In Sickness and in Death (6 page)

“What other choice do I have?”

“Well, we can go ahead and create a fistula, the connection between the vein and the artery, and while it is healing we can go in through the subclavian.” He touched the side of his neck and smiled. “In layman’s terms, a catheter is fed through the jugular vein into the subclavian vein.”

Brian felt his face blanch. “What caused all this, Doctor?”

Dr. Harris shrugged. “It could be the result of many things – a forgotten injury to the kidneys, side effects or interaction of certain drugs.”

“But, I don’t take any drugs. And I’ve never been injured.”

Doctor Harris shook his head. “Some people are just born with a predisposition to this sort of thing. It may be nothing you’ve done.”

“So, where do we go from here?”

“I want you to check into Central Hospital this evening – as soon as you can get there. I’ll schedule you for the fistula and the subclavian first thing in the morning.”

Brian slowly nodded his head. There didn’t seem to be any way to avoid it. “Okay, I’ll go home and put some things together.”

Brian drove home, his mind awhirl. What would his life be like from now on? He was just beginning to live; just beginning to make his way in the world. What did he have to look forward to when he had a date with a machine several times a week?

When he entered the apartment, Adrienne met him in the hallway. “Where have you been? I don’t know how many times I called your office and left you voice mails.”

“Sorry, I left about four. Dr. Harris’ nurse called and asked me to come into the Doctor’s office at four-thirty.”

“What for?”

“It seems I’m having kidney problems. I have to start going for dialysis. I don’t know how often yet, but I’m to check into the hospital tonight.”

“That is ridiculous! There’s no need for you to have to go to some stupid clinic where it’s hard to tell what kind of treatment you’ll get. I
am
an RN after all. There’s no reason why I can’t do it right here in the comfort of our own home.”

“What do you mean?”

“It’s simple really. There’s no need to be hooked up to a machine. If we do it here, we can even do it while you’re sleeping.”

“And they won’t have to slit my jugular vein open?”

“No way. I’ll speak to Dr. Harris first thing in the morning.”

Brian went into the bedroom, packed a small bag with a pair of pajamas and his toiletries and then, taking his briefcase, drove to the hospital. When he had completed the registration paperwork, he was escorted to a room containing two empty beds. A nononsense nurse insisted that he forego his pajamas and put on the hospital gown she provided. Finding it useless to protest he put on the gown and climbed into bed. Later in the evening, Brian was sitting in bed reading a report. A nurse came into the room.

“You need to take these,” she said, holding out the small pill container.

“What are they?”

“Something to help you sleep.”

“I don’t need anything.”

“Doctor Harris wants you to get a good night’s rest. Now, take them.”

With a sigh of resignation, Brian took the pills and the glass of water from the bedside stand that she offered.

“Better put that away,” she said, nodding to the paper in his hand. “It’s lights out now.”

Brian slipped the report back into his briefcase just as she flipped off the light. He lay back and punched on the television.

Brian awoke to a tremendous clatter in the hallway outside his room. What was going on? Were they bringing breakfast? Or was it just a shift change of the nurses? He waited patiently for a breakfast tray, but none was forthcoming.

When a nurse came in with a pill container, Brian asked rather petulantly. “Where’s my breakfast?”

“Sorry, no breakfast for you this morning. You’re going into surgery.”

A few minutes later Dr. Harris came into the room. “How do you feel this morning?”

“I’m okay, but I’d really like some coffee.”

“Later. I’ve just spoken with Adrienne and she tells me that she would like to do your dialysis at home. How do you feel about that?”

Brian shrugged, and then smiled. “I guess it’s okay, especially if it keeps you from slitting my throat.” He paused. “How would it work? Would I have to get one of those machines?”

The Doctor laughed. “Not unless you’re a millionaire and just have to have a new toy. It’s rather simple really. It’s called peritoneal dialysis and what happens is that, instead of reworking the vein and artery in your arm, we would insert a permanent external catheter in your abdomen. Adrienne would slowly introduce the dialysis solution into the site through a tube. During the next two hours or so the fluid would absorb the impurities from your body. Then it’s drained out and discarded. You would need two exchanges a day but there’s nothing to prevent you from doing something else while it’s doing its thing.”

