Salomé Furtado

Tom walked into Kaffe 1668 and immediately zeroed in on where Adam was sitting. He waved to him, but Adam responded only with a nod, as he seemed to be involved in a fairly intense conversation with his table mate.

Once Tom had bought his coffee and sidled up to where they were sitting, Adam paused their discussion to make introductions. "Tom, I'd like you to meet Takeo. Tak, this is an old friend of mine. We go way back. And Tom, Takeo is a successful designer and landscape architect."

"I can see that you guys are in the middle of talking about something important. Don't mind me," apologized Tom.

"Not that important," exclaimed Takeo, with a lilting California surfer accent. "We're just talking about women, that's all."

"Women, and the trouble they put us through," said Adam, raising his pint. Both of them were drinking beer.

"Here, here," announced Takeo, taking a draught.

"So let me hear this again," continued Adam, chuckling. "The big guy really came at you with a pistol?"

"Yeah," said Takeo, still looking scared. "And he was yelling all kinds of stuff and threats at me. I mean I could tell they were threats even though I could only understand like, half of it. I mean, I took Spanish 101, but whatever that dude was saying I wasn't digging. But I did get the message loud and clear. Stay out of here if you want to live."

"Woah, somebody was threatening you?" jumped in Tom, his senses starting to tingle. "Did you call the cops, or do you want us to take care of it?" The bones in Tom's neck spontaneously started to crack as his muscles flexed, ready for action.

Takeo just looked confused and stared back and forth from Adam to Tom, like he was just seeing Tom for the first time. Then he looked pleadingly to Adam, who took him up on the unspoken request for assistance. "I don't think the cops will do anything, Tom. And I think I'm going to let it go as well," he said, leaning back and sniffing. "Tak was banging the big dude's wife and all."

Tom frowned, as Adam laughed heartily at his summation of the situation, while Takeo shook his head with annoyance. "You're supposed to be helping me. This isn't helpful."

"C'mon, Tak. You have to admit, it's pretty damn funny."

"Not from where I'm sitting. Gustavo has some clout. I could lose contracts over this."

"Then maybe you'll think of that the next time before making a cuckold out of an influential man."

"It shouldn't be that big of a deal. I mean everyone knows that he's sleeping around. I thought he'd be cooler than that."

"Well you thought wrong, bitch," said Adam, still laughing.

"C'mon. Maybe you can put in a word for me. Calm the big fatty down a little."

"I'll tell you what. I'm actually heading uptown to visit Salomé in the hospital-"

"Mé's in the hospital? What happened?"

"She checked herself in. It's the pain acting up in her back again. So I'll try to see if there's anything I can do."

"Thanks, Airdog. You're a true friend."

Tom and Adam left together and headed for the subway. "So you don't mind being a come with guy?" Adam asked.

"Not at all," Tom replied. "I don't mind hospitals. I'd even be curious to see if I can offer any observations. You really going to get in the middle of their affair?"

"Are you crazy? Hells no! There's no way I'm crossing Gustavo for Tak. He signed his own death warrant as far as I'm concerned. Besides…"

"Besides, what?"

Adam shook his head. "Nothing." Tom smiled. He didn't have to be a mind reader to surmise Adam's other misgivings about helping Salomé's lover. He was obviously into her too. Tom decided to let this deduction slide to be expounded upon for another convenient time.

On the way to the hospital, Adam stopped at a Mexican take-out joint for chiles rellenos that Salomé evidently had requested. Upon arrival at the Bellevue hospital, they made their way up to her room, where she cried out upon seeing her visitors. "Adán!" shouted the throaty voice from the hospital bed. "Look at your poor Salomka, falling all to pieces and dying. Please tell me you brought me something decent to eat." Salomé was wearing less bling than usual and instead had gone for an Aztec beaded necklace and earrings, while her hair was done up in her standard messy, goth style accentuated with a big yellow flower pinned in the side.

"Chile relleno, just like you wanted," Adam said, looking stunned, like he was just meeting his prom date.

"Did you go to the place my father likes?" she asked, tearing into the rellenos. She had an excellent appetite for a dying woman.

"Of course. Señor René went with me to that place you like in the West Village. He also sends his love."

"Did he look like he's been eating well?"

"I should say so. He walked out with the mushroom tacos heaped with guacamole."

"He didn't sit down to eat? I'm always telling him to relax and enjoy his meal. Dios mío, the man's retired. Where's he running off to?"

"He was all dressed up. Maybe he had a date."

