“Hey, I just remembered something,” Michael said. “Ranibizumab was in the ophthalmology lecture yesterday. It’s used for macular degeneration and is well tolerated without allergic problems.”
“If it is already an established drug, I wonder why they are giving it to her?”
“Good question,” Michael said. “Maybe there are still some allergic issues that the lecturer didn’t mention. But one way or the other, I’m beginning to think coming here might raise more questions than give answers.” Ducking his head, he moved down alongside the cylinder, between the cylinder and the wall. He was impressed by the constantly moving roller system that kept the patient’s body in motion while avoiding pressure point problems. It was a kind of massage system in a tube that encouraged circulation and protected the integrity of the skin.
“Hey!” Michael yelled to Lynn. “Come here! Look at this!” Lynn was still captivated by the monitor. She was marveling at the range of physiological data that was being followed in real time and possibly continuously run through a supercomputer.
Lynn squeezed in beside Michael. In the restricted space, the noise coming from the machinery in the room seemed even louder. Lynn tried to follow Michael’s line of sight and pointing finger. She was as impressed as he was with the roller system. “What am I supposed to be looking at?” she yelled.
“The catheter embedded in the abdomen! What do you think that could be for?”
“No idea. Do you?”
“No! But it looks to me like the abdomen is a bit distended. What’s your take?”
“Now that you mention it, it does look a bit bloated. You think they are running fluid into the abdomen? That’s not unheard of. The peritoneal cavity has quite a surface area and can even be used for dialysis.”
“True! Maybe she’s got a kidney problem. Let’s go back and look at the monitor and see if the kidney function is normal.”
Lynn backed out of the confined space first, followed by Michael. When they looked at the monitor, they could see that the kidney function was perfectly normal, including urine output. Then something from the long list of things under observation caught Lynn’s attention. She pointed to it. “This is strange. One of the stats gives her output of ascites fluid. They’re not putting anything into her abdomen with that catheter, they’re taking fluid out.”
“And she’s putting out a significant amount,” Michael said, looking at the same recording as Lynn. “The main cause of ascites is liver disease, yet her liver function is normal. Weird!”
“The second major cause of ascites is low blood protein, but hers is raised. Double weird.”
“Uh-oh!” Michael shouted. “Quick! Duck back into the cubbyhole!”
The massive conveyor system, with its oversize tires, suddenly came in their direction, its weight making the floor tremble and momentarily trapping them in alongside cylinder 100. In the adjacent stack, a body was extracted, robotically disconnected from its various lines, and whisked out of the room. Then the conveyor system trundled away for its next assignment.
A moment later, when they emerged from their shelter, Lynn surprised Michael by climbing the ladder to peer into several of the upper cylinders.
“I think we better move on,” Michael yelled up to her impatiently. “We are pushing our luck. With all this mechanical activity in here and bodies coming and going, somebody’s got to be minding this place with video surveillance.”
“I just wanted to check to see if any other patients have an intra-abdominal catheter,” Lynn said, already climbing back down. “And they all do in this stack.”
Michael stepped over to the next stack and peered in at the patient in the lower cylinder. “You’re right. Seems they all have it.”
“That’s got to mean something, but what?”
“Good question,” Michael said, “but we’ve got to break out, girl.”
“I’m not leaving until I see Carl,” Lynn said with a tone that brooked no argument.
“My personal opinion would be to let it go,” Michael said, placing his hand on her shoulder in hopes of restraining her. “Seeing Carl here is not going to help you or him. You know what I’m saying.”
“I don’t care,” Lynn said. She shrugged off Michael’s hand and started down the line of cylinders.
For a moment Michael hesitated, wondering if it was best that she go by herself for a bit of privacy with her stricken lover. But he quickly decided otherwise. It was hardly the proper environment for any attempt at intimacy, and he didn’t want to risk her getting emotional, which he thought was a significant possibility, knowing how he would feel if the situation were reversed and his girlfriend, Kianna, was one of the patients. He quickly caught up with her. As he did so, the forklift-like mechanism that pulled the patients in and out of the cylinders suddenly came in their direction.
The students had to flee back to the walkway that ran the length of the room against the wall opposite the bank of cylinders. The conveyor track taking the patients in and out of the room arched overhead.
After a patient was deposited in a cylinder close to where Lynn and Michael had been, the whole apparatus began moving to the opposite end of the room to pick up another.
“For the life of me, I can’t imagine why they are constantly moving these patients,” Michael yelled, going up on his tiptoes to try to get a peek into the black hole into which the conveyor track disappeared. “Or where the hell they are going.” When he turned back to Lynn, he saw that she was well on her way to cylinder 64. By the time he caught up to her, he could tell she wasn’t happy.
“He’s not here,” Lynn yelled over the continuous noise.
A quick glance confirmed for Michael that cylinder 64 was empty, although the monitor displayed Carl’s home page, so it was where he had been or was to be.
“Just as well,” Michael yelled back.
“Do you want to see if Ashanti is here?”
“I don’t see any point,” Michael said without hesitation. “For the tenth time, let’s get a move on.”
“All right,” Lynn said, but still she hesitated. She had suggested seeking out Ashanti as a way to stall. Her irrational side wanted to wait for Carl to be returned as part of the continuous stream of patients coming and going on the conveyor system. At the same time, Lynn’s rational side agreed with Michael that they needed to leave. For a moment she struggled with her indecision, and as she did so her eyes caught the various color-coded and labeled lines that would be robotically connected to Carl when he was brought back to monitor him and keep him alive. There was the intravenous line in blue, an arterial line in red, a gastrostomy line for nutrition in green, and an intraperitoneal line in yellow.
Michael grasped Lynn’s upper arm. “I know it’s tough for you to leave, but it isn’t going to be any easier if you see him. We have to go!”
“I know,” Lynn shouted with a degree of resignation. “But look! Carl already has an intraperitoneal line!” She pointed to the yellow connector. “Why? He certainly doesn’t have ascites. Not yet, anyway.”
“We can debrief when we get out of this freaking place. We’ve got a lot to process.”
“You know what I think?” Lynn said with sudden urgency and a renewed degree of horror.
“I don’t, but I can tell you are about to tell me. But tell me out in the hallway, where I can hear you. This racket in here is driving me crazy.”