Tess hurried out to the car and threw the door open. Her heart was pounding in her chest, and her fingers were shaking so badly it took her three times to get the key in the ignition. She turned the car on, and as the engine roared to life, the older angel leaned back against the seat and took a few deep breaths, trying to calm herself down. "Get ahold of yourself," she said aloud, "You're not gonna be of any use to anyone if you're a wreck."
After sending up a quick prayer asking for her Angel Girl's protection, Tess put the car in gear and pulled up in front of the apartment building. Andrew came out of the building as Tess pulled up; Monica's quilt wrapped form in his arms. He put the younger angel down on her feet as the neared the car, but kept a strong arm wrapped around her waist as he opened the door for her and guided her into the backseat. He slid in next to her and shut the door, and Tess pulled out onto the road.
"How long is it going to take to get there?" Andrew asked, his voice betraying his concern.
"About 20 minutes," Tess replied. She drove for a few moments in silence, and then glanced through the review mirror at Monica, who had leaned her head back against the seat. Her dark eyes were closed, and her breathing sounded labored. "How are you doing, baby?"
Monica pulled her eyes open slightly and tried to look at her supervisor. "I don't think it's possible….. but I feel… worse than I did a few….minutes ago…" The young angel's voice sounded barely a whisper, like she wasn't getting enough air. "My chest… hurts… and it's hard to breathe…"
Andrew exchanged a terrified glance with Tess through the mirror before turning his attention back to Monica. She was almost gasping for air, and her face was breaking out in a fine sweat. He laid a hand on her forehead, and was alarmed to find that she was even hotter than she was when they left the apartment. "Just hang in there, sweetie," he said, trying to keep his voice steady and calm, "We're almost there."
"Just… hurry," Monica gasped weakly.
Tess sped down the street, hoping against hope that she didn't get pulled over for speeding. Since it was fairly late, there wasn't much traffic on the roads, something the older angel was grateful for. An accident was the last thing they needed. She could almost see the hospital up ahead when she heard Andrew's frantic voice calling, "Monica? Monica… wake up!"
"What's going on back there?" Tess asked, glancing into the review mirror. Monica was slumped against the window, her eyes closed. Her breathing was raspy and shallow, and Andrew frantically shook her shoulder, trying to rouse the younger angel. Monica's eyelids fluttered, but she didn't wake up. Andrew grasped her hand, startled at how cool it was to the touch, regardless of the fever raging through her weakened body.
Tess swung the big car into the hospital's driveway, and pulled up in front of the doors to the ER. Andrew slid out of the backseat and gathered Monica's limp form into his arms before racing toward the doors. Tess pulled the car into the parking lot and turned off the ignition. She sat in the car for a moment, gathering her thoughts. "Father," she began, her voice laced with worry, "Please look out for that little angel baby. I don't know what's going to happen over the next few days, but I have the feeling that we're all going to need You with us….even if we forget to ask for your help." Tess took a deep breath and gathered her composure before stepping out of the car and heading towards the hospital building.
****
Andrew rushed through the doors of Holy Cross Medical Center carrying Monica's still form gently in his arms. He was spotted by a nurse at the admit desk, who promptly shouted for a gurney. As soon as he laid his best friend down, she was whisked away towards the trauma bay. He started to follow, but a hand on his arm stopped him. "Sir, you'll have to wait in the waiting area," A nurse told him. "The doctor will be out to speak with you as soon as he can. What is her name?"
"Monica," he said, his voice hollow. "Oh, and they need to call her oncologist, Dr. Vandersluis."
"Ok, we'll get ahold of him," the nurse said as she made notes in the angel's chart. "What kind of cancer is she receiving treatment for?"
"Leukemia." A few tears threatened the blond angel's eyes. "But the chemo didn't work, and so we had taken her home to…" he couldn't finish the sentence. Monica was an angel. Angels couldn't die… could they?
The nurse showed Andrew where he could wait, and then she took Monica's chart and headed back to the trauma bay. She opened the swinging doors to reveal an organized chaos concentrated around Monica's frail body. Doctors and nurses were shouting out vital signs continuously. "Heart rate 125… resps 32… BP is 76 over 52."
The nurse walked up to one of the trauma doctors and said, "Dr. Malone, I just spoke to the person who brought her in. Her name is Monica, and she's one of Dr. Vandersluis's patients. She was receiving treatment for Leukemia, but treatment was unsuccessful and she was sent home."
Dr. Malone nodded and turned back to the other personnel in the room, his expression grim. "Ok people, Monica is a Leukemia patient in what looks like the end stage of the disease. Let's get a CBC, Chem 7, blood gases, chest x-ray, and lets give her some IV fluids and Metligine to get that BP back up. Let's keep an eye on her resps, too. We may have to intubate."
