A voice welcomed her. Pushing open the door she glanced a round; and shut the door behind her. The doctor was a tiny woman with dark hair just starting to grey. She eyed Olivia carefully. " You have cop written all over you."
Olivia smiled." I am but that is not why I am here. You are treating Eli Stabler right?"
" I am. Can I ask why you are interested?" She saw a hint of sadness flicker through the woman's eyes.
" He needs a donor and I may be a match I've known the family for years and today I came to visit and got talking to one of the nurses. I know I'm a match to his father, A positive." Olivia replied.
" That is a big part of a match but not all of it. Sit lets talk a moment." The doctor sat and gestured Olivia to the seat opposite her.
" If you are a blood match than there is a good chance you will qualify as a donor. A blood test compared directly to Eli's is the only way to confirm it. DO you know if you have had blood work done here?"Dr Miller asked, reaching for the computer mouse.
" Maybe but it would be several years old." Olivia shifted
" Your full name?"
" Olivia Benson."
There was a long pause as she flipped through records. " If you are serious I need you to sign some forms, consent to the procedure and awareness; as well as one for me to retain you medical records. You were taken in to emerge? Four years ago?"
" Yes."
"Okay just a moment. Here fill those out while I run the program to compare these." A stack of forms and a pen were pushed across the desk to her. There was silence for a while as both women worked through their own details. Olivia scanned each form and signed; some called for a witness but she would get someone for that later.
" The computer says you are a match. We will take an up to date sample to confirm. There will also be a complete history and physical. Then you can be confirmed as a donor. We will run some other tests to check your body's ability to cope with the strain."
" When?" Olivia again steeled her nerves.
" I can arrange it today, if you are willing. I don't like watching that child suffer any more than anybody else. I will take you down for the blood test and get a nurse to take over for vitals. You will have a chest x-ray and MRI then a fairly standard physical, depending on time and results either the nurse or I will ask a history. I need to ask if you have appointed a substitute decision maker?"
" No."
" I would recommend that you do. There may be points when you are not able to make coherent decisions. Of course even in those times anything you say will be considered." The doctor explained.
" I'll take care of it. How long will it be before he can receive treatment?" Olivia forced herself to use a breathing technique she had learned in the academy; and used many times since.
" I'll see how your results look and how he is holding out. We will set you up tonight if everything checks out. At some point I will have felt out a plan of treatment and will explain it to you; either after the physical or after the tests tonight. I would plan to spend the night here." Miller stood and Olivia mimicked; snagging her stack of forms as well.
She was led down to an exam room, a nurse joined them. The doctor took her blood and left, the nurse took over. " I'm Mary I'll take your vitals and stay with you until the doctor comes back."
Olivia nodded and followed the young woman to X-ray and then to the MRI; reality setting in The nurse told her to stay in the hospital gown and led her back to the exam room,
Mary took her blood pressure, heart rate and temperature. As she was told to lay down the doctor was back.
" Mary I'll take over. I need to discuss some things with Ms Benson." The doctor held a thick file and Olivia's stomach clenched.
The nurse left and the doctor went to the desk and sat down; spreading out her file. Olivia started to sit up , the woman was scanning the notes. " No stay put I'm ready."
Standing up the woman put on a pair of gloves and moved beside her. " I have your labs back, they are very good. Your body is at rest, white blood cell count is low; which means your body isnt dealing with an infection its self right now. Blood pressure is a little higher than your charts but I think that may be due to stress. Scans were clear, I see no concerns proceeding."
" That's good then?" Olivia relaxed, feeling a little relieved.
" Yes, its very good. We will see if you feel that way when we are done poking you. Tell me if anything hurts here." She paused, pressing firmly on Olivia's abdomen. " I'm going to finish your exam, and get a nurse to set you up in a room; you can finish your paperwork. We will start a few basic aids tonight and take blood in the morning.
"Okay" Olivia replied, keeping herself in check.
" You can slide down now." The doctor changed her gloves and sat on a stood at the foot of the exam table. " This is just standard procedure.
