Fireflies (12 page)

But in David’s case, a cluster of nerves, a “bundle branch,” on the right side of his heart had deteriorated. Energy impulses, which usually flowed in an orderly fashion, had been interrupted and forced to redirect themselves along another branch of nerves, taking longer to reach the right side of his heart. On a printout from an EKG machine, this redirection of energy produced an extra blip within an otherwise normal heart wave pattern.

The blip was not alarming, as long as you knew what it meant, and David’s condition wasn’t considered lethal. For twenty years, he’d run an average of four miles every day, and even though he was foolishly a smoker, he could finish that run and never be out of breath. So whatever was wrong with him, he was sure that the bundle branch block hadn’t caused it.

But something
was
wrong. Without a doubt. Pausing often to gasp for air, he described his symptoms.

Tingling.

Shivering.

Sweating.

Rapid heartbeat.

Rapid breathing.

Pressure on his chest.

Humming behind his ears.

Swelling in his head.

And swirling.

Terrible swirling.

David thought, If
you
had these symptoms, what would
you
guess was going wrong? A heart attack? You bet that’s what you’d guess. No, never mind guess. We’re talking fear.

“Okay, the extra blips match what you’re telling me,” the resident said. “A right bundle branch block.”

“Then what”—David’s chest heaved, both his lungs and heart—“is wrong with … ?”

“We’ll do more tests. Hang on. We’re trying, Mr. Morrell. We’ll do everything we can to find out.”

The nurse inspected David’s right arm. “His central vein’s good and thick.” She stuck an intravenous needle into the vein and extracted blood.

David felt too disoriented to feel the prick of the needle.

“Get lab tests as soon as possible,” the resident said.

The nurse rushed away.

And just then Sarie walked in.

Beautiful wonderful Sarie.

As when David had seen—too weak a word—
witnessed
Donna in the Bone Marrow Ward (after three hours of having been away or else half a lifetime), David’s soul swelled with love. Again, as when he’d seen Donna upstairs, he had the eerie sense of a triple image: of Sarie as a smooth-faced infant, of the glowing twenty-one-year-old she now was, of the haggard woman who wept beside his deathbed.

I’m going crazy, David thought. That’s what’s wrong. I’m not sick. I’m nuts.

And yet …

And yet …

Why am I so sure of
when
and
how
Matt’ll die?

Sarie’s blue-eyed, blond glow of young adulthood was dimmed with shock. “I just got out of class. I went up to visit Matt. Mom told me …”

“Yeah.” Despite his rushing heart, David did his best to grin. “Mom told you … I’ve got a few problems.”

Sarie clutched his hand. “She said you wanted her to stay with Matt, so I came down to see …”

“I’m glad you did.” The pressure in his head swelled, making him grimace. “It’s good to have you with me.”

Someone brushed past the curtain, entering the room. A woman. Not a nurse. She didn’t wear a gown but slacks and a blazer. “… neurologist,” she finished explaining. “I understand you collapsed an hour ago.”

An hour ago?
David would have sworn he’d been in the Emergency Ward for less than ten minutes.

“What are your symptoms?” the neurologist asked.

For a second time, David described them. Tingling … rapid … pressure … swelling … dizzy … humming …

The resident enumerated David’s vital statistics.

The neurologist frowned. “They’re not consistent with a heart attack.

David turned to Sarie. “Matt?”

“He can hardly move. His girlfriend called. He didn’t have the strength to talk to her.”

It’s starting, David thought. The infection’s building. I’m seven floors below him. I can barely move, but I’m the only one who can save him.

“Grip my hands,” the neurologist said.

“What?”

“Grip my hands.”

David obeyed.

“Squeeze them as hard as you can.”

David squeezed until her fingertips turned white.

“Good.” The neurologist took off his shoes and socks, then pressed the blunt end of a pen down the balls of his feet.

His toes curled inward.

“Good.” She tapped a rubber hammer against his elbows, knees, and ankles. His reflexes jerked.

“Good.”

“Stop the damned room from spinning.”

The resident checked David’s pulse. “What the—? It’s up to a hundred and ten.”

