Terminally Ill Read online

  Fadi shook my hand before getting down to business. “Mr. Serratore was doing quite well after some Epinephrine and Ventolin in the ambulance. We thought he was stable on arrival.”

  “Why’d he get the Epi?” I asked, even though it felt like I was interrupting.

  Fadi shrugged. “The paramedics said he was wheezing. In any case, his vital signs were good on arrival and he was no longer wheezing, but he had a seizure in the trauma room that lasted less than a minute. By the time we’d drawn up the Ativan, it had finished.”

  “A seizure? Did he have epilepsy or something?” Tucker asked, tapping his fingers on the end of the nearest stretcher. He didn’t notice the patient’s mother giving him a dirty look.

  “Not that we know of. His brother is calling their mother, just to be sure.”

  “Can we see him?” I asked.

  Fadi glanced toward the south end of the ambulance bay. “It is probably not a good idea. He just came out of the CT scan and, as far as I know, he is still in the post-ictal period.”

  That meant Elvis was confused and disoriented. I frowned, trying to puzzle this out. Lack of oxygenated blood to the brain could cause seizures, of course. During rounds at St. Joseph’s, one doctor had pointed out that the most common cause of seizures, in our elderly internal medicine patients, was a stroke. More memorably, one of the lecturers in medical school had told us that one of their party tricks was to get drunk, press on a friend’s carotid arteries until he couldn’t get any blood flow to his head, and hold him upright, still pressing his arteries, until he seized.

  But usually, unless you had epilepsy, you didn’t have a post-ictal period where you were confused and sleepy. People who passed out from arrhythmias were usually able to talk again right afterward.

  What was going on with Elvis? He missed his stunt, he’d come out pulseless and gotten CPR, Epi, and Ventolin, and now he was seizing.

  I glanced at Tucker. He took over asking for permission to visit, pouring on the man-dude-bro charm, but Fadi stood firm. “I must go check on him now. I will keep you posted, Tucker.”

  They switched back to Arabic and clasped hands again, and then Tucker and I were left standing there in the chaos of an unfamiliar hospital, feeling a little bit like a jilted bride.

  Chapter 8

  For Sunday morning, I’d braced myself for hours of rounding on internal medicine with the consultant, Dr. Samson, and Omar, the senior medical resident. We’d discuss every one of our patients, their blood work, their imaging, and the latest papers on how to best treat their problems. Sometimes I learn a lot. Other times, I’m trying not to yawn on “eternal medicine,” as Tucker once put it.

  But barely an hour in, Dr. Samson got a phone call while we were gowning up to visit a woman with MRSA pneumonia. “One of our admitted patients in the emerg has explosive diarrhea and a lowish blood pressure that isn’t responding to fluids,” said Dr. Samson, hanging up his phone. “Would you mind taking a look, Dr., ah, Zee?”

  “Of course,” I said, even though I secretly loathe bum-related complaints. When you’re the junior resident, with no medical student on call below you, you just smile and trot down to the emergency room.

  I left my mask, yellow gown, and gloves on, figuring they’d come in handy when I ended up face to bum with explosive diarrhea. And even though I was supposed to go to Hallway 24, not too far from Ms. Kincaid’s stretcher, I grabbed the chart and took the back door out of the emerg’s conference room to avoid another encounter with David Watson. Maybe they’d gone up to the floor, but I didn’t want to risk it.

  Maybe that sounds cowardly. I did my medical school in Ontario, where I would have said the waiting time and overcrowding can get bad, even occasionally dire. But that was before I came to Quebec, where dire has a whole new meaning.

  Families turned to look at me, and I avoided their eyes, speed-walking toward Hallway 24, which was opposite the pay phones and the vending machines I never used.

  “Hi, Dr. Sze.” Mr. Watson smiled at me. I couldn’t accuse him of stalking me, since he held up the bottle of water that had just thunked out of the vending machine. “Feeling thirsty?”

  I took a step back. “Not too bad, thanks. How are you? Is your mother still waiting for a bed?”

  “Of course she is.” He sighed. Some of Friday’s charm had leached away over the weekend, making the grooves in his forehead and the brackets around his mouth more obvious. “Dr. Huot saw her Friday night and recommended she go to a palliative bed instead of oncology, but Dr. Underwood said that she’d be better off on 5 South while she’s still on chemo. What do you think?”

