Suzy's Case: A Novel (2 page)

L
ittle Suzy is lying in a Brooklyn hospital bed fevered and weakened. If her temperature were heating a pot you’d hear the high-pitched tone of a whistling teakettle. That’s why her six-year-old frame is on top of the dingy white sheets and not under them.

If her lungs were a train engine you’d hear
puff, puff … chug, chug
with the internal dialogue of her autonomic nervous system repeating,
I think I can … I think I can
.

Her heart, meanwhile, is in tachycardia, thumping
boom-boom, boom-boom, boom-boom,
nearly twice its normal rate.

Whistle, puff, puff, chug, chug, boom-boom. Whistle, puff, puff, chug, chug, boom-boom.
Not good.

Since the arrival of her mother two hours ago, Suzy’s vitals have picked up their rhythmic tempo. Again, not good. But there’s nothing a mother can do in this situation, even one as dedicated and resourceful as June Williams. She has no choice but to watch and wait, sitting there in the standard-issue bedside chair. Sitting, watching, and waiting go against the grain of her take-charge personality, but, like most of us, June defers to the expertise of the medical professionals.

Suzy pops forward jackknife-style at the hips, expelling a deep “cough-cough” with lung rales inconsistent with her childish appearance. You’d think she’d dragged two packs a day for thirty years by the sound of it. She finishes by clearing her throat with a softer, more age-appropriate “uhum-hum” while patting her chest, so as to say, “It
hurts here.” Her head drops to the pillow, yet she flashes a smile at her mother.

The kind Caribbean nurse at Suzy’s bedside turns to June. “No worries,” she consoles as she softly dabs Suzy’s clammy forehead. The medical term for the beads of sweat collecting on her light brown skin is diaphoresis. “Them doctors mons be making their rounds now. De’ll be here soon. Your Suzy be’s just a little hot. No worries.”

June looks her in the eye and nods with the sincerity of a mother’s appreciation. “Okay. Thank you, nurse.”

The woman performs one last caring dab so as to say, “There now,” then gives Suzy and June a serene, comforting smile as she leaves the room.

June moves from the chair onto the bed and snuggles up to her daughter. Suzy takes her hand. “Don’t worry, Mommy, I’m fine. Like the nurse said, I’m just hot.”

“You’re the best little girl a mother could ask for.” They share a smile, acknowledging how fortunate they are to have each other, then tighten the cuddle.

“You’ll feel more relaxed if I read to you, Mom,” Suzy suggests, pointing to the table. “Reach over and hand me that book.”

The warmth of happiness comes upon June’s face as she feels her daughter’s concern. Suzy shines brightness on overcast days. June often wonders how a child of her tender years could have such maturity and caring presence. In kindergarten the teacher had called Suzy her “little helper” because of the way she looked out for less independent classmates.

“Hold on, Mom, we’re going for a ride!” Suzy warns, smiling. “I’m gonna press this button and the head of the bed is going to come up even higher.” They giggle together as the bed buzzes and vibrates on the rise. “Cool, huh? Right, Mom?”

June looks at her daughter with a blend of adoration and admiration.

“Now put your head on my chest,” Suzy tells her. “And listen to this story. It’s a good one. It’s called
Old Yeller
. That nurse from Jamaica brought it from the library when I told her how much I loved dogs. The librarian gave it to her. Can you believe this place has a library?
With a librarian? It’s on the second floor. And you know, Jamaica’s an island in the Caribbean. Now before I begin, I just want your promise that we can get a dog as soon as I leave here, so say ‘I promise.’ ”

“We’ll discuss it when you’re discharged.”

Suzy’s having none of that. “Say ‘I promise,’ Mom?” she responds, in an insisting tone.

“I promise,” June replies, giving in. She rests her head on Suzy’s chest. It’s burning hot. She hears the wheezing sound of labored breathing, with rapid respirations like the beats of Suzy’s stressed little heart. Everything that’s happening right now scares her. She raises her head to check her daughter’s face. Their eyes meet and Suzy perfectly reads her mother’s look of concern.

“What’s the matter, Mom?”

“It’s your heart. It sounds like it’s beating so fast.”

“That’s because it is. Now listen to the story,” she says, dismissing her mother’s worry. “It’s my new favorite, even though I’m not done yet.” Suzy holds the book out, displaying the cover. “You see that dog, Mom? That’s Old Yeller. That dog chased an angry mother bear away.”

