“It’s not going well,” Andy continued, when Kate didn’t speak.
“I know that,” Kate said sharply, stung by the judgement and criticism Andy had not intended.
“That’s not what I meant.”
Kate sat up, leaning back against the cold tile. Her blood pounded through her body in slow, sluggish waves, her body dealing with the overwhelming heat of the bath. They didn’t say anything for a long while, each sizing up the other, testing the air.
“I know it’s been a long day,” Andy finally said, and Kate had to stop the flood of images that threatened. She focused on Andy’s voice, focused on keeping it together. “I’m glad you came back here tonight.”
“The on-call room was too cold,” Kate said, aiming for conversational, wondering if she could make the climb to normalcy. Wondering if that was even something to aim for.
Andy smiled. “Well, I got all the pillows last night, so I didn’t miss you too much.”
Kate flicked some water at her in response, leaving splotches on Andy’s pants and shirt.
“Watch it,” Andy said in a mock, warning tone, “or you’ll get some company.”
Kate kept her eyes on Andy, waited a beat, then flicked water at her again.
Andy slid fully clothed into the bath, lifting one leg over Kate’s head until she was positioned between Kate’s knees, her legs wrapped around Kate, eyes shining.
“I did warn you,” Andy said, reaching around Kate, her fingers cold against Kate’s warm, wet skin.
Kate had to laugh, the sensation feeling only slightly strange, only slightly out of place. She wondered how one person could so easily make everything slip away, as if she could eclipse, merely with her presence, anything difficult.
Kate hesitated, uncertain if she could give voice to her worry. Or if she should reach out, as she knew Andy hoped she would, and begin to unbutton Andy’s soaked shirt.
A heartbeat, two, three…
Kate trailed her fingers down the collar of Andy’s shirt. And when she met Andy’s eyes, smiling, relieved, she had only one thought before she took her up on her offer of oblivion. Andy was right.
*
Kate spent the next day moving between floors, checking in on her Ward B patients and triaging patients in the ER. She knew it was a waste of time to sit by Harris Trenholm’s bedside and watch him fight for breath. His sats were no longer fluctuating, they were firmly in the grey area between critical and low-end normal. They had a tube tray ready, the ventilator on standby. Kate wanted to pray they would remain untouched but couldn’t find the energy for hope. She hadn’t slept well last night. Not with Andy’s arms around her, not after the distraction of their lovemaking, not even with the intense tiredness of her body and soul.
She saw patients in the ER, listened to their lungs, catalogued their complaints, scrawled out scripts, ran down the risk factors, assured, feigned patience, forced a smile, remained calm behind her mask. Always remaining calm. Back upstairs, wanting to see the monitors for herself, compare chest x-rays and saturation levels. Her thoughts moved rapidly, always thinking, always searching for the elusive key, something to ward off the fluid, to stop the build-up, to keep the oxygen flowing through their body. And down again to the ER, pick up a chart, ask the questions, stay alert for red flags, question history, listen to their lungs. And again. And again.
“Katie, want to stop for lunch?” Jack met her on yet another trip up to Ward B, wondering what she would find when she got there.
“No, not now, Jack,” Kate said, distracted.
“Okay, but can I show you something?” He seemed nervous, fidgeting and rocking.
Curiosity won over impatience. “Sure, what is it?”
Jack motioned for her to follow him into the office.
“Maybe it’s nothing, but maybe it’s something, I don’t know, not enough data yet, but I thought you should see it,” he babbled, clearly nervous. He hit a few keys on the laptop and turned it so Kate could see. It seemed to be the patterns algorithm she had asked him to work on a few days ago. The columns of information meant nothing to her, so she looked at him and waited for an explanation.
“I keep inputting data, mining the patient files for whatever fits into your parameters, just wanting to see what it comes up with,” Jack said, still fidgeting. Kate was surprised. She hadn’t realized he was still working on it. “So after I put in Jackson Ross’s information, the program flagged something. Now, it needs more data to confirm, I’m not even sure I should bring it to your attention since it’s still so raw—”
“Spill it, Jack,” Kate commanded in her best Andy Wyles voice. She needed to know what had been flagged. Right now she could use anything.
