looked pale, and still as fragile as a wounded fawn, she was smiling; her face more placid than he had seen in weeks. “I think I’m ready to start on them, Ty,” she announced hoarsely.

After a bewildered moment, he understood. “You mean the antibiotics?” he asked.

“Yes.”

“Good. Great, actually.” Tyler squeezed her hand. His relief was intense. “It’s the right decision, Jill.”

“I know.”

He viewed her for a moment. “What changed your mind?”

“The things you—and especially Erin—said touched a nerve.” Her voice cracked. “And, of course, seeing that tiny beating heart . . .”

Tyler swallowed hard, but said nothing.

“I’m thinking clearer now, Ty. You guys were right. No matter what, the baby can’t survive without me.” She chuckled weakly. “And look how she’s battled so far, surviving through the whole dehydration thing. Clearly, this is one little fighter.”

“She gets that from her mom.”

Jill touched his wrist gently. “Her dad, too.”

“A little, I suppose.”

“A lot. I figure if she can survive what we went through yesterday then she can hold her own with any antibiotic.”

Tyler wanted to wrap his arms around her but had to settle for another squeeze of her hand.

Jill ran her thumb over his latex-covered knuckles. “I love you, Ty.”

“I love you, too, Jill.”

She cocked her head and viewed him with frail hopefulness. “Our baby is going to be okay, isn’t she?”

“Remember? She’s a fighter like her mom.”

Jill laughed again. “Let’s hope she inherits some of her Auntie Erin’s persuasiveness.”

The rolling rumble of a cart yanked Tyler from the poignant memory. Tyler looked up to see the chemotherapy cart being wheeled through the SFU’s nursing station by one of the pharmacy techs. Similar carts rolled onto the sixth floor all day long, but the sight of this one—with the tinted bottles he recognized as Vintazomab hanging from the attached pole—launched his apprehension. Tyler had run out of excuses to delay Keisha’s treatment another moment.

He took a few slow breaths, inhaling a faint whiff of his own body odor. Self-conscious and exhausted, he ached for a shower, a shave, and a nap. But he had no intention of leaving the hospital any time soon. Still, he decided he owed it to the Berrys to appear a little more presentable, so he
had a quick shower in the staff lounge and then changed into a pair of scrubs. A glance in the mirror confirmed that, with sunken eyes and heavy stubble, he still looked like death warmed over, but at least he smelled better.

On his way out of the lounge, he stopped to phone the surgical ICU where Jill and all the other
C. diff
victims were clustered. “Your wife drifted off to sleep as soon as you left, Dr. McGrath,” the nurse informed him.

“And her vital signs?” Tyler asked.

“Just fine,” the nurse said compassionately. “The antibiotics are already making a real difference.”

Jill’s upgraded condition came as a massive relief, but the news did little to quell the dread that rose in the pit of his stomach with each step closer to Keisha’s room. Inside, Jonah and Maya—both dressed as though attending a formal church function—sat in the chairs on each side of Keisha’s bed. Despite her dark skin coloring, a noticeable pallor had overcome Keisha in the past days. But her demeanor was as unflappable as ever. Though minutes from her lumbar puncture and latest chemotherapy, she sat in her bed with her sketchbook wide open, absorbed in another picture.

“What are you drawing today, Keisha?” Tyler asked, fighting off his butterflies.

“Not you,” she said.

“Oh?” Tyler frowned. “You mad at me?”

“No. You’re hard to draw, is all.”

“How come?”

“Your head is too big.”

“Keisha!” Maya scolded.

Tyler laughed aloud. “So what is it then?” he asked.

“A self-photograph,” she said proudly.

“You mean a self-portrait, honey,” Jonah corrected.

Keisha shrugged. “It’s gonna be better than a portrait, Dad.”

“I bet.” Tyler smiled. “Mind if I have a look?”

Keisha eyed him guardedly for a moment but then slowly turned the sketchbook around to show him. He was impressed by the eight-year-old’s picture. Keisha had drawn herself riding a tall horse in a meadow with sunflowers reaching to the level of the horse’s chest. “Awesome, Keisha. You’re a real artist.” He held out his palm to her, and she slapped it in a high five. “But I thought you preferred riding ponies.”

She shrugged again. “Only ’cause my blood’s too thin now. Once the medicine makes me better, I’ll be able to ride horses,” she said with certainty. “I’m not afraid of falling.”

Her words tugged at his heart, and Tyler forced a smile. “Keisha, I’m going to talk boring grown-up-doctor stuff with your parents again. Okay?”

She sighed heavily. “And I’m gonna try not to listen.”

“I’ll make it even easier for you,” he said. “I will take Mom and Dad out of the room.”

“ ’Kay.” With a single nod, she flipped the sketchbook around and returned her attention to the drawing.

Maya and Jonah followed Tyler out into the hallway. He closed the door behind him before he spoke. “We’re going to move Keisha down the hall to our procedure room so we can start running the Vintazomab.”

Maya’s lip quivered. “Can we stay with our baby?”

“Of course,” he said. “You do realize she will be heavily sedated?”

Jonah turned to his wife and grabbed her hand in his. He looked over to Tyler. “We still want to be there, Dr. McGrath.”

“Understood.” Tyler felt a new flutter of butterflies. “I know we’ve talked about this, but I want to walk you through all the steps again. All right?”

They nodded their consent, and Tyler launched into his explanation as though telling them for the first time. In lay terms, he described how Vintazomab worked. Then he turned to the potential side effects. “This is a very new drug. Most patients have done all right, but there have been a few very serious reactions in the early studies.”

“How serious, Dr. McGrath?” Jonah asked.

“Very.” Tyler cleared his throat. “Roughly one in a hundred patients died.”

Jonah grimaced. “Died?”

“We don’t know for sure if the medicine or the cancer was responsible in all the cases. Certainly the Vintazomab played a role.”

“I see,” Jonah said distantly.

Tyler looked from Maya to Jonah. “Only patients who received Vintazomab intrathecally, in other words through the spinal infusion, have died during treatment.”

“Like you’re going to do with our Keisha?” Jonah’s tone dropped an octave.

“They have to, Jonah,” Maya spat. “The cancer is around her brain and the medicine won’t reach it any other way, right?”

Tyler nodded.

Jonah viewed Tyler solemnly. “What is your experience with Vintazomab, Dr. McGrath?”

Maya’s eyes widened, silently begging Tyler to hold his tongue.

“Not good, Jonah.” Tyler shook his head. “I’ve only used it once before. And the patient did not make it.”

“I see,” the minister said stonily.

Jonah turned to his wife, his expression dubious, but he did not say a word. Maya stared back without flinching. After a moment, Jonah exhaled heavily and then nodded. He looked over to Tyler. “God has sent us to you for a reason, Dr. McGrath.” With that, the discussion was over.