“That sounds a lot easier than the alternative you’ve described.”

“In some ways it is, but there are some disadvantages.”

“Like what?”

“Well, for one thing there’s the frequency. You would only have to go to a clinic three times a week.”

“Yes, but I can be at home the whole time. I’m sure my management will allow me to rearrange my schedule so that I can telecommute a lot of the time.”

“There’s also an increased risk of infection, but Adrienne’s a good nurse. She knows what to watch for.”

Brian was relieved that the surgical procedure he had to go through was much less drastic than the one he had anticipated. When he was released from the hospital he went into work and knocked on the open door of his manager’s office.

“Mr. Harrigan, do you have a minute?”

“Sure, Brian, come in.” Brian closed the door and crossed the large corner office. “Sit down. What’s on your mind?”

“Well, Mr. Harrigan, it seems as if I’ve developed some kidney problems.”

“Really? It’s nothing serious I hope.”

“I don’t know yet. I do have to begin dialysis and Adrienne, she’s an RN by the way, is going to do it at home. That’s going to require me to work from home a lot of the time. Will that be a problem?”

Mr. Harrigan frowned. “I don’t see why we can’t work around it. You have your laptop and you’ll be near a phone if we need to reach you personally. Of course, there are some meetings that it will be necessary that you attend. At least those with new or potential customers, for the staff meetings we can rely on a conference call.”

“That’s a big relief to hear you say that. Hopefully, it will only be a temporary deal.”

Brian started to get up from the chair then resettled himself and leaned forward. “By the way, Mr. Harrigan, I’d appreciate it if the others didn’t know what’s going on. I don’t think I could take their pitying me.”

“I understand. It’ll be just between us.”

“Good.” Feeling much relieved, Brian left the manager’s office and returned to his own desk. Adrienne wouldn’t be home until about four so he might as well pack up everything he might need. He glanced at his watch. Maybe he could even get a little work done.

As four o’clock neared, Brian gathered up his files, grabbed his briefcase and left the office. When he entered the apartment, Adrienne greeted him with a smile.

“Ready to begin?” she asked. “I bought all the necessary supplies today and stowed them in one of the kitchen cabinets.”

Brian took off his jacket and headed for the bedroom. “I guess we might as well get it over with. Let me get out of this monkey suit first.” Brian removed his clothes and was shrugging into a robe when Adrienne came into the room. “Just think,” he said cheerfully. “Most of the time I can work like this. That won’t be bad at all. Where do you want me?”

“Why don’t you just lay back on the bed?”

Brian reclined against the headboard and watched Adrienne prepare the equipment. When she inserted the needle into the catheter and eased open the clamp, he could feel the fluid flowing into his body. As the level in the plastic bottle declined he began to feel uncomfortably full, even bloated, and wondered if he’d ever get used to it. Finally, she closed the clamp.

“Now all we have to do is wait a while. Do you want a magazine or something to read?”

“Would you bring me the paper? I haven’t had a chance to look at it today.”

Adrienne brought him the paper and then returned to the living room and Brian soon heard the sound of the TV. He kept one eye on the alarm clock. Two hours the Doctor had said. If he could just concentrate on the paper, it would go faster. At length Adrienne returned to the bedroom. “Okay,” she said. “Now let’s just drain this into the toilet.” She helped Brian up from the bed, took the plastic bottle from the IV

stand and accompanied him into the bathroom, where she disconnected the bottle and directed the tubing at the bowl.

Brian felt the relief as the fluid drained away. When it was gone, he turned to Adrienne with a smile. “Good as new.”

“In a few days you’ll really feel the difference,” she assured him.

Over the next several weeks Brian spent the majority of his time working from home. He enjoyed taking the conference calls instead of sitting in meetings, doing his marketing presentations and reports on the laptop, but, most of all, he enjoyed the casual attire allowed by his situation. Even though he was required to go in for the occasional meeting with customers it was not much of a burden on him, in spite of the tiredness that the treatments brought about.

