“Of course, Doctor.”
He watched as she gracefully unfolded herself, and stood. As she walked past him in her green scrub dress toward the door to the unit, he noted that she was about five feet eight inches in height with an athletic, female shape.
When she stopped to face him at the first baby, she was wearing a red AIDS awareness pin, and a Know More pink bracelet for breast cancer. In addition, she wore a brown pin that he didn’t recognize.
“What’s the brown pin for?” he asked.
“That’s the anti-tobacco pin, Doctor.”
Why does the word “doctor”, from her lips, sound like an insult? he thought.
Forget about it, he thought, you can’t connect with everyone.
He picked up the vital sign clipboard from the side of the incubator, noting that there were no entries for the last two hours.
“Where are the baby’s most recent vital signs?”
“I have them here,” she said, reaching into the pocket of her scrubs for a folded scrap of paper.
“Please try to keep the vital signs sheet updated.”
“Yes, Doctor,” she said as she looked at her feet.
“It’s important,” he said, trying to criticize the omission, and not her, personally. “If something should happen to one of these babies, especially if her nurse is momentarily unavailable, the vital signs could be lifesaving.”
“I’m sorry, Dr. Cooper. It won’t happen again.”
Enough said, he thought.
After completing rounds, Mike left the unit for his office on the sixth floor of the hospital.
“What’s with that guy, Sharon?” Lisa asked after Mike left.
“What are you talking about?”
“He acts like he’s got a rod up his ass.”
“Listen, Lisa, I don’t know where you get any of that. Mike Cooper may be the best pediatrician I’ve ever known, and I’ve worked for more than a few. Moreover, he’s a great guy, dedicated to his patients, compassionate with their distraught parents, and he’s a joy to work with.”
“There’s something about him that bugs me,” she said, rubbing the thin scar across her left eyebrow.
“I don’t know what’s on your mind, Lisa, but you’d better look inside yourself before you dismiss a guy like Mike Cooper.”
Of course, she knew why she felt this way. Mike Cooper, tall and bear-like, with thinning brown hair, reminded her of her father. Of all the psychobabble foisted upon women, the saying that women tended to choose a man from the shadow of their fathers, was the one that she could least abide. The winds of ambivalence swirled in her mind. She had sought her father’s protection, acceptance, and love, but had found only betrayal, rejection, and brutality.
Early the next morning, Mike sat in the office lounge drinking coffee with his partner and close friend, Bradley Rosin. “Have you worked with that new nurse, Lisa Cooke?” Brad asked.
“Cool—icy-cool—I think. We met yesterday, and it didn’t go well.”
“Earthy, I think,” Brad said. “And exotic-looking, too.”
“Share that with Marcia, why don’t you? She’s a modern, understanding wife.”
“Marcia says I can look, as long as I don’t touch.”
Mike’s partners were married, though Brad’s was more successful than Kenny Dillard’s. Kenny and his wife, Rita, had done more to caution Mike against marriage than anything else.
“All I need to do is spend another evening with Kenny and Rita, and I’ll unpack my monastery robes. If there’s anything I’d expect from marriage, it would be peace and a soft place to land.”
“I know,” Brad said, “but somewhere in the midst of the constant bickering and the occasional blowouts, they care for each other.”
“If that’s caring for each other, then I’ll pass.”
Mike liked Marcia Rosin. She was like a sister, always after him to modify his diet, and to get more exercise. Mike’s bachelor status was the irresistible object to Marcia’s immovable force. “You must meet so-and-so. She’s perfect for you.”
Marcia had introduced him to several beautiful and interesting women, but they had never clicked.
“I want you to come over to meet someone on Sunday night,” she said.
“I can’t, Marcia. I’m having a liver transplant.”
Mike dated in college, medical school, and through his years of specialty training. He discovered that, while surrounded with desirable women, his first instinct was to befriend them, rather than bed them. He had many female friends, few lovers, and then there was Karen Andrews…
“I knew she was wrong for you,” Mike’s oldest sister, Lilly said.
