Waiting
WITH Derrick as part of our little ensemble now, a steady stream of people appeared in our room to ask if they could get us anything. Some came bearing tidbits of news, such as Bill was in the MRI machine, or they had finished the first set of brain images, or it would be another ten minutes before he was moved here or there. This was probably part of Moira’s thinking in getting Derrick into the ER in the first place. A little star power opened a lot of doors in this town.
We sat for hours. While it was nice to have our own space that kept us sheltered from people constantly interrupting us, it was also confining and meant that we couldn’t pace or do the things that other people were able to do in the rest of the hospital. As the evening wore on, we were becoming increasingly frazzled and frustrated.
When the door opened for what seemed like the millionth time that evening, we were prepared for yet another person to ask us if we wanted anything. Yes! What we wanted was information. What we wanted was to have Bill whole and healthy and to be able to take him home. What we wanted was for Bill to walk through the door and tell us it was all a mistake and that he was ready to go home. At least this time we got someone we wanted to see: Bill’s doctor. And this time he was not alone but was accompanied by several other people.
“I’m sorry that this has taken so long, but we’ve been running a variety of tests and waiting for the results to come back from the lab. We’ve rushed every test that we were able to rush and pulled every string we could pull. While we don’t have all of the answers, we are beginning to get a picture of what we face.” The doctor that we knew took a breath before continuing. Oh, this did not look good.
“At this point, our best guess is that we are dealing with some form of encephalitis. And to answer your question before you ask it, encephalitis, in the most basic terms, is an inflammation of the brain. There are many types of encephalitis, most of which are caused by viral infection.”
“Is there—” Moira started to ask.
“No. I’ll be brutally honest with you. There is no known cure.” He paused, looked down, and then looked back at us and continued. “We are treating him with the prescribed therapy in this sort of situation. He has been moved to ICU for supportive care. We’ve started him on anticonvulsants to prevent seizures. Encephalitis can cause increased intracranial pressure, so we’re also giving him diuretics to remove some of the fluids from his body.
“When you go upstairs to see him you’ll see that his head is also elevated, which is another part of trying to reduce intracranial pressure. We’re also using corticosteroids to help control intracranial swelling.
“This is most likely viral. There are no known effective anti-viral agents that work in this situation. I wish that I could say that yes, there is a wonder drug, but there isn’t. Still, we’re going to try a variety of antiviral medications to see if any of them might offer some assistance. We are most likely eliminating bacterial infection, but on the off chance that there is something we haven’t picked up on yet, we’re also giving him antibiotics.”
He paused to give us a moment to digest what he was telling us.
Moira asked the first question. “What sort of chances are we looking at here? And I know that it’s an impossible question. We’re not looking for the definitive answer, but just a rough idea of what we’re facing.”
“It’s a fair question. All I can tell you is that in mosquito-borne virus cases like this that occur in northern Australia and New Guinea that cause encephalitis, the infection may produce no symptoms in some people, but of those that do become ill, it is estimated that about twenty percent die and fifty percent of survivors have permanent neurological damage.”
We all gasped in shock at this bit of news. This doctor certainly was not sugarcoating his bad news, which I think we all appreciated.
Derrick asked a question that I had been wondering about. “I was there too, in the same conditions. Why didn’t I get sick? Do I have some sort of immunity? Can we take blood from me, purify out some immune factor—I don’t have the words—and give it to Bill to help him get better?”
The doctor gave Derrick a smile but shook his head. “I wish it worked that way, but unfortunately it doesn’t. And in terms of why you didn’t get sick, our best estimates are that only about one in five hundred infected people actually become ill.”
“Why did Bill get sick?” I asked bluntly. “Why him? Why now? Hasn’t he been through enough?” And I was losing it but did my damnedest to pull myself together to hear everything he had to say.
“What about specialists?” Moira asked. “I’ll pay to bring anybody in from anywhere. No expense is too much to make him better. If you know of someone who might have a shot at helping, get them on a plane ten minutes ago.”
“You’re thinking along the same lines that I have been. But we don’t need to bring people in, because we’ve got some of the world experts on these diseases right here in Los Angeles. And in fact, you have three of them here in this room at the moment.” He introduced us to the three people he had with him, who until that time had been quiet. One was a neurologist and two were infectious disease experts.
“I also have calls in to several additional people who might be able to give us some help, and as soon as I can reach them I’ll have them in here as well. We’re assembling the best possible team we can to deal with this case.”
My turn to ask another question. “When will we know if he’s in the twenty percent, the fifty percent, or the other group? And what additional steps can be taken if he starts to deteriorate?”
“You all have great questions. Sometimes in these cases the person develops difficulty breathing. If that happens we’ll start controlled ventilation, which is just what it sounds like: we’ll use a machine to do what his body is not able to do. We’ll have a device that will pump air into his lungs in case he isn’t able to do so for himself.
