Bygones (43 page)

“Respiration?”

“Poor.”

“How bad are the arrhythmias?”

“Bad. Heart is moving like a bag of worms in there. Very irregular and rapid. We put him on D5W.”

Three patches were already pasted on Randy's chest, and a blood pressure cuff ringed his arm. Someone snapped leads to them, connected to monitors on the wall. Intermittent beeps sounded. Randy's eyes were wide open as a doctor in white leaned over him. “Randy, can you hear me? Can you hear me, Randy? Did you take anything?”

The doc pulled back Randy's eyelids one at a time and studied the periphery of his eyes. A woman in blue scrubs said, “His parents are here.”

The doctor caught sight of Bess and Michael, standing to one side, supporting each other. “You're his parents?”

“Yes,” Michael answered.

“Are there any congenital heart problems?”

“No.”

“Diabetes?”

“No.”

“Seizure disorders?”

“No.”

“Is he on any medication?”

“None that we know of.”

“Does he use cocaine?”

“I don't think so. Marijuana sometimes.”

A nurse said, “Blood pressure's dropping.”

An alarm sounded on one of the machines, like the hang-up tone on a dangling telephone.

The doctor shouted, “This guy's coding! Page code blue!” He made a fist and delivered a tremendous blow to Randy's sternum.

Bess winced and placed one hand over her mouth. She stared, caught in a horror beyond anything she'd imagined, while her son lay on the gurney dying and a medical team fought a scene such as she'd witnessed only on television.

More staff came running, two more nurses, one who started a flowchart, a lab technician to help monitor the vital signs, a radiology technician who watched the monitors, an anesthetist who inserted a pair of nasal prongs into Randy's nose, another doctor who began administering CPR. “Grease the paddles!” he ordered. “We have to defibrillate!” With stacked hands, he thrust at Randy's chest.

Bess and Michael's interlocked knuckles turned white.

A nurse turned on a machine that set up a high electrical whine. She grabbed two paddles on curled cords and smeared them with gel. The doctor ordered, “Stand back!” Everyone backed away from the metal gurney as the nurse flattened the paddles to the left side of Randy's chest.

“Hit him!”

The nurse pushed two buttons at once.

Randy grunted. His body arched. His arms and legs stiffened, then fell limp.

Bess uttered a soft cry and turned her face against Michael's shoulder.

Someone said, “Good, he responded.”

Through her tears and her terror, Bess looked back at the table, little understanding why these methods were used. Electrical current, zapping through her son's body, making it jerk and flop, that precious body she'd once carried within her own.
Please don't! Don't do that to him again!

The room fell silent. All eyes riveted on a green screen and its flat, flat line.

Dear God, they've killed him! He's dead! There is no heartbeat!

“Come on, come on . . .” someone whispered urgently—the doctor, who'd made a tight fist and pushed it into the gurney mattress as he stared at the monitor. “Beat, damn it . . .”

The line stayed flat.

Bess and Michael stared with the others, linked by wills and hands, in near shock themselves from this quick plunge into disaster.

Tears leaked down Bess's face. “What is it? What's happening?” Bess whispered but no one responded.

The green line squiggled.

It squiggled again, lifting to form a tiny hillock on that deadly, unbroken horizon. And suddenly it picked up, became regular. Everyone in the room sighed and let their shoulders sag.

“All right, way to go, Randy,” one of the medical team said.

Randy was still unconscious.

The lab technician, in a businesslike tone, with his eyes locked on the screen, reported, “We're back to an organized rhythm . . . eighty beats per minute now.” The nurse with the clipboard checked the clock and made a note.

Bess looked up at Michael and her face sagged, as if made of wet newsprint. His eyes were dry and burning. He put both arms around her shoulders and hauled her close, cleaving to keep his knees from buckling while Randy began to regain consciousness.

“Randy, can you hear me?” Again a doctor was leaning over him.

He made a wordless sound, still groggy.

“Do you know where you are, Randy?”

He opened his eyes fully, looked around at the ring of faces and abruptly grew belligerent. He tried to sit up. “What the hell, let me outa—”

“Whoa, there.” Hands pressed him down. “Not much oxygen getting to that brain yet. He's still light-headed. Randy, did you take anything? Did you take any cocaine?”

A nurse informed the doctor, “The cardiologist is on his way over from the clinic.”

The doctor repeated to Randy, “Did you take any cocaine?”

Randy wagged his head and tried to lift one arm. The doctor held it down, encumbered as it was by the blood pressure cuff and the lead-in for an IV.

“Randy, we're not the police. Nobody is going to get in trouble if you tell us but we have to know so we can help you and keep your heart beating regularly. Was it cocaine, Randy?”

Randy fixed his eyes on the doctor's clothing and mumbled, “It was my first time, Doc, honest.”

“How did you take it?”

No answer.

“Did you shoot up?”

No answer.

“Snort it?”

Randy nodded.

The doc touched his shoulder. “Okay, no need to get scared. Just relax.” He lifted Randy's eyelids again, peered down, held up an index finger and said, “Follow my finger with your eyes.” To the recording nurse he said, “No vertical nystagmus. No dilation.” To Randy, “Are any of your muscles twitching?”

“No.”

“Good. I'm going to tell you what happened. The cocaine increased your heartbeat to the point where there wasn't enough time during each beat for it to properly fill with oxygenated blood. Consequently not enough oxygen was getting to your brain so at first you probably felt a little light-headed, and finally you fell off your stool. After you got here to the hospital your heart stopped beating completely but we started it again. There's a cardiologist on his way over from the clinic right now. He'll probably give you some medication to keep your heartbeat regular, okay?”