“Okay, last we checked, the data suggested that the acute onset edema occurred only in patients who had not had any proactive steroids. But the newest data suggests that the steroids only delay the onset. It doesn’t and can’t prevent it entirely. The bigger the dose and the longer the exposure are factors, but this data suggests an inevitable downward course to potentially fatal pulmonary edema,” Jack finished, his hands flicking at the keys with apprehension.
Kate’s body felt cold and she shivered. It made sense, it added up. Even if it wasn’t definitive at this point, Kate’s instinct told her that Jack was exactly on track.
“How long?” Kate finally asked. “Can it predict how long? For Harris Trenholm, can the program track his exposure to steroids, what his O2 sats are now and how long until the pulmonary edema catches up to him?” She was afraid to ask. She had to know.
“Maybe, but it would be ballpark at best,” Jack cautioned.
“Do it. Send it to my phone,” Kate commanded. She moved automatically towards the door before she stopped and turned. “Thanks, Jack.”
“Sure, Katie. And stop for lunch sometime soon, okay?” Kate smiled but shrugged it off, needing to get back upstairs.
As soon as she reached Ward B, Lucy handed Kate a chart. “Mr. Trenholm’s sats are down, and here’s his latest EKG results.”
Lucy handed Kate the printout, and Kate’s heart fell. Harris Trenholm’s heart showed signs of stress, the arrhythmic dips and peaks an indication of the strain on his body.
“Shit,” Kate said, scanning the entire printout, hoping to see some good news. Nothing.
“Maybe it’s a blip,” Lucy said, trying to be helpful. Trying to be hopeful. “He’s taken worse turns and come back from it.”
“No,” Kate said sharply, not capable of hearing hope. Not with what Jack had just shared with her. “We need to treat him like he’s dying, not like we’re just hoping that he’ll live.” It was a cruel thing to say, especially to Lucy, whose optimism had been helping keep Kate afloat these last few weeks. But Kate didn’t offer an apology. She walked into Harris Trenholm’s room and sat heavily in a chair.
When her phone chimed that she had a text half an hour later, Kate could do nothing but stare at the screen: 24-48 hours from initial sustained drop below normal range O2 sats.
A day or two. Maybe more, maybe less. The numbers trickled through her head, streamed and screamed, pounded behind her eye. She was worse than useless, not even able to think let alone put thought into action.
A sickly cheerful voice intruded into Kate’s rapidly deteriorating thoughts. “Word on the street is that you’re losing it, Dr. Morrison.”
Kate looked up to see Mona Kellar sauntering into the room, a look of near glee on her thick face.
“Go harass someone else, Dr. Kellar, I’m not in the mood for your shit,” Kate said coldly. She had to admit, though, that she was almost glad Kellar was there, someone she could attack without the smallest trace of guilt.
“Don’t flatter yourself that I came here to spend time with you,” Kellar said, taking a seat on the other side of Harris Trenholm’s bed. “The morgue is filling up fast, and I’m afraid to say you and I are the best Hidden Valley’s got at the moment.”
Kate surveyed the woman across the bed, thinkin
g about how much trouble she had caused in the past ten days, how much anger and humiliation and more than a little stress. But she had also driven samples to Public Health, made herself available for every meeting, and treated each victim of the virus with a simple kind of respect.
“What do you want?” Kate asked cautiously.
“You need me,” Kellar said, her voice so close to suggestive that Kate almost screamed at her to get out. “You need a mind smart enough and fast enough to keep up with yours. No more collaborative medical teams, no more pussyfooting around ideas and conservative treatments. Quit wallowing in self-pity and find a way to treat your patients, Dr. Morrison.”
Kate looked away from her, down at Harris Trenholm. She didn’t need his chart to know how low his sats were, didn’t need an x-ray to confirm his lungs were slowly, stealthily filling up with fluid, even as she and Dr. Kellar discussed the morgue over him. Kate looked back up, meeting those bright, shrewd eyes over her mask. She nodded once in acknowledgement, not trusting her voice.
