Friday, August 11, 2000

In/Exhale - September 9, 2000 - Part III

September 9, 2000 - Part III


Nikki had dozed off, too, at some point, because she woke suddenly to the unexpected sound of someone screaming in agony. It took her a moment to get her bearings, to realize the harsh, barely human cries of pain were coming from Kai.
 
He still lay--if the word could be used--beside her on the bed, his body contorted, his muscles jumping, pulling his limbs in a dyssynchronous, macabre dance, obviously entirely out of his control.
 
“Kai? Can you hear me?”
 
His eyes were tightly shut, tears streaming from them, his hair plastered to his face with sweat. He opened them, and his breath was shallow, panting. “Yes.” His voice was a rasp, stolen by pain and screams.
 
“What can I do to help?”
 
Now that he knew she was awake, he seemed to be making some effort to contain his cries, or perhaps he was trying to save his voice. She couldn’t tell. She saw his jaw work, and she looked down. His legs were still twitching discordantly, but the spasms seemed to stay there and had subsided a bit.
 
“Bad like this. Waves,” he said, spitting out the words with effort.
 
Her brows knit as she watched him carefully push himself into a semblance of a sitting position, his face going chalk-white with pain as he moved, and she rushed to help him. He didn’t have the energy to shrug her off, panting from pain and effort for several minutes.
 
“It comes and goes in waves,” he said, finally, when he had his breath. His voice was still hoarse, still tinged with pain. He let his head fall back against the wall with a loud thunk, his fingers digging into his thighs, his chest rising and falling with effort and the occasional hitch, his face scrunching up in response to a spasm Nikki couldn’t necessarily see. His body had stilled, for the most part, the worst seemingly over. But more was coming.
 
“What do you want me to do?”
 
He breathed harshly for several minutes, then wiped his face with the side of one arm, blinked a few times. “Drive me home.”
 
She stared at him. “Kai.” Then at the front door, which was maybe fifteen feet away, but might as well have been fifteen miles. She was strong for her size, but there was no way she could carry Kai even a couple feet, let alone all the way to his car.
 
“I’ll manage,” he said, his hands testing each leg before pushing himself to the edge of the bed with a pained grunt. Wearing only boxers, he didn’t bother with his pants, braces, or shoes, simply angled his legs as well as his muscles would allow, slipped his arms into his crutches, planted them carefully, and heaved himself to his feet.
 
He wavered, any remaining blood drained from his face, but he didn’t fall. “Don’t have much time,” he said between strained breaths. She quickly gathered the rest of their stuff, including Kai’s clothes, shoes, and braces, and jogged toward the door. She wanted to be sure it was open, and the car, too, by the time he made it. He was making his way toward her, using a modified swing-through gait and focusing as much weight onto his arms and crutches as he could.
 
It was harder for him once he was out of the apartment, his legs looking less secure and his arms beginning to tremble. She wasn’t sure if it was fatigue, pain, or the resurgence of spasms--perhaps a combination of them all--but she didn’t waste time getting the car door open so he could fall into the seat, where he continued to tremble. She hurried to shove his stuff in the back, and she heard a hurling sound, then the splash of liquid on concrete, followed by a groan.
 
Nikki hurriedly crawled into the driver’s seat, because it was faster than rushing around to Kai’s side of the car. She could see his legs had started to twitch again, and he was reclined in the seat, looking piqued and drained. He barely blinked. She could smell vomit faintly on his breath, and the vacant, distant look in his eyes terrified her as she leaned over to make sure his door was shut before she started the car.
 
“Kai?” she asked hesitantly as she backed out of the spot.
 
“‘M ‘K,” he managed to say, followed by a groan.
 
She could hear his ragged breathing, his muted moans, the subtle sound of his legs as they moved against his will. She tried to talk to him, but either the pain was too much for him to speak, or she was losing him.
 
“Kai?” she asked him again at the first red light. His entire body was trembling, and his eyes were half-lidded. He’d quieted, and that worried her more than anything. “Kai?”
 
She lifted his eyelid, and noticed his eyes were drawn back in his head. Panic flared. He was breathing, quick and shallow, like a hyperventilating puppy. She grabbed his wrist, and her stomach clenched when she felt nothing. She took a few breaths. She was a waitress, not a nurse; just because she hadn't felt anything didn't mean. . . . A few horns began to honk behind her, but she ignored them, checking his neck now.
 
She definitely felt something, but it wasn’t the regular rhythm she expected. It was weak. Fast, but barely palpable. She pressed harder, and she didn’t get the expected resistance. This was definitely out of her paygrade. Cars moved around her at speed, honking, but she ignored them, fishing her phone out of her purse and hurriedly dialing Jon as she raced toward the hospital.

