POCKET CHANGE 2: A GAME OF CARDS
by Sharon R.

Chapter Five

Sean's voice stopped them momentarily. "Hey John, what's Mr. Tyson doing in Toomay's kitchen?"

"I asked her to find a place for him to get to work."

"With an apron on? Cleaning vegetables?"

"What?" Carter was puzzled then slapped his forehead with his hand. "Oh shit. I told her he was a bean counter."

Carter was lucky the swinging doors didn't pop him back in the head as he barreled through them on the way to rescue the appointed Carter Foundation peripatetic accountant from unintentional KP duty. Luka and Sean's laughter couldn't be missed, but the vaguely familiar voice of the woman barely registered with him.

There at a table duly scraping vegetables was Norman the Number Nerd. Carter scrambled to find a doable way to explain the situation while saving face. "Good to see that you're finding your way around the kitchen," he said as he strained to hide his out of breath lungs.

"Personally, doctor, I don't see how this aids me in my fiscal responsibilities."

"Well," he cleared his throat, "actually we… ah… believe that everyone here has to experience what… all of the jobs entail." Carter slowed his words hoping that the next sentence would magically slide out of his fumbling mouth. Glad that the man was normally slow to catch on, Carter decided to continue his embellishment. "We don't have the luxury to interview from… from a pool of applicants when help is needed, so it's important that in a crisis we… um… can step into another area." There. That sounded good. Reasonable. Text book-like. A white lie. Sort of. Carter swallowed hard and nodded as he hoped that his bullshit of an explanation was bought at better than face value.

Toomay's voice became louder as she walked into the kitchen from the storeroom. "Alright Mr. Tyson, here are your beans. Oh, hello Dr. Carter. Nice of you to visit my kitchen."

Carter raised his eyebrows at her trying to telepathically convince her to shut up. "Yes, ah Toomay, why don't you…"

"You Americans have a funny way of doing things…"

"Yes, yes we do," Carter put out, motioning towards the door, "but now Mr. Tyson needs to move on."

"… but I will not argue. If Mr. Tyson needs to count the beans before dinner I don't have a problem with that as long as he completes his job. Do you also have a rice counter coming?"

Norman Tyson stood so quickly his hips jarred the table spewing the cassavas he was cleaning in all directions. "A joke? Hmmm? You think this is funny?" Throwing the apron onto the table, Norman stormed out of the kitchen door, Carter close behind.

"Mr. Tyson…. sir… sometimes communication is a problem here. Colloquialisms don't always translate even though we….. Mr. Tyson… please… " The man was oblivious to the direction he was walking in heading straight towards a path at the edge of the wooded area, "… sir, don't go in there."

"More advice, Dr. Carter? A game? Perhaps you should work on your poker face," he spewed haughtily as he unrolled the sleeves of his dress shirt and carefully re-buttoned them. "I think I'd prefer to be alone."

"That's fine, but let me find you a place in the camp. An office. My office."

Norman Tyson strolled through the treed archway of the jungle pausing only to orient himself to the lush green surroundings that contradicted the dusty brown dirt and paved tarmac of the refugee camp. Looking above him and around, he listened to the mesmerizing sounds of the wildlife. A false invitation that he naively accepted. He fancied himself a nice walk in the woods.

"I resent your malevolent attitude and disdainful regard for my position," he spouted blindly to who he saw as the arrogant Carter family nepotistic doctor standing at the tree line in back of him.

Carter opened his mouth to explain, but Tyson put his finger in the air obviously refusing the young man any words.

"You came to us and asked for millions of dollars - more than we have ever applied to any one charity, and we gave it to you. Yet, you toy with me when I come here on behalf of the Foundation simply to help manage the funds?"

Carter leaned against a tree arms crossed in front of him in relaxed fashion and, knowing his words would simply bounce off Tyson, half heartedly and quite calmly warned the man of the danger ahead of him. "I wouldn't go too far into the woods."

The handkerchief out again, Tyson dabbed at his forehead before continuing his tirade. "This is a business. Whether in Africa, New York, Paris or Chicago - this is a business. Do you not understand?"

"Mm hmm," Carter sighed as he maintained his calm composure.

Tyson finally looked back over his shoulder at the doctor, and shoved his glasses up on his skyward nose. Before he could take another step forward the muzzle of a very long gun found its way to the little man's chest prompting his arms as far over his head as he could manage. Mouth quivering and knees threatening to buckle, the gun had its intended affect.

Allowing for a few moments of squirm factor, Carter finally stepped forward to intervene. "It's okay. He's with me," he calmly told the familiar soldier whose eyes he connected with. Putting an arm around Tyson, the two walked out of the woods back towards the camp. "You can put your arms down now."