Monica whimpered, and slowly pulled her eyes open. Dr. Malone saw that his patient was waking up, and moved to the head of the gurney, so he could speak with her. "Monica, I'm Doctor Malone. Do you know where you are?"
"H-Hospital," she whispered weakly.
"Right. Are you having trouble breathing?" Monica nodded slightly. "Okay. We're going to help you with that." He placed an oxygen mask over the angel's face, and then said, "We're going to try this first, and if you still have trouble breathing, we may have to put a tube in your throat to help you. We're also going to give you some antibiotics and some medicine to bring your blood pressure back up, so you should start feeling a little better soon."
Monica nodded again, and whispered, "Thank you," before closing her eyes again.
"You're welcome," Dr. Malone replied. "Just hang in there, and we'll take good care of you. Who's here with you? Family?"
Monica shook her head, "They're my…. closest friends. Please….. tell them what's… going on….. they'll….. worry."
"Okay, Monica. I'll go and talk to them in just a minute. Just rest now." Dr. Malone turned and walked over to the counter, taking his gloves and gown off and making notes in Monica's chart. After giving a few more orders to the nurses, he took the chart and headed out to speak with Monica's friends.
*****
"Andrew, would you please stop pacing?" Tess asked for what seemed like the hundredth time. Monica had only been in the back for about 15 minutes, but to the two worried angels, it seemed like hours.
Andrew sat heavily in one of the hard plastic chairs in the waiting area, looking at Tess. "How long is it gonna take until someone comes out and talks to us?" He asked, exasperated.
"I don't like this any more than you do, Angel Boy, but wearing a hole in the tile is not gonna accomplish a thing. Now, just be patient. The doctor will be out soon." Andrew sighed and looked at the ground, looking for all the world like a little boy who had just been put in time out.
The angels sat in silence, each lost in their own thoughts, until a man in scrubs and a white coat entered the waiting area. He looked to be in his thirties, with dark hair and dark eyes. His lean frame was tall and his expression was unreadable, except for his eyes, which shone with deep compassion. "Is there someone here for Monica?" He asked aloud, addressing the few people scattered throughout the waiting area.
Tess and Andrew stood and walked over to the doctor. "That's us, doctor," Tess said. "My name is Tess, and this is Andrew." The two angels shook hands with the doctor.
"I'm Doctor Malone," he said. "Let's go over here, ok?" He led the two angels to the corner of the waiting area, where they would have a bit of privacy. They sat down, and Dr. Malone said, "Monica was brought in to us in serious condition. She has a high fever, and she's having some slight trouble breathing."
"What's wrong with my baby?" Tess asked, her face etched with worry.
"We're running some tests right now, but I suspect something called septic shock." Dr. Malone hesitated for a moment before continuing, "Sometimes, especially in patients like Monica who have a weakened immune system, a bacterial infection can get into the blood and cause the body to go into shock. The blood tests we ran will confirm this, but I think that's what we're looking at here."
Andrew grasped Tess's hand tightly in his own as he asked the question that he wasn't sure he wanted the answer to. "How serious is that?"
Dr. Malone ran a hand through his dark hair. For the first time, his poker face cracked, and he looked sympathetic. He could tell that these two people cared about Monica very much, and this was the only part of his job that he hated. "I won't lie to you. It's critical. This kind of infection has only about a fifty percent survival rate. The danger here is that Monica's organs may begin to shut down. We'll know if that's happening and to what extent when her test results come back, but I'm most concerned about her heart and lungs."
Andrew felt like someone had just punched him in the stomach. He remembered the conversation he had with Monica the night before, and the full severity of the situation hit him full force. Did she know? He thought. Did she somehow know this was going to happen?
Dr. Malone looked quickly through Monica's chart and hesitated again, trying to find the right words for what he was about to say. "There is one thing I want to speak with you about. Tess, Monica has you listed as her next of Kin, is that right?"
Tess nodded, "That's right."
"Well, as you know, Monica is in the end stages of Leukemia. Now this infection may be treatable, but we have to consider her quality of life. If her lungs or heart start to fail, the only way to keep her alive would be through a breathing machine and other invasive procedures."
"What are you saying?" Tess looked heartbroken.
Dr. Malone placed his hand gently on Tess's arm, "I've spoken with Dr. Vandersluis, and we both agree that it may be in Monica's best interest for you to sign a DNR. It's an order that prevents us from taking any heroic measures. We would take measures to ensure comfort, but we wouldn't use any breathing machines or procedures specifically aimed to prolong life, in order to spare her any more suffering. Right now, Monica is still coherent enough to sign it herself, which I'm going to speak to her about. But, if that changes, you may have to make the decision for her. I'm really sorry to spring this on you at a time like this, but we need to remain realistic about the situation, and there is a very real possibility it may come down to that."