Tony Scott - Along Came COVID - Love and Loss in the 2020 Pandemic

“What do you think about lung cancer and smoking?”

“Smoking causes lung cancer.”

“So, are those patients responsible for their illness?”

“I guess so,” Brian said. “More and more, people recognize that they brought this on themselves.”

“My brother-in-law, Skip, is certainly in that situation with his lung disease. We don’t talk about it in the family, but everyone knows that his smoking was the problem. Don’t you think this is sort of the same?”

“I hadn’t thought of that, but it’s a valid point.”

“Both cancer of the lung and obstructive lung disease are consequences of smoking, which is a substance abuse. They don’t die of overdose, I don’t think, but they die of heart disease, stroke, lung disease, and a lot of cancers.”

Brian scratched his ear again, “Those are physical diseases that seem more tangible than substance abuse with lethal potential. I think of it differently, and I can’t help but think others think of it differently too.”

“We can’t control what others think,” Peggy said. “But you can control what you think about it. If you approach it like cancer of the lung or obstructive lung disease, since you don’t want me to go back to cancer of the pancreas and lymphoma, it might lead you to a better outcome.”

“Man, oh man.” Brian stood and turned away from Peggy, sauntered toward the door, then turned and briskly returned to the desk. “I need to thank you. You are always here late in the morning, I can come without an appointment, you don’t set rigid time limits, and you have been insightful. I need to thank you for that.”

Peggy, totally taken aback, stood and shook Brian’s hand.

“I’ll see you later.”

The window gently affirmed Brian’s progress. Brian had to look back at the door he had just closed. Was this the first time he had heard it rattle?

“I’m getting worse, Josh. I can feel it.”

It was not the greeting he expected. It shook him to the core. She had now been here four days. “What makes you think so?”

“It’s really getting harder to breathe, like before the CPAP. And they keep increasing my oxygen to keep my pulse ox up. Look, right now it’s only eighty-nine percent.” She was using a makeup mirror to look at the numbers on the monitor.

He sat and held her hand. Aspirin was keeping his fever away. Luckily for him, no cough, trouble breathing, or muscle aches had appeared, but food had lost its taste. Showered, dressed, and in good spirits, he had come to spend the night with her and to help the exhausted Labor and Delivery staff. The ride over had been through an uplifting sunset and a warm breeze. This revelation spoiled the pudding.

“We need to check this probe out,” he offered, looking at its pristine appearance and perfect placement. The truth was repulsive. It wasn’t the probe. His heartthrob was becoming critically ill. She was going to need a ventilator. What if we didn’t have one? In the guise of needing the bathroom, he left the area, found a stall, sat, and cried.

In less than an hour, Peggy sat with Josh at the side of Faith’s bed. Ricky appeared in PPE. Josh knew what was coming and didn’t like it a bit.

“We were thinking we should intubate you, Faith, since you are getting worse, and we don’t want this to become an emergency.”

“I was thinking I was getting worse. It’s now hard to breathe even with my CPAP.”

“So, I’ll tell Ann we agree with her,” Ricky said and disappeared as stealthily as he had appeared.

“Will you put me to sleep?” Faith asked.

“Yes. You won’t know a thing,” Peggy said.

“Josh.” She coughed again. “Kiss me. What if I don’t see you again?”

“Don’t talk like that. I’ll see you later. Get well quick.” He kissed her. “Go back to Sandia Peak.” It sounded lame this time.

Ann appeared, Josh held her hand, and Peggy emptied one full syringe of milky white propofol and one clear syringe of vecuronium into her IV. Faith’s body relaxed, she stopped breathing, Peggy slipped the endotracheal tube in, and hooked the tube up to the ventilator. With each breath it gave her, she listened to Faith’s lungs, then applied the stabilizing device between her teeth.

Faith’s pulse ox came up, her skin pinked, and her blood pressure decided on its position. “One hundred percent,” Josh exclaimed. “We haven’t seen that in a while.”

Peggy was encouraged, too. “This step was clearly necessary.” A Doppler materialized and Cori’s heart swished along.

Peggy and Ann exited the ICU and removed their garb. “She looks a lot better like this,” she told Ann.

“Yes, but I’m not happy,” Ann said. “This just seems to be gradually declining.”

“Well, but at least it took four days to get to this point. That’s better than any other patient we’ve had who needed a ventilator.”

“Is that a good sign? Or are you rationalizing?”

“I don’t know. I’m not happy, either. Are we getting any more lab tests?” Peggy asked her.

“No,” Ann said. “A, I don’t want to know. B, it won’t make any difference. And C, tomorrow is soon enough.”

“Yes. You’re right. I’m just anxious.”

“We all are,” she agreed. “Haley’s a mess, Josh is a basket case, and Emily keeps calling me. I even heard from Michelle Scroggins today.”

“The department chairman? Is that right?”

“Haley and I talked for half an hour this afternoon,” Ann said.

“Were they friends before the residency?”

“No,” Ann answered. “Haley came from Arizona, and Faith is from Texas.”

“I knew Faith was from Texas. She only has to open her mouth to know that.”

They both looked back through the window in the door, but neither could quite read the numbers on the monitor.

“This has been a hell of a run,” Ann said. “We’ve had deaths, I helped Ricky do a true cesarean section to save a baby while it’s mother died, and now Faith is threatening.”

“I haven’t been sleeping well,” Peggy admitted. “I shouldn’t burden you with this, but this has been a ‘run,’ as you said. I have had dreams about patients, which I only had one other time in my career.”

“I’m sorry,” Ann said, “although it is reassuring that you are telling me this. We are all having our issues. I am most worried about Ricky.”

“Me too. But in recent days, I think he is better. I think he and Haley play off each other, and that seems to be a good thing.”

She and Ann strolled down the hall making small talk.

After Josh had regained some composure, he held Faith’s hand. “OK, you turkey, you need to stop this right now, snap out of it, and get out of here.”

He used her hairbrush to refresh her ponytail and tighten the clip. Her silky hair always lifted his spirits. He put her silver stud earrings back in. He picked up the Doppler and listened to Cori’s heart. “Hello Cori. You need to hang in there while your mother gets well. Don’t leave me.”

He adjusted her pillow and folded one arm on her abdomen. “Cori sounds good, doesn’t she?” he said to Faith. “I’m glad she’s OK. Now you have to get well!”

The sedatives were working. She didn’t move. Her face looked peaceful, an expression he hadn’t seen for days. It was obvious she was declining slowly, but he tried to blink harrowing thoughts away, trying to enjoy the moment. Her eyes were closed with ointment in them to protect the corneas. The tube was in her mouth, with wires and tubes all over the place. He had seen ICU patients before, and several of them had required a ventilator, and two of them that he had taken care of had died. While he was intimately familiar with critical care equipment, it was unwelcomed and repugnant now. How would this end?