" I know, but that doesn't mean I have to like it." Olivia obeyed, not thrilled but remembering how many girls she had stood beside who had to deal with things much worse than this; she had made a choice.
" I don't blame you Want to tell me how you know the Stablers?"
" I was Elliot's, Kathy's husband's, partner for twelve years. I've known all the kids since they were little and I was with Kathy when Eli was born." Olivia forced a smile; thinking of how cute the baby had been.
" Knew there was some connection. I'm done you can change back into you clothes until you get to your room." The doctor pushed her stool back, stripping off the gloves.
Slipping back into her street clothes Olivia took the chair beside the desk The doctor was making notes on a lined pad.
" Olivia I need to ask these questions; they are part of a standard history we take. Do you use any recreational drugs?"
" No."
Are you taking any medications?"
" No and I only drink socially, one or two at most." Olivia knew she was reading off a standard issue list; she had seen it.
" Can yo tell me when you had your last drink? Its only routine." The woman gave her a forced smile.
"Last weekend" Olivia met her eyes; they both knew the next questions.
" I assume you are sexually active?" The woman looked down at her page.
" Yes, four months and no." Olivia answered three questions in one.
" Family history, and then I'm done for now." The doctor reached gently for her shoulder before glancing at the page again; Olivia beat her to it.
" I don't know anything about my father; I never knew him Later in life my mother struggled with alcohol but that was trauma related." Olivia flinched, one of the reasons she hated talking to doctors was the topic that always came up; most people didn't know.
" Okay we are going to get you set up. We will be starting and IV and putting in a catheter. You will take a diuretic and be thankful for that catheter. We will run a few more tests."
" What are you doing for Eli?" Olivia asked softly.
" In the morning we will take a unit of blood and a small bone marrow tap. We will discuss it then." The doctor put a hand on her shoulder.
Olivia followed a nurse to her room, changed into the gown. She settle into the bed, fighting her nerves. She almost cried when the catheter was put in; the entire concept did not agree with her.
A code was called in the hall and the nurse left. Olivia reached for the phone; dialling a familiar number. Melinda answered almost immediately.
" Medical Examiner's Office."
" Hi Melinda? Its Olivia I need your help. I'm not hurt but I am at Mercy General; its important."
" I'll come now."
Olivia disconnected, shifting her hips uncomfortably, eyeing the IV. She knew it wouldn't be as bad. Yet it was only a taste of what was to come.
The nurse didn't reappear, when the door opened Melinda slipped in, Olivia recognized the clothes from her friends; she had come straight from work. Silently Olivia watched the woman take in the room before sitting beside her.
" Whats going on Liv?" Melinda's face was written with concern.
" You heard Eli was sick?"
" Yes Chediak- Higashi Syndrome. Its a nasty one. Are you a donor?"
" I'm going to be." Olivia whispered.
" Do you know what you're getting into?" Melinda took her hand.
" No and it scares the hell out of me. But I have to do it."
" Liv" Melinda's voice cracked, Olivia felt her gut twist; her friend had a better understanding of what she was getting into.
" I know. Its just that Elliot has been through enough; that family deserves a break at least once."
" I'll look out for you Olivia, have you told Cragen?" Melinda perked.
" No you don't. If they need to put me under or anything I need someone to make decisions for me. There is some for we both need to sign.
You know what this is, what they need to help him recover; you tell them to take it. Please Melinda, I just want him to be okay."
" Have they given you any treatment plan?" Melinda asked, pulling the chair closer.
" Kind of, I have the catheter in. I get the IV at some point. Tonight I take a diuretic; maybe they start in the morning. At some point the doctor is planning to tel me; she keeps pushing it back."
" She doesn't know what to tell you. I take it her basic plan is hydrate you, get you ready to give fluids. She'll need more once it gets going. Olivia, she may get to a point where he begins to recover; she may ask for an organ.