“Start at the beginning, everything you know. Go,” Kellar barked in her drill sergeant’s voice.
So Kate started at the beginning. Every detail from every chart of every patient in the past two weeks. Every discovery by Public Health, by the National Microbiology Lab, and even by Jack just a few hours ago. Kellar grilled her with questions, forcing her to connect those pieces of information, not allowing for any breaks in the information chain. Kate began to get frustrated, feeling they were coming back to the same conclusion.
“Then make a conclusive statement, Dr. Morrison.” Dr. Kellar’s voice was heavy with condescension.
Kate barely controlled the anger in her voice as she answered. “We need to stop the acute onset pulmonary edema,” Kate said through clenched teeth.
“Do you?”
Kate stopped the instant retort that sprang so easily to her lips. She paused, eyes on Dr. Kellar, thinking.
“Why are the patients dying?” Kellar asked, leaning forwards in her seat.
“Fluid build-up in their lungs prevents oxygen from being absorbed which causes multi-system failure,” Kate said automatically. She watched this exact scenario with Jackson Ross play out in morbid detail in her head.
“So lack of oxygen is the issue,” Kellar prompted.
“Yes…” Kate said absently, watching the rise and fall of Harris Trenholm’s chest, the re-breather mask fogging over with each strained, wet breath. She knew he needed to be on a ventilator soon, needed to force the oxygen down into his lungs. She wished they could find another way to supply the oxygen his body so desperately needed. She imagined, wildly, an O2 bath, immersing him in the simple molecule, letting it absorb through his skin like a life-sustaining bath…
Kate’s body jolted, both her feet hitting the floor, her heart pounding with a sudden rush of adrenaline.
“What is it?” Dr. Kellar asked immediately.
Kate opened her mouth to speak, but she was having trouble forming words. “Not taking it far enough…oxygen therapy…” She stumbled over the words, over the thought in her head, picturing the useless researcher in Winnipeg yelling those same words over his shoulders.
“We’ve been over that,” Kellar said derisively, leaning back in her chair, disappointed.
“No!” Kate shouted at her, angry that she couldn’t spit it out. “Oxygen therapy, use a hyperbaric chamber to flood their bodies with oxygen. If we can manage the fluid while keeping their O2 levels up, we can get them through the critical period, let the virus run its course. We can stay ahead of it,” Kate finished, looking desperately now for approval from Dr. Mona Kellar.
Dr. Kellar said nothing for a moment, her eyes calculating. Kate fidgeted, the adrenaline in her body making small tremors run through her chest and arms.
“Yes,” Dr. Kellar said finally, simply. “Yes.”
“Where?” Kate asked, her relief only temporary.
“One in Whistler, two in Saskatchewan,” Dr. Kellar said immediately, standing also. “Dr. Doyle needs to get on this, now. I’ll find her, you prioritize the patients. Use that algorithm predictor, find out who’s the next most critical.”
Kate agreed, already calculating vitals and oxygen levels in her head, staring unseeing at Harris Trenholm.
Dr. Kellar had almost left the room when she stopped and turned back. “Good work, Dr. Morrison,” she said, grudgingly.
“Thanks for your help,” Kate added, striving for genuine appreciation, even now struggling with it, knowing who Dr. Kellar was and what she was capable of.
True to form, Mona Kellar gave a sly wink. “Maybe now you’ll put in a good word for me with Ms. Wyles. See if she and I can’t come to an understanding.” The emphasis on the last word made Kate’s skin crawl. It must have shown on her face because Dr. Kellar laughed as she walked out of the room.
Kate pushed it out of her head, not letting it intrude. Her body felt utterly re-energized as she inputted Harris Trenholm’s most recent vitals in the chart and walked quickly to the nurse’s station. They had a plan. Not a definitive plan. No guarantees. But a plan. And Kate’s gut told her they were on the right track. If they could keep their patients steady through the peak of fluid, the virus would run its course and they could walk away from this. Just as Natalie Cardiff had asked of her not so long ago.