  I tried to pick my words carefully. I’m a resident. I kind of do what I’m told. I learn as much medicine as I can. I see the patients I’m supposed to see, and I keep my ears open, but I’m pretty ignorant about politics and bed management and “flow,” which is the more politically correct term for emergency overcrowding. I know even less about arguments between internal medicine and palliative care. So I thought of the Bérubés and admitted, “The patients and their families seem very happy on palliative care, but I’ve heard of people waiting up to four days for a room.”

  “Four days!” He pressed his hand to his cheek and dragged the skin down, pulling his bottom eyelid away from his eye and making him look like something of a Mad Magazine sketch instead of a polished executive. “She can’t stay here that long.”

  “That was a private room,” I added hastily. “Maybe the wait might be a little shorter for a semi-private.”

  He cleared his throat. “I just want to look after my mother. She raised me and my two brothers after our father died in a car accident. She had to get a job cleaning other people’s houses, and then she’d be up cooking and cleaning all night for us. She wouldn’t even sit down to eat. She’d eat over the sink and then get back to work.”

  Hmm. I couldn’t help wondering why he and his brothers didn’t pitch in so that their mother could rest for a few minutes, but she sounded like quite a woman.

  “She never wanted money or a fancy car, but now that she’s sick, I want her to have the best medical care possible. We were happy at the Royal Vic, but…”

  I knew that the oncologists at the Royal Victoria Hospital had resigned en masse, in protest. I didn’t know why, exactly, but I assumed it was the usual Quebec reason: patients got substandard care while the doctors were overwhelmed and underpaid. Of course, this was a good symbolic gesture, but meant a lot of cancer patients were left without anyone to care for them at all. When is shitty care better than no care?

  Hard to say.

  “So I found someone who would take her here. I had to use all my connections.” Mr. Watson shook his head, unsmiling. “She needs a bed. She needs quiet. She needs a bathroom. She wants to go to a bathroom that isn’t a commode in the hallway. She wants to sleep somewhere where the lights aren’t shining in her eyes and the other patients aren’t moaning around her like they’re casualties in a battlefield. It’s making her sick.”

  I shifted from foot to foot. Not to be callous, but his mother was already sick, and unfortunately, I couldn’t help her any more. I had to tend to explosive diarrhea, although fortunately not my own.

  “I’m keeping you. I’m sorry, Dr. Sze,” he said, and nodded goodbye.

  “I’m sorry, too,” I said softly, and then I located Hallway 24.

  After we finished rounding and tying up a few more cases, it was 2:20 p.m. I decided to grab a bite to eat. Before I’d made it up the first flight of stairs, though, my pager went off with a 514 area code number that I didn’t recognize.

  Was it Tucker, from someone else’s house? I checked my phone in case I’d missed a text. I found one from Ryan instead. Left hip broken. Will need surgery. She is scared and confused.

  Oh, no. Ryan, his grandmother, and the rest of his family must be agonizing. I texted back a brief, inadequate message, but it didn’t explain the call on my pager. Ryan was in Ottawa, which is a 613 area code. I couldn’t see h
im deserting his Pau Pau and driving to see me when I was barricaded in the hospital for the next 24 hours or so.

  The last time I answered an unfamiliar number on my pager, I accidentally called a phone sex line. But this wasn’t a 1-800 number, and, the merest possibility of Ryan within sniffing distance (and touching distance, and kissing distance) got my juices surging. Even if Ryan was still annoyingly, Christian-ingly celibate, we could lie down together. He could wrap his arms around me, and I could press my face into the space between his neck and shoulder, breathing him in, feeling his warm brown skin against mine.

  I licked my lips and called the 514 number from the resident’s room while my leftovers sizzled in the microwave.

  “Hi, it’s Hope Sze, the resident on internal medicine,” I said.

  After a pause, a man’s voice said, “Hi, my name’s Archer Serratore. You remember Elvis the Escape Artist? He’s asking for you.”

  “For me?” I said. My stomach growled. I crossed my arms over it and willed it to be quiet. “Um, I think you might have the wrong number.”