#

Jon rubbed his eyes and tried to focus. He was tired, and focusing on the complicated grant paperwork he was attempting to work on wasn’t going so well. Maybe it was time for him to go home. He needed to talk to Kai, and since Jon had patients in the morning, it might be his only opportunity in the near future. He had begun saving and shutting down his computer when his phone rang.
 
He stopped before he finished going through the motions that would safely and securely turn off his computer to check his phone. By the time he got to it, the ring had cut out. The number was unfamiliar. He wasn’t on-call, and he wasn’t on-call for the fellows, either. Besides, they normally would have paged him. He dismissed it as a wrong number, returned his phone to his belt, and finished up with his computer. While he waited, he decided to check his blood sugar. It might not be a bad idea for him to eat something before he headed home. Though he felt all right, it’d been several hours since he’d eaten.
 
His phone rang again while his computer shut off and he waited for his glucose monitor to register. It was the same number, but he managed to somehow drop the phone before he could answer, and he missed the call a second time. He really needed to upgrade to one of those phones that you could set different ringtones to different numbers. It’d make things a little easier. At least he’d know immediately, without having to even check the screen, when Kai was calling, for example.
 
His sugar was low, not dangerously so, but enough he needed to eat pretty soon. He checked his watch, and decided he’d grab something from the cafeteria quickly. He snagged a syringe from his minifridge, checked the cap, and slipped it in his pocket, then slung his briefcase over his shoulder.
 
He was locking his office door when his phone rang again. Jon sighed and unclipped his phone from his belt. The same number again. Maybe it was Kai? Calling from a friend’s? He answered with his customary greeting, his voice slightly lower than normal.
“Dr. Taylor.”
 
“Jon? Kai’s brother?” The female voice was unfamiliar, wavering. Nervous.
 
Jon swallowed hard and began walking toward the elevators, then thought better of it, and bee-lined toward the stairs, instead. “Yes. Who is this?” Years of practice helped him keep his voice level, though his heart thudded in his throat.
 
“Nikki. I’m . . . a friend of Kai’s,” she said, as if she were pulling the words out. That couldn’t be good.
 
Jon sucked in a breath. “Yes.”
 
“Kai’s MLS hit him bad this afternoon. He passed out while I was taking him home. Something wasn’t . . . right. So I brought him here. To the hospital. They took him to ICU, fifth floor. I’m going to go wait, but I’m not sure if they’ll tell me anything. They’re probably going to call you, but I had your number from Kai, and--”
 
“It’s OK. Thank you,” Jon said in his practiced calm tone. “I’ll meet you there in a few minutes.” He hung up, and caught himself on the wall beside the stairway, bracing himself, taking slow, measured breaths. He could break down later, once he had all the facts. No point in panicking or worrying yet. It wouldn’t do anyone any good.

#

The ICU waiting room was mostly empty when Jon arrived, minutes later. A young woman in a rumpled robin's egg blue uniform dress sat cross legged in one of the chairs, bobbing her knee and nibbling on her thumb. She looked tired and nervous and worried, but even so, she was attractive, and Jon could see why his brother liked her.

"Nikki?"

She looked up, flustered at first, but she soon composed herself. "Dr. Taylor?"

Jon nodded.

"You two could be twins," Nikki said as if to herself, rising to her feet and offering Jon her hand.

"Did you hear anything yet?"

Nikki shook her head, and opened her mouth to speak, but her eyes darted over Jon's shoulder, and he turned to follow her gaze.

Kai's neurologist, Dr. Gates, stood in the door, surprising Jon. Perhaps he was the neuro on-call. Or perhaps things were even more serious than Jon imagined.

“Dr. Taylor,” the man said, his face serious, offering his hand. They shook quickly. He looked at Nikki, an eyebrow raised, about to speak, probably to ask her to give them privacy, but Jon interjected.

“Dr. Gates, this is Nikki--a friend of Kai’s. She’s the one who brought him in.”

Dr. Gates frowned, but nodded. Then he sighed, focused on Jon. “Kai’s vitals were dangerously unstable when he got here. We started him on fluids, intubated, and treated him with Pavulon to control the spasms--”

“Pavulon?”

Jon sighed and turned to Nikki, who looked apprehensive. “It’s a powerful muscle relaxant. Anesthetic. Used as part of lethal injection in most states.”

“And it’s the only thing Kai responds to when he has this severe of an MLS attack,” Dr. Gates added. “He’s still not stable, so we’re keeping him sedated and monitoring him for now.” He checked his watch. “The effects of the muscle relaxant should last another hour, if we’re lucky. We’ll see how he is and go from there. He may need multiple infusions. We’ll just have to wait and see. I’m hoping, within a day or two, we’ll be able to extubate and bring him up. I don’t want to keep him sedated and in ICU any longer than necessary, especially since he’s immunocompromised.”

Jon nodded. “You think his MLS caused his blood pressure to drop?”

