Chapter 29
Heading down the hallway to the morgue, Al Robbins was surprised to find Sara standing in the hallway. She gave him a hesitant smile as he approached.
"Sara, are you all right?" the coroner asked in a quiet voice.
She shrugged in a non-committal manner, knowing he wouldn't believe her if she said everything was fine. It was too apparent even to a casual observer that she wasn't. She had been frazzled earlier in the day and her day had continued to get worse. She never had the chance to try to get more sleep.
After hearing about Teresa's condition and recalling the stack of unanswered messages from her parents, she had headed straight to the hospital. The shock of seeing the little girl in the ICU haunted her. Even though she hadn't been allowed in to visit, Sara had watched from the observation window until it was time to head to work.
The Hernandezes' shocked expressions were her first clue that she should have at least tried to cover her appearance with some make-up, but it wasn't until an intern came over and offered to give her a check up that she realized how disheveled she must have seemed. Later, heading into the bathroom, she understood their concern. Between the lack of sleep, lack of make-up and stress, she looked horrible. For the first time, she noticed how pale and gaunt she had become.
"Just didn't sleep well, Doc. I was wondering if you could walk me through something."
"Sure, come on in," he said, indicating the changing area next to the morgue. Joining him, Sara was shocked when he opened his medical bag and started pulling out equipment. "Have a seat and take off your jacket."
"Doc ..."
"I don't normally charge for answers, but you're going to sit through an exam today."
Smiling at his paternal tone, she followed his directions as he took her blood pressure and checked her pulse and respiration.
"Going out on a limb here, but I think you're going to say I'm suffering from an acute case of stress."
"You are, Sara. It's not a laughing matter," he said firmly, but kindly. "Your blood pressure is too high. It's not bad enough that I'd recommend medication, yet, but it's not good."
"I know. Sorry. But I could have told you that I was stressed. Believe me, I know," she said lightly, but the coroner remained concerned.
"Are you taking anything?"
"Right now, just a sleeping aid."
"It's not working, I take it."
"No, going to sleep isn't the trouble. It's staying asleep that's the hard part. Nightmares. Real bitch of one yesterday," she said, trying to reassure the doctor.
"Has Philip mentioned taking some sort of anti-anxiety medication?"
Sara regarded the doctor cautiously. She didn't really want to make a habit of talking about her mental condition, but knew from his questions that Robbins was probably already aware of, or had suspicions about her troubles.
"Yeah, but we both agreed that it should be a last resort. If I have to, I will, but I really want to try this without drugs first. Too easy to rely on them," she said softly. If alcohol had been a temptation, she didn't want to consider what tranquilizers would be like.
"You may want to try yoga or meditation. Even a regular exercise routine. It can help relieve the stress naturally. How's your appetite?"
"Nonexistent. I know, I've lost weight. I'm trying," she said, reaching over to pull some canned supplemental nutritional drinks from her bag. "I picked these up on the way over. I can make myself drink these things easier than I can force myself to eat."
"All right. That'll do for now. But I want to see you again next week. If there's no improvement, I'll have to talk to Kane. Now, what did you want to know?"
Sara started to object, but realized Robbins was just trying to help and that he was right. Besides, she needed answers. "What can you tell me about endocarditis?"
He gave Sara a confused look. While he had been uncertain why she wanted to talk, that wasn't something he would have guessed.
"Inflammation of the endocardium, the inner lining of the heart. Usually affects the valves. Do you know the underlying cause?"
"Yeah. A staph infection went systemic."
"Acute bacterial endocarditis. Very nasty, but it is usually treatable. Do you know if the person has any other conditions which could cause complications? Heart defects, anything like that?"
"I don't think there's any defects. The doctors aren't having much luck treating the infection, though. And she lost a lot of blood."
Realization hit the coroner when he recognized the look of sadness on Sara's face. The news reports had only said her condition had worsened. "Is this the little girl from the bus?"
"Yeah. One of her cuts got infected. Spread pretty quickly."
"I'm not really surprised. Picking up infections in a hospital is always a risk. Most people have several strains of staphylococcus present on their skins and in their mouths. Accidental cross-contamination can easily occur, even in a hospital. For a healthy person, the worst that usually happens is a boil. But if the bacteria get into the blood stream, like through a serious cut, it can spread rapidly. Unfortunately, hospitals are also home to antibiotic-resistant strains of Staphylococcus aureus. Do you know what they are using to treat her?"
"Uh, no actually, I didn't ask. Her parents said they were increasing the dosage of her current antibiotic before they try anything stronger."
"Hopefully, that'll work. The stronger antibiotics have some very serious side-effects. The normal treatment calls for intravenous treatment for up to six weeks. It all depends on how well the body fights off the underlying infection."
"She's in intensive care, already. Her temperature spiked rapidly. When they ran some tests, they realized she had developed the endocarditis."
