Stephen White: Critical Conditions

“You said it’s an insurance company? Which one?”

“Excuse my vernacular-it’s actually a managed care company. I think it’s-”

“MedExcel.”

“Right. How did you know?”

“Lucky guess. Usual suspects. Is MedExcel on solid ground in refusing to pay for the procedure?”

“Sounds like it. Everybody agrees it’s an experimental approach the Washington hospital is doing. The drugs they use to kill the virus aren’t approved by the FDA for anything but investigative use.”

“How critical is Chaney’s condition right now?”

“The news reports make it sound grim. Dani-she works with John Trent a lot, she should know-says it’s bad, the baby’s heart muscle is mush, that John’s in Denver whenever he’s not working, day and night. Mom is carrying the ball publicly, trying to raise sympathy to keep pressure on MedExcel, without further alienating them. Tough act, huh? I think the parents are still hoping for a last minute change of heart, so to speak. Me, I think the strategy is naive.”

“Sounds naive to me. I think I’d just call Jon Younger and take my chances with MedExcel at the courthouse.” Jon Younger is a lawyer friend of mine.

“Me, too.”

“How much does it cost? The procedure that they won’t approve?”

“I think I heard the Seattle hospital wants almost four hundred thousand dollars in cash to walk in the door.”

“And what kind of success have they had?”

“Remember, it’s rare and experimental. Even the Seattle center says so. They’ve only done a handful of cases and they’ve saved a couple, three maybe.”

“That’s hopeful, given the prognosis otherwise, right?”

“It definitely beats the alternative.”

“What’s Brenda Strait like?”

“I only know her from the news. She’s pretty in a hard way. Acts like one of those eighties women who thought they had to be way too serious to get along in a man’s world. Remember them? But her hair’s a little too big and she wears clothes that are a half-size too small for her, you know, like Oprah does. And if you ask me, she should wear a little less makeup and a lot more sunscreen.”

Diane was never far from an opinion. “And her work? How is it?”

“I admire her work. She pisses people off. Uncovers graft. Makes politicians look silly. Exposes consumer fraud. That’s her beat.” The media voice came back. “She is Brenda Strait and she gives us The Strait Edge.”

I did recognize her. I think I’d seen Brenda Strait on a billboard or the side of a bus.

I arrived back at the hospital before she did. When I walked in, the same ICU ward clerk I’d met earlier was having a whispered conversation with, I’m guessing, his boyfriend. It was something about someone getting home too late last night. I dug for Merritt’s chart and flipped through Merritt’s spartan record to discover that her last name had been changed from “Doe” to “Strait,” that she was just shy of fifteen and a half years old, and, as of twelve minutes before, she was still unconscious. It was absurd of me to read the chart to find out her level of responsiveness; it was akin to tuning in the Weather Channel instead of glancing out a window to discover that it was raining. I knew it was absurd, but it allowed me a transition to the clinical tenor of intensive care, a distance I needed.

I replaced the chart and started toward Merritt. From ten steps away I could hear her ventilator. My ears told me it was the only one operating in the unit. The puffing sound it made was much too mundane to be so essential to life.

The red-haired nurse stood at the next bed. Her arms were above her head as she hung some fresh IV fluids on a person so bandaged up I could determine neither age nor gender. She looked at me, mouthed a silent, “Hi. Motorcycle.”

I nodded and pulled a chair up beside Merritt. Without thinking, I reached for her hand. She was warm. I was a little startled, unconsciously expecting Merritt’s body temperature to have taken on the chill of the circumstances.

Merritt’s hand was large, as large as my own, and her fingers were thin and beautifully proportioned. The nails were painted carefully with a bright red polish, though the nail on her ring finger was broken badly, exposing some of the tender skin below. The break must have hurt.

Her hand wasn’t limp; she had tone. But her fingers didn’t respond with any pressure to my touch. I said, “Hello, Merritt, I’m Alan Gregory, Dr. Gregory, and I sure hope that I can help you.”

Behind me, across the room, I heard a loud, “I’m her mother, that’s who I am. Where? Where? Over there? Is that her? Is that my baby?” and saw the face from the side of the bus rushing across the ICU. I released Merritt’s hand and stood.

The nurse stepped between Brenda Strait and her daughter, Merritt.

“Excuse me, please, ma’am, you are…?”

“I’m her mother, damn it, get out of my way.” Brenda stepped sideways to maneuver around the nurse, who anticipated the deke and managed to outflank her.

“Hello, I’m Susan, I’m Merritt’s nurse. Have you talked with the doctor yet?”

“No, we played phone tag the whole way over here.” Brenda’s voice broke. “Please get out of my way. May I see my daughter? Oh, God, Merritt. Oh, my baby.”

Susan, the nurse, grabbed Brenda Strait’s hand and led her to the bedside opposite me. Although Brenda was incapable of hearing anything but the puffing and exhaling of the machine that was breathing to keep her daughter alive, Susan adopted a compassionate tone and began to patiently explain Merritt’s condition.

“Ma’am, as you can see, your daughter is on a ventilator to help her breathe. She is still unconscious from her ingestion but her vital signs have begun to…”

“Is she okay? She’s not okay, is she? Where’s her doctor?” She noticed me standing across the bed as she leaned close to her daughter. Her arms were hovering but not touching, the machinery of survival an effective barrier to a mother’s touch. She didn’t look at me as she said in a voice that was half-demanding, half-pleading, “Are you her doctor? She’s going to be fine, right? I can’t lose two girls. Please tell me she’ll be fine. Please, please.”

“I’m Dr. Alan Gregory, I’m a clinical psychologist. I was called in by her-”

“Oh, God, where’s her doctor? What did she do? Oh, Merritt, what the hell did you do? Oh, God.” She took a deep breath. “I promised myself I’d be calm. I need to be calm.” Another deep breath. “Can she hear me? Merritt, darling, can you hear me? It’s your mom. I’m here, oh, sweetie, I’m here.”

“Mrs. Strait, I’m Dr. Klein. Marty Klein.” I turned and saw Marty holding out his hand. “Why don’t you take a few minutes to be with your daughter and then we’ll talk. Alan, you’ll join us, please?”

I guided Brenda Strait into a small conference room off the ICU and listened to Marty while I observed his defeated audience of one.

Brenda Strait’s frantic entrance had deteriorated into a semicatatonic hand-wringing that was as full of pathos as anything I had recently observed. Occasionally Brenda interrupted Marty’s recitation to ask a question, as often as not confusing her younger daughter’s symptoms with her older daughter’s symptoms, the lines of despair having blurred and blended in mother’s horror.

Twice, after requesting a clarification about something Marty was explaining, she said, “Excuse me, I haven’t slept much. Did I already ask that?”

Her eyes were red and the tissues wadded in her hands would have needed to be sea sponges to manage to contain all her tears and sniffles.

Marty was patient, twice ignoring beckons from his beeper, but he was not able to ignore the urgency of a STAT overhead page. He took Brenda Strait’s hand in both of his and excused himself reluctantly, promising to answer all her questions another time, before rushing back to the ER.