Gates sighed. “I don’t know what caused it. Pain, maybe. It’s one of those one-in-a million situations, but then Kai’s body is not exactly predictable in the best of times.” A buzz emanated from Gates’ belt, and he checked his pager. “I’ll have someone page you in an hour or so, once I decide whether we need to keep him on the Pavulon or not,” Gates added with a pat to Jon’s shoulder. He hesitated a moment before leaving and studied both their faces. “Kai had some . . . wounds on his chest and abdomen--”

“Cat,” Nikki interjected quickly.

Both Gates and Jon looked at Nikki, eyebrows raised.

Nikki straightened her shoulders. “I got a new cat, and it scratched him.”

Jon knew she was lying--especially since Kai was incredibly allergic to most animals-- and he was worried about Kai now more than ever--but he admired the way she defended his brother so unflinchingly. He knew Kai would be grateful.

Gates’ pager buzzed again, and he seemed willing to let it go for now, giving Jon a look that said, We’ll talk later before disappearing out the door.

Jon stood for a minute, pulling his fingers through his hair, barely noticing when Nikki stooped to grab her purse and sling it over her shoulder. She looked up at him, a hint of nervousness surrounding her, like an aura.

“I have to get to work,” she said. Then she took in a breath. “If they’re keeping him asleep with drugs, when they stop the drugs, he’ll wake up, right?”

Jon didn’t answer immediately, wondering if he should ask Nikki about Kai’s wounds, but decided it would be a topic better broached with his brother himself. “Basically.”

She nibbled her lip, shifted her bag, then looked up at Jon. “Would you--could you--call me when they’re going to wake him up?”

Jon studied her, his eyes guarded. But he saw in hers a mixture of worry and concern and maybe--even love. It was a look he recognized well; he’d seen it often enough in the mirror in the months before Kai’s transplant. Either Kai had lied to him about the seriousness of his relationship with this girl--which Jon wouldn’t put past his brother--or Kai didn’t realize.

This girl cared about Kai deeply.

“Of course,” Jon said at last.

A look of relief and gratitude swept over the girl’s features, and for the first time, Jon realized she was older than she’d seemed, somewhere between 25 and 30. Perhaps more his contemporary than his brother’s. After what happened with Becca, it made Jon feel a little better to know there was someone besides himself to defend Kai, to worry about him, to want to be there when he woke up.

“Cat, huh,” Jon said as she turned to leave.

She froze for the briefest of moments before shrugging a single shoulder and glancing over at Jon. Then she turned and got close enough Jon could smell her, a mixture of fruit and lust, making his body react in ways totally inappropriate to the current situation.

“Kai’s . . .” she struggled to find a way to express herself. “He feels . . . lost. Alone,” she finally settled for. She stepped back, offered a faint smile. “If you ever come by the diner, coffee’s on me. Pie, too, if you like it as much as Kai.”

Jon watched her go, then forced himself to head down the hall toward Kai’s room.

#

Diane was curled up on the couch, absently channel surfing when Renee came in. She didn’t need to ask how things had gone; she could tell immediately by her roommate’s body language. She muted the TV, tossed the remote aside, and opened her arms. Renee shuffled across the floor and threw herself into the hug.

“He stood me up,” she muttered. She wasn’t crying, exactly, but her voice was thick, and when she pulled back, Diane could see Renee’s eyes were puffy.

She bit back a sigh. “I’m sorry.”

Renee frowned. “It’s OK. You can tell me ‘I told you so.’”

Diane carefully stroked Renee’s hair, avoiding tangling or pulling the curls. “I did tell you so. This guy is gorgeous, right? Beautiful men are trouble. Just ask my mother.”

A shade of a smile stole across Renee’s face.

“The guy kisses you. Disappears. Reappears. Kisses another girl. Begs your forgiveness, but insists he has to ‘explain later,’ then is a no-show. He’s playing you.”

Renee blew out a breath. “I don’t know. You didn’t see him yesterday. Or this morning. I just wonder if something happened.”

Diane let out a snorting laugh. “All part of the act. That’s how he reels you in. So when he shows up later--and he will--all apologetic, with some story about how his pet llama died, and it was given to him by his mother when she was on her deathbed and it’s the only thing he had left to remember her by--you’ll eat it right up.”

“But when you call his phone, it asks you to call his brother if it’s urgent. You don’t think that’s strange?”

Diane shrugged a single shoulder. “Maybe his brother’s in on it. Maybe they fuck the girls together.”

“Jesus, Diane.”

She laughed. “Forget about him. All right? It was a crush, he hurt you, you’re over it, end of story. Moving on.”

Renee nodded weakly. “Moving on.”

#

Jon spent over half his week treating patients in ICU. Although now that he was no longer a fellow he focused primarily on respiratory patients--FS, severe asthma, emphysema, ARDS--all the critical-care nurses knew him, and he knew them. That didn’t make it any easier to stroll the few feet from the ICU waiting room to the small room where he knew his brother lay.

