Of Flesh and Blood (54 page)

Tyler hurried down the hallway to the SFU’s procedure room, where the oncologists administered the intrathecal chemotherapy. Inside the scaled-down operating room, Nikki stood alone preparing the intravenous tubing and poles of medication.

They shared a shy smile when Tyler stepped inside. She nodded at his scrubs. “You actually look like a real doctor for once.”

He chuckled. “Yeah, well, looks can be deceiving.”

“Tyler, you sure you’re okay with this?”

“Yes,” he said without hesitating. “How about you?”

She pointed to the line of poles supporting bags and bottles of medication. “I think we’re all ready.”

“The CAT scan of Keisha’s brain is normal, but just in case she seizes—”

Nikki reached into her pocket and pulled out two filled syringes that were marked with handwritten labels. “I’ve already drawn up lorazepam and diazepam,” she said, referring to the two drugs most commonly used to abort seizures.

“I should have known you’d be ahead of me.” He grinned. “Can you also prep Dilantin and phenobarb drips?” he asked, requesting two more backup antiseizure medications.

“Good as done,” she said as she hurried for the door.

Standing alone in the room, Tyler had a flashback to the awful moment when he’d broken the news to the Staffords that their son died during the
Vintazomab infusion. He could still hear Laura’s mournful wail and see the anguish in Craig’s furious eyes.

Keisha is not Nate!
he reminded himself as he wrestled the self-doubt out of mind.

Tyler headed to the table in the room’s corner and slipped on his mask and hood before donning his sterile gown and gloves. He turned to the stand that held the lumbar puncture tray and unfolded the drapes covering it. As he was preparing his needles, Nikki rolled Keisha into the room on a stretcher flanked by her parents, who looked grave and uncomfortable in their procedural gowns. Tyler felt another brief bout of nerves when he saw Dr. Jane Lomas, the same anesthesiologist from Nate’s ill-fated procedure, saunter into the room. But the heavyset anesthesiologist showed him a friendly smile, and he found her calm poise soothing.

Keisha was transferred from the stretcher to the bed. She was already sleepy from the sedative given to her before being transferred to the procedure room. Her gaze swam as she looked up from the table at the adults surrounding her. She did not say a word, but she offered her parents a heartrending gap-toothed grin and reached her hand out to her mother.

“Keisha, it’s nap time now,” Lomas said gently. She plunged the milky white anesthetic into the tubing that ran into the girl’s arm. “Twenty, nineteen, eighteen . . .,” she counted down.

Lomas’s count was still in the teens when Keisha’s eyelids fluttered and then closed. Nikki glanced over to Tyler, who nodded his approval. She pressed a button on the electronic intravenous flow meter and turned the dials on the nearest of the lines. The yellow-tinted Vintazomab medication began to drip into the girl’s intravenous line.

“I’m going to reposition Keisha now,” Nikki explained to the Berrys as she rolled their anesthetized daughter onto her side and into the fetal position in preparation for her spinal tap.

Tyler moved closer to the tray. He felt slightly nauseous when he inhaled a whiff of the alcohol-based cleanser. As he sat down on the stool, his pulse pounded in his ears but his hand was steady. He reached for a pair of clamps and dabbed Keisha’s back with a wet sponge.

After cleaning and draping the area, he walked his fingers along the backbone until he found the space between the third and fourth lumbar
vertebrae. He froze the skin with a squirt of local anesthetic and then grabbed the spinal needle off the tray. Steadying the needle between his thumb and index finger, he poked it through the spot he had just frozen. He advanced the needle until he felt the familiar gentle pop as the tip entered the spinal canal. He removed the introducer from the needle and watched the clear spinal fluid drip slowly onto the sterile drape.

Tyler felt two sets of eyes upon him. He looked up at Keisha’s wide-eyed parents and nodded reassuringly. “The needle is in the right spot now,” he said. “We’re going to start running the Vintazomab in now.”

Nikki passed him the tubing. Through her mask, she showed him a small smile, but it didn’t bolster his spirits. Tyler felt more on edge than ever as he connected the tubing to the needle.

