Dr. Easterday edged the tongue blade between Eddie’s lips and shined her penlight into the back of his throat. She worked quickly and confidently, laying the head of her stethoscope over the left and then the right side of his tiny chest. She tucked her fingertips into each armpit and moved them along each clavicle. She bent and then straightened his elbows and knees. She rolled him over, ran her fingertips over his back, and then turned him frontward again. She prodded his belly, tapped below his kneecaps with the rim of her stethoscope, pushed a finger into the skin over his shin. Her eyes, steady and deep in their sockets, never left Eddie. She seemed to be studying every breath, every heartbeat, every inch of him.
Dr. Easterday stood up straight and turned to her. “Mrs. Campbell,” she said, the snap of authority cutting her voice, “Eddie’s a very sick baby.” She paused a moment, shifted her weight to the other foot, and then continued speaking. Her voice was like velvet, softened by a Southern accent. “I’m worried about meningitis. That’s an infection of the tissues surrounding his brain.”
Anna’s head throbbed. The light overhead seemed to dance in circles, shining, flickering, turning. Bright spots floated like glitter before her eyes, sparkles that didn’t disappear when she closed her lids. She reached for Chris’s shoulder. He buried his face in the folds of the shift that covered her nightgown and began to wail. The doctor’s voice sounded wobbly, far away—like an echo ricocheting through a long, narrow, empty space. This wasn’t real. It was a bad dream. She wasn’t standing in the ER with Eddie on the gurney. Any minute now it would all evaporate.
“. . . very serious infection,” the doctor continued. Her words filled the air, drowned Chris’s sobs. She spoke of a spinal tap, of sending specimens to the lab, of starting antibiotics.
“Okay,” Anna whispered. She didn’t understand what the doctor had just said or what she had agreed to. It didn’t matter, as long as Eddie would be all right.
She lifted Chris and straddled him on her hip. He laid his face against her shoulder, and his fingers, probing like pincers, picked at her hair. She felt an arm slide across her shoulders.
“You and your older son may wait in the lounge,” Mary said. “It will only take a few minutes and then you can come back.”
Anna stood firm as the nurse pushed against her shoulders. She couldn’t leave. Eddie couldn’t stay here alone.
“We’ll take good care of him.” Mary nodded toward the gurney. “Your older son won’t want to watch this procedure. It’ll take only a moment.”
She didn’t know what to do. Eddie needed her to stay. Chris needed her to take him to the lounge. Eddie. Chris. Which son would she pick? Why did she have to choose one and leave the other?
Guided by Mary, she carried Chris to the waiting room. A breath of chilly air brushed against her arm. She stood, shivering, beside a giant aquarium. A school of angelfish glided to one end of the tank, turned in unison, and glided back to the other end. Back and forth. Over and over. Their rhythmic movements—monotonous, hypnotic, synchronous—filled her mind.
After what seemed a very long time, she felt someone at her side. She turned. It was Jake. A white lab coat covered his wrinkled scrub shirt and pants. Scabs of dried blood dotted the paper booties over his shoes and his hair was stuffed beneath a gauzy green cap.
“What happened?” he asked.
She tried to explain. “He was limp, hardly moved. He had a seizure.” The words spilled from her in jerks. “The doctor thinks he has meningitis.”
“Jesus Christ,” Jake groaned. He wrapped his arms around her and Chris, leaned his cheek against the top of her head. He was strong. Now everything would be okay.
She set Chris on the floor.
“Daddy?” Chris leaned against Jake and pulled on the hem of his scrub shirt. “Daddy?”
Jake sank into the nearest chair. A tortured grimace, its creases carved into the shadow of beard stubble, spread over his face.
“Mommy made me come in my jammies.”
Jake patted Chris’s hair. “It’s okay, Son. It’s okay.” Then he pulled him into his lap.
