Chapter 8
Jake
C
hris lay curled like a lynx in Jake’s lap. His son’s right ankle dangled between his calves, the pajama leg pushed up past the scratches on his knee, the result of a disagreement with Bullet. Chris, still asleep, squirmed and his fingers clawed at the uppermost scratch. He caught his son’s hand, clamped it against his chest.
Anna slouched in a chair in the corner of the waiting room, the hem of her nightgown taut against her knee, her eyes hidden behind her hands. Maybe she was asleep or maybe she had retreated into her own world. He couldn’t tell which.
Something about the lighting—the olive green glow from the plastic seat cushions, the electric blue glare from the fluorescent lights, the dark blond striations of Anna’s uncombed hair, the apricot tint of her cheeks—made her look old. As people walked in and out of the room, their shadows, eerie shades of gray, wafted ominously across her forehead.
“Excuse me, Dr. Campbell.” The papers in the young man’s hands quivered, his voice was tentative. “My name’s Sunil Patel and I’m the med student in the ER today.” He picked up a
National Geographic
and set one of the papers, askew, on the cover for support. “Your son needs a spinal tap and Dr. Easterday sent me to get the consent form signed.” He pointed to the sheet of paper on the magazine.
Jake didn’t read it. He knew what it said: The possible complications of a spinal tap include bleeding or pain at the needle’s insertion site, post-spinal headache, nerve damage, hematoma, paralysis, and herniation of the brain stem into the foramen magnum.
Foramen magnum. Big hole. It was the drain hole at the bottom of the skull. He winced, shook his head, tried to banish the images that raced through his mind. Brain stem herniation. Eddie’s soft little brain stem, the command center for his breathing and his heartbeat, could jam through the drain hole during the spinal tap, shoved downward by the pressure inside his head. A near instant killer.
He shook his head again. The risk of herniation was minuscule; Eddie’s open fontanel would protect him.
Chris wiggled. Jake stroked his leg. Was Eddie’s fontanel still open? He couldn’t remember the last time he’d felt his baby’s soft spot. No matter, the risk was tiny, the rest of the complications relatively minor.
He pulled a pen from his scrub shirt pocket, turned the form to fit squarely over the magazine cover, and scribbled his signature on the line at the bottom.
“Date?” he muttered.
Sunil glanced at his watch. “Um . . . April fifteen, I believe.”
Jake wrote the date on the next line. He stared at what he had written. “Jacob S. Campbell, MD.” The trailer “MD”—med-ical doctor, the signature of a physician—was scrawled beyond recognition. He wrote those two letters behind his name a hundred times a week—on insurance forms and prescriptions, on medication orders and X-ray requisitions. Sometimes, at home, when he wasn’t paying attention, he wrote them on checks to Detroit Edison or on the income tax return. Last week he had written it on a birthday card Anna had passed in front of him, her finger pointing to the white space beneath the greeting. Here, his signature, Jacob S. Campbell, MD, was on the consent form for his son’s spinal tap. It seemed very wrong, an error of colossal proportions. Something had gone badly awry.
He knew what was happening on the other side of the door to the patient area—he’d done maybe ten spinal taps himself, back when he was a medical student. Eddie would be lying on a gurney. One of the nurses would be holding Eddie, his body folded into a C, against the sheet. One of her hands would be clamped on the back of his neck and the other would hold his knees as close to his chin as she could bend him. Would he wiggle? Was he well enough to fight her grasp? Another nurse would paint his lower back with Betadyne, drawing concentric brown circles with the sponge. Then she would cover him with a sterile green sheet, placing the eyehole over the brown antiseptic.
He knew the drill—doctor pulls on sterile latex gloves, snaps the fingers until they fit evenly, palpates the iliac crest with one forefinger to orient herself to Eddie’s anatomy and, with the forefinger on the other hand, locates the L3–4 lumbar space on Eddie’s backbone. Like a well-rehearsed dance.
He wiped his forehead with his palm. Would it go well? Would the ER doc hit it right? She would advance the needle slowly into Eddie’s back until she felt the pop, the signal the needle’s tip had stabbed the dura. Then she would remove the stylet from the needle.
The details of the spinal tap played over and over through his head. In one version, fluid clear as water dripped from the hub of the needle—normal spinal fluid. In another, the fluid was cloudy, looked like diluted skim milk. That would be bad, would mean meningitis. In a third version, the fluid was bright red because the doctor had hit a blood vessel with the needle tip. The blood in the specimen would obscure the lab results; they might not be able to tell if he had meningitis or not.