"Well, at least they caught it early. That increases her chances of recovery. Still, it's a serious condition, Sara."
"What are her chances?"
"Survival rates run up to 80 percent. It all depends on what complications, if any, she develops. And there are a lot of potential complications. The infection can damage the heart; the valves are especially vulnerable. A surgical replacement is often necessary. Abscesses can develop. Congestive heart failure can also happen. The infection can spread to other organs. Stroke, aneurysms, arrhythmia, meningitis or infectious arthritis are all possible.
"The most serious complication, though, come from vegetations which grow in the heart. These are clumps of bacteria, platelets and immune cells. If they break free, they can enter the blood stream. If they are large enough, they'll block an artery, much like a blood clot. That can cause extensive tissue damage, if not death."
"Damn," Sara swore softly, trying not to cry. "She's only eight, Doc. She already had to go through the wreck. Sometimes, life really sucks, you know?"
"She has a good chance. They caught it early. Don't write her off. Kids can be amazingly resilient. Come on," he said, leading her into the morgue. "I want to get your weight. I'm serious, Sara. See me next week. I'll let Philip know I'm monitoring your physical condition."
"Sure, Doc," she said without conviction.
Leaving the morgue, Sara headed to the stairs with her head down. She just wanted to get to her temporary office without any interruptions. It was taking all of her self-control not to cry. She couldn't stop thinking that she had promised to visit Teresa and now there was a very real chance the girl would die before she could fulfill that obligation.
Biting her lip, she tried not to rationalize her avoiding the hospital: as hectic as her week had been, she could have made the time for at least a short second visit. The truth was she had been hurt that the family had talked to the reporter. It was unfair: the parents hadn't talked about what had happened on the bus and Teresa was too young to understand that it wasn't a topic to be discussed lightly. Hell, the reporter probably hadn't even explained that she would be writing about it.
"Sorry," she muttered when she bumped into someone coming around the corner, but froze when a hand grabbed her arm.
"God, Sara. What happened?"
"Nothing, Grissom. Please," she said, trying to pull her arm free from his grasp.
When he realized what she was doing, he pulled back his hand as if he'd been burnt. "I'm sorry. I wasn't thinking," he said in despair. "I'm so sorry."
The pain in his voice was too real to ignore. Hearing someone approaching down the hallway, she grabbed his hand and pulled him under the staircase. Letting go of his hand, she backed up slightly, but gave him a reassuring smile. He took the hint to keep his distance.
"It's okay. I'm sorry, I lied. It's not 'nothing'. It's, I, damn. I'm a mess right now, Grissom. Don't expect a coherent conversation. I know I must look like shit. Sorry if I scared you. Just had a hell of a day and I didn't sleep well."
"The bruises?"
"What bruises?" He pointed to the mark showing on her arm. "Oh, I hit the doorframe this afternoon. Must of happened then." Sara noticed the explanation didn't seem to relieve his concerns. Wiping at the tears that were forming despite her best efforts, she gave him a shaky laugh. "God. Your timing really sucks, you know that? You really caught me at a bad time. I wish you didn't see me like this. I'm sure it looks worse than it really is."
He tried to return her smile, but doubted if it seemed real. She was right: she did look like hell. More than anything, he found he wanted to hold her, as much for his own comfort as her own. "Can I do anything?"
"Not really. Thanks for caring."
"I meant what I said, Sara. I'm not going to turn away. I'll give you all the space you need, but I'll do anything I can for you. I mean it," he said, resisting the urge to move closer. He didn't want to startle her; it was clear that she was extremely tense.
"Thanks. But, I, it's best for you to stay away."
Grissom closed his eyes briefly, before nodding. "If you say so. I just wish there was something I could do to help."
"I know. But you said it yourself: sometimes the hardest thing to do, is to do nothing at all."
He gave her a quizzical look. "I said that? When?"
"During the Strip Strangler case. The decoy operation that was a bust? You told me that as we left the supermarket."
Grissom gave her another confused look. "God, I really am starting to think you tape everything I say. You know, just because I say something, it doesn't make it true."
"Confucius?"
"Buddha, actually. Well, it's a paraphrase, but ...," he paused, realizing he was starting to babble. "You want to take the night off? Get some rest?"
"No. I don't think I could sleep right now. And I have a meeting with Philip in the morning. Might as well just stay here."
"Your choice," he said, pursing his lips, before continuing in a low tone. "You know how to reach me, Sara. Any time, for anything. Just let me know. Okay?"
"I promise, Grissom. I'll let you know when I'm ready."
"Okay."
She started to pass him to head up the stairs, but he closed his eyes and leaned against the wall. Seeing his obvious pain, she surprised both of them by giving him a quick kiss. Before he could react, she pulled back, blushing and raced up the stairs.