The neurologist straightened. “Blood pressure.”

“Up. A hundred and fifty over ninety-five.”

“Sarie, go back upstairs,” David blurted. “Go back to Donna. Tell her, whatever happens to me, tell her—”

“Mr. Morrell, has anything happened to you in the last few days? To change your medical—”

“I fainted this morning.”

“
Fainted?
”

“I went out running. I came back, started to drink a glass of water, and …”

“You ran in this heat and
fainted?
” the resident said. “You’re probably dehydrated.”

“No! I drank plenty of water after I woke up!”

“Electrolytes,” the neurologist said. “They must be off-balance.”

“No!” David said.

He understood about electrolytes. They were elements in a person’s blood that allowed the body’s “electricity” to flow efficiently through vital organs. But if these elements weren’t present, the “electricity” couldn’t flow, and the vital organs went into shock. The principal electrolytes were potassium and sodium.

“No!” David repeated. “I swallowed a potassium pill. I put salt on my palm and licked it.”

“Have you had
medical
training?”

“Sarie, get back to Donna and Matt!”

“His pulse is up again,” the resident said. “A hundred and fifty.”

“Pressure,” the neurologist said.

“A hundred and sixty over—”

David felt such swelling in his chest and head, such heaving in his lungs that—

“I’m going to die,” he said.

“Code blue?” the resident asked.

Despite his delirium, David recognized the hospital’s signal for summoning maximum help in case of imminent death.

“Code blue? Should I call it in?” the resident repeated.

The neurologist opened her mouth, her lips forming “yes.”

“Wait, his pulse is coming down,” the resident said. “A hundred and forty.”

The neurologist rubbed her forehead. “Pressure?”

“Down. A hundred and fifty. Code blue?”

“Not yet.”

“His pulse is down again,” the resident said. “A hundred and thirty.”

“Pressure?”

“Down. A hundred and forty.”

The room became silent. In David’s swirling mind, the walls seemed to narrow.

“His pulse is down to a hundred,” the resident said. “His pressure’s a hundred and thirty.”

David’s delirium began to clear. He stared at the cabinet to his right and managed to steady his vision.

“Pulse?”

“Ninety.”

“The same as when he came in here. Pressure?”

“A hundred and twenty. Almost what he says is normal for him.” The resident shook his head. “This thing’s like a roller coaster, suddenly up, then down.”

The neurologist rubbed the back of her neck. “I don’t know. Labyrinthitis maybe.” She referred to an infection of the inner ear that affected a person’s ability to balance, making the patient dizzy.

“No,” the neurologist corrected herself, “that wouldn’t explain the pressure on his chest. Mr. Morrell, apart from your fainting spell after running this morning, has anything else happened to change your medical condition?”

“The last six months have been the same.”

“I don’t understand.” She responded to a sudden thought. “When did you eat last?”

“This morning. Or maybe last night. I don’t remember.”

“You don’t
remember?
”

“There isn’t always time. It’s been mostly hospital food, and …”

“Hospital food?”

“
Dad
”—Sarie clutched David’s arm—“
tell
them.”

“Tell us what?”

“About
Matthew
,” Sarie said.

“Who’s … ?”

“My son.” Despite his dizziness, David told them everything.

In hesitating gasps.

All of it.

A breathless babble.

The turmoil of the last six months.

Every fear-filled instant.

“Mr. Morrell,” the neurologist said, “you’ve just had a panic attack.

“Of course, I feel panicked! Didn’t you listen! My son has cancer! Six months of chemotherapy! I watched him lose his hair! I held him while he vomited!”

“Take it easy,” the resident said.

“I watched him get weaker, watched him stagger, watched him get thinner! They tried every goddamned chemical they thought would work! He lost four ribs … a third of his lung! He had a bone marrow transplant! Three weeks ago, I didn’t even know what a bone marrow transplant was! They … !”

“Try to relax,” the neurologist said.

“If I don’t do something, Matt’s going to die!”

The nurse who’d rushed off with samples of David’s blood pulled open the curtain, entering the room. “His tests came back.”

The neurologist reached for the computer printout and scanned it. The resident peered over her shoulder.

