Of Flesh and Blood (25 page)

“I understand,” Wilder said. “I have been thinking about your study a l . . . lot lately.”

Jill’s pulse quickened. The senator’s enrollment would be the icing on the cake. “Have you reconsidered?”

He began to speak, but his face darkened and he looked as if he might choke.

“Senator?” Jill raised a hand out to him, but he waved it away.

“I’m okay.” He breathed heavily. “I just want to be clear about the stem cells you are using.”

“What about them?” she said warily.

“If I were to . . . to . . . be enrolled,” he said, raising his head off the bed with obvious effort, “I would have to be sure that no cells from human embryos would be involved in my treatment.”

“This study only uses autologous cells, Senator. In other words, your own cells. If you consent, we will only use scrapings from the lining of your nose to harvest your stem cells. Then we’ll transplant them back into your spinal fluid and brain stem.”

Satisfied, Wilder sank back into his bed. “Okay.”

Jill’s chest welled with exhilaration again. “So you’ll agree to enroll?”

“If it’s all right with you, I would like to do more than just enroll.”

“What do you mean?”

“Since I dropped out of the cam . . . campaign,” Wilder said with a note of sadness, “I have avoided all public appearances. With good reason.” He made another gagging noise.

“Senator?”

“I’m okay.” His head steadied. “Dr. Laidlaw, if you are agreeable, I would like to go public with my support of your research.”

Jill could barely contain her excitement. “I am not asking—”

“I know you’re not.” He smiled. “I want to. Listen, I know how difficult it is to fund research nowadays. I want people to see what I’ve become. What multiple sc . . . sclerosis can do to a person—to a life. Maybe together, we can raise awareness. And if I res . . . respond to the treatment, the added publicity might help your cause. Lord knows it would help mine.” His chuckle turned into another burp, but it didn’t deter him. “I want another shot at public service. There’s so much more to accomplish.” He sighed. “I want my life back, Dr. Laidlaw.”

And what if you don’t respond, Senator?
Jill considered the stakes and immediately saw that the huge upside of having a former presidential front-runner as her study’s spokesman outweighed its risks. “Thank you, Senator. You have no idea—”

Suddenly, Wilder’s face turned dusky and he began to gag uncontrollably. He lurched forward in the bed and his head almost slammed into the blanket covering his legs. He uttered a horrific retching sound.

Just as Jill leapt to her feet and grabbed him by the shoulders, vomit erupted from his mouth.

Erin scanned the inpatient chart in her hands. “Damn that storm,” she muttered to herself as she considered how negatively the weather-delayed transport chopper might have impacted Kristen Hill’s future. The young woman had improved minimally since her surgery. Her transplanted heart was still badly stunned from its protracted time spent on ice. With each passing day, the possibility of it never recovering grew more likely.

Erin thought of Kristen’s twins, Katie and Alex. She had run into them the day before as they were being led away from the Henley Building by a stooped and pale woman, Kristen’s aunt, the only other relative involved in the children’s lives. They had dressed up—Katie wore a blue sundress and Alex had on a matching short-sleeved shirt and bow tie—for their first visit to see their mother after her surgery. Erin had to resist the urge to sweep them both in a big hug, but neither of them seemed to even notice her. The kids shared the same wide-eyed, overwhelmed look that she had seen so often in people of all ages after a first visit to an intensive care unit.

Brushing off the memory, Erin stepped into Kristen’s room to find her patient crying. She hurried over to the bed. “Kristen, are you in pain?”

Kristen shook her head.

“What is it?”

“The kids.” Kristen sobbed through her oxygen mask. “They’re not allowed to come visit me anymore.”

“I know. I’m so sorry.” Earlier in the morning, Erin had received a dire e-mail from her father, copied to the entire surgical staff, warning that a patient in the surgical ICU had contracted
C. diff
infection. Everyone in the unit was now at risk. As a consequence, the whole unit had been placed on the most stringent infection-control measures to prevent further spread.
Only essential staff members would be permitted inside, meaning no visitors, not even family, would be allowed.

Erin reached for Kristen’s free hand and squeezed it in hers. “I know it sucks, Kristen, but the hospital has to take these precautions. You understand?”

Kristen shrugged.

“They’re meant to protect you. Katie and Alex, too.”