Heading down the hallway to the morgue, Al Robbins was surprised to find Sara standing in the hallway. She gave him a hesitant smile as he approached.
"Sara, are you all right?" the coroner asked in a quiet voice.
She shrugged in a non-committal manner, knowing he wouldn't believe her if she said everything was fine. It was too apparent even to a casual observer that she wasn't. She had been frazzled earlier in the day and her day had continued to get worse. She never had the chance to try to get more sleep.
After hearing about Teresa's condition and recalling the stack of unanswered messages from her parents, she had headed straight to the hospital. The shock of seeing the little girl in the ICU haunted her. Even though she hadn't been allowed in to visit, Sara had watched from the observation window until it was time to head to work.
The Hernandezes' shocked expressions were her first clue that she should have at least tried to cover her appearance with some make-up, but it wasn't until an intern came over and offered to give her a check up that she realized how disheveled she must have seemed. Later, heading into the bathroom, she understood their concern. Between the lack of sleep, lack of make-up and stress, she looked horrible. For the first time, she noticed how pale and gaunt she had become.
"Just didn't sleep well, Doc. I was wondering if you could walk me through something."
"Sure, come on in," he said, indicating the changing area next to the morgue. Joining him, Sara was shocked when he opened his medical bag and started pulling out equipment. "Have a seat and take off your jacket."
"Doc ..."
"I don't normally charge for answers, but you're going to sit through an exam today."
Smiling at his paternal tone, she followed his directions as he took her blood pressure and checked her pulse and respiration.
"Going out on a limb here, but I think you're going to say I'm suffering from an acute case of stress."
"You are, Sara. It's not a laughing matter," he said firmly, but kindly. "Your blood pressure is too high. It's not bad enough that I'd recommend medication, yet, but it's not good."
"I know. Sorry. But I could have told you that I was stressed. Believe me, I know," she said lightly, but the coroner remained concerned.
"Are you taking anything?"
"Right now, just a sleeping aid."
"It's not working, I take it."
"No, going to sleep isn't the trouble. It's staying asleep that's the hard part. Nightmares. Real bitch of one yesterday," she said, trying to reassure the doctor.
"Has Philip mentioned taking some sort of anti-anxiety medication?"
Sara regarded the doctor cautiously. She didn't really want to make a habit of talking about her mental condition, but knew from his questions that Robbins was probably already aware of, or had suspicions about her troubles.
"Yeah, but we both agreed that it should be a last resort. If I have to, I will, but I really want to try this without drugs first. Too easy to rely on them," she said softly. If alcohol had been a temptation, she didn't want to consider what tranquilizers would be like.
"You may want to try yoga or meditation. Even a regular exercise routine. It can help relieve the stress naturally. How's your appetite?"
"Nonexistent. I know, I've lost weight. I'm trying," she said, reaching over to pull some canned supplemental nutritional drinks from her bag. "I picked these up on the way over. I can make myself drink these things easier than I can force myself to eat."
"All right. That'll do for now. But I want to see you again next week. If there's no improvement, I'll have to talk to Kane. Now, what did you want to know?"
Sara started to object, but realized Robbins was just trying to help and that he was right. Besides, she needed answers. "What can you tell me about endocarditis?"
He gave Sara a confused look. While he had been uncertain why she wanted to talk, that wasn't something he would have guessed.
"Inflammation of the endocardium, the inner lining of the heart. Usually affects the valves. Do you know the underlying cause?"
"Yeah. A staph infection went systemic."
"Acute bacterial endocarditis. Very nasty, but it is usually treatable. Do you know if the person has any other conditions which could cause complications? Heart defects, anything like that?"
"I don't think there's any defects. The doctors aren't having much luck treating the infection, though. And she lost a lot of blood."
Realization hit the coroner when he recognized the look of sadness on Sara's face. The news reports had only said her condition had worsened. "Is this the little girl from the bus?"
"Yeah. One of her cuts got infected. Spread pretty quickly."
"I'm not really surprised. Picking up infections in a hospital is always a risk. Most people have several strains of staphylococcus present on their skins and in their mouths. Accidental cross-contamination can easily occur, even in a hospital. For a healthy person, the worst that usually happens is a boil. But if the bacteria get into the blood stream, like through a serious cut, it can spread rapidly. Unfortunately, hospitals are also home to antibiotic-resistant strains of Staphylococcus aureus. Do you know what they are using to treat her?"
"Uh, no actually, I didn't ask. Her parents said they were increasing the dosage of her current antibiotic before they try anything stronger."
"Hopefully, that'll work. The stronger antibiotics have some very serious side-effects. The normal treatment calls for intravenous treatment for up to six weeks. It all depends on how well the body fights off the underlying infection."
"She's in intensive care, already. Her temperature spiked rapidly. When they ran some tests, they realized she had developed the endocarditis."
