Could I Have This Dance? (34 page)

The next thought made her smile. She realized her own life was almost the same. She worked hard, still took tests, and respect? Well, at least the nurses called her “Dr. McCall.” The third-year medical students had to put up with their designation of M-3s. Claire thought that sounded more like a weapon than a title of a graduate medical student.

She remembered the O-man and his nightly teaching sessions with the medical students. “Wedges. The simplest tool to move a load.”

Martin looked up. “What?”

She blushed, realizing she had verbalized her thoughts. “Nothing. I was just remembering what it was like to start the third year of medical school.”

“Torture. Pure and simple.”

“Oh, come on, Martin. I know you,” she teased. “You’d do it again in a heartbeat.”

He ran a hand through his unwashed hair. “I stayed up all night in the ICU. I haven’t showered. I haven’t eaten since last night. The nurses in the ICU don’t appreciate the instruction I give them. And I think I’m getting an ulcer.” He pointed to a stack of charts on the desk. “Ask me tomorrow, after your night on call.”

Stop instructing the experienced ICU nurses, and they’d let you get a little sleep, Mr. MD, PhD.

Claire’s beeper sounded. It was the operator. She picked up the phone and dialed “0.” “Dr. McCall. I was paged.”

The operator’s voice was feminine, but monotone, almost mechanical. “I have Dr. McCall on the line, ma’am. Go ahead.”

“Claire?” The voice was strained, but easily recognizable to Claire.

“Mom? What’s wrong?”

“It’s your father. He’s in the hospital in Carlisle. He’s on a ventilator, Claire.”

Claire’s hand went to her mouth, and she sank into a chair. “When? What happened?”

“After I talked with you yesterday, I found him in the kitchen. I think he choked on my peach pie.”

“Oh, Momma.”

“The doctor says he aspirated or something. He’s afraid he might have brain damage.”

“Brain damage?”

“He was jerking so. I told the doctor that he always does that, but he thought it may be signs of something serious, like maybe he didn’t get enough oxygen while he was choking or something.”

Claire sighed, unsure what to say.

“The doctor says that Wally was drinking. He had alcohol in his blood, Claire.” She sniffed and started to sob. “He said he might d—die, honey.” She blew her nose.

Claire pulled the receiver away from her ear.

“They had to paralyze him. He’s just lying there all still, with all these tubes. He looks like he’s dead already.”

“I’m coming home,” Claire mumbled. “I’ll leave right away.”

She said good-bye and hung up the phone.

Martin had obviously overheard Claire’s intentions. He stood in her way as she picked up her stethoscope. “Just like that? You’re going to leave me here by myself?”

She nodded and took a step toward the door of the ICU. “It’s my father. He’s on a ventilator. The doctor says he might die.”

Martin shook his head. “B—but you can’t leave me on this service by myself. They’ll make me take call every night.” His voice was pleading, desperate. “The nurses won’t listen to me, Claire. I won’t sleep.”

She walked numbly to the exit. She turned and looked at Martin Holcroft, MD, PhD, his hair stringy, his shoulders stooped in defeat. “Get a grip on yourself, Martin. I’ll talk to the program director. We’ll work something out.”

She stomped toward Dr. Rogers’ office. She clenched her fists as she walked and quietly voiced her resolve: “My father needs me, so I’m going home.”

Chapter Twenty-Four

C
laire pushed her seat into a reclining position shortly after takeoff and wondered how her life could get any more complicated. She’d been given one week off which she’d have to take out of her two weeks yearly vacation. Another intern, Brian McNeil, was pulled from his ER rotation to cover CT while she was away. In two hours, she’d gone from writing notes in the ICU to thirty thousand feet, flying home to a parent reported to be on death’s door. She hadn’t even stopped in at her rented brownstone for a suitcase. With her call bag packed, and her new clothes purchases carefully folded inside, she ought to have enough to make it until she returned.

She closed her eyes and reflected on the one advantage of her flight. At least she’d be away from Lafayette and out of Roger Jones’s reach for a few days.

She thought of her father and wondered if her ideas about Huntington’s disease were totally off the wall. She’d been accused of ivory-toweritis, and her mother implied that she was being paranoid about every disease she saw. She knew that was an exaggeration, but had known other students in medical school who always developed the symptoms of the disease they were studying. It wasn’t so uncommon. A little hypochondria circulates in every medical school class.

