"I wouldn't be able to sleep even if I did go home," Kim said, without lifting his face from his hands. "Now I know too much."
During the entire time Becky had been in surgery, Kim had researched HUS in the hospital library. What he'd learned had been frighteningly overwhelming. Everything Kathleen had said had been true. HUS could be a horrible illness, and now all he could hope was Becky had something else. The problem was that everything was pointing in the direction of HUS.
"You know, I'm beginning to appreciate how difficult this is for you, above and beyond your medical training," Tracy said sincerely.
Kim lifted his face from his hands and looked over at Tracy. "Please don't patronize me with any of your psychological bullshit. Not now!"
"Call it what you like," Tracy said. "But I'm realizing this is probably the first time in your life that you've been faced with a major problem that your force of will or expertise cannot alter. I think that must make this especially hard for you."
"Yeah, and I suppose all this isn't affecting you at all."
"Quite the contrary," Tracy said. "It's affecting me terribly. But it's different for you. I think you're having to deal with a lot more than Becky's condition. You're having to take a hard look at new limits, new constraints that are impeding your ability to act on Becky's behalf. It's taking a toll."
Kim blinked. He always hated his former wife's psychological theorizing, but at the moment he had to admit she was making a certain amount of sense.
TEN
Thursday, January 22nd
Kim ended up going home, but as he expected he had not been able to sleep much, and the sleep he did get was marred by disturbing dreams. Several of the dreams he found incomprehensible; they were about being ridiculed for poor performance on tests in college. By far the most horrible nightmare had been about Becky, and it was easy for him to understand. In the dream she had fallen from a jetty into a surging sea. Although Kim was on the jetty. he couldn't reach Becky no matter what he did. When he had awakened, he had been covered with perspiration.
Despite getting little rest, Kim's going home did afford him an opportunity to shower and shave. With at least an improved appearance, he was back in his car just after five in the morning. He drove on mostly deserted streets slick with a dusting of wet snow.
In the hospital he found Becky as he'd left her. She appeared deceptively peaceful in her slumber. Tracy was fast asleep as well, curled in the vinyl chair and covered with a hospital blanket.
At the nurses' station Kim came across Janet Emery dutifully doing her chart work.
"I'm sorry if I was rude last night," Kim said. He sat down heavily in the seat next to Janet. He pulled Becky's chart from the rack.
"I didn't take it personally," Janet said. "I know what kind of stress it is to have a child in the hospital. I experienced it with my own son."
"How was Becky's night?" Kim asked. "Anything I should know?"
"She's been stable," Janet said. "Most important, her temperature has stayed normal."
"Thank God," Kim said. He found the operative note that James had dictated and which had been put into the chart over night. Kim read it but didn't learn anything he didn't already know.
With nothing else to do, Kim went to his office and busied himself with the mountain of paperwork that had accumulated. As he worked, he eyed the clock. When he thought the time appropriate, taking into account the hour difference on the East Coast, Kim gave George Turner a call.
George was enormously sympathetic when he heard about the perforation and the resultant surgery. Kim thanked him for his concern and quickly came to the point of the calclass="underline" he wanted to ask George's opinion of what to do if the diagnosis of HUS secondary to E. coli 0157:H7was confirmed. Kim was particularly interested in knowing if Becky should be transferred elsewhere.
"I wouldn't recommend it," George said. "You've got an excellent team with Claire Stevens and Kathleen Morgan on board. They've had a lot of experience with this syndrome. Perhaps as much as anybody."
"Have you had any experience with HUS?" Kim asked.
"Just once," George said.
"Is it as bad as it's described?" Kim asked. "I've read just about everything I could find on it, including what's on the Internet. The problem is there's not a lot."
"The case I had was a very unnerving experience," George admitted.
"Could you elaborate?" Kim asked.
"It was unpredictable and relentless," George said. "I'm going to hope that Becky's problem turns out to be something else."
"Can you be more specific?" Kim asked.
"I'd rather not," George said. "It's a protean syndrome. Chances are that even if Becky has it, it will not be anything like my case. My case was quite depressing."
After a few more minutes, Kim brought the conversation to a close. Before hanging up, George asked to be kept informed about Becky's progress. Kim promised to do so.
After disconnecting from George, Kim phoned the nurses' station on Becky's floor. When he got Janet, he asked about Tracy.
"She's up and about," Janet said. "I saw her last time I was down that way taking vital signs."
"Would you mind putting her on the phone," Kim asked.
"Not at all," Janet said agreeably.
While he waited, Kim thought about George's comments. He didn't like the sound of "relentless and unpredictable" and that George's case had been depressing. Such descriptions reminded Kim of his nightmare, and he could feel himself perspire.
"Is that you, Kim?" Tracy asked as she came on the line.
They talked for a few minutes about how they had each passed the previous five hours. Neither had slept well. Then they got around to Becky.
"She seems a bit better than last night," Tracy said. "She's more lucid. I think she's slept off the rest of the anesthesia. Her main complaint is the nasogastric tube. When can that come out?"
"As soon as her whole GI system seems to be working," Kim said.
"Let's hope that can be soon," Tracy said.
"I spoke to George this morning," Kim said.
"What did he say?" Tracy asked.
"He said Claire and Kathleen were a good team, especially if HUS is confirmed. He told me that we couldn't do any better anyplace else."
"That's reassuring," Tracy said.
"Listen, I'm going to stay here," Kim said. "I'll see a few patients, including the pre-ops for tomorrow. I hope you don't mind."
"I don't mind in the slightest," Tracy said. "In fact I think it's a good idea."
"It's hard for me to sit there and do nothing," Kim explained.
"I understand completely." Tracy said. "You do what you have to do. I'll be here, so don't worry."
"Call me if there is any change," Kim said.
"Of course!" Tracy said. "You'll be the first to know."
When Ginger arrived just before nine, Kim told her to cancel whatever patients she could, because he wanted to get back to the hospital sometime in the afternoon.
Ginger asked about Becky, saying she was disappointed Kim hadn't called her the night before. She'd been worrying all night but had been afraid to phone.
Kim told her Becky was doing better following the surgery. He also explained that he'd not gotten home until after midnight and thought it much too late to call.
At first Kim found seeing patients was not easy under the circumstances, but he forced himself to concentrate. Gradually the effort paid off. By noontime, he felt slightly more relaxed although his heart would race every time the phone rang.
He wasn't hungry at lunchtime, and the takeout sandwich Ginger had brought in sat untouched on his desk. Kim preferred to immerse himself totally in his patients' problems. That way he didn't have to deal with his own.