Wake for Me (Life or Death Series) (4 page)

“Well, it could be a number of things. But in this case, I think he might be suffering from…” he glanced in Sam’s direction, already needing a Hail Mary. Not a good sign. “Obstructive jaundice, due to….”

Oh, no. Why did it have to be jaundice? As casually as possible, Sam moved his hand into his pocket and made a fist. It was the only signal he knew for a fact Brady couldn’t miss.

“Gall stones,” Brady finished proudly.

“That is very true, Dr. Brady. He might be suffering from obstructive jaundice. If he were, it might be due to gall stones. But internal medicine requires slightly more precision than blind guesswork.”

“Sorry, Dr. Chakrabarti,” Brady said. “What I meant was, he’s most likely suffering from gall stones, which an ultrasound will most likely support.”

“It would,” Chakrabarti agreed. “If the patient had progressed to obstructive jaundice. Fortunately for Mr. Jenkins, and unfortunately for you, he has only progressed to pre-hepatic jaundice. Which, as Dr. Tanner will tell you, is most likely due to....”

“Hemolysis,” Traci Tanner answered, shooting a smug look in Brady’s direction.

Brady’s ego—which had swelled with the assumption that he’d passed Chakrabarti’s first test of the morning—deflated, and Sam could see the wheels in his head turning as he tried to figure out a way to get back at Traci. Most likely, the revenge would come in the form of sleeping with her, and then blowing her off the next day. Or shaving cream in her locker, whichever one turned out to be easier.

After firing off a few more questions about Mr. Jenkins’ general status, diagnosis and prognosis, Dr. Chakrabarti led the way into the next patient’s room.

The moment he stepped into 714 and heard the sound of breathing, Sam felt like a weight had been lifted off his shoulders. She was still alive, for now. As usual, the air smelled like roses and something sweet that he couldn’t quite place. Because it was still early, the light coming through the window was pale grey and cast deep shadows across Viola’s peaceful face.

“Dr. Philips,” Chakrabarti nodded in his direction, folding his hands in front of him expectantly. “Please present.”

Dr. Tanner grabbed Viola’s chart and held it out to him, and Sam thanked her. But he didn’t open it. He didn’t have to. Instead, he rattled off the patient vitals from memory.

“Viola Bellerose, nineteen. Came in eight days ago by ambulance, post MVA. Status upon arrival was semi-conscious, with injuries consistent with abdominal trauma—including rib fractures, internal bleeding and splenic lacerations. She was also severely hypothermic, after being pulled from the East River. After the initial assessment in the ER, the patient was taken directly to surgery, where Dr. Takasaki performed reparative surgery on her hepatic and superior mesenteric arteries, among other reparations. During surgery, the patient reacted poorly to anesthetic, causing a systemic anaphylaxis. The surgical team managed to stabilize the patient, but following the surgery, the patient did not regain consciousness. She has been in a comatose state for seven days.”

In spite of himself, Dr. Chakrabarti looked impressed. Throughout the entire presentation, Sam could feel his attending waiting for him to screw up or miss some tiny detail, so Chakrabarti could make an example of him for going off-book. But that wasn’t going to happen, because Sam had already screwed up where Viola was concerned—that first night, when getting all the details right had mattered the most. He was determined never to repeat that mistake again.

“What is causing Miss Bellerose’s coma?”

“The short answer?” Sam could’ve phrased it better, but he was tired of beating around the bush. “We don’t know. It could be any number of things. Blood loss, malignant hypothermia, a traumatic brain injury that didn’t show up on the CT or MRIs….basically, we won’t know unless she takes a turn for better or worse.”

He felt disgusted with himself for saying it, but there it was. The truth. As far as this patient was concerned, he was helpless. They all were.

“And what is your prognosis, Dr. Philips?”

Sam forced himself to answer the question stoically. “If the patient does not regain consciousness within the next twenty days, we’re looking at severe and permanent brain damage.”

“And if she does wake up?”

Not if, Sam wanted to say, but when. Because she had to wake up. She had to.

“Chances are, there will most likely be some loss of brain function, temporary or permanent paralysis, sterility, post-traumatic stress disorder….”