At that moment the cardiologist swept in, moving directly to the gurney in brisk steps. The physician speaking said, “Randy, this is Dr. Mortenson.”

While the specialist took over, the other doctor approached Bess and Michael. “I'm Dr. Fenton,” he said, extending his hand to each of them in turn. He had grand gray eyebrows and a caring manner. “I imagine you both feel like you're going to be next on that table. Let's step out into the hall, where we can talk privately.”

In the hall, Dr. Fenton took a second glance at Bess and said, “Are you feeling faint, Mrs. Curran?”

“No . . . no, I'm all right.”

“There's no need to be heroic. You've just been through a stressful ordeal. Let's sit down over here.” He indicated a line of hard chairs across from the emergency-room desk. Michael put his arm around Bess and helped her to one, where she sank down gratefully. When they were all seated, Fenton said, “I know you have a lot of questions, so let me fill you in. I think you heard what I was saying to Randy in there—he snorted some cocaine, which can do a lot of nasty things to the human body. This time it caused an abnormally high heart rate—ventricular tachycardia, we call it. When the paramedics answered the call, Randy had been playing the drums and had fallen off his stool. That's because there wasn't enough oxygen getting to his brain. When you saw him arrest, there was so much electrostimulus going through his heart it wasn't actually beating anymore, it was only quivering. When a heart does that we have to bring it to a complete standstill so its normal rhythmicity can return. That's why I struck his chest, and that's what we did when we defibrillated him. Once you do that the normal electrical pathway can take over again, which is what's happened now.

“You saw how Randy got a little belligerent when he was coming awake. That often happens when the oxygen is returning to the brain but he should rest easier now.

“I have to warn you, though, that this can happen again during the next several hours, either from the drugs or from the heart itself, which is very irritable after all it's been through. My guess is Dr. Mortenson will prescribe some medication to prevent fibrillation from recurring. The problem with cocaine is that we can't go in there and get it out like we could poison, for example. We can only offer supportive care and wait for the effects of the drug to wear off. It stays in the system long after the high is gone.”

Michael said, “So what you're saying is, there's still a chance that he could die?”

“I'm afraid so. The next six hours will be critical. But his youth is a plus. And if he does go into a fast rate, chances are we can control it with the drugs.”

The cardiologist appeared at that moment. “Mr. and Mrs. Curran?”

“Yes, sir?”

Michael and Bess both stood.

“I'm Dr. Mortenson.” He had steel-gray hair, rimless silver glasses and thick hands with a generous peppering of black hair on them. His handshake was hearty and firm. “Randy will be in my charge for a while yet. His heartbeat has leveled off now—a little rapid but we've administered inderal, which should help stabilize his heartbeat. If we can keep it reasonably steady for—oh, say twenty-four hours or so—he'll be totally out of the woods. Right now the lab people are drawing his blood gases. Our toxologist will do a drug screen and we'll be running a routine battery of other tests as well—blood sugar, electrolytes—standard procedure where cocaine is involved. We'll monitor him here in the ER for a while, then in a half hour or so he'll be transferred to Intensive Care. He's actually very alert now and asking if his mother is here.”

“May we see him?” Bess asked.

“Of course.”

She gave a timorous smile. “Thank you, Doctor.”

Michael thought to ask, “Are there legalities involved, Doctor?”

“No. As I told Randy, we're not the police, neither do we report these cases to the police. Because he's admitted to using cocaine, however, he'll be referred for counseling, and a social worker will more than likely get involved.”

“I heard him say he's never used it before. Is that possible?”

“Absolutely. You recall the death of the young basketball player, Len Bias, a couple of years ago? Sadly enough it was his first time, too, but what he didn't know was that he had a heart defect, a weakness too great to endure the effects of the cocaine. That's the trouble with this damned stuff. It can kill you half a dozen different ways, even the first time you let it in your body. That's why we have to educate these kids
before
they try it.”

“Yes . . . thank you, Doctor.”

The ER medical staff was still watching Randy's monitors as Bess approached the gurney, with Michael lingering several steps behind. A nurse in a traditional white uniform and cap was filling a syringe with blood from Randy's arm. She snapped a piece of rubber tubing off his biceps and said to him, “You've got nice veins.” She sent him a smile, which he returned halfheartedly, then closed his eyes.

Bess stood watching, willing her eyes to remain dry. The lab nurse finished drawing her samples and left, pushing a tray containing rows of glass test tubes that clinked like wind chimes as she moved away. Michael hung back while Bess moved to the bed and bent over their son. He looked ghastly, sickly white, his eye sockets gaunt and his nostrils occupied by the oxygen prongs. The leads from his chest draped away to the monitors. She remembered when he was one and two years old how deathly afraid he'd been of doctors, how he'd cried and clung to her whenever she took him into the clinic. Again she struggled against tears.

“Randy?” she said softly.

He opened his eyes and immediately they filled. “Mom . . .” he managed in a croaky voice as the tears made tracks down his temples. She leaned down and put her cheek to his, found his hand at his hip and took it gingerly, avoiding the IV lead-in taped to its back.

“Oh, Randy, darling, thank God they got you here in time.”

She felt his chest heave as he held sobs inside, smelled smoke in his hair and shaving lotion on his cheek, and felt his warm tears mingling with her own.

“I'm sorry,” he whispered.

“I'm sorry, too. I should have been there for you, talked to you more, found out what was bothering you.”

“No, it's not your fault, it's mine. I'm such a rotten bastard.”

She looked into his eyes, so like his father's. “Don't you ever use that word.” She wiped the tears from his temples but they continued to run. “You're our son and we love you very much.”