Suzy turns to the first page. Just as she’s about to read, a group of doctors shuffles into the room, six in all, entering by order of medical rank. One is an experienced doctor, while the five others are residents. The group approaches and the attending doctor, in a commanding voice, addresses June. “Good morning. I’m Dr. Gino Valenti. I’m one of the staff hematologists taking care of your daughter. Chief of the department, I might add.”

June has never seen or met this Dr. Valenti before. Dr. Richard Wise has been the hematologist assigned to Suzy’s care since her admission three days ago, though she doesn’t think much of him. June has good instincts for most things and takes an instant liking to Dr. Valenti. He’s tall, in his midsixties, with a full head of silvery hair, a Kirk Douglas chin, and the air of knowing precisely what he’s doing.

“Oh, I’m glad you’re here,” June anxiously replies. “Suzy’s all sweaty and her heart sounds like a drum solo from a halftime band. And she’s breathing really quickly, too, but with difficulty if you listen close.”

“That doesn’t sound good. No one made me aware. Let’s have a look.”

June stands off the bed, without letting go of Suzy’s small hand. This causes
Old Yeller
to slip and fall to the floor, landing at the feet of Dr. Valenti. “One of my favorites,” Valenti says as he bends down, picks up the book, and hands it to one of the residents. “A real classic.”

Suzy is pleased by the comments and smiles at him. “I’m halfway through and Yeller is some special dog. I hope the book has a happy ending.”

Valenti smiles back, says, “Yes, well …,” and takes a step closer as the residents fan themselves out like a poker hand at the foot of the bed. “Good morning. I’m one of your doctors. Like I told your mother, I’m a hematologist. That means—”

Suzy politely breaks in. “I know, Dr. Valenti. A hematologist is a doctor who specializes in disorders of the blood, like my disease. If you’re one of my doctors, then how come I’ve never met you before?”

“Well, you got the hematology definition exactly right, and I feel it’s my loss that we’ve never met before this moment.” Dr. Valenti pauses and studies her. “Now, how are you feeling this morning?”

“Just like my mom told you, hot and sweaty, and if my heart were a dog it would be a greyhound. That’s a racing dog, you know. I love dogs and I’m getting one when I leave here.”

“I love dogs, too. Now—”

“Sorry for cutting you off again, but are you a pediatric hematologist who takes care of kids like me or just a regular one?”

“That’s a very intelligent question, Suzy. I’m a regular one.”

“What happened to Dr. Wise, who saw me the last two days? He’s a pediatric hematologist, you know, but no offense.”

Dr. Valenti shakes his head in appreciation of her moxie. He glances at the residents, lifting a brow, then back to her. “No offense taken. He had to take a personal day today, but he told me all about you, Suzy. Are you okay with me treating you this morning?”

“Sure. We like the same books and you seem like you know what you’re doing.”

The residents share a common chuckle, making their presence felt
for the first time. As Valenti’s smile disappears he directs his attention to one of them. “Dr. Hassan, take a look at that chart and tell me what you see happening here.”

The resident puts his clipboard down and begins to reach for Suzy’s medical record hanging on the end-of-bed patient chart holder.

“Hassan,” Valenti barks, with an annoyed look on his face, “never put your clipboard down on a patient’s bed. It’s invasive, rude, and discourteous.”

Hassan quickly picks it up, then takes Suzy’s chart off the holder and begins flipping through it with all eyes on him. A moment later, he speaks.

“The patient’s temperature has been spiking throughout the night and her pulse rate shows a pattern of continued elevation, Dr. Valenti.”

“Hassan,” Valenti demands with an annoyed look on his face, “hand me that chart. This sweet little girl has a name and it’s Suzy.” Valenti pauses and looks down at Suzy, who grins. “When talking about a patient in her presence, use her name. Don’t depersonalize her by using the term
the patient
. Are we clear, Dr. Hassan?”

“Yes, sir.”

Dr. Valenti flips through the chart with a studious eye, then hands it to the resident still holding
Old Yeller
. “Dr. Gold,” he says to a different one, “when I’m done listening to Suzy’s heart, I’m going to ask you the significance of the chart findings Hassan told us about relative to Suzy’s disease. I’m giving you a head start on this one, so begin formulating your answer. For the rest of you, you’ll be filling in the gaps of Dr. Gold’s response.”