Her father was drinking again. It wasn’t so hard for her to believe. But did that mean nothing else was wrong? Were all his symptoms simply alcohol intoxication or alcohol withdrawal, or a combination?

She tried to close her eyes to rest, but the nagging feeling about her father’s case wouldn’t go away. She drank a diet cola and stared at the clouds.

Everything below her looked so small. Cars and trucks were ants. Buildings were blocks and the rivers were spaghetti. It was all a matter of perspective. All of the mountains that loomed so large when they were right in front of you looked like goose bumps from an airplane window.

Perspective. Maybe that’s what she needed in her life.

Her problems seemed so big, but maybe that was because they were in front of her nose.

She was in an all-out competition with the best medical school graduates in the country. Her life was threatened by a man who blamed her for killing his daughter. Her father was on death’s door in an ICU, and even if he recovered, he might still suffer from an incurable genetic disease, which he may have passed to her. She was engaged to a man she rarely got to see. She was attracted to a man she felt guilty for desiring. It had been months since she’d been to church, and weeks since she’d read the Bible.

Could things get any worse?

She looked at a man in a business suit next to her, busily typing on a laptop computer. He was a salesman, an attorney perhaps. If he made a mistake, someone might lose a few dollars. If she made a mistake, a mother lost her only daughter and a little girl would never ride her purple bicycle again. Claire felt her eyes begin to tear. She blinked and turned her head toward the window. Some perspective.

She landed in Pittsburgh, waited two hours, and then rode a puddle jumper into the Apple Valley Regional Airport in Carlisle. There, she contemplated her ride options. She didn’t want to bother her mother. She had sounded too out of sorts. She didn’t want to bother Margo. They really hadn’t been close since Claire had left home. That would seem too awkward. And she couldn’t call her twin, because his restricted license wouldn’t allow him to pick her up. She was left with taking a cab.

She rode to the hospital with a talkative driver, watching out the window and offering minimal responses which never discouraged him from blabbering on and on. She didn’t dare mention that she was a doctor. The man had already told her about his sickly aunt with stomach ulcers and a cousin with lupus simply because their destination was a hospital. She was sure he would pull over and ask her to look at a mole or some other hideous skin lesion hidden under his shirt if he only knew her occupation. She smiled sweetly and looked away.

At the hospital, Claire found her mother sitting in a corner booth in the cafeteria sipping cold coffee and pushing salad greens around a plate with her fork. Clay had gone to work at the cabinet shop. Margo was caring for her family of three girls. Della had stayed through the night catnapping on a couch in the ICU waiting room. They walked arm in arm, the way close families are supposed to do. As they trudged the long hall toward the ICU, Claire sensed a desperation in her mother’s demeanor. The last months of life with Wally had taken their toll.

They visited Wally together, holding his hand, watching his chest rise and fall with mechanical regularity, the ventilator whooshing and humming
in the background against a symphony of clinical noise. Electronic beeps and alarms, pulse monitors blipping, gastric tubes pumping, and the soft whirring noises of the inflatable air stockings all provided the medical music which Claire had come to love.

A nurse reported his progress. There had been no essential change. He started twitching again when the paralyzing agent was removed, so the medicine was resumed and the ventilator continued. Dr. Smuland should be around for evening rounds at nine. Claire should feel free to stay.

With some urging, Della agreed to return to Stoney Creek for the night. Claire would talk to Wally’s doctor and keep up the vigil, sleeping, if she could, in the ICU waiting area.

Dr. Smuland arrived to see Wally at nine-thirty, and stopped, at the request of Wally’s nurse, to see Claire in the waiting room. He looked tired. He had dark circles beneath his eyes, and his bald head was tan and glistening with perspiration. He stood at the corner of the waiting room and surveyed the crowd. “Claire McCall?”

Claire stood and greeted him with a handshake. “Dr. Smuland, I’m Claire McCall, Wallace McCall’s daughter. Thanks for coming by.”

He nodded. “I understand you’re in medicine?”

“I’m a surgery intern at Lafayette University in Massachusetts.” She paused. “How are things with my father?”