Chakrabarti held up a hand, and Sam found himself staring at the dark brown lines that ran through the man’s palm as if they could predict the future. It was easier than meeting his attending physician’s eyes, since they were most likely filled with either pity or disdain. At the moment, Sam didn’t think he had the patience to put up with either.

“Obviously, you’ve put a lot of thought into this case, Dr. Philips,” he said. “There’s nothing wrong with that. But for now, we must focus on the symptoms as they happen. We cannot make decisions based on what we think will happen. We must make decisions based on what has happened, and what is happening.” Chakrabarti broadened his focus to include the entire room in what was shaping up to be a rare Hallmark moment. “That is how we will care for our patients. One day at a time. So, Dr. Philips. How will we care for this patient today?”

Essentially, they would do nothing. Sam could feel the muscles in his jaw working overtime. “We’ll monitor the patient’s respiration and circulation. Nursing staff will move the patient every few hours to avoid typical problems such as decubitus ulcers, pneumonia and deep vein thrombosis. We’ll continue to provide oxygen, IV fluids and parenteral nutrition, until the patient’s status changes.”

“Excellent.” Finally, Dr. Chakrabarti seemed satisfied. “Dr. Miller, what is the difference between a coma and a locked-in state?”

As Dr. Miller rattled off the answer, which basically came down to eye movement and blinking—such a simple difference between being held captive inside your own body, totally aware, and being peacefully if not pleasantly unconscious—Sam let his eyes wander to Viola’s comatose form. She seemed to take up so much less space than she had when she was awake. And it wasn’t just because she was lying in a hospital bed, covered in blankets, instead of being perched on a bar stool while wearing five inch heels. It was also because with each passing day, the personality, the unapologetic confidence that had stopped him in his tracks, was slowly ebbing away. The person she’d been was diminishing, right before his eyes.

Before long, she’d be nothing more than an empty shell. A cautionary tale for teenagers afraid of living life to its fullest. Just like Ben.

Eight years ago next month, his older brother had still seemed unstoppable. So full of possibilities, too many to count. Then he was gone.

“Move it along, Sammy.”

Brady jostled him lightly with an elbow to the ribs, prodding him to walk out of Viola’s room first so they could get a prime spot at the back of the room for the next case. That way, Chakrabarti would hopefully forget Brady was there and forget to call on him. Sam was so used to the way his best friend’s mind worked by now, he could practically draw a diagram. The thought of a two-line structure branching from food to sex, with nothing in the middle, made him forget about his problems for a few seconds, and he smiled.

“Why give up now? Every question you get wrong is one you’ll remember forever. Plus, you’re the one who’s always telling me, if you’re going to tank, tank hard.”

“Fuck you, Doogie Howser,” Brady whispered good-naturedly. “Not all of us can be premature medical geniuses.”

Sam laughed quietly. If it wasn’t for concurrent enrollment, he’d still be in his first year of med school. But why not let everyone think he was some kind of baby Einstein? It kept them from asking why he’d given up any semblance of a functional social life for six years running.

As he led the way into room 712—Mrs. Goldblum, a 72-year-old woman who’d been in a persistent vegetative state for going on three months now—Sam tried to put his demons firmly behind him. But it was harder than it should’ve been, because spending his days with Sleeping Beauty and her fellow unconscious inpatients had a way of bringing out everything he was afraid of. They couldn’t outrun their nightmares. What was his excuse?

“Dude, I think Mrs. Goldblum’s family is going to pull the plug on her today,” Brady whispered, as the rest of their peers shuffled solemnly into the room. They must’ve heard the news about the patient’s imminent passing, too. “I guess that means we’ll have one less link in the Matrix.”

That was what Brady called the coma ward. The Matrix. It was probably in bad taste, but Sam kind of liked to think it was possible that all these unconscious people were living full, meaningful lives in some alternate reality. Hell, if he could make himself believe it, maybe it’d even help him sleep better at night.

But probably not.

Because the thing was, until that moment Sam hadn’t really even let himself think about the worst-case scenario. The scenario where unlike him, Viola’s family decided to give up on her and pull the plug. Legally speaking, that day could come at any time.

And if they did decide to pull the plug, there wasn’t a damn thing Sam could do about it.

CHAPTER FIVE

“I cannot think of any need in childhood as strong as the need for a father’s protection.” –Sigmund Freud

“Viola, where are you?”