Dr. Valenti takes the stethoscope, which had been draped around his neck old-school-style, and plugs it into his ears. He leans over, softly places it on Suzy’s chest, and moves it about while listening intently. “Now take a few deep breaths for me, Suzy,” he directs. She does. Dr. Valenti stands up and unplugs. All eyes are on him. He’s formulating.

“One second,” he says, then walks to the door and looks out. First left, nothing. Then right. “Nurse!” he calls in a firm voice. “Oh, nurse! Yes, I’m talking to you. Please come over here for a moment.”

From the hall the sound of slowly approaching footsteps is heard, then a nurse can be seen crossing the six-inch gap made between the right side of the doorframe and the well-built body of Dr. Valenti.

“I’m sorry, I don’t know your name,” he says. “You must be new around here. I’m Dr. Gino Valenti, just like the tag says. Nurse, please bring a heart monitor to this room right away and hook Suzy up to it.”

“Yes, doctor sir, mon, right ahway,” the nurse replies in a lilting island accent. Dr. Valenti may not have recognized her, but June and Suzy know who she is.

He struts confidently back to the bedside. “Nothing to worry about,” he says. “I just want to monitor your heart rate more closely, Suzy. Would that be okay with you?”

“I guess,” she answers with hesitation. “Is a heart monitor the clip thing you put on my finger?”

“No, Suzy, that’s something different that basically measures your pulse rate. What I want to use is a cardiac monitor, which evaluates your heart directly. So, is that okay with you?”

“I never had that done before. How are you going to do that? Will it hurt?”

“No, it’s not going to hurt.”

“How does it work?”

“Well, technically speaking, the nurse is going to place something like stickers on your chest that are really called electrode patches. Then she’s going to connect plastic-coated wires to those patches, which are called lead wires, and plug the other end of those wires into a cable coming from the machine.”

“How does that monitor my heart?”

Valenti looks at June. “She’s a real pip, isn’t she?”

“That’s my baby,” June says. “She’s going to be the first African-American female president.”

Valenti grins, then turns back to Suzy. “The way it works is the electrode patches pick up the tiny electric current made by your heart muscle during a heartbeat and it is transmitted by the wires to the machine, which is really just a recording instrument that prints
out a graphic tracing of the electric current generated by your heart. Got it?”

“Got it,” Suzy confirms.

“I know
you
understand, Suzy. That ‘got it’ was for Dr. Gold over here.” Another chuckle circulates at the foot of the bed. “Now, Suzy, I’m going to step outside with your mother and these doctors and have an adult conversation. All right?”

“That’s fine with me, Dr. Valenti. I know you’re going to tell her the bad stuff you don’t want me to hear. My mom will want to know everything, so don’t hold back.” She gives Valenti an endearing smile. “Just say it like it is.”

Dr. Valenti makes a “you’re quite the precocious kid, aren’t you” nod. “Thank you, Suzy. We’ll be right back.”

Once outside the room, he leans against the wall facing June. The residents keep their same positions in the horseshoe, now around them. “That’s a remarkable little girl you have there, Mrs. Williams,” Dr. Valenti comments.

“It’s Ms. Williams, and yes, she’s something special. But she can never get a break from her disease.”

Before Valenti responds, the group’s attention is distracted by a loud noise. It’s a continuous
click-click
sound with a split second between the double clicks. Approaching from down the hall is the Caribbean nurse wheeling a cardiac-monitoring machine with a broken wheel. As she slowly nears, pushing the machine, the clicking sound becomes louder. She reaches the group, stops, and so do the
click-click
s. She’s breathing heavily, very heavily. She leans over and rests her hands on her thighs just above her knees, tugging at her whites. Her position resembles that of the guy at the foul line late in the game waiting for the basketball from the ref so he can tie things up. The residents have inverted their horseshoe circling the nurse and watch as she sucks air to catch her breath.

She takes one last big inhale as she uses her hands to push off her thighs, then stands up. “Oh, I be tired, mon,” she gasps. “Had to go all da way to da basement to get dis here machine, ya know. Not a one
available on dis here floor, mind ya. Da basement I be tellin ya, it be far, far away. Here you go, doctor sir, mon.” She turns to walk away.

“Nurse,” Dr. Valenti says in a stern voice, “my instructions were for you to hook up that child in there. Could you please do that?”