Chapter 7
Rose Marie
Steam rose like a ghost from the teakettle, floated across the kitchen, and settled on the window. Rose Marie watched the children smear finger paint on the pages of yesterday’s newspaper. Sawyer plunged his palm into the bowl of red paint and slapped it on the photo of a goalie. Meghan, a smudge of blue on her cheek, dipped a fingertip into the purple paint and drew circles diagonally across the page. Amanda printed a string of green x’s on the want ads. In the meanwhile, a bead of condensed mist loosened its grip on the windowpane, skittered down the glass, and puddled on the sill.
This was her third mug of tea for the morning. She smiled at the orange fist prints Davey had made and said, “Good job.” When she looked sideways at his picture, she saw a row of pumpkins against the black and white and gray of the newsprint. His mother, who wore oversized jewelry and tie-dyed caftans, would especially enjoy receiving her Mother’s Day gift wrapped in this wildly colored paper.
“Where’s Chris?” Sawyer asked.
“I don’t know,” she answered. “Probably he and his mommy are still sick.”
The clock on the stove read 9:35. Chris and Eddie hadn’t come yet and their mother hadn’t called. It was unlike Anna to be negligent. She had never failed to call before if the boys weren’t coming.
She didn’t want to charge Anna for today, especially if she was ill, but the rules were clear—no-shows had to pay. Even if Anna was still sick, their father could figure out how to get the boys to day care, couldn’t he? Or, at least, to call?
Time for the morning snack. “Anybody hungr—” she asked and, before she finished the question, Davey yelled, “Me.”
“Wash the paint off your hands.” She set the dishpan, with soapy water warmed in the teakettle, on the center of the table. “And here’re the paper towels. When your hands are dry, you may get a muffin from the sideboard.”
As the children scrambled away from the kitchen table, she called, “One. One muffin each.”
Ten o’clock. Still no word about Eddie and Chris. She dialed the Campbells’ home phone number and heard Anna speaking from the answering machine. She left a message.
After the paints were put away, after the morning snack, after she had taped the damp, handprint-filled pages of newsprint to the back door to dry, she set up the second activity of the morning. She enjoyed helping the children with their projects, marveled at their movements, their patience, their tenacity, the speed with which they learned new skills. Their brains were like little blotters, soaking up everything that hit the surface. New songs? They sang like choirboys. A French poem? Twice through and they sounded as if they were born in Paris. Now, Meghan, Amanda, Davey, and Sawyer gathered, elbow to elbow, around the kitchen table while she showed them how to string Cheerios onto pieces of twine.
“Moisten it to a point.” She drew the end of the string over her tongue. “Hold it close to the tip—otherwise it’ll flop over. Then stick it through the hole.”
They were making necklaces for Mother’s Day presents. Chris would feel terrible if he didn’t have a necklace to give to Anna. He didn’t like to be left out of anything. She dumped two handfuls of cereal into a plastic bag and laid a hank of twine on top. Next time Chris came, he could either work on the necklace or take the packet home.
The children’s legs dangled like tassels beneath the kitchen table. Beefeater wandered from chair to chair, his nose surveying the linoleum, his tongue gobbling up stray pieces of cereal as soon as they hit the floor. He was a perfect day care dog, loyal, gentle, tolerant of kids and their foibles.
“Come here, Beefeater,” she called. The points of his ears, usually turned down, now stood straight up, and he lifted his nose into the kitchen’s air. “Here, boy . . .” He padded across the floor to his mistress. “Good dog.” She held out a half-eaten muffin.
She turned back to the children. �
��Hey, Sawyer.” She tapped the boy’s chubby hand as it palmed another fist full of o’s into his mouth. “No more eating or you might not have enough Cheerios to finish the necklace. Keep stringing.”
Chapter 8
Jake
Chris lay curled like a lynx in Jake’s lap. His son’s right ankle dangled between his calves, the pajama leg pushed up past the scratches on his knee, the result of a disagreement with Bullet. Chris, still asleep, squirmed and his fingers clawed at the uppermost scratch. He caught his son’s hand, clamped it against his chest.
Anna slouched in a chair in the corner of the waiting room, the hem of her nightgown taut against her knee, her eyes hidden behind her hands. Maybe she was asleep or maybe she had retreated into her own world. He couldn’t tell which.