He wanted to be in the cubicle, to watch the tap, to send mental telepathic instructions that would guide that needle into the right place. No blood. No complications. Quick.
No, that wouldn’t be a good idea. He didn’t want to be there if the sample was cloudy or even bloody. Didn’t want to be in the room if things didn’t go well, if the doc had to stick Eddie’s back several times, if she grew frustrated and impatient and sloppy, if the needle couldn’t be coaxed smoothly into the subdural space.
Anna seemed to be still asleep, tucked into the corner of the green chair. What had happened last night? Yesterday, when he left for the hospital, he had kissed Eddie’s head as it lay propped against her arm, her nipple in the baby’s mouth. His son’s skin hadn’t seemed feverish. But his nose was stuffy, and clear snot had bubbled out one nostril. Eddie had a cold. Same cold as Anna, which she probably caught from Chris. She had called him last evening, said something about Eddie having a fever. From what she told him, the baby didn’t seem very sick. She said he was still nursing, hadn’t said anything about vomiting. What happened?
The questions hammered inside his head. What had she done? Or not done? Why hadn’t she recognized he was so ill?
Had he missed a clue when she called? It didn’t sound too bad, baby with a fever and a cold. Happened all the time. Why hadn’t he questioned her more carefully? If he had understood how ill Eddie was, he would have told Anna to get the baby to the ER last night. How could this be happening to them?
Chapter 9
Anna
“W
hat was going on with Eddie last night, Anna?”
She heard Jake’s voice over the drone of the ER waiting room. Then a woman’s cry rose above the noise, replaced by a man’s grunt. A phone rang, a baby screamed, wheels rolled over linoleum, something metallic fell with a clang.
She stared at his pale, whiskery face, at his tired eyes. “He was sick.”
“Honey, what happened after we talked on the phone?”
It was chilly in the waiting room. She wrapped her arms around her chest, folded them under her breasts—her achy breasts. “I rocked him for a little while.”
“Was he nursing?”
“Not very well. But he took a little bit. Jake, I’m so scared. Is he going to be all right?”
“I don’t know.” He wiped his forehead. “Was he crying? Or whimpering?”
“He was fussy, eventually he fell asleep.”
Then she remembered. She had begged Eddie not to wake up when she laid him in the crib. And then he didn’t. She couldn’t tell Jake about that.
She pulled a piece of Kleenex from her pocket and blew her nose. “Then I put him in his crib.”
She was cold. She kicked off her clogs, folded her legs up into the chair, and gathered her shift around her bare feet.
“Then what?”
“Then it was morning.”
“And?”
She didn’t know how to describe it. “Eddie didn’t wake me up for his middle-of-the-night feeding.”
“And then what?”
Jake was accusing her of something. Of not taking care of Eddie. “This sounds like a criminal interrogation,” she said.
“No, no. I’m just trying to figure out what happened last night. Did you call Dr. Elliott?”
“No.”
“I told you to do that if you were worried about him.”
He wouldn’t stop. He kept pounding her with questions. “Do you think Eddie was crying in the middle of the night and you didn’t hear him?
“Did you take a sleeping pill or something?
“What time did you wake up this morning, anyway?”
She didn’t answer. Finally he quit asking.
He rose, set Chris in the seat of his chair, and stepped toward her. At her side, he stooped, laid his hand on her knee, and stroked her hair. “Please tell me about last night. I just need to know what happened.”
“Well, I don’t know what happened. When I went into his room this morning, he was pale and barely breathing.” She hid her face behind her palms, made Jake disappear.
“Okay. Enough questions. I think I get the picture.” He returned to his chair and pulled Chris back into his lap.
The white band of cloth—the bottom of her nightgown—hung beneath the green and blue plaid hem of her shift. She ran her fingers over the knit fabric, folded it, folded it again, and folded it yet again. Then she unfolded it, and slowly refolded it once more.
Eddie was still in the treatment area. What was taking so long? He seemed so far away and she was stuck in the waiting room, the place where people idly lingered. Some paced from wall to wall, as Jake had done in ten-minute cycles. Some paged through dog-eared magazines. Others just sat. For her, time was strings of empty seconds tied together like foam buoys along an endless rope—dangling, twirling, bobbing, swaying, but going nowhere.