“Nobody’s ever good enough for you guys,” Mike replied.
He called Lilly after he ended an eight-month relationship with Karen. Mike trusted women too much, which was one disadvantage of his upbringing. Karen, a beautiful, outgoing rep for a drug company, peddled her wares—and, some nurses said, her ass—to available Brier Hospital physicians. His secretary had kept drug and equipment salespeople at bay, but when Karen entered his office, he had decided to make an exception.
“It’s no mistake that they choose the beautiful people to be drug reps,” said Harriet Cox, his secretary. “Don’t make a fool of yourself,” she had whispered in Mike’s ear before she sent Karen into his office.
They had hit it off from the start. She was exciting and intelligent, and they were great in bed together. Mike had a busy call schedule, and hers required that she cover a territory extending from the San Francisco Bay Area to the California-Oregon border. Getting together was difficult and frustrating.
After Karen returned from her last trip, she had said, “We can’t go on this way.”
“This way seems pretty good to me,” Mike replied as he pulled her by her narrow waist to his side.
“No,” she smiled. “We waste too much time apart. Why don’t we move in together?”
A few months into their new arrangement, Mike knew he’d made a mistake. Afterward, he had an appreciation of the value of this trial marriage that saved each of them from making a terrible choice.
Mike had tried to weigh their potential for a long-term relationship, but in the heat of romance and their raw sexuality, this was like standing on a scale with one foot on the floor. They didn’t fight over where you squeezed the toothpaste, or whether or not the toilet seat was left up; living together was a revelation of personality and character.
“You’re holding back, Karen,” he had said one night after they had made passionate love.
“Holding back?”
“Emotionally, I mean.”
“You’re getting everything I have to give, Michael.”
Mike sought the gateway to her soul, the emotional equivalent of their sexual intimacy, while she kept him at bay. He never knew why. Alternately, he blamed himself. The arguments that followed were surrogates for this one crucial issue, and had led to their separation.
Chapter Six
When Mike had first arrived at Brier, the hospital had only a nursery with one corner designated for intensive care babies. State and Federal regulation regarding NICUs had become strict, so the choices were to either get into the business of intensive care big time, or get out. Brier decided to become a regional center for neonates. They recruited a board-certified neonatologist, Mike Cooper, and together they built a first-rate NICU. Each time Mike entered the unit, he felt the satisfaction and pride of having been part of that process.
Lisa Cooke was in the midst of changing one of her baby’s diapers when Mike arrived for rounds. “Let me clean up, Dr. Cooper. I’ll be right with you.”
“No problem. When you’re done, I’d like you to come with me while I talk with the Kramers about their daughter, Amanda.”
“I want to apologize to you, Dr. Cooper. I was rude the other day,” she said with a smile that made him blush.
He hesitated for a moment, fixed like a deer in the headlights, and then looked into h
er soft green eyes. “It was nothing,” he sputtered, “I should have waited until you were through with your Yoga. After all, you were on a break.”
“No, it was something else…”
“Something else?”
“You reminded me of someone, and too many unpleasant experiences, but,” she paused, “I can see that you’re not that way, at all.”
Unpleasant experiences? What way? He thought.
She removed her gloves, and washed her hands before coming to his side.
“This isn’t going to be easy, Lisa. I need to bring Ted and Karen Kramer up to date on baby Amanda’s condition.”
Lisa felt sick.
The Kramers sat side-by-side on the faded sofa in the waiting room. They grasped each other’s hands, and rose as one when Mike and Lisa entered.
“What is it?” Karen cried.
“Please have a seat,” Mike said as he grabbed a footstool and slid it over to sit before them. While sitting, he remained at their eye level, and looked directly at each of them as he spoke.
“I wish I had better news.”
Karen gasped, and then she started to cry.
