Monday, August 21, 2000

In/Exhale - August 21, 2000 - Part 3

If you haven't already, you might want to read my Introduction so you understand a bit of what I'm doing here.

Let's pick up where we left off, shall we? It's still August 21, 2000. Kai finished his classes, spent some time with Nikki, and went home to bed. But what about Jon, what has he been up to?

Note: I realize that whenever we get in Jon's head he can get a little technical with the medical jargon. That's who he is. If anything confuses you, don't be afraid to ask. And don't worry, I'll try not to bog you down with him too much ;).



August 21, 2000 (continued)

The words on the chart in front of him started to grow blurry, and Jon began to get that anxious, restless feeling that signaled he was heading for a hypoglycemic crash. Annoyed, he sighed and pulled open his top desk drawer, removing a small zippered black case. Setting it on the desk, Jon opened it carefully, removing his glucose monitor, threading a test strip into it before pricking his finger. After over twenty years of this, he barely even felt the lance, frowning as he squeezed the droplets onto the paper.

While he waited for the reading, he fished a glucose candy out of the same drawer, tapping it lightly on the desktop. His hands were shaking, which didn't help his annoyance, not to mention the fact that Jon's mood always soured when his blood sugar was low. Sometimes he hated being diabetic, even though he'd dealt with it since he was a kid, and it was old hat by now. Jon was like an express train, rolling quickly, focused, and he hated having to stop to do anything, and that included eating, checking his sugar, taking his insulin. It wasn't the disease so much that bothered him but the way it interrupted the flow of his life. Kai suggested it was probably God's way of ensuring Jon ate; Jon had the habit of being so focused on his work he'd skip meals, bad enough for someone with a normally functioning pancreas, potentially fatal for someone with type-I diabetes.

Jon sighed as the reading displayed at last, frowning at the low figure, popping the candy in his mouth and chewing it carefully to give him a temporary boost. He knew it wouldn't be enough; he had to eat something, and soon, but it would at least prevent him from going fully hypo and passing out. As he chewed, he glanced at his watch; his vision was already clearing a bit, and his unease was settling as the sugar entered his blood and fed his starving brain. 11:03 PM. Jon was grateful he didn't need an endocrinologist to get his insulin prescription, so he didn't have to hear a lecture about how bad his hemoglobin A1c numbers were.

Sighing, Jon packed his kit and replaced it in his desk, pushing himself up wearily. He knew he should take better care of himself; if Kai was as neglectful of his body as Jon was of his, Jon would never let his brother hear the end of it. But Taylors were stubborn, Jon particularly so; it was one of the things that made him such a great doctor. Annoyed that he'd have to leave the rest of the work on his desk for the morning, Jon grabbed his briefcase and keys and headed out of his office toward the employee parking garage.


Jon knew he probably shouldn't have driven himself home, but the candy had boosted him at least temporarily and his apartment was only a five minute trip from the hospital at this time of night. After he was separated from his siblings when their parents died, Jon had spent time in several foster homes before finally--and surprisingly due to his age--being adopted by an older man who'd lost his son only a few years earlier, and Jon had reminded him so much of his dead child he'd immediately taken Jon in as if he were his own.

Although Jon had been initially disturbed by being a "replacement" son, he could commiserate on some level, because he'd never gotten over being separated from his brother, whom he'd taken care of almost as if he were his parent instead of his sibling. And the adoption had been good for Jon; the man was kind and appreciated Jon's natural intelligence and inclination to knowledge. He'd taken Jon away from the small town in which he'd grown up, steeped with heavy memories of the family he no longer had, and encouraged him to pursue medicine.

But Jon had returned to Jonesville as soon as he could, hoping, praying to find his siblings again--especially Kai--and reconnect. He'd been too late for Sara, the youngest, who he'd learned had died of leukemia when she was only eleven; ironic, Jon always thought, since she had been a healthy child before their parents were killed. Unlike Kai, who had struggled simply to breathe since the day he was born.

Jon sighed heavily at the memories of cradling his brother to sleep, doing his best to ease Kai's ragged breathing. They'd had a connection, the two of them, that even their parents hadn't understood. Jon had always thought of it as a kind of sixth sense, or perhaps it was simply intuition of the kind you read mothers having for their children, knowing instinctively when something was wrong with one of them. It was a feeling Jon had always carried around with him, even before Kai was born and was still in their mother's womb. Maybe it was simply Jon's natural proclivity toward worry and anxiety, but at least when they were younger, before their parents' deaths, Jon had always seemed to know when Kai would need him and what he needed. Much the way some people could predict and sense a change in the weather, Jon seemed to know his brother.

As Jon pushed his way into the dark apartment, he realized that now that Kai was potentially cured of his FS, and with his MLS not posing anything life-threatening, at least not for several years, he could relax. Kai would be OK. But still, that worrying part of him buzzed, as if it weren't ready to be set aside. Jon tried to convince himself it was simply a matter of habit, that vigilance that Kai would have a major attack or develop a deadly pneumonia at any time a remnant of so many years of tension. But then Jon would reassure himself again that he was simply channeling the risks of being a transplant patient into his usual anxiety, something to fill the void. Kai still had the chance of rejection, of fibrosis, of opportunistic infection, but while these were all real threats, Kai had already survived the most treacherous periods--the first hours post-surgery, the first month, the first three months, the first year, and so far, Kai had been healthier than he'd ever been in his life.