“There are a number of different drugs we can try to control swelling, and we can also physically alleviate pressure inside the cranium. But we’re not there yet.”
Moira took Derrick’s hand in her own and grabbed my hand with her other, either to give us strength or to draw some strength from us, or maybe a bit of both. She looked at me and then at Derrick. “All right. We need to see him. And I think you should know that someone will be here, and I don’t want to hear anything about visiting hours. There is no way we’re leaving him alone right now.”
“We understand. But please be assured that he is in no pain and is not aware of what is happening to him.”
“Fine. But we are aware. Being sick involves more than just the patient.”
He started to object but stopped. “You make a very reasonable point.”
“If you know of any nurses that would like to earn some extra money, I’d like to hire some to be sure that there is a medical professional with him at all times.”
“We’ll spread the word and see what we can do.”
“And I’m obviously willing to help with that if my celebrity might help to open some doors and get people to agree. It’s brought me enough trouble lately. It’s about time it did something productive.”
“Now if you could give us directions on where to go we would be most appreciative.”
“We’ll all take you there,” he said, standing. When he opened the door we were all startled by a flurry of activity, including numerous flashes from cameras. Quite a crowd had gathered while we had been talking. Questions were shouted, but all three of us ignored them and followed the doctors. Hospital security did a good job of keeping the pack from following us. We were under no illusions that they wouldn’t find us very quickly.
We took an elevator up several floors, were buzzed into a separate, isolated area labeled Intensive Care Unit and Critical Care Unit. Derrick was recognized immediately by numerous people who stopped what they were doing to follow where we were going. The doctors led us into Bill’s room. I think we all were surprised that he looked as good as he did. People have certain preconceived ideas about what happens in an ICU, but aside from two IVs and several monitors, he looked fairly normal.
While we spoke to Bill, whether or not he could hear us, the doctors disappeared to start lining up the nursing help we had requested. They apparently had no problem getting people to volunteer, returning almost immediately with a nurse who introduced herself and told us she was just going off duty but could stay for a couple of hours if we wanted her to. Derrick poured on the charm, which seemed to help our cause. I just hoped she wouldn’t be so overwhelmed by his presence that she forgot about Bill.
The rooms on this unit were significantly different than any I had seen before in other hospitals. In addition to a small sofa, there was also a recliner. Clearly, whoever designed these rooms knew that family and friends would want to be nearby while their loved one was in here. The rooms had been set up to accommodate not just the patient but their family as well. The rooms were large enough that hospital staff could come and go and interact with the patient without our being in the way.
The nurse pulled a chair up to the side of Bill’s bed and sat, lifting his hand. She turned her back on us and simply sat, holding his hand, gently stroking his hand. I gave her huge points. Derrick’s celebrity was not at all the focus. Moira sat with us for a while before surprising us both. “Boys, I’m an old woman. I’m exhausted. I’m not going to be of any use to you if I don’t get some sleep. I’m going to go home and get some sleep and then come back and relieve you so that tomorrow morning you can go do the same. I think we’d make better use of our resources if we take shifts so that none of us get too exhausted to be of any use. Does that sound workable to you?”
We nodded our consent and agreement. Before she left, she made sure that we each had our cell phones and that we had her cell phone number programmed into ours. She gave her number to the nurse in the room as well as the doctors and nurses outside. And then she was gone. Derrick took the recliner, and I took the sofa. Without intending to, we each fell asleep, rousing a little occasionally when someone came into the room to check vitals or to relieve the nurse.
At about 4:00 a.m. we were both startled awake by some sort of medical alarm going off. It brought people running from all over, taking our room from quiet to suddenly full and active. We asked what was happening but were asked to step outside. It was at that point that I did lose it, completely, no questions asked. I lost it. I was bawling my eyes out and hugging Derrick. He was crying and held me tightly as well. It was not our finest moment by a long shot: startled awake, worried, emotional, frazzled.
And wouldn’t you know it—there was a photographer that had somehow tracked us down and staked us out and took our pictures at our worst moment. We knew there was no escaping them, so we simply tried turning so that they could only see the backs of our heads. A little spitfire of a nurse came rushing at the photographer, chasing him away. When he didn’t move fast enough for her liking she grabbed a broom that someone had left nearby and started swinging it at him.
The door to Bill’s room reopened, and people started filing out. Someone told us that it was a false alarm and that there was no problem—a wire had simply come loose, which set off the alarm. We heaved a huge sigh of relief, returning to the room to each grab one of Bill’s hands and tell him that he had just scared the crap out of us. We each gave him a kiss and then returned to our seats, although sleep didn’t come to either of us that time.