Accelerated (23 page)

“We should give Sean some space,” Shineman said.

“I don’t want space. I want to talk to a goddamn doctor!”

“I’ll get one,” Jess said, and looked at Sean with an unguarded openness he hadn’t seen since The Night. She was gone a second later. He wished Shineman had gone instead.

“Don’t jump to conclusions, Sean,” Shineman said. “That’s not useful now.”

His head spun with the horror stories Altherra and Dr. Jon had told him to disregard. “There was a story online about a boy on Ritalin who dropped dead while he was riding his skateboard.”
Dropped dead
. God it was a horrible expression. He fought the tears burning behind his eyes.

“You have no idea what caused that boy’s death.” Shineman was trying to be reasonable. He wanted to strangle her. “Who knows if he had a preexisting condition? There are a million things that could have hurt that child that had nothing to do with the Ritalin he was taking to treat his ADD. You’re a good father, Sean. You did not hurt Toby.”

He wanted to hurt
her
. “Can you just stop talking,” he snapped. Why was she here, anyway? “Where’s the fucking doctor?”

Jess ushered the doctor into the room. He was unshaven and looked like he hadn’t slept in a week.

“This is Dr. Schwartz,” she said.

It looked like it took a lot of effort for Schwartz to extend his hand and shake Sean’s. “Your son had an arrhythmia—an irregular rhythm of his heart,” he said. “Which deprived his brain of oxygen for a short time.”

“His heart stopped beating?” Sean couldn’t believe he was standing here having this conversation, that this whole thing was really happening. “For how long? What does that mean?”

Schwartz rubbed his eyes. “No one knows,” he said. “We have to wait.” He wasn’t in a coma, Schwartz said. He kept calling Toby’s condition a persistent vegetative state.
Vegetative
. Like vegetable. For a moment, it was as if all the molecules that made up Sean’s body, his brain, the universe, had come undone. He wasn’t sure what the purpose of anything was.

Schwartz said Toby’s organs were functioning on their own but that there was no way of knowing how extensive the damage was—especially to his brain—until Toby regained consciousness.
If
he regained consciousness.

Sean took deep breaths to avoid vomiting. “This is my fault,” he said, shaking. He told the doctor about the Metattent Junior. “That’s what this is from, right?”

Dr. Schwartz crossed his arms in front of his chest. He wore a thermal T-shirt under his green scrubs. He pursed his lips in thought. “I don’t know,” he said, finally. “What I do know is methylphenidate is an amphetamine. Amphetamines accelerate the heart rate, and if someone is exercising and it increases to a dangerous level yes, that can cause problems.”

“So … but …” The room was starting to sway. “It’s from the pills, right?”

“Look,” he said, running his hand through his hair. “Not that this has much to do with your son’s case, but I took Ritalin all through med school as a study drug. Everyone I know did. This kind of reaction is extremely rare.”

Sean assumed this piece of information was supposed to make him feel better. He wanted to take the guy by the shoulders and shake him as hard as he could. “So why is this happening? Why is my son unconscious?”

“I wish I could tell you more. All I can say is that in healthy children with no preexisting condition, this kind of thing is very rare. Very.” He paused. “Does he have any kind of heart condition that you know of?”

“No, of course not.” Toby’s heart was fine. At least he thought it was. He did a quick mental inventory of his dead relatives, cataloguing how they died. His father’s father died of a heart attack. Did that count? Maybe there was something buried in his genes that Sean should have known about, told someone about.

“He’s going to be okay, right?” Sean asked, focusing all his mental powers on the doctor’s brain and willing him to say yes.
Yes
. It was such a simple word.

“You have to understand,” the doctor said, “in any given population of children, there are always a few instances of sudden death whether they’re taking medication or not.” The word
death
hung in the air. This guy was brutal. Had he ever heard of bedside manner?

Dr. Schwartz tried to gloss over the ominous report he’d just given. “The good news is he’s still alive and he’s breathing on his own. Let’s hope he wakes up in the next forty-eight hours.” The doctor paused. “Because if he doesn’t, the chances that he will, get slimmer and slimmer. Mr. Benning, you should be prepared. This kind of thing can go either way.”