Something about the lighting—the olive green glow from the plastic seat cushions, the electric blue glare from the fluorescent lights, the dark blond striations of Anna’s uncombed hair, the apricot tint of her cheeks—made her look old. As people walked in and out of the room, their shadows, eerie shades of gray, wafted ominously across her forehead.
“Excuse me, Dr. Campbell.” The papers in the young man’s hands quivered, his voice was tentative. “My name’s Sunil Patel and I’m the med student in the ER today.” He picked up a National Geographic and set one of the papers, askew, on the cover for support. “Your son needs a spinal tap and Dr. Easterday sent me to get the consent form signed.” He pointed to the sheet of paper on the magazine.
Jake didn’t read it. He knew what it said: The possible complications of a spinal tap include bleeding or pain at the needle’s insertion site, post-spinal headache, nerve damage, hematoma, paralysis, and herniation of the brain stem into the foramen magnum.
Foramen magnum. Big hole. It was the drain hole at the bottom of the skull. He winced, shook his head, tried to banish the images that raced through his mind. Brain stem herniation. Eddie’s soft little brain stem, the command center for his breathing and his heartbeat, could jam through the drain hole during the spinal tap, shoved downward by the pressure inside his head. A near instant killer.
He shook his head again. The risk of herniation was minuscule; Eddie’s open fontanel would protect him.
Chris wiggled. Jake stroked his leg. Was Eddie’s fontanel still open? He couldn’t remember the last time he’d felt his baby’s soft spot. No matter, the risk was tiny, the rest of the complications relatively minor.
He pulled a pen from his scrub shirt pocket, turned the form to fit squarely over the magazine cover, and scribbled his signature on the line at the bottom.
“Date?” he muttered.
Sunil glanced at his watch. “Um . . . April fifteen, I believe.”
Jake wrote the date on the next line. He stared at what he had written. “Jacob S. Campbell, MD.” The trailer “MD”—med-ical doctor, the signature of a physician—was scrawled beyond recognition. He wrote those two letters behind his name a hundred times a week—on insurance forms and prescriptions, on medication orders and X-ray requisitions. Sometimes, at home, when he wasn’t paying attention, he wrote them on checks to Detroit Edison or on the income tax return. Last week he had written it on a birthday card Anna had passed in front of him, her finger pointing to the white space beneath the greeting. Here, his signature, Jacob S. Campbell, MD, was on the consent form for his son’s spinal tap. It seemed very wrong, an error of colossal proportions. Something had gone badly awry.
He knew what was happening on the other side of the door to the patient area—he’d done maybe ten spinal taps himself, back when he was a medical student. Eddie would be lying on a gurney. One of the nurses would be holding Eddie, his body folded into a C, against the sheet. One of her hands would be clamped on the back of his neck and the other would hold his knees as close to his chin as she could bend him. Would he wiggle? Was he well enough to fight her grasp? Another nurse would paint his lower back with Betadyne, drawing concentric brown circles with the sponge. Then she would cover him with a sterile green sheet, placing the eyehole over the brown antiseptic.
He knew the drill—doctor pulls on sterile latex gloves, snaps the fingers until they fit evenly, palpates the iliac crest with one forefinger to orient herself to Eddie’s anatomy and, with the forefinger on the other hand, locates the L3–4 lumbar space on Eddie’s backbone. Like a well-rehearsed dance.
He wiped his forehead with his palm. Would it go well? Would the ER doc hit it right? She would advance the needle slowly into Eddie’s back until she felt the pop, the signal the needle’s tip had stabbed the dura. Then she would remove the stylet from the needle.
The details of the spinal tap played over and over through his head. In one version, fluid clear as water dripped from the hub of the needle—normal spinal fluid. In another, the fluid was cloudy, looked like diluted skim milk. That would be bad, would mean meningitis. In a third version, the fluid was bright red because the doctor had hit a blood vessel with the needle tip. The blood in the specimen would obscure the lab results; they might not be able to tell if he had meningitis or not.
He wanted to be in the cubicle, to watch the tap, to send mental telepathic instructions that would guide that needle into the right place. No blood. No complications. Quick.