Olivia this could become a much bigger thing than you think depending on how far gone he is. His body may be able to compensate but even the help may not be able to recover." Melinda paused as the door opened, the doctor entered.
" I'm hoping we are not that far. I'm sorry Olivia there has been some confusion on the floor. How are you feeling?" The doctor's voice was tense; she looked much more tired than earlier.
" I'm alright." Olivia replied softly.
" Good. I'm going to get you IV started Get you to take the diuretic." She paused handing Olivia a small cup. " This will just be a little prick."
Olivia offered her arm, the doctor pushed the needle in, attached the tubing and hung the bag easily. Tossing back the pills she glanced at the IV taped to her forearm. The doctor sat on the edge of the bed Olivia looked at her.
" I'm Melinda Warner, Olivia's asked me to be her substituted decision maker." Melinda interjected.
" Sonya Miller, I'll be overseeing Olivia's care. I have the form here; if you both want to sign it." The doctor reached over for a file folder.
Olivia read and signed the bottom before passing over to Melinda. Sonya continued. " I will outline our plan of treatment now that I've reassessed Eli's condition. He is stable enough to start receiving transfusions. Tomorrow morning we will take blood, bone marrow and a spinal tap. The blood and marrow will go directly to him. I want to run a test on the cerebral spinal fluid; it is mainly a back up.
Then we are going to inject a small amount of the virus he is fighting into you; only the amount of a vaccine.
Your body will react, we will test your immune response. It will feel like a mild flu; your body will start to fight it off immediately."
" In such a wide spread infection, do you think transfusing a few white blood cells will make a difference?" Melinda cut in, clearly surprising Dr Miller.
" No I don't think it will be enough, but it will be a start. And it will give Olivia a taste of what she's getting into." The woman's face had changed to confusion.
" That wont be enough to change the boy's chances. If you were serious about hitting this you would keep her clean, get your fluids for transfusion. Stick her under, IV for fluids and NE line for nutrients.
Push her with the infection the drop her white blood cells in him and let her counts sky rocket; its not an option in a kid but it sure is in an adult. Let her body fight on its own either until he starts to pull up or she starts to give.
Then use the meds, antihistamines or whatever you want. Both will handle the meds. Olivia is no question and if it is coming in off of her cells Eli should handle it Get ready for his crash once Olivia's cells eliminate the infection." Melinda countered forcefully.
" Assuming I don't land both of them in a coma or worse. They are both my patients, I have to consider Olivia's health and future quality of life as much as his." Her face betrayed that the idea had already occurred to her
" Yes but you don't act the child's body wont hold out, he will decompensate fast. He wont hold on forever. You have an option now and I would take it." Melinda replied firmly, in the same tone she often used when delivering nasty facts of certain cases.
She saw the doctor open her mouth again. " Stop both of you. Melinda is a doctor as well and I trust her with my life. If her idea is better than do it. I'll be okay."
" Its not that simple Olivia. Beating the infection is not the hard part with Chediak-Higashi. Beating the infection is not the end of it.
Classic CH is either the infection kills or they pull through on the antibiotics but then their organs shut down. Sometimes its because the immune system never restarts or doesn't recognize its own cells and kill its self." Melinda explained.
" In the successful case the recipient's body accepted two sets of DNA; the child became a chimera. A condition we recently learned can be medically induced. It is complicated and even after this round there could be more." The doctor continued.
" What are his chances of getting through this?" Olivia felt her head starting to spin.
" Better with you but not that great. The treatment needs to be very intensive; much more than I would like. Your friend is right, we have to count on your body being able to kill the infection on its own. So that we can take its response to Eli and then take care of you with antibiotics." The doctor seemed resigned.
" Then there's your answer. You need to do what is best for him. I don't expect this to be comfortable or easy. I'll take it." Olivia replied firmly.
" Alright then, I will look at a more aggressive approach. I will talk it out with Melinda. I want you to have an ECG done; just so we know what your heart rhythm is." The doctor stood and went toward the door.
Thanks for the review... would love to keep hearing from people.