"Well, at least they caught it early. That increases her chances of recovery. Still, it's a serious condition, Sara."
"What are her chances?"
"Survival rates run up to 80 percent. It all depends on what complications, if any, she develops. And there are a lot of potential complications. The infection can damage the heart; the valves are especially vulnerable. A surgical replacement is often necessary. Abscesses can develop. Congestive heart failure can also happen. The infection can spread to other organs. Stroke, aneurysms, arrhythmia, meningitis or infectious arthritis are all possible.
"The most serious complication, though, come from vegetations which grow in the heart. These are clumps of bacteria, platelets and immune cells. If they break free, they can enter the blood stream. If they are large enough, they'll block an artery, much like a blood clot. That can cause extensive tissue damage, if not death."
"Damn," Sara swore softly, trying not to cry. "She's only eight, Doc. She already had to go through the wreck. Sometimes, life really sucks, you know?"
"She has a good chance. They caught it early. Don't write her off. Kids can be amazingly resilient. Come on," he said, leading her into the morgue. "I want to get your weight. I'm serious, Sara. See me next week. I'll let Philip know I'm monitoring your physical condition."
"Sure, Doc," she said without conviction.
Leaving the morgue, Sara headed to the stairs with her head down. She just wanted to get to her temporary office without any interruptions. It was taking all of her self-control not to cry. She couldn't stop thinking that she had promised to visit Teresa and now there was a very real chance the girl would die before she could fulfill that obligation.
Biting her lip, she tried not to rationalize her avoiding the hospital: as hectic as her week had been, she could have made the time for at least a short second visit. The truth was she had been hurt that the family had talked to the reporter. It was unfair: the parents hadn't talked about what had happened on the bus and Teresa was too young to understand that it wasn't a topic to be discussed lightly. Hell, the reporter probably hadn't even explained that she would be writing about it.
"Sorry," she muttered when she bumped into someone coming around the corner, but froze when a hand grabbed her arm.
"God, Sara. What happened?"
"Nothing, Grissom. Please," she said, trying to pull her arm free from his grasp.
When he realized what she was doing, he pulled back his hand as if he'd been burnt. "I'm sorry. I wasn't thinking," he said in despair. "I'm so sorry."
The pain in his voice was too real to ignore. Hearing someone approaching down the hallway, she grabbed his hand and pulled him under the staircase. Letting go of his hand, she backed up slightly, but gave him a reassuring smile. He took the hint to keep his distance.
"It's okay. I'm sorry, I lied. It's not 'nothing'. It's, I, damn. I'm a mess right now, Grissom. Don't expect a coherent conversation. I know I must look like shit. Sorry if I scared you. Just had a hell of a day and I didn't sleep well."
"The bruises?"
"What bruises?" He pointed to the mark showing on her arm. "Oh, I hit the doorframe this afternoon. Must of happened then." Sara noticed the explanation didn't seem to relieve his concerns. Wiping at the tears that were forming despite her best efforts, she gave him a shaky laugh. "God. Your timing really sucks, you know that? You really caught me at a bad time. I wish you didn't see me like this. I'm sure it looks worse than it really is."
He tried to return her smile, but doubted if it seemed real. She was right: she did look like hell. More than anything, he found he wanted to hold her, as much for his own comfort as her own. "Can I do anything?"
"Not really. Thanks for caring."
"I meant what I said, Sara. I'm not going to turn away. I'll give you all the space you need, but I'll do anything I can for you. I mean it," he said, resisting the urge to move closer. He didn't want to startle her; it was clear that she was extremely tense.
"Thanks. But, I, it's best for you to stay away."
Grissom closed his eyes briefly, before nodding. "If you say so. I just wish there was something I could do to help."
"I know. But you said it yourself: sometimes the hardest thing to do, is to do nothing at all."
He gave her a quizzical look. "I said that? When?"
"During the Strip Strangler case. The decoy operation that was a bust? You told me that as we left the supermarket."
Grissom gave her another confused look. "God, I really am starting to think you tape everything I say. You know, just because I say something, it doesn't make it true."
"Confucius?"
"Buddha, actually. Well, it's a paraphrase, but ...," he paused, realizing he was starting to babble. "You want to take the night off? Get some rest?"
"No. I don't think I could sleep right now. And I have a meeting with Philip in the morning. Might as well just stay here."
"Your choice," he said, pursing his lips, before continuing in a low tone. "You know how to reach me, Sara. Any time, for anything. Just let me know. Okay?"
"I promise, Grissom. I'll let you know when I'm ready."
"Okay."
She started to pass him to head up the stairs, but he closed his eyes and leaned against the wall. Seeing his obvious pain, she surprised both of them by giving him a quick kiss. Before he could react, she pulled back, blushing and raced up the stairs.