Adrienne had taken a leave of absence from her job and spent much of her time taking care of the apartment and cooking fantastic meals for the two of them. She grilled steaks, made chicken-fried steak and did a great pot roast that Brian absolutely loved.

“You’re getting better,” she would tell him with an approving nod. “I want to make sure you eat right.”

Brian and Adrienne had established a regular routine for the dialysis treatments and he was feeling much better. His coloring had improved and the swelling had gone from his face and legs. In fact he believed that he would soon be able to forego the sessions and return to his regular work schedule.

Then, one day as they started the treatment, Brian felt that something was amiss. His guts felt as if they were being encased in ice and the bloated feeling came on swiftly. Within seconds, excruciating pains seared throughout his abdomen. Suddenly, the pain ceased and he experienced a floating sensation. Looking around, he saw that he was hovering near the ceiling, looking down on his body below him. His only thought was
what is going on
? He searched Adrienne’s face for some clue as to what had happened to him. He saw her gazing down at his body with a small smile of satisfaction curving her lips.

He screamed out, “What have you done to me? What happened?” She ignored him as if he had said nothing.

Adrienne opened the roller clamp, laid the bottle on the floor and allowed the fluid to drain back into the bottle. Then she removed the needle from the catheter and went into the bathroom where she emptied the bottle into the toilet, pushed the flush handle and threw the bottle into the trash. Brian followed her as she crossed the bedroom into the living room where she turned on the television. Sitting down on the couch, she began to watch a soap opera. He returned to the bedroom where his body lay pale and still. An hour later, Adrienne returned to the bedroom. Brian noticed that his lips had now turned blue. She stood for a long minute looking down at him, and then she touched the side of his neck. Slowly, she turned toward the bedside phone.

“Doctor Harris, please,” she said calmly. After a moment’s wait, she screamed hysterically. “Doctor! Doctor! Something’s gone drastically wrong! You’ve got to help me!”

“Now, now, Adrienne, calm down and tell me what the problem is.”

“Oh, Doctor. It’s Brian. I don’t know what happened. I just came in to check on him . .

. He’s turning
blue
, Doctor, and I can’t find a pulse!”

“Call nine-one-one now!” he shouted. “I’ll head over to your place. Text me if they get there before I do.”

“Please hurry, Doctor Harris. There’s got to be something we can do for him!”

“I’ll be there as soon as I can get there,” he assured her. “But, for now, hang up and call nine-one-one!”

Adrienne hung up the phone and took a deep breath. She punched in the emergency number. “Help me! Help me!” she cried. “It’s my fiancé and he’s not breathing!”

“Are you sure he’s not breathing?”

“Yes, I’m sure. And I can’t find a pulse. What can I do? Tell me, what can I do?”

“Just give me your address and I’ll send a team of EMTs right over.”

Adrienne gave the address, hung up the phone and returned to the living room to wait. After about fifteen minutes, she punched off the TV and sat with her head in her hands. When the doorbell rang she went to answer it, wearing a worried frown. She showed the EMS team to the bedroom and stood by, watching their reaction. One reached for Brian’s pulse, then turned to the other and shook his head.

“I’m sorry, Miss—” he said, turning to Adrienne, “—but there’s nothing we can do here. We’ll just have to—”

The doorbell interrupted his sentence and Adrienne hurried to answer it. “Oh, Doctor Harris,” she said, flinging open the door, tears welling in her eyes. “The EMS team just got here and they say there’s nothing to be done!”

“Now, now, my dear. Where is Brian?”

“In the bedroom. This way.”

She led him into the room. He reached out his right hand to the emergency responders, feeling for a pulse with his left. He found none. “I’m Doctor Harris,” he told the EMS

team. “Brian was my patient.”

“As you can see, Doctor, there’s nothing we can do.”

Dr. Harris slowly shook his head. “No. No, there’s nothing any of us can do. Please take the body to the Central Hospital morgue. I’ll see to the death certificate tomorrow.”

Brian felt himself being whirled through a black vortex. He could feel other beings around but, try as he might, was unable to perceive who or even what they were. Then he saw a glimmer of light. As he came closer, the glimmer became bigger and blindingly brighter than anything he could have ever imagined.