Robin Cook - Toxin

"Everything staying nice and normal," Janet said in a low voice.

Kim nodded.

"Maybe you folks should think about going home," Janet added. "I'll be keeping a sharp eye on your little angel here."

"Thanks but I prefer to stay," Kim said.

"Seems to me you could use some rest yourselves," Janet said. "It's been a long day."

"Just do your job," Kim grumbled.

"No question about that," Janet said cheerfully. She went to the door and silently disappeared.

Tracy opened her eyes and glanced over at Kim. He looked wretched under the strain. His hair was a mess and his face covered with stubble. The single nightlight near the floor accentuated the gauntness of his cheeks and made his eye sockets look like dark hollows.

"Kim!" Tracy said. "Can't you control yourself? It's not helping anyone not even yourself."

Tracy waited for a response, but it didn't come. Kim appeared like a sculpture depicting anguished frenzy.

Tracy sighed and stretched. "How's Becky doing?"

"She's holding her own," Kim said. "At least the surgery handled the immediate crisis."

The surgery had gone quickly. In fact, James had reported to Kim that what had taken the most time was a painstaking irrigation of Becky's abdomen to lessen the chances of infection. Following the surgery, Becky had spent a short time in the recovery room before being brought back to the floor. Kim had requested the ICU but again he'd been overruled.

"Tell me again about her colostomy," Tracy asked. "You said it can be closed in a couple of weeks."

"Something like that," Kim said tiredly. "If all goes well."

"It was a major shock for Becky," Tracy said. "As was the tube in her nose. She's having a hard time coping. What's made it worse is she feels betrayed because no one told her these things might happen."

"It couldn't be helped," Kim snapped.

Kim backed up and sank into a chair similar to Tracy 's. With his elbows on the hard wooden arms, he buried his face in his hands.

Now all Tracy could see was the top of Kim's head over Becky's bed. He didn't move. The sculpture of anguished frenzy had assumed another, even more expressive pose.

Looking at Kim's dejected posture forced her to think about the situation from Kim's point of view. Drawing on her experience as a therapist, she could appreciate how hard it had to be for him, considering not only his surgical training but, more important, his narcissism. All at once her anger toward him melted.

"Kim," Tracy called. "Maybe you should go home. I think you need some distance as well as rest. Besides, you have to see patients tomorrow. I can stay. I'll just be skipping class."

"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.

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 call: 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.