“Look at those numbers,” the resident said, amazed.

“You found it?” David asked. “You know what’s wrong with—”

“These numbers indicate you’ve got—”

The neurologist interrupted. “The healthiest blood I’ve seen tested this year. Cholesterol—one hundred and seventy-nine. Well below the danger level. Creatinine—point nine.”

David had never heard of creatinine. He was sure the term was unfamiliar to him. And yet …

He recalled his seizure on the kitchen floor this morning. A shudder aggravated his tingling.

Creatinine, he understood suddenly, was an element in blood that indicated how well a patient’s kidneys were functioning. The lower the number, the more efficiently the kidneys were filtering poisons from the body.

How do I know this?
David thought.

His 0.9 was excellent, David realized, as if he’d been taught it many years before. An average person had a creatinine level between 0.1 and 1.1. Over 1.1 meant the kidneys weren’t working as hard as they should. Over 3.0 meant the kidneys were failing. Over 4.0 meant the kidneys weren’t working at all. Unless emergency procedures were taken, the body’s toxins would accumulate to a fatal level.

In David’s nightmare on his kitchen floor—or in his memory, floating over his deathbed—when Matthew had contracted septic shock, one of the major consequences had been kidney damage. The kidneys had shut down totally (though temporarily, David had been told). Matthew’s urine had stopped completely. He’d been put on dialysis to vent excess fluid and filter toxins from his blood. But despite the dialysis, Matthew’s creatinine had risen to—dear God!—the lethal level of 4.5.

And even
that
hadn’t been what killed him!

Had?

Would?

But none of these disasters had happened! They were only from David’s nightmare! And yet he knew, tomorrow afternoon Matt’s unexpected septic shock would set them in motion!

Have to get up there! Have to save … !

The neurologist kept reading the results of David’s blood tests. “Sodium, potassium, chloride … electrolytes all normal. No sugar problem. Mr. Morrell, I repeat, you’ve had a panic attack.”

She raised her hands. “Yes, I understand you’re worried about your son. You’re afraid for him. But that’s not the kind of fear I’m talking about.”

Sarie spoke quickly, “What do you mean?”

The neurologist continued to stare at David. “For the past six months, you’ve been in a constant state of increasing crisis. Each stage of your son’s treatment has been more prolonged and more extreme.”

“Extreme? Every time the damned phone rings …”

“You jump? Your knees get weak? Of course. You’re afraid you’ll hear more unnerving news about your son’s condition, a worse diagnosis of …”

“His pain, his horrible pain. I don’t know how he bears it. We tell him he’s been through the worst, and then something else goes wrong, and he needs some other kind of treatment, and the worst turns out to be nothing compared to … ! I don’t know how he keeps up his strength! How can he be so brave? He never complains! He … !”

The pressure behind David’s eyes broke. Tears streamed down his face. “Matt’s just a kid! How can he be so strong?”

“You’re proving my point,” the neurologist said. “After six months of constant chaos, your body finally told you it reached its limit. Imagine if you’d almost been in a traffic accident. A truck veers toward you, forcing your car off the road. You manage to stop an instant before you hit a tree. What’s your reaction? Your stomach feels on fire. Your heart races. You can’t catch your breath. In effect, you’ve been having that near-accident for the past six months. I could give you a lot of technical words about neurotransmitters in your arteries and the
nucleus locus ceruleus
in your brain, but basically what it comes down to is, your crisis glands have been working constantly, to the maximum. And you’ve become used to it. You think it’s normal, because for the last six months, it’s all you’ve known. You’re so saturated with adrenaline your body can’t deal with the chemical effects any longer. You’re hyperventilating, and that makes your heart pump faster, and that makes you dizzy. Of course the dizziness makes you more afraid. That in turn makes you hyperventilate more extremely, and that in turn makes your heart pound faster and … you’re trapped in a terrifying, worsening, self-perpetuating circle. The more your crisis glands pump, the more they
will
pump because they’re reinforced by fear. A panic attack. And if the cycle isn’t stopped, the ultimate consequence is total physical collapse and possible catatonia.”