Salomé fixed him with her withering stare. "I wouldn't blame him for wanting a little action, now that mamá is gone. I just don't really want to hear about it." She fixed her killer gaze on Tom. "And I see you brought Bandido el travieso. Which is good because I'm having a party and I wanted to invite you. El Travieso, you can even bring a date if you want. Ex-lover. Current lover. Whatever you feel like coming out with."

Tom smiled uncomfortably. "Sounds great." Desperate to distract the conversation, he looked for a topic where he felt more at ease. "How are you feeling, Salomé? You're looking kind of flushed. Are they treating you well here?"

"These nurses are perfectly friendly, but the doctor is a real pendejo. Even when he does bother to come by, he barely looks at me. I could probably get sick and drop dead, and he would only learn about it if it was written on his chart."

"Why did you check yourself in?"

"Oh yeah, you're the one who wants to be a médico, right? Well I'm your patient from the depths of hell."

"Tell me about it."

Salomé flashed her mirthless smile. "I have a complicated history, health wise. When I was a kid, I spent more time in the hospital than I did at home. Then when I was eighteen, I was in a terrible accident on the bus. I suffered broken bones and lacerations, and I still suffer from chronic pain. And this year, it seems like I've just had one fever after another. This week, my back was really bothering me, which is not unusual, but then my legs were also really sore. So I was thinking about seeing a doctor when I came down with this fever, so I decided to check into the hospital, to see if they could help me." Tom put his hand on Salomé's forehead. "Just get right in there. Don't wait for an invitation," she teased.

Tom looked a little flustered, but tried to focus on the patient. "It looks like they're giving you a broad-spectrum antibiotic," he remarked, looking at her IV drip. "How long have they been treating you with antibiotics for?"

"About 15 days."

"You'd think your fever would have broke by now. And how long have you had a fever for?"

"I've had this fever on and off for a while, as well as feeling tired and weak. Basically I've been feeling generally yucky for about a month now. It's been quite the year."

"So you said. What kind of fevers have you experienced?"

Salomé smiled. "I can't remember the last time someone took such a detailed history. I had this wicked fever about six months ago. I couldn't get out of bed, and we had to hire a nurse to bring me food and help me go to the toilet. I felt better after a couple of weeks, but I still get a lot of pain in my bones. Some days are worse than others."

Just then the nurse came in for her regular check. "Hey darlin'," she sang with a southern twang. "How we doin' today?"

"Things are looking up," she said cheerfully. "I got a world famous doctor here to come save my life," she said, winking at Tom.

Tom began to shake his head but Salomé shot him a look that clearly told him to shut up, as the nurse watched both of them suspiciously. But then the nurse blinked her long eyelashes and decided to play it cool. "And what has the famous doctor learned?"

Tom felt nervous. It was one thing to mess around with diagnosis as a hobby. But talking with an experienced professional was something else altogether. "Just trying to get a bit of an idea of her recent medical history." He turned to Salomé. "So it sounds like you had a bout with Chikungunya."

Salomé's eyes flashed. "Yes. That was it!"

"Chicken what?" asked the nurse.

"Chikungunya," Tom explained. "It's practically pandemic in certain countries in the Caribbean and Central America, and I'd heard it had started to make it's way through parts of Mexico and the southern States. I'm guessing you brought it from Mexico." Salomé's eyes narrowed to slits as she shot him a look of death.

"Is it contagious?" asked Adam.

"It's spread by mosquitos, so New York in December is probably the safest place to be. One good thing about being in the deep freeze, eh Salomé?" She still just glared at him. "Although I've heard that the after affects feel a lot like arthritis, so maybe the cold doesn't really help you with the aches in your bones. But Chikungunya recovery could explain your back pain."

"And my fever? I should mention that I also had Dengue a couple of months ago."

Tom smiled. "Now I see what you mean when you say you've had a bad year. You know, you really should sleep under a mosquito net."

"Que grosero. Thanks for the obvious, donkey. I do sleep under a net but the little bastards bite you all day and in the evening."

Tom turned to the nurse. "Has she been tested for Malaria?"

"I don't think so. I'd have to double check her chart. But as a rule, we don't usually check for tropical diseases."

"Malaria!" Salomé cried.

"I know, that would suck. But you've already had the bad luck of getting Dengue and Chikungunya. All that's left for the mosquito borne trifecta is Malaria. Or Zika for that matter, but I don't think that would last much longer than a week. I'll see if I can get my partner to help me run some tests."

Tom was soon on the phone with Gwen. "So you must be calling me to tell you're ready to meet with Iraklis," she said.

"Not quite. But when you agree to do this favour for me, it will definitely move me in that direction."