Jon knew he should find all of it comforting, but he couldn't. Instead of being the calm after the storm, it felt more like the eye of the hurricane, the storm behind him, but also swirling dangerously toward him again, threatening to bring even more chaos in its wake. Kai was already asleep; unlike Jon, he was pretty responsible with his health on most days, dutifully taking his medicine on time and resting when his body called for it, but he'd left a note, indicating there was leftover cheese pizza in the fridge if Jon was hungry. Jon laughed as he read the postscript, scribbled in Kai's slanting caps, underlined for emphasis, "CHECK YOUR BLOOD SUGAR."

Sighing, Jon pulled open a drawer and took out the kit he kept in the kitchen, quickly pricking his finger and waiting for the reading while he grabbed a slice of pizza out of the fridge. He knew the carbs in the pizza would spike his blood glucose, but as low as it was right now, he could afford it. Not in the mood to wait for it to heat, he took a bite of the cold slice just as the reading registered.

The apartment was quiet; the only sound the soft hum of the fridge behind him as he chewed on the cold pizza. As he expected, his sugar was low, but not dangerously so, and the pizza would ameliorate that quickly. The silence surrounded him, reminding Jon why, especially while Kai was too sick to live here, that he so often fell asleep at his desk or curled up on the small couch in the corner of his office. Not wanting to risk a full second slice, Jon ate the cheese off instead, then checked his sugar yet again, a yawn stretching his mouth as his exhaustion began to sink in. He had a presentation to make to some of the medicine residents tomorrow morning. It wasn't officially a Ground Round, especially since some of the internists frowned at Jon's eccentricities, but despite his youth, he was considered one of the best pulmonlogists on staff, and pulmonology and critical care were essential parts of the internal medicine curriculum.

Tossing the tester back in its bag, Jon grabbed an insulin syringe from the fridge, lifted his shirt, pinched the skin, and injected himself, remembering he'd have to switch sites for his morning dose. Carefully disposing the needle in the sharps container he kept for the purpose, Jon trudged toward the back hall where their bedrooms were.

As he passed, Jon noticed Kai's door was slightly ajar. He could hear the soft, subtle snore of Kai's breath as he slept; even post-transplant, Kai's breath was noisier than most, although it was low and even and not labored the way it once was. Jon resisted the urge to pop his head in and confirm that Kai was OK. Again, after so many years, it was a struggle for Jon to remember that Kai was all right, that perhaps the worst was behind him. Reflexively, Jon pulled his fingers through his hair as he turned toward his own bedroom.

Jon's room was small and neat--spartan--Kai had teased him when Jon first brought his brother to the apartment. Kai knew Jon's adoptive father had made some money in various business interests and Jon had been fortunate enough to grow up in a comfortable environment--a far cry from the group home where Kai had lived as a child. Still, Jon spent very little time here, and as it was, was a man of few needs and desires.

Jon finally slipped out of his white coat, its pockets heavy with small reference books, hanging it on the coat hanger that stood near his single dresser. He toed off his shoes, nudging them toward the base of the rack, and stared at his face in the mirror for a moment. During the decade of their separation, Jon had hated to look at his reflection, because he saw Kai in it every time, and for years Jon had been unable to determine if Kai was even still alive, so that it was almost as if his brother haunted him in every mirror.

Like Kai, Jon was tall and lean, although his frame was narrower and less muscular, and despite years of insulin treatment for his diabetes, extremely thin. But their faces were nearly identical; Jon's nose perhaps angled a bit sharper, his lips finer, his jaw just a hint more square. Jon's eyes were nearly twins to his brother's as well, but older, faded, less the brilliant Caribbean-sea blue of Kai's and more of a misty grey, with lines of age and worry marking their corners. Like his eyes, Jon's hair was also a softer mirror of Kai's; less golden and more wheaten, like a brilliant fabric left too long in the sunlight, stripping it of its once lustrous color. And though Jon was only eight years older than Kai, he seemed much older, especially when he was tired like this, dark circles under each grey eye, the shade of stubble on his cheeks.

In fact, they looked so much alike, their differences so subtle, that if it weren't for age, they could easily pass as identical twins. As Jon shrugged out of his tie, shirt, and pants, he wondered what the two of them may have been like if things had been different; would Jon have been able to table his anxiety over his brother enough to keep him youthful so that their age difference narrowed, at least in Jon's face? Jon shook his head as he realized Kai's lungs had begun to fail him at just 18, and even their parents, even being together as a family for those twelve extra years, wouldn't have changed that.

Jon collapsed in his bed, pulling the sheets over his naked body as he shut out the light. He disliked teaching residents, mostly because most internists planned on becoming GPs who didn't care about critical care and whose only pulmonary concerns were asthma, occasionally pneumonia or COPD. Or, worse, they had their eyes on a fellowship, something glorified like interventional cardiology and yawned behind their hands when Jon lectured on the significance of understanding the pulmonary curves and how that related to proper ventilatory management. As much as he tried to stress the importance of understanding, preventing, and treating ARDS--the subject of tomorrow's lecture--he knew most of them only wanted to know the minimum required for their boards, content in the fact that someone like him would be managing their patients' respiratory care.

Jon rolled over, a sigh mixed with a groan escaping his lips. Maybe he should take Kai up on his suggestion of a vacation. A few days of relaxation might do him good. Jon laughed as he adjusted his pillow. Relaxation. Kai was right. That was a word Jon had no understanding of.

Wow! What an exciting first day! Stay tuned next week, where we skip ahead to Friday, and see how Renee, Kai, and Nikki are spending their first Friday night of the school year...

Continue to August 25, 2000 --->


  1. Excellent piece opening the window into Jon. Can't wait for more.

  2. I like this so much. It's sort of a shame we have to wait another week (pretty pretty please? Could we have an extra chapter for good behavior? Or bad behavior?) The brotherly interaction and the worry... it's just so classic. You've done a really good job on Jon's diabetes as well... it's quite realistic and accurate to the time.