He stood from his chair and walked to the foot of the bed, so he could watch Keisha’s face. Eyes shut, her expression looked peaceful. “Okay, Nikki,” Tyler said.

The nurse adjusted the roller dial on the IV bag and pressed two buttons on the machine. Yellowish fluid began to snake through the tubing toward Keisha’s back. The room went very quiet as everyone watched the medication flow into her.

Tyler’s stomach flip-flopped, but all was calm.

Twenty minutes ticked past without incident. Nikki calmly monitored the infusions like an air traffic controller tracking planes landing. Jonah looked his usual contemplative self. Only Maya was still taut with worry. Tyler pointed to the emptying bottle of Vintazomab, two-thirds of which had already run into the spine without complication. “We’re getting there, Maya.”

The words had just left his lips when, out of the corner of his eye, he noticed Keisha’s chin bob. His gaze darted over to her just in time to see her whole head jerk up and down as though violently nodding. She shrieked a high-pitched moan. Suddenly her arms and legs began to flail, and she convulsed wildly. One of the intravenous lines flew free of her arm like a power line falling in a windstorm.

Tyler lunged forward to pin her thrashing body to the bed.

Damn it! Not again!

“
Keisha, no!
” Maya screamed.

“Oh, dear Lord,
please
show our daughter Your divine providence and mercy!” Jonah cried out in prayer.

As Tyler clamped Keisha’s involuntarily bucking body to the bed, his eyes searched frantically for Nikki. “Lorazepam two milligrams IV stat!” he yelled.

“Already given,” Nikki called from somewhere over his left shoulder.

Tyler glanced up at the head of the bed. Lomas studied him with quiet alarm. “She’s still seizing,” she said. “Do you want me to paralyze her?”

The anesthesiologist’s offer to give Keisha a drug to temporarily block all muscular activity wouldn’t stop the potentially lethal electrical storm from continuing to rage inside her brain. “No,” Tyler said, as he struggled to hold the child through her fierce convulsions. “We won’t be able to monitor the seizure if she’s paralyzed.”

“Another dose of lorazepam?” Nikki called to him.

“Yes. And start the Dilantin and phenobarb running!”

Keisha’s moans evolved into gasps that sounded like someone trying to breathe through a chokehold. Then she stiffened as rigid as a log in Tyler’s arms. A moment later, she stopped breathing altogether.

Not again! Not Keisha, too
.

“Please, baby,
please!
” Maya wailed, as Jonah continued to mutter prayers.

Right as Lomas was shoving a breathing mask onto the girl’s face, Keisha suddenly went limp as a rag doll in Tyler’s arms. She grunted and then began to inhale in short whistling breaths. “Hold off,” Tyler told the anesthesiologist, and Lomas pulled the mask away from Keisha’s face.

Keisha’s breathing quieted. Tyler felt her chest expand and contract in steadier respiration. Loosening his grip on her, he straightened up and turned to her anguished parents. “It’s over now.”

“They say the Spanish flu killed nearly fifty million people in the fall of 1918
alone
,” Dot said with an astounded shake of her head. “Over a half million Americans died. Almost all the victims were young and healthy.”

“And the Alfredson?” Lorna asked.

“Thanks to Evan McGrath—who kept the doors open despite Grandfather’s wishes—the hospital saw her share and then some,” Dot said with another yawn.

Lorna had noticed the old woman’s eyes start to glaze over the past hour, and she worried Dot might nod off at any moment. Lorna was hauling up unexpected payload now; like mining for copper and striking gold. She needed to keep the old crone focused. “So, as I understand it, Evan was responsible for Marshall’s stroke?”

“That would
certainly
be the Alfredson family take on the whole mêlée.” Dot sighed. “Of course, old Marshall was the one who attacked Evan with a cane, but why get hung up on the details?”

Why, indeed?
“How bad was his stroke?”

“It’s all relative, isn’t it?” Dot said. “At the time, the morgue at the Alfredson was running out of space with the young bodies piling up so fast. An old man with left-sided weakness would not exactly have been a priority patient in October 1918. Then again, darling, that old man owned the place, so he was well taken care of.”

“Did Marshall recover?”