  “You’re the detective doctor, right?”

  The microwave beeped three times, signaling that it was done. A medical student gestured at it, asking if he could kick my fried rice out and put his lunch in. I nodded in agreement and turned away from him. “Right. I mean, that’s what they used to say,” I said, wondering if they’d chisel “detective doctor” into my tombstone. Oops, bad thought. “But I don’t really know Elvis the Escape Artist.”

  “You helped rescue him at the St. Lawrence river, right? On Hallowe’en?”

  “Yes, of course. I remember you, Mr. Serratore.” I slipped into my default mode of calling strangers, mostly patients, by their titles. I also call them “sir” and “ma’am.”

  He snorted. “Mr. Serratore’s our dad. Call me Archer. I’m his manager and his brother.”

  The voice of the man on the phone rasped a little, like Archer’s had yesterday. But it was more likely that Tucker or someone else was playing a joke on me. I was hungry, and only had a few minutes to scarf my food down before my pager beckoned. “Okay, Archer,” I said. “Or should I say Tucker?”

  “What? Oh, that’s the other doctor, huh? Listen, I’m not joking. It took me a long time to track you down through the hospital operator.”

  That, at least, was believable. St. Joe’s “locating” system leaves a lot to be desired. “Let’s say I believe you, that you’re Archer. Why did you bother to look for me?”

  “Elvis needs to see you.”

  “Why me?” I gazed longingly at my fried rice, now sitting on top of the microwave, only ten feet away, but since I’d touched the phone, I’d now have to walk down the hall to the bathroom and wash my hands before I ate. In my mind, hand sanitizer won’t cut it if I’m about to eat or drink.

  “I don’t know. But he keeps asking for you.”

  I snorted before I could stop myself. “He doesn’t know who I am. He was unconscious.”

  “But when he saw you on TV this morning, he couldn’t stop pointing. I had to look you up online, and then he kept saying, ‘Yes. Her.’”

  Shoot. I hadn’t realized I’d ended up on TV after all. I ignored that bit. “What about me?”

  Archer paused. “Well, it’s kind of tricky because he doesn’t remember a whole lot.”

  “He doesn’t remember—”

  “Much of anything about the accident. He got amnesia, I guess.”

  That sounded like a soap opera, but I guess since his brain lacked oxygen for almost four minutes, it wasn’t too surprising. Hmm. “If he has amnesia, how did he remember me?”

  “I don’t know.” He sighed through the receiver, and suddenly I remembered that Archer had driven all the way from Winnipeg and his brother had almost died. In fact, technically, he had died.

  “I’m sorry. I mean, I can come see him, but—”

  “You’ll come see him? Excellent. When?”

  Uh oh. I did not want to go down to the University College during my off-time. “Well, not for a while. I’m on call today, I’m post-call tomorrow, and I’m on call again on Wednesday. So, you see, I’m really not your best bet. I’m sure his neurologists is excellent, though. I know one at the University College, Dr. Yablonsky. I could maybe call him.”

  “He’s got his doctors. He wants you.” His voice got rough. “Look. We thought we were going to lose him. It was like a miracle when he came through. He woke up. I thought that was it. But he doesn’t want to eat. Even the dog they brought in to cheer up the hospital patients, he just looked at it. I had to tell him to pet it. I showed him a pair of handcuffs. Nothin’. But when he saw you on TV, he couldn’t stop talking. I thought maybe he just wanted to see the footage of him in the coffin, but he wasn’t really interested until it got to you. And when I play the clip on the website, he wants me to stop at the three-minute mark, so he can see you.”

  I was touched, but that’s how I got roped into helping Mrs. Lee in August. I steeled my heart and forced myself to say, “I’m sorry, Mr.—Archer.”

  “Just come see him. I’ll pay you $200.”

  I opened my mouth to refuse, but nothing came out. For a student who’s paid $17000 per year for med school tuition, two bills would help a lot. Like, with groceries. It used to be that you could moonlight as a resident, but those days are over. Now you have to be fully licensed before they’ll let you work at other hospitals in your copious free time, and even then, competition is pretty fierce. We’re all in debt.

  “We have sponsors. If we lose him...”