“His X ray looks like pneumonia. He is oxygenating better than yesterday. We tried to wean him from the ventilator, but when we took away the paralyzing medication, he had so much twitching and jerking that we had to put him back down again.”

“What do you think is going on?”

“To be honest, I’m not really sure. I’m worried about ischemic encephalopathy.” He seemed to be studying Claire’s face for signs of comprehension.

She understood he was worried about brain damage from lack of oxygen.

Dr. Smuland continued. “It could be delirium tremens, alcohol withdrawal. I’ve seen some pretty remarkable tremors and twitching with that.”

“Just what happened? My mom hasn’t told me much. She seemed so depressed, I didn’t want to drag it from her.”

“Your father evidently choked while eating at home. Your mother did a Heimlich maneuver on him while she was on the phone with a 911 operator. She saved him, really. He started breathing, but was still having a lot of difficulty maintaining a good enough oxygen level, and his lungs sounded horrible, so after his arrival in our ER, he was sedated and placed on the ventilator.”

“Did he get a bronchoscopy?”

“Yes. Dr. Cale did that. He sucked out a lot of particulate matter.”

Claire winced. “Gross.”

“Look, Claire, I don’t want to scare you, but I don’t really know how much of his function will return. We may have saved his heart, but his brain might be severely damaged.”

“Can we get a neurologist to see him?”

“If we had one.” He shrugged. “We’re a small community hospital. A neurologist, Dr. Visvalingam, comes over from Brighton twice a month to run a clinic in Carlisle. If we have an emergency, sometimes we can get him to come for a consultation.”

Claire recognized the neurologist’s unique name. In fact, she’d done a rotation with him as a medical student. He was as eccentric as his name was difficult to pronounce. To the students at Brighton University, he was simply Dr. V. He was caring and brilliant. Oh, how wonderful it would be to have him see her father.

Dr. Smuland didn’t seem inclined to pursue a consult. Claire thought of another diagnostic tactic. “What about an EEG?”

“We have a tech that can run the test, but in order to get it interpreted, we have to send it to the neurologist in Brighton.”

“Do it.”

Dr. Smuland’s eyes widened. Evidently he wasn’t accustomed to such directness.

Claire repeated her opinion. “If my father needs it, do it.”

The attending took a deep breath. “I’m not sure how it would change things, exactly.”

“It could show whether he has extensive brain injury from ischemia. Or if his twitching and jerking may be signs of something else entirely.”

Dr. Smuland sighed. “True, but I’m not convinced we would do anything differently, at least not right away.”

“Can I give you my theory?”

Claire watched as the muscles in Dr. Smuland’s neck tightened. He tugged at the knot of his tie and looked at his watch. “Sure.”

“I think my father may have Huntington’s disease.”

His eyes widened. “Is it in the family? Your mother didn’t tell me this.”

“It’s not exactly in the family. In fact, I don’t know exactly who my father’s real father was. And nobody has diagnosed HD in the man who I suspect was his real father, but the way my father stumbles around, and jerks, and slurs his speech, and the way that the man who I think was his father acted is so characteristic of—”

“Dr. McCall,” the attending interrupted paternalistically, “I think we’d better just work on getting your father over his pneumonia. First things first.”

“My father has jerked and twitched for months. His symptoms are—”

Dr. Smuland put his hand on Claire’s arm. “Claire, I hear your concern. But your father is an alcoholic. You know that.”

Claire nodded quietly.

“He came into our hospital with an alcohol level of twice the legal level for intoxication. Before we worry about rare genetic diseases, don’t you think we should concentrate on the things that seem to be more obvious?”

It didn’t seem like a question that he wanted Claire to answer. “Couldn’t we just send a blood sample for a genetic screen for the Huntington’s gene?” she pursued.

He shook his head. “We can’t send an expensive genetic test on a whim. We need a family history, some strong evidence …” His voice softened, and his eyes locked on Claire’s. “Can I give you some advice, Claire?”

I bet I can’t stop you.
“Sure.”

“You’re Wally’s daughter. That’s why you’re here. That’s your role for now. You’re not his physician. You really shouldn’t get tangled up in treating your own family, not even if they want you to.” He dropped his eyes to the floor. “I should know. I tried to treat my mother, back when I started. It was a disaster.”