Mike clasped his huge hands over Karen’s. “Please,” he begged, hear me out.” He hesitated before meeting and holding their gazes. “It's a struggle for premature babies; they’re not ready for life outside the womb. Amanda’s problem, respiratory distress syndrome, is simply due to her immature lungs, which struggle to provide her body with enough oxygen.”
Lisa moved to the couch, and sat next to Karen.
Ted loosened his tie, and said, “I thought the cortisone and the stuff you’re putting into her windpipe…”
“Surfactant,” Mike said.
“Yes, the surfactant. You said that they designed that medicine to head off these problems.”
“It was helping, but today she had another lung collapse. I removed the air in her chest to re-expand her lung, but I’d be lying if I didn’t tell you that I’m concerned.”
“Can’t you do anything else?” Karen asked. “What about another consultant?”
“If you want another opinion, I’ll arrange for someone I trust to see her.”
“It’s not that we don’t trust you, Dr.…”
“Don’t apologize, Ted. I understand. Let me outline where we are. We’ve given Amanda the best available therapy. We’re a referral center for high-risk premature infants, so we’re up on the latest treatments. You’ll discover, if you inquire, that we’re caring for Amanda exactly as they would if she was at the University of California Medical Center in San Francisco, or at Stanford.”
“I’m sorry,” Ted said. “We’re not questioning you, or what you’re doing for Amanda. We’re upset. We trust you. If you think an outside consultant might help, then let’s get one.”
Mike moved his eyes between the two. “How about this, I’ll discuss Amanda’s case with Dr. Ira Greenfield, the chief of neonatology, at UC. He’s been caring for preemies for thirty years, and he taught me everything I know about babies like Amanda. Let’s see if he has any other suggestions.”
“It’s okay if we stay here?” Karen asked, “We want to be near her.”
“Of course,” Lisa said.
Mike stood, started for the door, and then turned to face the Kramers. “It’s difficult to talk about Amanda. I want you to understand what’s happening with your daughter, though I know it’s frightening to hear the details about someone so small and helpless being this sick. Don’t let my cautionary words rob you of hope. That’s not my intention. I believe that she’ll come through this, and you should, too.”
Karen stood, walked to Mike, and placed a soft kiss on his cheek. “Thank you. It means so much to us that you care about Amanda.”
Lisa felt her eyes welling as the first tear streamed down her cheek.
Mike and Lisa stood outside the waiting room. Lisa blew her nose, and wiped her tears away. “You were great with them, Dr. Cooper.”
“Please, if you’re comfortable, call me Mike. Everyone does.”
“Thanks, Mike, but I’m more embarrassed now about how I treated you the other day.”
“Forget it. I’d give anything to take back some of the things that came out of my mouth.”
He looked at her as she glanced through the windows over the bay. The grey-black western clouds billowing over the horizon, obscuring the setting sun, befitted her mood.
“I still feel the need to say more,” she said. “To explain.”
Be careful, he thought. Sharon told me what Lisa said. She’s already on record as disliking me. All I need now is a sexual harassment charge.
“I’m around. We can talk anytime.”
She again gazed through the window for a moment, and then turned to face him with the warmest smile. “Why don’t you buy me a drink after work?”
Be still, my heart, he thought, inwardly laughing at himself for the corny line. Then, thinking twice, he said, “Don’t take this the wrong way, Lisa, but I don’t think that would be a good idea at this time.”
Mike’s flat rejection shocked Lisa. Not a good idea?
Chapter Seven
Mike Cooper awoke with a start at five-thirty in the morning. His arm flailed out, grasping for the phone to silence the piercing ring.
“Mike, it’s Leona Lee in NICU. It’s baby Kramer. You’d better get over here, ASAP.”
“What?”
“Mike, wake up. It’s baby Amanda.”
“Amanda,” he repeated, shaking off the cloud of sleep. “What’s wrong?”
“I think she’s septic. You need to get over here—now.”
“Are the Kramers there?”
“Yes, and they’re freaking.”