Kristen’s tears stopped flowing, but she clung tightly to Erin’s hand. “Dr. McGrath, if I were to pick up this infection—”

“That’s what these measures are supposed to prevent.”

“Yeah, but with my recent luck . . .” Kristen laughed bitterly. “I’m so weak. And I know my new heart is not working as well as it should.”

Erin knew Kristen was right. Her frail body could not cope with the added insult of a major infection.

Kristen swallowed. Her voice cracked again, but her eyes remained dry. “I’m not going to see Katie or Alex again. Am I?”

A lump formed in Erin’s throat. “You can’t think—”

“I am only trying to be realistic.”

“Kristen, maybe you haven’t bounced back as quickly as we’d like. But you’re not worse. That’s the important thing.”

Kristen’s lips formed a brave smile. “Dr. McGrath, I know I don’t have any right to ask you . . .” Her words petered out.

“Go ahead, Kristen. Ask.”

“You have twins. You know what it’s like.” She paused and her voice lowered. “If something happens to me . . . if I don’t make it, will you keep an eye on Katie and Alex for me?” Her face creased with concern. “Not all the time or anything like that. Just, you know, from time to time. To make sure they’re doing okay?”

Erin squeezed Kristen’s hand even tighter. “What Katie and Alex need is for you to come home.”

“I know, but if . . .”

Erin closed her eyes and nodded. “Of course, Kristen,” she said. “
If
. . . I would make sure that they’re doing okay. I promise you.”

“Thank you,” Kristen said with obvious relief.

After Erin finished her rounds, she headed toward her office in the newly erected cardiac sciences building. Her brain was knotted with unpleasant
thoughts and worries. The promise she had made to Kristen weighed heavily on her. She knew she had already become too enmeshed in her patient’s life.

As she neared the office building, the imaginary fingers encircled her neck again. The sense of suffocation was as acute as in earlier episodes. Dread seized her again. Her hands went numb from the wrists down. Gasping for air, she staggered over and collapsed onto an empty wooden bench in front of the building. She clasped her head in her wooden hands and rocked back and forth, desperate for the attack to abate.

She felt someone touch her arm. “Dr. McGrath? Erin?” a voice asked.

Erin pulled her hands from her face to see a nurse in navy scrubs kneeling in front of her and checking her pulse. There was something familiar about the woman’s kind face, and especially the scar running underneath her eye, but Erin was too distressed to place it.

“I’m Nikki Salazar,” the nurse said, pulling her fingers from Erin’s wrist. “I work with your brother, Tyler. We met once in the cafeteria.”

“Oh, of course,” Erin sputtered.

“Erin, what’s the matter?”

She shrugged.

“Can I get you anything? Maybe a glass of water—”

“No. No.” Erin fought to slow her breathing. “Just a migraine. Like a terrible ice-cream headache. Thankfully, they never last too long.”

Nikki eyed her doubtfully. “Your color is a little off.”

“I get light-headed from the pain sometimes. I’m okay now.”

Nikki straightened up but continued to view her with concern. “I saw Tyler on the ward earlier. I could page him for you—”

“No! Nikki, please. I’m better now.” The words tumbled out more frantically than Erin intended. She forced herself to her feet to prove her soundness. The world spun around her, but she managed to hold her footing. “Honestly, I’m feeling better. Thank you.”

“Good,” Nikki said, though her tone was still dubious. “I’m on break for another half hour. You want some company where you’re going?”

Feeling calmer, Erin forced a smile. “Thanks, Nikki, but I’m good to go now. I do appreciate your concern.”

“Okay. I better get back to minding my own business now.” Nikki turned and, with a quick wave over her head, was gone.

As soon as the ground stilled under her feet, Erin trudged toward the
building and up to her office. By the time she reached her door, a slight residual dizziness was all that remained of the most recent panic attack.

Erin wasn’t scheduled to see patients and was looking forward to the solitude. But no sooner had she slipped her key in the deadbolt than she heard her father’s somber voice coming from behind her.

“Erin, do you have a moment?” William asked.

“Hi, Dad.” She hesitated. “Sure. Come on in.”

Erin watched as William strode toward her. Were it anyone else, she wouldn’t have noticed anything unusual in his approach, but her father’s normal military rigidness was off-kilter. He listed slightly to his right, as though favoring his hip or back. And he looked even paler than the last time she saw him. “Dad, you okay?”

