Although it had only been four years since the ribbon-cutting ceremony, the Stenson Family Children’s Hospital had matured into an outstanding facility. An eight-story architectural triumph, the hospital incorporated multiple inspirational themes that successfully captured what modern children’s hospitals strove to achieve. Its construction would not have been possible without the efforts of Southeastern State University’s charitable foundation, which had raised ninety million dollars for the project. Although Madison served on many hospital committees, she was most proud of being asked to serve on the foundation’s board of directors.
Avoiding the packed waiting room, Madison led Jack into the emergency room through the staff entrance. Having been there several times to consult on teenage high-risk pregnancies, she was familiar with the ER’s layout. Jack, on the other hand, could barely remember the last time he’d been in a children’s hospital. The voices of harried personnel barking orders while wailing children clutched at their parents was a stark reminder to Jack why he never gave serious thought to going into pediatrics.
Following Madison down a hallway crowded with equipment and staff, he glanced back and forth into the examination rooms. Not a single one was empty, and the patients spanned the gamut from infancy to adolescence. Approaching the nursing station, they walked past a six-bed pod specially designed for the treatment of asthma. Even from the hall, his eyes fixed on the anxious face of a father cradling his squirming daughter. He struggled to hold a plastic mask that spewed a medicated aerosol over her mouth and nose.
Just as they reached the central station, Linda Haise, a veteran nurse with a skeletal frame and a pair of tortoiseshell reading glasses that teetered on the tip of her nose, emerged from the trauma treatment area.
“Hi, Dr. Shaw. I heard they called you to come to see Isabella Rosas.”
Madison nodded. “How’s she doing?”
“Not great. Her vital signs have been all over the place and she’s pretty out of it. When the paramedics first brought her in we thought she had suffered an unwitnessed head injury, but when we saw the dancing eye syndrome…well, it didn’t take too long to figure out she was the first case of pediatric GNS.”
“Is Dr. Effratus still in there?”
“Yeah,” she said, brushing a few obstinate strands of auburn hair from her forehead. “When I left the room a few minutes ago, he was still scratching his head. Sam’s been in there with her for a while,” she said. A nurse’s aide walked up and handed Linda a printout of lab results. “I gotta go. I have a two-year-old who decided to eat his toy soldiers and their cannons for dinner. I think it’s affecting his digestion.”
“That sounds terrible,” Madison said.
“There are a lot worse things. I’m sure if we wait a day or so the entire army and their artillery will come out in the wash.”
Madison and Jack made their way down to Isabella’s room. When they were a few feet away, they noticed a sign on the door indicating isolation precautions. They each slipped on latex gloves, a yellow paper gown and a mask.
Dr. Samuel Effratus was hunched over the bed listening to Isabella’s heart. He was a placid man who maintained an optimistic outlook on most things and who waged a never-ending war to keep his weight down. If asked, he’d be the first to admit he’d lost the last few battles. His usual engaging smile absent from his face, he glanced up at Madison and shook his head.
“Sam, this is Jack Wyatt,” Madison said. “He’s a visiting professor of neurology from Ohio State.”
“Nice to meet you,” he said, strolling over to shake his hand.
“How’s she doing?” Madison asked, glancing up at the cardiac monitor.
“I’d say fair at best. Her blood pressure and pulse are finally okay. She’s still conscious but she’s not responding to verbal commands. She has muscle twitching in both legs and dancing eye syndrome.”
“Doesn’t sound like there’s much doubt about the diagnosis. Are her parents here?”
“Unfortunately her father’s been MIA for the past five years and mom’s been in and out of rehab so many times the court awarded permanent custody to the grandmother. She brought her in. She seems very concerned. She needed a break so I sent her out to the waiting room.”
“Have you done a CT scan of her head yet?” Jack inquired.
“It was normal,” Effratus answered. He then turned to Madison and added, “I spoke with a pediatric neurologist and went over the case with him in detail. Because you guys have all the experience dealing with GNS, he suggested we transfer Isabella to the main hospital. He slung his stethoscope around his neck. “What do you think?”
“I think it’s a good idea,” Madison said. “When were you planning on sending her over?”
“I wanted to get your approval first. I’ll give our transport team a call. They’ll have her over there within the hour.”
Madison walked up to the head of the bed. She reached under the covers and gently palpated Isabella’s tummy. She looked over at Marc. “Pretty normal abdomen. What did her ultrasound show?”
After a brief silence, Marc said, “We didn’t do one.”
“Why not? What are you waiting for?” she asked with an impatient huff.
“Her physical examination shows no signs of her being pregnant. We sent off both urine and blood. They both came back normal, so we repeated them and they both came back normal again.” With a furrowed brow, he turned away and covered his mouth for a few seconds. Finally, he said, “There’s no way she’s pregnant.”
Madison took a step back from the bed.
“The only factor these patients have in common is that they’re all pregnant. It’s the only damn clue we have…or should I say, had.” She gazed overhead with disbelief fixed on her face. “Now what the hell do we do?” She exhaled sharply and, then, in a more controlled voice said, “Thanks for everything you’ve done, Sam. We’ll check on her as soon as she gets over to Southeastern State.”
Jack could well appreciate Madison’s mounting frustration. He’d been in the same situation many times himself, chasing an elusive diagnosis. The problem was that Madison was right. In a clinical investigation already fraught with one dead end after another, losing the one glimmer of hope that could lead to a major breakthrough was hardly a trivial setback. They retraced their steps out of the emergency room. This time Jack was lost in thought and oblivious to the commotion around him. They stepped outside and continued in silence toward the parking lot. They waited for a minute while an ambulance with its red and green lights flashing backed into one of the four bays.
“This may not be as bad as it looks,” Jack said, trying not to dampen her resolve anymore than it already had been.
“For God’s sake, Jack. The only clue we had just evaporated in front of our eyes. From where I sit, we’re back to square one. How much worse could this be?”
“It’s just a matter of expanding the possibilities. Even though Isabella’s not pregnant, there still has to be one or more factors she shares with the other GNS patients.”
“Your optimism is commendable, but if you look at things objectively, you don’t have to be a Jedi Master to see we’re screwed. You’ll have to excuse me for not breaking into a victory dance over the events of the evening.”
Madison picked up her pace, leaving Jack a few steps behind. He sensed any further pep talks would be as useful as shouting at the rain. He reached the car a few seconds after she did, climbed in and sat in silence.