I’m under my father’s big, wooden desk, hiding with my arms wrapped around my knees. My legs are little, and I’m wearing a fluffy, pink dress. I can’t remember what I’m hiding from, but a moment ago I felt scared. Until I heard my father’s voice.

“I’m here, Papa!” I crawl out from under the desk, and find myself in the middle of my grandfather’s old vineyard in Bellemonte. The skies are pink, and the air smells like roses and sweet grape leaves. Somewhere off in the distance, soft jazz music plays. When I see my father standing at the edge of a row of vines, so tall and proud in his favorite gray suit, I smile.

“There you are,” he says. “Come here,
mon chaton
.”

I run to him, feeling the grass tickle at my feet. I think I had shoes on before, but now they’re gone. I don’t mind. The grass is soft and still warm from the blush-colored sun.

He kneels at my side, taking my little hand and running it over the dark green grape leaves. They’re almost as big as my hand, and they shine like they’re made of wax. Or plastic. I reach in to pluck one and my hand connects with a thorn.

“Ouch!”

“
Fais attention
,
mon chaton
,” he says, pulling my hand back to inspect it. He lays a kiss on my open palm as purple blood flows in rivulets down my skinny little arm. “You’ve forgotten about the roses.”

“What roses?” I ask, indignant. I don’t see any roses. But something deep down tells me I know better. Our best Cabernet is called
Piqùre l’Epine
for a reason. It means ‘sting of the thorn.’

But Papa doesn’t act as if my question is silly. Instead, he smiles like I’ve just stumbled upon a great treasure. A secret treasure, one that only the two of us can know about.

“Roses are the family secret,” he says. “They are part of the reason our wine has a taste that no one else can duplicate. But we must cut off the flowers. Do you know why?”

“Why?” I ask, because I love the way his voice sounds when he talks about his one true passion.
I’d give anything to have something I cared about that much.

“Because,” he says, his expression serious. “The blooms steal the sweetness from the grapes. They’re very selfish, roses. They need so much light, so much energy, to sustain their beauty. That’s the problem with pretty things, isn’t it,
mon chaton
?”

He reaches out to caress my face, but his hand is covered in thorns, and it tears my skin instead. More of my blood drips onto my pretty dress, staining it the color of red wine.

I don’t let it bother me, though. I roll my eyes, suddenly tired of his tale. It’s nauseatingly trite, and the moral is far too obvious.

“I understand, Papa. Too much beauty, and you get sour grapes.”

He laughs, and his face is suddenly Aiden’s face. Rugged and tan, with dark lines around his eyes. His mouth is twisted into a sneer.

“God, can’t you ever just enjoy the moment?”

At the sound of his voice, the vines wither and turn to dust. There’s a howling sound from the far end of the row, and a huge wolf stalks into view. When his big yellow eyes fall on me, he licks his lips. I look down at my dress and realize that he probably thinks I’m covered in blood, instead of wine.
But no, that isn’t right, is it?

I stagger to my feet, but Aiden grabs me by my ankles.

“Stay with me.”

“I can’t, he’s going to eat me!” I break free and run toward the house as fast as I can. Everywhere my feet fall, the grass turns brown and dies. But I can’t stop, because he’s going to rip me to shreds.

I push through the front door and race up the stairs, toward my bedroom. When I get inside, I fling the door shut and lock it behind me. Everything falls quiet, except for a faint beeping noise I can’t quite place. The walls are painted pink, with silver and white vines. My mother is lying in my bed, pink blankets pulled all the way up to her chin. She’s almost completely buried in soft feather pillows.

“Mom,” I say, moving toward her. “There’s a monster. It’s after me. May I crawl in there with you?” She doesn’t answer, so I try again. “Mom? Mama? Can you hear me?”

My mother covers her face with a pillow, and suddenly there is no bed. Just a giant pile of beautiful, useless pink roses. I scream in frustration, and the door behind me starts to shake with the force of something trying to get in.

I run to another door in the wall, a door that wasn’t there before. It’s heavy black oak, and somehow I already know where it leads. I yank it open and run into my father’s office, looking around frantically to see if there are any open doors the beast can use to get in. There’s only one, but it’s small, just waist high. It looks like it might be locked.