"Sure," she said automatically. "Just name it."

"I need you to help me run some tests on a patient here at Bellevue."

The cheer went out of Gwen's voice. "You have another patient that you want me to help you with?"

Tom detected the ice-like tone, but wasn't sure what to make of it. So he just continued as if it was a normal request. "Yeah, she's been suffering from a low-grade intermittent fever, fatigue, and generalized weakness for about a month now, and the doctors here have made no progress."

"She? Of course it's a she. Let me guess. She's a young woman whom you just happened to befriend and now is in need of help that only you can provide."

Tom was getting annoyed for this unexpected hostility. "Look. This is what we do. We help people that are sick. And I thought I could count on you." He was unsuccessful in his attempt to keep the hurt from his voice.

"If I agree, then you have to meet with Mark. There's no more dodging it. You'll owe me, and that's how you'll pay me back," was her phlegmatic response.

"Okay, then we have an agreement."

Tom and Gwen got to work on their tests and a workup for fever. They performed two blood smear exams for the malarial parasite, and both came back negative, ruling out Tom's first theory. Her antigen test was also negative for Malaria, but positive for dengue, which was what they expected. They performed many tests, and could not find any abnormality.

Gwen came up with the idea that she was anemic, but her tests for sickling and osmotic fragility were also negative. Soon it was getting late, they had next to nothing for a diagnosis, and tiredness and frustration started to come out. Finally, as they were both staring down their respective microscopes, Gwen just came out and said what was bothering her. "So who is she?"

"Who? The patient?"

"Duh. Who else would I be asking about?"

"Um, obviously. The patient. She's an artist. A friend of a friend."

Gwen scoffed. "You sure like to fall for the artists, don't you?"

Tom was getting irritated. "I didn't fall for her. I just happened to observe that she wasn't getting a proper diagnosis. Besides, she's married." He paused, then said, "Going for the married types is more your thing." As soon as the words were out of his mouth, Tom regretted it.

Gwen's head shot up, and she had that look like she was going to make him eat his microscope. "What's that supposed to mean?"

"Nothing. I don't know why I said it."

"I do. You've always resented me asking you for help for some reason. I think we can agree that I've done quite a bit to get you to where you are today."

Tom at this point was willing to do anything to placate the now angry Gwen. "You're right, and I'm sorry. I've taken you for granted."

"I don't understand why it's so hard for you to just agree to do even one little thing for me," she fumed.

"I don't know. I was being selfish and I am sorry. But you have my word. I will talk to Mark Iraklis, and I will give my full attention to helping him. Hey." He reached for her hand but she pulled away. "Listen. I do appreciate your support and your help. I couldn't do this without you. And I promise you that I will make it up to you."

Gwen didn't respond, but returned to her microscope. Finally she said, "Well, you're right about one thing. This is what we do, and I daresay we do it better than anyone else. You know, she has a very high level of LDH."

"Do you think she has a malignant cell tumour?"

"That's very rare. Did we test for HIV?"

"HIV and hepatitis tests were all negative."

"Anything to support the anemia theory?"

"She had dengue a couple of months ago. In rare cases, that can cause hemolytic anemia."

"Okay, let's look at what we got." Gwen walked over to a whiteboard, and added the new data. "Her haptoglobin measures were …?"

"Very low."

"Which is suggestive of sever hemolysis. How was the test for ANA and RA?"

"Both negative."

"So we can rule out any autoimmune diseases," she said, crossing those off the board. "Can we cross off any common infections? Yes. And hemalotogical conditions?"

"We ruled out iron deficiency because her hemoglobin electrophoresis was normal. And her protein electrophoresis showed a normal albumin/globulin ratio, with no presence of any M-band or cryoglobulins."

"Okay, that's all the normal," Gwen sighed, running her hand under her head scarf while trying to blink away her exhaustion. "Didn't we find anything that was off?"

Tom looked at his notes. "Her homocystein levels were high."

Gwen's eyes perked up. "Elevated homocysteine are usually caused by an inadequate intake of B vitamins. Okay, let's go over what we have, and please tell me that it's making sense. We have pyrexia, hemolytic anemia and thrombocytopenia," she said with the air of a professor teaching a class. "I think we can go with the provisional diagnosis of B12 deficiency, which we can treat with injections."

Tom nodded. "She could have developed the anemia from her bout with dengue, causing the deficiency of B12, which then further exacerbated the anemia. It works, and the treatment is easy and safe." He looked up at his partner, smiling. "Can I hug you, since you're such a genius?"

"I guess you may," she said with a grin.