Kate moved quickly, inputting the data into the system, brushing off any offers of help from Lucy, wanting to do it herself. Wanting Jack to be able to use this data to help her prioritize the patients. Kate checked in on Serena just before she went downstairs. The young woman was asleep. She’d been on O2 all day, her breathing laboured. Even with a plan, Kate felt the sick worry thud in her chest. She thought she knew who would be next highest on the priority list.
She took the stairs quickly, almost running down the hall, skidding into the meeting room. Jack looked up as she came in, breathless.
“You okay?” he asked, alarmed.
“Hyperbaric chamber. We’re going to try a hyperbaric chamber with the critical patients. But there aren’t very many available, so we need your algorithm to predict timing, which is the next most critical patient. Can you do it?”
“Sure, I can,” Jack said, “I just need the most recent data.”
“I inputted it myself and I told the nurses the updated vitals have to go directly into the system every half hour so you can have it immediately,” Kate finished, almost breathless. Everything seemed too slow. She wanted to be three steps ahead already, could almost feel the lift-off of the helicopter transport, taking Harris Trenholm to what she desperately hoped was a cure.
“Have you talked to Andy today?” Kate asked Jack.
“Yeah, she was talking her way around Hidden Valley this morning, trying to figure out who Roberta Sedlak offered a ride to,” Jack said, talking and typing at the same time.
Kate decided not to interrupt Andy, though she wanted to share the news. There would be time. Kate stood quickly, deciding to go see Eric after all.
“Call me if you need anything, okay?” Kate said to Jack, already half out the door.
It had been so long since Kate felt this light, this normal. But no, that was an illusion. The weight still shadowed her, hovering just overhead. Kate forced it away, focusing on the good news, on the excited expression on Eric’s face as she walked him through the new plan. Though they were both supposed to be going off shift in less than an hour, Kate would stay, manage the remaining Ward B patients and continue to update the priority list. Eric would take Harris Trenholm on the transport to the first available hyperbaric chamber. He promised to stay in constant communication.
As Kate left the ER again, feeling almost light with the promise of action like a drug in her system, her phone rang. She checked the screen—somewhere from in the hospital. She answered, hoping it wasn’t Lucy with bad news, hoping each patient could make it through to the next treatment stage.
“Dr. Morrison? It’s Trick…from the lab?”
It took
Kate a moment to place the voice and the name. “How can I help you, Trick?”
“I found something a little odd, I thought maybe you’d want to know.”
“Okay, shoot,” Kate said quickly, leaning up against a pillar, focusing on Trick’s voice. She watched absently as people moved around the main lobby, masks and gown obscuring faces and expressions.
“Well, you know how you sent down more blood samples, wanting to test the Ward B patients for immunity to last year’s influenza?”
That already seemed like a lifetime ago, like old news. But Kate forced herself to listen. “Yes.”
“Well, when I ran Serena Cardiff’s sample and compared it to her other blood work, I noticed something different. Serena Cardiff has the original strain of the virus, not the mutated strain as first assumed.”
“Are you sure?”
“Double-checked and then sent my findings to John Crann at the NML to confirm. It’s the original strain.”
Kate’s thoughts slowed, pulled back, shifted gears. She watched one hospital staff member walk up the stairs, his gown tied hastily, his feet hitting the stairs with athletic precision. Kate watched him pull out ID and get admitted to the ward, all the while calculating, counting, and trying to make sense of this newest information.
“Dr. Morrison?”
“Yes, thanks. It’s good that you called,” Kate said automatically into the phone. She hung up without waiting for a reply and walked quickly back to the meeting room.
“Call up Serena Cardiff’s chart,” she said the moment she walked in the room. Jack complied immediately without question. He hit a few buttons and looked up for his next instructions.
“When was she admitted for pneumonia?” Kate asked.
“October third.”
“Discharged?”
“October ninth.”
Kate’s head hurt. “Today’s date?”
“October fifteenth.”
It didn’t make sense. It didn’t add up. They’d assumed Serena had contracted the airborne virus after she left the hospital. Her immunity was already low, her body ripe for this virus to find its way into her lungs and take up residence. If she had the original strain and had started to show symptoms only four days ago… Kate’s brain did the math.
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