The doctor might as well have told him to prepare himself for the end of the world. Sean collapsed into the chair next to Toby’s bed and listened to the monitor’s hypnotic beeps. He wasn’t at all prepared, much less remotely willing to entertain the idea that Toby might … He couldn’t even think the word. He couldn’t bear it.

He had to call Ellie. And Nicole. Dick and Maureen. He had to get everyone on board so that Toby would not be alone for a second. He had a surge of energy when he realized there was something he could do. It wasn’t much, but it changed everything. He took out his cell phone but he couldn’t get reception.

“Fuck, fuck, fuck!”

“Go,” Jess said. “I’ll stay.”

Gratitude surged through him. “I’ll be right back,” he said to Toby. “I’m going to call Mommy.”

He left Ellie a message telling her to get into the city and come to Mount Sinai as soon as humanly possible. He told her that Toby was unconscious, but he didn’t tell her why. Why should he? At least not on her voice mail, not like this. That conversation could wait. Besides, the doctor didn’t say for sure it was the pills.

Sean also left a message for Ellie’s parents. Their machine said they were on a Queen Elizabeth cruise. Since they didn’t believe in cell phones, they wouldn’t get the message until they came home. Nicole was on her way.

When he got back to the ER, Shineman was gone, thank God. Jess watched Toby silently. She looked like she might cry.

“Thank you,” he said.

“Can I talk to you?”

A nod was all he could manage.

“I don’t know how to …” And then she was crying. “I noticed something earlier today at school. I don’t know how to describe it exactly, but Toby was acting, well, kind of
off
. I started to email you, but …” She took a deep breath, trying to stop crying, but the tears came in another wave. “I wanted to give it ’til the end of the day, to make sure Toby wasn’t just … coming down with a cold or something.”

His lungs quivered. “Off how?”

“There were no jokes, no smiles, no goofing around.”

Another surge of anger, no, hatred as he remembered Shineman’s constant nagging about Toby’s behavior. “That’s what the school wanted,” he said bitterly.

“He just didn’t seem like himself, is the only way to say it. He didn’t eat lunch again today. And I’m not sure about this, but … I think his left hand was twitching a little during reading.”

Sean closed his eyes, trying to imagine what it must have been like for Toby at school, before it happened.

“I didn’t want to jump the gun.”

“So you just let him suffer?” Jumping the gun could have prevented this. An easy phone call. An email. Toby’s life had been in her hands. He could never have imagined Jess would be the target of the kind of anger building in him.

“I made the wrong choice,” she said. “I’m so sorry.”

“Sorry? You’re sorry?” Screaming at her wasn’t going to change anything, but he couldn’t help it. “Look at him.”

He stared at Toby, rehashing every moment, every wrong decision along the way, wishing he could go back and do it all again. He was mad at Jess—furious—but not as mad as he was at himself.

She touched his arm, an offer of solace. But he didn’t want solace. He wanted Toby back.

“Get out,” he said, shaking.

“I’m so sorry.” She looked stricken, miserable.

“Could you just get the
fuck
out?!”

S
EAN
’
S EYES BURNED
. H
E RUBBED THE
B
RILLO SPROUTING FROM
his cheeks. Somewhere around three a.m. they’d moved Toby into the Pediatric Intensive Care Unit, or
pick-you
as everyone kept calling it, like Toby had been specially selected, chosen as the sickest of the sick kids. The PICU, which circled back on itself in an endless loop, existed outside the parameters of the real world where time, space, life, and death were clear-cut concepts. Here, even the basics seemed surreal. The sound was muted, the light unnatural. Nurses padded around the hallways to incessant beeps. They seemed unaware of day and night as they tended to patients who, though not dead, were not fully alive either. Definitions were blurred. Sean’s head hurt.

He kept checking his cell phone, but it had died at some point. He sat and watched Toby, waiting for something to happen while the math circled through his brain: Toby hadn’t moved in twenty-six hours. He had another twenty-two hours left—just under a day—to pull himself out of it.

The throbbing lodged in the fleshy base of his skull. Had Ellie called him back on his dead cell? Why the hell wasn’t she here? He’d tried one more time, but again the call went straight into voice mail. Maybe she’d lost her phone, or it had been stolen and she hadn’t gotten his messages. That thought was better than the alternative—that she simply didn’t give a shit.