“Slight flare-up of my sciatica. Nothing really.” The corners of his lips hinted at a smile. “I think I’ll have to cut back on my triathlon training.”

“I didn’t know you had sciatica,” Erin persisted.

“For years,” he said as he followed her inside. “Besides, I came by to discuss your injury, not mine.”

“Injury?” It took Erin a moment to make the connection. “Oh, the carpal tunnel,” she said, looking away.

The evening before, Erin had informed her department head, Dr. José Chavez, that she intended to take a leave of absence for health reasons. She told him she had a flare-up of carpal tunnel syndrome, a common nerve compression in the wrists that caused needles-and-pins discomfort and weakness of the fingers. She claimed the numbness was interfering with her ability to safely perform certain precision surgeries in the OR. Chavez—a good surgeon, whose people skills were at times wanting—was not particularly sympathetic but, for medicolegal reasons alone, had no choice but to grant her a leave.

Erin wasn’t surprised the news had already reached William’s ears. It seemed nothing went on at the Alfredson without her father knowing. “How long have you suffered from carpal tunnel?” he asked.

“Ever since I was pregnant.” Erin turned away as she spoke the half-truth. While she had suffered from carpal tunnel syndrome in the later stages of her pregnancy, she had not experienced a single symptom since she shed the extra thirty pounds soon after the boys’ births. She felt sheepish about lying to her department head, and even worse for misleading her father. But the
alternative—admitting that she had become too terrified to step back into the OR for fear of being immobilized by another panic attack—was unthinkable.

“How long will you be sidelined?” William asked.

“Not sure,” she evaded. “I’ll give it a week or two and then see how they’re feeling.”

“Are you planning to have it fixed? Joe Gallant is a terrific plastic surgeon. He performs the surgery through an endoscope. The recovery time is minimal—”

“Dad, I just want to rest my hands for a little while and see if that helps before I stick them under the knife.” She frowned. “If that’s okay with you.”

“I see.” William’s hand drifted behind his back, and he began to rub. “Erin, you’re acknowledged as the best transplant surgeon we have here.”

“That’s not true. Mitch Halverson and Abdul Qatar are just as good or better—”

“I am not telling you because you’re my daughter—in fact, I never told you before precisely because of that. Erin, it’s the truth. And the heart program needs you operating again. As does the Alfredson.”

She shrugged off her father’s rare compliment. “I need a few weeks. That’s all. Meantime, we have enough surgeons here to cope with my load.”

William eyed her without comment.

“Dad, why does it matter to you or the hospital if I take a short leave?”

It was his turn to be evasive. “There’s a lot going on right now.”

“Thanks, Dad. Now everything makes sense.” For a moment, she felt like a petulant teenager again.

William viewed her for a long moment. Then, without another word, he limped over and lowered himself gingerly into the chair across from her desk. Erin walked around and dropped in the chair across from him.

“I haven’t told anyone else, but I suppose you will all find out soon enough anyway,” William said in a defeated tone. “The hospital—at least as we know it—is in trouble.”

He might as well have told her that the oil or beer industry was on the brink of collapse. “The Alfredson in trouble? Come on.”

“The Alfredson family is meeting at the end of the month to decide the hospital’s future.”

Erin shook her head. “Why would its future be any different from its last hundred years?”

“Some members of the family want to sell the hospital.”

“
Sell
the Alfredson?” She rose from her seat without even realizing it. “To whom?”

“An HMO or some other private health-care corporation. I suspect those behind the motion already have a buyer in mind, but I have no idea whom.”

“If the Alfredson is sold to a company in the private sector . . .,” she said to herself, already calculating the consequence to Kristen Hill and patients like her who would never have the insurance coverage or means to pay for the care they needed.

Reading her thoughts, William sighed. “Exactly, Erin. It would become another private hospital.”

“Can they really do it, Dad? Sell the entire medical complex?”

“Probably. The family still owns the hospital and the land. However, it’s legally complex with the foundation involved.” He exhaled again and, with obvious discomfort, repositioned himself in the chair. In the space of a single breath, he suddenly looked old to Erin. “Regardless, if the family tries to sell the Alfredson it would cause irreversible upheaval.”