  I could fill in the blanks. I’m not sure what kind of work there is in Winnipeg for a former escape artist who no longer looks at handcuffs the same way.

  “If you get him talking and moving, I’ll pay you a thousand dollars. Cash.”

  I half-laughed. I must be looking pretty poor, because everyone was offering me money today. “Mr. Serratore, that’s what your doctors, nurses, and physiotherapists are for.”

  “I don’t need doctors, nurses, and physiotherapists. I need results.”

  “They’re the ones who’ll give you results. Occupational therapists, too,” I belatedly remembered.

  “What do you say?” He waited a beat. “Please. We’re talking about my brother’s life. And before you say anything, remember, call me Archer.”

  I sighed deeply. “You don’t have to pay me, but I can probably stop by tomorrow, around supper time, Archer.”

  “Yes!” He held the phone away from his mouth. “She’ll come! Hey, buddy, she’s coming tomorrow!”

  Elvis didn’t answer, but I almost smiled, just before my pager went off. Again.

  Chapter 9

  After reassessing a patient on 5 South who’d vomited five times, despite IV Gravol and Ondansetron, I washed my hands thoroughly at the nursing station. I still wanted my fried rice, gol ding it. While striding into the hall, I almost collided with a man carrying a vase of red roses.

  “Sorry,” I said.

  “No problem, Doctor.” He grinned at me over the red petals, baby’s breath, and ferns. He had a slight accent, and his formal way of talking didn’t sound quite French. “You’re a busy woman.”

  I was impressed that he hadn’t assumed I was a nurse, even though he looked to be at least in his late 60’s, with laugh wrinkles around his eyes and salt and pepper hair. Maybe the white coat gave me a certain gravitas.

  The man detoured around me, the pant legs of his three-piece silver suit swishing. Hardly anyone wears a suit to the hospital anymore. Well, maybe an older psychiatrist or two. But for the most part, it’s scrubs or, if you’re lucky, a clean shirt and pants.

  The man also didn’t move the way a doctor does, which is generally hurrying from place to place, staring at a watch, kind of the White Rabbit from Alice in Wonderland. This man moved more like a dancer, setting the vase on the nursing station counter with a smile and a little bow.

  “Who’s that?” I asked, Sandra, a round, middle-aged nurse who w
as rolling a portable vital signs machine down the hall.

  “Oh. Peter the preacher,” she said, her mouth relaxing into a smile.

  “Is he one of the ministers here?” I’d never seen him before, but this was my first ward rotation. Up until now, I’d only done emerg (yes!), psychiatry (uhh) and family medicine (ugh).

  “Not officially, but he’s a cancer survivor from St. Joe’s. We thought he wouldn’t make it, but he showed us all. Now he comes to preach every Sunday afternoon.”

  Peter the preacher leaned over the counter to speak to the receptionist and the nurse who were sitting there. “Here is a gift for my favourite secretary and my favourite nurse.”

  They laughed.

  “We’re all your favourite nurses,” called the nurse, but she was smiling.

  “As you should be. The gift is for all of you, for saving my life! Ah, Sandra, my angel,” he said, crossing the hall toward us. “Are you still working your magic on your sweet patients?”

  “I don’t know if it’s magic, but I’m working,” said Sandra.

  “I know and you know it’s magic indeed.” Peter the preacher made a little bow at me, snapping his heels together. “And who might this young lady be?”

  I said, “I’m on call for internal medicine, but I’m the palliative care resident, Dr. Hope Sze.”

  “Ah.” He nodded sagely and held out his hand to shake mine. His fingers trembled only very slightly, and he didn’t appear to be hiding any money in his hand.

  I shook it. He gave my hand a little squeeze, bowed his head, and said, “Enchanté.”

  I murmured back, “Enchanté,” a French expression that never fails to delight me. I mean, when was the last time an English stranger said he was enchanted to meet you? Then Peter the preacher added, “Would either of you lovely ladies you like to come to our Sunday meeting? It’s at 3 p.m. in the palliative care lounge. Patients and caregivers come together to talk and sing.”

  Sandra patted the vital signs machine. “I wish I could, Peter. I have to work.”

  “This is work as well as play!” said Peter, but he turned to me. “Dr. Sze?”