No, that wouldn’t be a good idea. He didn’t want to be there if the sample was cloudy or even bloody. Didn’t want to be in the room if things didn’t go well, if the doc had to stick Eddie’s back several times, if she grew frustrated and impatient and sloppy, if the needle couldn’t be coaxed smoothly into the subdural space.
Anna seemed to be still asleep, tucked into the corner of the green chair. What had happened last night? Yesterday, when he left for the hospital, he had kissed Eddie’s head as it lay propped against her arm, her nipple in the baby’s mouth. His son’s skin hadn’t seemed feverish. But his nose was stuffy, and clear snot had bubbled out one nostril. Eddie had a cold. Same cold as Anna, which she probably caught from Chris. She had called him last evening, said something about Eddie having a fever. From what she told him, the baby didn’t seem very sick. She said he was still nursing, hadn’t said anything about vomiting. What happened?
The questions hammered inside his head. What had she done? Or not done? Why hadn’t she recognized he was so ill?
Had he missed a clue when she called? It didn’t sound too bad, baby with a fever and a cold. Happened all the time. Why hadn’t he questioned her more carefully? If he had understood how ill Eddie was, he would have told Anna to get the baby to the ER last night. How could this be happening to them?
Chapter 9
Anna
“What was going on with Eddie last night, Anna?”
She heard Jake’s voice over the drone of the ER waiting room. Then a woman’s cry rose above the noise, replaced by a man’s grunt. A phone rang, a baby screamed, wheels rolled over linoleum, something metallic fell with a clang.
She stared at his pale, whiskery face, at his tired eyes. “He was sick.”
“Honey, what happened after we talked on the phone?”
It was chilly in the waiting room. She wrapped her arms around her chest, folded them under her breasts—her achy breasts. “I rocked him for a little while.”
“Was he nursing?”
“Not very well. But he took a little bit. Jake, I’m so scared. Is he going to be all right?”
“I don’t know.” He wiped his forehead. “Was he crying? Or whimpering?”
“He was fussy, eventually he fell asleep.”
Then she remembered. She had begged Eddie not to wake up when she laid him in the crib. And then he didn’t. She couldn’t tell Jake about that.
She pulled a piece of Kleenex from her pocket and blew her nose. “Then I put him in his crib.”
She was cold. She kicked off her clogs, folded her legs up into the chair, and gathered her shift around her bare feet.
“Then what?”
“Then it was morning.”
“And?”
She
didn’t know how to describe it. “Eddie didn’t wake me up for his middle-of-the-night feeding.”
“And then what?”
Jake was accusing her of something. Of not taking care of Eddie. “This sounds like a criminal interrogation,” she said.
“No, no. I’m just trying to figure out what happened last night. Did you call Dr. Elliott?”
“No.”
“I told you to do that if you were worried about him.”
He wouldn’t stop. He kept pounding her with questions. “Do you think Eddie was crying in the middle of the night and you didn’t hear him?
“Did you take a sleeping pill or something?
“What time did you wake up this morning, anyway?”
She didn’t answer. Finally he quit asking.
He rose, set Chris in the seat of his chair, and stepped toward her. At her side, he stooped, laid his hand on her knee, and stroked her hair. “Please tell me about last night. I just need to know what happened.”
“Well, I don’t know what happened. When I went into his room this morning, he was pale and barely breathing.” She hid her face behind her palms, made Jake disappear.
“Okay. Enough questions. I think I get the picture.” He returned to his chair and pulled Chris back into his lap.
The white band of cloth—the bottom of her nightgown—hung beneath the green and blue plaid hem of her shift. She ran her fingers over the knit fabric, folded it, folded it again, and folded it yet again. Then she unfolded it, and slowly refolded it once more.
Eddie was still in the treatment area. What was taking so long? He seemed so far away and she was stuck in the waiting room, the place where people idly lingered. Some paced from wall to wall, as Jake had done in ten-minute cycles. Some paged through dog-eared magazines. Others just sat. For her, time was strings of empty seconds tied together like foam buoys along an endless rope—dangling, twirling, bobbing, swaying, but going nowhere.
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