Waiting. Waiting. Waiting until she could see Eddie again, could learn what was wrong with him. Was he still alive? The possibility of good news tugged against the probability of bad news; the unknown made her head ache. He’ll be just fine, she told herself. He’s going to die, she told herself a minute later. She ran her fingers through her hair, combing it back away from her face. She wanted the suspense to end. And yet, at the end of the waiting, could she deal with what came next?
She wanted to make the time go faster. She didn’t want to read. Didn’t want to talk. Didn’t want to answer Jake’s probing questions. Didn’t want a cup of the stale coffee from the urn across the room. She couldn’t sleep while sitting up in the chair, couldn’t consider sleeping while Eddie was trapped in the other room. What were they doing to him, anyway? She shifted her weight to her right hip. What was taking so very long? Then she shifted her weight back to the left.
It seemed as if she spent her life waiting for something to happen: She had waited for her wedding, waited for Jake to finish medical school, for Chris to be born, for Eddie to be born. On a more mundane, day-to-day scale, she waited for Jake to come home in the evenings, for Chris’s birthday, for the trip up north next time Jake had a full weekend off, for the blue linen jacket with the bone buttons she had ordered from the Talbots’ catalog, for the next semester of new students who spoke three or four or six different languages but not English.
Now, she was waiting to hold Eddie in her arms, to rub her hands against his skin. He’d be scared without her, back in that room, would know something was missing—would know
she
was missing, that he was being hurt and the usual comforts, her smell, her kisses, her singing, her warm, sweet milk, weren’t there. He’d look around the cubicle, stare at those ugly curtains and wonder where she was. If he could wonder. Can a six-month-old baby wonder? Her fingertips smoothed the hem of her nightgown against her shin, patted out the wrinkles. Surely he’d wonder why she wasn’t there with him.
It was her third visit to this emergency room. Last summer, on the Fourth of July, Chris had a fever and scratchy voice. She thought it must be strep throat. Turned out to be an ear infection. The summer before he had had a fever, then a bright red rash.
“Probably baby rash,” Jake had said.
“Maybe scarlet fever or measles,” she said.
“Not measles. He’s been vaccinated against that.”
The rash turned out to be roseola, an innocuous virus.
During those other visits she stayed in the cubicle with her sick child, hadn’t been banished to the waiting room while they examined him or drew a blood sample from him. Everything else was the same, the waiting for the tests to come back, the flickering fluorescent lights, the moans and shouts of the other patients, the confusing smells that seemed both antiseptic and rotten. Only, this time was worse.
She knew what they were doing to Eddie—sticking needles into him. Taking blood samples. Doing a spinal tap. Why didn’t someone tell her what was going on? She stared at the vacant door that led to the hallway that led to the room of cubicles that led to the gurney where Eddie lay.
“What’s taking so long?” she asked.
Jake rearranged Chris on his lap. “They’re probably starting an IV, drawing blood, doing the lumbar puncture, infusing his antibiotics.”
She folded the hem of her nightgown yet again, and then unfolded it. “Is he all right?”
“I hope so.”
His voice sounded thin. He seemed to be on the moon and yet he was slumped in his chair, Chris snuggled in his lap, merely six feet to her left. She stood up—couldn’t stand to sit any longer—and wandered into a hallway.
A sign with a large arrow pointing to the right said
CAFETERIA.
The thought of food made her stomach lurch. She turned to the left, away from the cafeteria, and walked down the hallway among the clutter of empty gurneys, wheelchairs, IV poles, and cribs. First a man and then two women, all three dressed in wrinkled green scrubs, zigzagged through the maze of equipment, their arms loaded with boxes, stacks of linen, coils of tubing, plastic bags filled with clear fluid. She had been waiting and waiting and waiting. They were busy.
Of course Eddie would be okay. The soles of her clogs padded against the floor to the rhythm of her thoughts. Would be okay, would be okay, would be okay. He has to be okay. He’s had a little spell, a snit from his cold. Most certainly he had a virus that would soon pass and they could all go home.
Ahead was a crossroads in the hallway. An arrow that said
X-RAY
pointed to the left; one that said
GIFT SHOP
pointed to the right. One that said
CHAPEL
pointed straight ahead.