“I don’t blame them,” he said. “I’ll be right over.”
Mike rolled out of the bed in the on-call room. He stumbled to the bathroom, quickly brushed his teeth, and combed his thinning brown hair, which stood upright. He put his lab coat over his scrubs, and headed for the NICU.
Even in the midst of an emergency, at least one short of a Code Blue resuscitation, the NICU evoked the sense of calm control. Leona Lee and the respiratory care technician stood at the side of Amanda’s incubator. Their drawn looks told Mike that this baby was again in deep trouble. He looked through the plate glass window of the unit. The Kramers were staring at him.
“I’ll be there in a moment,” he said, exaggerating the words so that they could read his lips.
They nodded in understanding.
Mike redirected his attention back to the incubator. “Leona, what have you done so far?”
“I followed protocol and had the lab draw a blood count, electrolytes, and several blood cultures. They completed the chest x-ray a moment ago. We should have everything back soon.”
Mike reached into the incubator, and exposed the tiny body. The baby’s skin was red, and paper thin with little fat. That allowed him to see each rib, as if examining a skeleton. Amanda’s respirations had increased, and, in spite of support from the ventilator, she struggled to breathe. Through his latex gloves, Mike could feel the baby’s fiery hot skin.
“Get me a spinal tap set,” he said. “We need to see if the infection’s spread into the central nervous system.”
With so little subcutaneous tissue, the landmarks for the spinal tap were obvious, and, in a minute, he held a small test tube full of clear spinal fluid.
Thank God it’s clear, he thought. The tension in his abdomen eased a bit.
Mike ordered broad spectrum antibiotics, and then sat at the nursing station viewing the chest x-ray image on the monitor. It showed changes consistent with the respiratory distress syndrome, but no other new infections. The lab data reflected an ongoing severe infection of the blood stream, which they called sepsis.
The Kramers remained at the window. Mike could feel their eyes tracking his every move. He looked up again as Lisa approaching them with a broad smile as she arrived for her shift. Her smile evaporated as they exchanged the
first few words. Karen gesticulated wildly as she pointed toward her daughter’s incubator. Lisa stared at Mike through the window. A moment later, she was at his side.
Leona gave Lisa a quick, but thorough, report on Amanda’s condition, and what they’d done.
“Do you want me to talk with the Kramers, Mike?” Leona asked.
“No, I’ll do it. Let me finish writing my notes and the new orders, first.”
As Mike prepared to leave the unit, Lisa asked, “Do you want me with you?”
“I’d love it, Lisa, but I need you here with Amanda. Come get me the second you see anything alarming. I’ll be right outside in the waiting room.” He started to walk away, but hesitated. Turning to Lisa with a face fixed with determination, Mike said, “I won’t let this baby die! I can’t let her die!”
Mike’s ferocity both alarmed and touched Lisa as he struggled to hold together the barriers of Amanda’s failing defenses.
When Mike left the NICU, the Kramers approached him, clutching each other for support. Ted’s face was stone. Karen’s was red and tear stained. She blew her nose repeatedly, and twisted the frayed handkerchief between her hands.
“Please, come into the waiting room,” Mike said.
Both parents wouldn’t look into Mike’s eyes as they sat on the sofa, terrified by what might come.
Mike sat next to them. “I never get used to this, yet I do it all the time. Babies like Amanda get sick in a blink of the eye, and they get better just as quickly.”
“What’s wrong?” Karen asked.
“Amanda has an infection in her blood stream. It’s serious—anything that happens to her now can change her condition from serious to critical. I’ve started her on antibiotics.”
Karen turned to Ted, placed her face against his chest, and cried.
“What are her chances?” Ted whispered.
“I’m going to do everything possible to get her through this.”
“The tension is overwhelming,” Karen said, pushing Ted away, and beginning to pace. “I feel like I’m on a tightrope, swaying, shaking in the anticipation of the fall. I can’t stand it.”
Trapped Page 4