Seeing Nicole and Kat in the doorway caused something inside him to crumble. “God I’m glad you’re here.”

When Kat saw Toby, she buried her head in her mother’s fleshy stomach.

“We talked about this,” she told Kat. “It’s okay.”

Kat nodded, looking at the floor. This would probably traumatize poor Kat, but right now he didn’t care. He needed family. He needed not to be alone.

“How you holding up?” Nicole asked.

He shrugged to show he wasn’t holding up at all.

“Sean,” a voice whispered from the doorway. Dr. Altherra had slipped into the room. He vaguely remembered leaving her a message in the middle of the night.

“I’m so sorry,” she said. “I thought I’d come by to see how he was doing. I hope you don’t mind.”

She’d been the one to diagnose Toby, turning all the school’s bullshit into reality. She was to blame, at least as much as he was, and she was going to have to answer some basic questions. “We need to talk.”

He led her around the loop of the hallway and into the lounge, a hodgepodge of chairs and couches upholstered in purple and turquoise, while Nicole kept watch over Toby. Now, face to face with the doctor, his rage had drained away and he was left with a profound sadness. What was it about shrinks? One look at them and all you wanted to do was cry.

“I’m terribly upset by this,” she said. “But there’s a very good chance this is all completely unrelated to the medication. I’ve given his doctor the pertinent information.”

“Come on, just admit you were wrong,” he said. He wanted to sound more angry, but desperation was winning out. “He never needed those drugs.”

“Sean, I understand your desire to reinterpret the facts.” She paused to show she was human. “I do.” She leaned forward in her chair. “But here’s how I saw it and still do see it. Toby was acting out because his lack of attention in class was causing him to fall behind. Three separate teachers filled out Conners scale questionnaires that without a doubt pointed to ADHD behavior. The medication focused him in class. His teachers saw results—that was clear from the questionnaires they completed. He was doing better. As for my part diagnosing the disorder, it was open and shut. I prescribe Ritalin and Metattent Junior frequently for ADHD and negative reactions are extremely rare. Extremely. Toby’s collapsing in gym class is very disturbing, and I’m honestly not sure what to make of it.”

The teacher questionnaires had factored heavily into the diagnosis and he realized he had no idea what they said. “I need to see the Conner things.”

“They’re in my office. I—”

“I need to see them.”

“I’ll send them to you this afternoon,” she said. “You’ll see that Toby—”

“Toby didn’t need those drugs.”

She set her mouth and stared at him impenetrably.

He didn’t know what to believe, and it didn’t matter anyway. Toby needed him and he was wasting his time with Dr. Altherra. “I need to get back.” There was nothing else to say. He pushed his chair away and headed into the hallway, which was unnaturally quiet for housing sixteen children. He tried not to look at the sick kids on his walk to Toby’s room, but the walls were made of glass so the nurses could see their delicate charges at every moment, from every possible location on the floor. These kids were not only sick, they were hanging on by a thread. He wondered how many of them would leave the floor alive. He wondered whether Toby would be one of them.

When he reached Toby’s room, Kat was sitting on the bed reading him a
Magic Treehouse
book about ninjas. She was good at reading. Better than Toby, despite her supposedly sub-par public school education. He realized now it made absolutely no difference. Reading was nothing. It didn’t mean anything. Nicole looked up from marking a brief.

“Any change?” he asked, even though it was pretty clear there’d been no change.

Nicole shook her head wearily. She’d been at the hospital with him until late last night and then at work all day. He hadn’t seen her this wrecked since their dad had died.

“You should go,” he said. “Take Kat home. This is no place for a healthy kid.”

Kat put the book next to Toby’s bed. “I’ll finish the story tomorrow,” she said to Toby. She paused, then gave him a kiss on the cheek. “Love you.”

“I’ll bring her to the neighbor’s and come back.” Nicole reached out and wrapped her arms around him. Nicole wasn’t a hugger, but she held on to him for a long time. Tears started to leak out of his eyes. There was no way to stop them so he didn’t even try.

When she let go, he saw she’d been crying, too. He picked up a Kleenex box and they both wiped their eyes.