She could pray. She stepped inside the doorway. Rows of benches led to the altar. A white beam from somewhere—the ceiling? somewhere else?—lit the altar. A cross and a Star of David glowed in the pool of eerie light.
She didn’t know what to pray for. Forgiveness for not calling Dr. Elliott? Absolution for sleeping through the night? For Eddie to be okay? She didn’t know how to pray, except to repeat the Lord’s Prayer she had spoken by rote in Sunday School when she was a little girl. Worship wouldn’t help Eddie. It was the doctors who would make him better. She turned around and walked back the way she had come.
The seat of her chair in the waiting room was cool. She wished she had worn a sweater. Her old brown cardigan lay draped over the chair in her bedroom. Why hadn’t she thought to bring it? If Chris were nestled in her lap, he would keep her warm, but he clung to Jake’s shirt like a baby monkey to his mother monkey’s hairy front. He seemed to be asleep, hidden from the world behind closed eyes. Suddenly his arm jerked. He uttered a smothered yelp, grabbed at Jake’s shirt again, and snuggled back against his dad’s chest.
Jake looked like a pile of wrinkled laundry in his chair. The legs of his scrub pants twisted around his knees. His puffy eyes showed his weariness, his tangled hair his discombobulation. The stubble on his jaw was a leftover from his long night on call. If he’d been home last night, he would have shaved by now, his clothes would have been pressed.
If he’d been home last night, none of this would have happened. He would have taken care of Eddie and Eddie wouldn’t have had the seizure, wouldn’t be so sick. On the phone he’d said Eddie was fine, said he merely had a cold. If Jake had been there, he would have known what was happening to their baby. He wouldn’t have said everything was fine, wouldn’t have misled her.
She wanted to be warm, tried to remember what it was like to be warm. She coughed into a Kleenex, curled her feet against the cushion beneath her bottom, and waited. She closed her eyes and tried to remember the warmth of the Upper Peninsula sun against her face.
“Mr. Abrams?” a nurse called. “Is Mr. Abrams here?” The old man in the corner struggled to his feet, grasped his cane, and, with a woman’s lumpy purse dangling from his arm, tottered out the door behind the nurse.
She spotted the tuft of caramel-colored hair that peeked from the V neck of Jake’s scrub shirt. She wanted to poke the tuft back inside his clothes. She leaned forward, about to rise from her chair, and then sat back. Let it be, she thought.
“Mrs. Campbell?”
She turned toward the voice. A young man in a short white lab jacket—the medical student who had asked Jake to sign a permit for the spinal tap—stood before her.
She jolted upright in her chair. “What’s happened?” she asked. “Is he okay? Can I see him?”
“Um . . . Dr. Easterday is with him now, and . . .”
“Honey, they’ll tell us when they’re done,” Jake said.
“So, Mrs. Campbell, my name is Sunil and I’m a med student working in the ER today. I met your husband earlier.” Sunil turned toward Jake, smiled briefly, and turned back to her. “I have a few questions about Eddie.”
“What?” she said.
“I said, I have a few questions . . .”
“I know. What questions?”
Sunil squatted beside her chair. A clipboard rested on his knees. He pulled a card from his pocket and a pen from another pocket.
He stared at the list of words on the card. “When was Eddie born?”
“October eleventh, six months ago.”
She watched him write
DOB: 10/11/00
. “What’s DOB?” she asked.
“Date of birth. October 11, 2000.” Sunil glanced at Anna and then back to his paper. “How much did he weigh when he was born?”
“Eight pounds, one ounce.”
“How many pregnancies have you had?”
“Two.”
The student continued down the list. Any complications with the pregnancies? Any medications during the pregnancy with Eddie? Any problems during Eddie’s birth?
“Apgar scores were 8 and 9,” Jake interrupted.
Sunil looked over at him.
Jake added, “I think it was one off each for color and tone at one minute and one off for color at five minutes.”
“Thanks.” Sunil jotted down the numbers. “I usually don’t get that kind of detail from parents.” He shot a momentary smile toward Jake and then returned to his cue card.
Coal-colored hair tumbled over Sunil’s forehead and brushed against his eyebrows. As he spoke, his fingers swept through the hair, pushing it away from his face. His skin, the color of freshly brewed tea, made her think of warmth. His chin was pointed and his lips were thin and dry, which, for her, downgraded the warmth to tepid. The crust of a cold sore stippled the corner of his mouth.