There’d been so much good news lately that the morning the phone call came in, it took a while for its gravity to register.
“Dr. Logan?” said the male voice, at once familiar and unplaceable.
“Yes.”
“This is Phil Lester.” He waited for some sign of recognition. “I met you with Hannah Dietz?” he added, tentatively.
“Oh, yes, of course. What can I help you with?”
“I’m sorry to bother you, Doctor. Hannah asked me not to.”
“No problem, that’s what we’re here for.” Though, abruptly, his antennae were up: what was going on here? Hannah was one of their success stories! And why wasn’t she on the phone?
“I’m a bit worried,” he continued. “I think something’s not right with her.”
“What do you mean, exactly?”
“Last night, in the middle of the night, she started vomiting. And she doesn’t look well.”
“Has the vomiting been continual?” The guy’s tone was so moderate, it was hard to believe anything could be seriously wrong.
“Continual? Yes, I would say so. Six or seven times. I don’t think there’s anything left to come out now.”
Jesus H. Christ! This woman should be in a hospital!
“She’s just exhausted, Doctor,” he continued, “and she’s also sweating a lot. She’s like a dishrag.”
“You were right to call. I think she should be looked at.”
These words of reassurance were all it took to crack Phil’s veneer of calm. “I knew it! It’s very bad, isn’t it?”
“I can’t tell you that, Phil,” he said. “Probably not.”
“But she was getting better! I thought she was well!”
“It’s probably nothing to worry about. Just a minor setback.”
“Should I take her to the hospital here?”
Where the hell were they?—somewhere in the New Jersey ’burbs! Chances are no one there would even begin to know what to look for!
“Look, if at all possible, I’d like to get her in here.” His mind was racing. “I have a thought—can I call you right back?”
A helicopter! That way she could be on site in little more than an hour. The ACF used them occasionally, but only for dire emergencies; and that required clearance by the director’s office.
In seconds, he had Shein on the line. Less than a minute after that, Shein called him back with formal authorization. “It’s being arranged through the New Jersey National Guard. Call your guy and tell him to sit tight.”
“Thank you, Dr. Shein.”
“Thank me if it pans out. Otherwise, keep me the hell away from it. We’re both spending a lot of capital here, Logan.”
It ended up being more like an hour and a half before the copter put down on the quad. Mrs. Dietz was hustled into the hospital on a stretcher.
Logan and Sabrina were waiting for her. Reston had declined an invitation to participate in the treatment.
One sight was all it took to assess the gravity of the patient’s condition. She was extremely pale and completely disoriented. Most worrisome, the whites of her eyes had a distinctly yellow cast, evidence that her liver was no longer functioning properly.
By prearrangement, Sabrina took charge of the patient’s care while Logan saw to her friend.
Phil, alone in the waiting room, wearing a Hawaiian shirt and pants of Day-Glo orange, was doubled over, head in hands. When Logan touched him gently on the shoulder, he was surprised to find he had not been weeping.
“Phil,” he said softly, “I’ve got to get back in there. I just want you to know we’re going to be running a few tests.”
“Tests?”
“We need to assess her overall condition. But I want you to know you haven’t been forgotten. If you feel you need to speak to me, tell a nurse.”
He nodded. “I understand. Thank you, Doctor.”
Sabrina, assisted by a nurse and an orderly, already had Mrs. Dietz hooked up to an IV line to counter her dehydration. The monitor over her head revealed that her heart was racing and she was hypotensive. But the greatest concern was the possibility, based on her obvious sense of confusion, that she was encephalopathic—yet another sign of liver failure.
Still, she appeared to be somewhat more alert now. Sabrina was leaning over her bed and talking soothingly. “Hello, Hannah. Do you recognize me?”
There came a smile on the old woman’s face. “How are you, Dr. Como?”
“Good, Excellent. Can you tell me how you are feeling, Hannah?”
“I’ve been better, thank you.” She paused, anxious eyes searching the room. “Where’s my Phil?”
“Right in the next room.”
“He’s fine, Hannah,” spoke up Logan, moving closer. “He’s just concerned about you. Like all of us.”
“He’s a good man, don’t you think?”
“I do,” agreed Sabrina. “You are a very lucky woman. Such a man is not easy to find.” She paused. “Now I am going to ask you to do something for me.”
“Yes?”
“Could you hold your arm out straight?” She demonstrated with her own.
It is the simplest possible test for hepatic encephalopathy. When a patient is suffering the condition, the hand will jerk back and forth spasmodically.
Which is precisely what Mrs. Dietz’s now began to do.
Sabrina looked to Logan and their eyes momentarily locked. There was no need for words.
“Can I put my arm down?”
“Yes, of course.” Sabrina managed a smile as she stroked her forehead. “See, nothing to it.”
“You’re a very kind girl, do you know that? Very loving.”
“Thank you. From you, I consider this a great compliment.”
Dietz opened her gray eyes a little wider. “I’m going to die now.”
For an instant, Sabrina thought to protest.
But, no, Mrs. Dietz wasn’t looking for reassurance. It was a declaration.
Though it sounds like myth, many doctors who’ve done serious time in hospitals believe it: when a patient tells you they’re dying, even in apparent contradiction of the facts, they usually are.
Neither of the doctors doubted now it was true.
As she drifted off to sleep, Sabrina remained perched on the side of the bed, watching the beautiful old face.
She touched Logan’s hand. “You should get Phil.”
He was there a few minutes later when she fell into a hepatic coma; and still there early that evening when she peacefully died.
The initial autopsy report came in two days later. As he read through it, Logan physically shuddered.
A congested and grossly distended liver. Fulminent hepatic necrosis. Holy shit! It was almost identical to the one on the damn rabbits!