“Dr. Taylor?” One of them--a young nurse named Alice, not much older than his brother--called out as he passed her station. In this part of ICU, the ratio of nurses to patients was 1:2, with each nurse parked in front of computer screens at a desk directly across from the glass-fronted, doorless cubes that passed for rooms, making it easy for them to rush in and take care of hypercritical patients when necessary. “Dr. Taylor?”

Jon froze; he’d been walking on autopilot, and hadn’t heard her immediately. He turned to her, waiting, his eyes drifting down the hall, where he knew Kai was.

“I didn’t think you were on schedule tonight.”

“I’m not.” Then he glanced down at himself and realized he was still wearing his white coat.

Her brows furrowed. “Kai?”

Jon nodded.

Alice frowned. “Rejection?”

Jon shook his head. “We’re not sure what it is right now.”

“He’ll be fine,” she said confidently, with a reassuring smile. Alice was tall but well proportioned, with dirty-blond hair she often teased into curls. She nearly always wore brightly colored and printed scrubs, and despite the environment, was bubbly and friendly. Jon always thought she’d be better off in peds than ICU, but she was good at her job. In fact, one of the better critical-care nurses they had on staff, despite her youth.

“Thanks, Alice.”

Alice looked like she was going to say something, but then just smiled and returned to her station. Jon was grateful, walking toward his brother’s room in relative silence, for the sounds of the ward filtering in around him: the click of keyboards, the soft whisper of nurses speaking to one another, the hiss of respirators, and beep of monitors all weaving together into a familiar, reassuring hum.

When Jon reached Kai’s room, he stopped in the doorway. Despite his experience with ICU patients, despite knowing that this situation was different, seeing his brother unconscious, not breathing on his own, made Jon’s hands tremble. It wasn’t the same room. It wasn’t even the same floor. The machines were different. Kai looked different.

Yet Jon couldn’t help seeing his brother the way he’d been over a year ago, before the transplant, when things had looked almost hopeless, and Jon had begged, begged the God he barely believed in to do something, to bring his brother back to him.

Jon’s stomach roiled, and he was barely able to keep himself together as he made his way into the room toward the machines. Maybe if he looked at this clinically, studied the numbers, the settings on the respirator, he could convince himself Kai would be OK. That the worst was behind him. This was just a fluke.

Staring at the mode, the oxygen percentage, and saturation on the respirator’s screen didn’t change the fact that it wasn’t just some patient lying in the bed beside him.

It was Kai. His brother.

Jon forced himself to look. Kai was pale and so, so still. When Jon took his brother’s hand, it was cool and clammy, and Jon had to stretch his opposite hand toward the wall and dip his head, measuring his breathing to keep himself calm and his stomach from asserting itself.

After a few minutes, he regained control over his emotions and smoothed a hand over his brother’s forehead, trying to ignore the endotracheal and orogastric tubes protruding from Kai’s mouth. Then, carefully, he turned back the blanket and lifted Kai’s gown. It didn’t take long to see a few of the marks Dr. Gates had mentioned. There were so many of them, Jon thought, but he quickly re-covered his brother. With his blood pressure still low, Kai’s body had to work hard enough to maintain basal temperature; Jon didn’t want to leave his skin exposed anymore than necessary.

“Dammit, Kai. I’m sorry,” Jon whispered, taking up his brother’s limp hand again. Even if he could somehow become a sign language savant in the next few days, it wouldn’t change anything, Jon thought bitterly.

#############

Continue to September 10, 2000 ------->

7 comments:

  1. superb!! magnific!!
    my heart was on my mouth in this chapter

    thanks

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  2. Wow -- what an emotional, moving episode! I love the insights we get into Nikki's character. She really loves Kai a lot. It's not Renee's fault in how she seems to feel. It's that she doesn't understand everything. I sure wish she could talk with Art and see Kai for who he really is.

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  3. I hope you had more time for writing because I would read your works every day - you chapters are written so beautifully and with deep understanding and compassion for human beings.
    Thanks for sharing - can't wait for the next one!

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  4. Amazing chapter! You write so well. :) Poor Kai - I hope things get better for him soon.

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  5. Good chapter. I was really looking forward to for Kai to finally open up to renee though. I guess I'm kinda on 'team niki' at this point. I Just feel like their both kinda fucked up. In the end though I wonder if either girl can really handle whats going on for Kai.

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  6. I know that Becca cares for Kai, but I'm rooting for Renee - I hope that she has the opportunity sometime to show Kai that she can have feelings for him too if he gives her the chance. Loving this story - more please!!!

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  7. Hi - dear Moderator - I meant to write Nikki and not Becca in my last comment - any chance you can change that - thanks!

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