“To a degree. He recovered much of the use of his left arm, but the old bugger would never walk again. I only ever knew him as wheelchair-bound.”
Dot wiggled a finger at Lorna. “Make no mistake, darling, even from that
cumbersome
chair he could still strike fear into people’s hearts.”

“I guess so,” Lorna said. “Did he follow through on his threat to chase Evan out of the hospital?”

Dot offered one of her now-familiar enigmatic smiles. “Marshall was preoccupied with his own infirmity. Evan was trying to cope with the worst natural disaster in recorded history. There was simply no time.
Besides
, before Marshall could do much of anything, Fate intervened and made his threat a moot one.”

“How, Dot?” Lorna blurted out in her excitement.

Dot stared at Lorna for several seconds. “Despite all Evan’s measures, poor Cecilia McClellan would not be the only member of staff to fall sick with the Spanish flu.”

The Spanish flu wrought more heartache and tragedy than even the world war that preceded it. Though the hospital was overrun and its staff exhausted, Marshall insisted that the doors never be closed to the sorry victims of this dreaded disease.

—
The Alfredson: The First Hundred Years
by Gerald Fenton Naylor

Evan sat at his desk, holding the phone’s earpiece in one hand and the mouthpiece in the other as he waited for the operator to connect his call to the military supplier who had last filled the hospital’s oxygen tanks. He had been awake for almost three straight days and nights and could barely recall what sleep felt like. He had not left the grounds of the hospital during that time. The house was left empty since Grace had rushed off to Everett a week earlier to stay with her ailing mother.

Marshall’s revelation that Evan had fathered a child with Olivia had so acutely evoked the memories of her that, despite the overwhelming demands on his time, his mind kept wandering back to those stolen hours spent joyously in a room at the Sherman Hotel. Evan felt like a fool for not having seen it earlier. The space between Olivia’s wedding and Junior’s birth was barely seven months, but he had never questioned the validity of the boy’s premature birth.

Still shocked and numb from the news, Evan had yet to see Junior since
learning he was the birth father. However, he knew Junior would be arriving soon to visit Marshall, even though the old man had banned him from the premises during the Spanish flu outbreak.

Evan winced again at the memory of Liv and Junior’s clandestine kiss. Marshall was absolutely right—the young couple needed to sever all romantic ties immediately.

His thoughts turned to Marshall, who lay nearby recuperating from his stroke. Evan had assumed the old man’s attitude regarding Liv and Junior was born from nothing more than sheer vindictiveness. Out of guilt, Evan had trudged over twice to visit him on the ward. Marshall was still in a stupor and didn’t seem to recognize the doctor, let alone recall firing him. But he was already better than the day before, and Evan had little doubt his memory would improve as he continued to convalesce. He suspected the stroke would not shake Marshall’s determination to banish the McGraths from the Alfredson.

The Alfredson had been Evan’s life for over twenty years and yet, oddly, he fully accepted the inevitability of his departure. However, he intended to use every inch of leverage with Marshall and Junior to ensure that his disabled son could step into his role as the Alfredson’s medical administrator. The Alfredson owed the McGraths that much. Besides, with George’s wisdom, single-mindedness, and tenacity, he would make a very able leader for the clinic.

Assuming, of course, the hospital survives the Spanish flu
.

The Alfredson was in the throes of a crisis worse than any Evan could have imagined. In three days, the clinic had admitted well over a hundred victims of the Spanish flu. As of last count—and the numbers were rising by the hour now—thirty-two patients had succumbed, including poor Cecilia McClellan, who died the day before her twenty-second birthday.

Evan had consulted frequently with the Alfredson’s lung specialist and the clinic’s other doctors who were most experienced in treating influenza and pneumonia. Between them, they tried every known remedy from silver to camphor, but nothing dented the lethality of this new flu. The only intervention that provided any measure of reprieve from death was the oxygen masks that Moses and Evan had fashioned out of rubber. Despite what Evan had considered a large stockpile, all the tanks were in use and patients were lined up threefold for their turn. Worse still, he knew that
no matter how carefully they rationed the precious gas, the tanks would soon run dry.