"Now let me explain something. This is a business here too: my business. But it's not all about the numbers here. It's about lives, and that line between life and death is awfully thin here." Carter stooped slightly to look Norman in the eyes, not quite certain he had his complete attention. He decided to pull out the trump card and lower his voice almost to a hush before continuing on. "I assume you know what happened to Dr. Kovac and me a few months ago just over the border in the Congo. Rebels are more than willing to take foreigners in exchange for cash or political gain."

"Are there rebels all around the camp?" Even the sweat beading along his upper lip was orderly.

"He isn't a rebel. He is a Ugandan soldier here to protect us."

"How can you tell?"

"Well, it's not always easy. The rebels know how to pass themselves off as soldiers. Just stay within the camp and you'll be fine."

"What if they took me? Would they do something…" Norman looked around hastily, dropping his faux poise, "… something untoward to me?"

"Untoward?" Carter fought to maintain his composure, losing out to his raised eyebrows. "You mean… like, as in… oh… well, look, rebels in this part of the world wouldn't think twice about raping women, girls or even kidnapping them to use as sex slaves. But as far as raping men, I understand that that just isn't something…." Maintaining eye contact with Tyson nearly put Carter away as he searched up and down, around, anywhere but straight at the man. "I… I don't think you have anything to worry about. Relax. Now, I'm sorry about the communication problem earlier with Mrs. Bisango… Toomay. Don't hold it against her, she'll be cooking your food after all."

From behind the exam curtain, she heard a familiar voice, but by the time she had stepped around the corner and caught the doors swinging back and forth, the voice's owner was dashing across the camp towards the Midway, nearly falling on his face as he stumbled on the edge of the stone path. His gate, tall stature, dark hair - all familiar to her. She had seen enough to make a qualified guess.

"Is that John Carter I just heard? From Chicago?"

"You know Carter?" Luka asked.

"Well, yeah. I worked at County. Since when does John Carter trade the comforts of the family mansion for the African Continent?"

"You'll have to ask him that yourself." Luka really didn't want to talk about Carter's personal life behind his back, especially with someone he didn't quite get along with.

"You know him well?"

"I've worked with him for about four years, give or take."

"Is he still kind of klutzy and flighty?"

Luka was slowly getting the impression that this woman thrived on adversity with her peers and didn't want to have to defend Carter before he even got a chance to re-introduce himself. "He's an excellent doctor and a very good teacher." He didn't feel he should have to qualify Carter's professional ability and mumbled under his breath, "he's been through a lot."

"What do you mean by…"

"Excuse me," Paulette interrupted them, "I think we have a new patient." The teenaged assistant was accompanied by one of the newer American volunteers. "Mrs. Wiant has some bruising I think you should see."

"Really, I don't think this is really necessary," the embarrassed woman announced. "I'm tired but I don't feel sick. I've been helping to put the school building together and must have just over done it."

The doctors took her arms and noted the deep bruises before asking her to get into a gown for an exam. They knew what they were seeing and hoped they had caught it early. Other than a low grade temperature and slightly elevated heart rate, the woman's vitals were within the normal range. Upon exam they found more bruising on her legs and back as well as petechiae - pinpoint-sized hemorrhages of small capillaries in the skin resembling tiny red dots - on her face.

"Well," Luka sighed as he sat next to the woman, "it's obvious from the exam alone that you are experiencing something called thrombocytopenia, which means your bone marrow is no longer producing platelets, your platelets are being destroyed or both. Platelets are what cause your blood to clot." Luka spoke calmly to Mrs. Wiant as she sat up straight in the bed obviously becoming anxious. "What's triggering this is a mystery at this point. Sometimes people get what's called Idiopathic Thrombocytopenia Purpura, or ITP. Idiopathic means 'without known cause.'"

"Will I die from this?" the woman asked, her eyes now wide with nervousness and tears.

"If left untreated, yes, you will die," the woman doctor interjected coldly from above and behind Luka's shoulder.

Luka shot of look of disgust at his colleague. "Let's not put the carriage before the horse here. Regardless of the cause, we need to start giving you medication - IV steroids - to stimulate your bone marrow. Are you allergic to anything? Any medications?"

"No. In fact I've been taking an antibiotic for about a week now for a urinary tract infection. I saw a doctor at Nebbi Hospital in the village."

"A sulfa? Bactrim or Septra?"

"Yes, Bactrim DS," the woman sat up suspicious now of her doctors' sudden concern. "Is that what is causing this?"

"It could be an allergic reaction, yes. It's been known to happen," Luka answered.

"But I've taken it before. Maybe three or four times. That's why I asked for it."

"Well then your bleeding could be caused by something else. We have no way of knowing," the female doctor told her.

Luka, still sitting by the patient, turned his head towards the standoffish doctor and spoke without looking directly at her. "Not necessarily. Can I see you outside, doctor?"

Carter and Tyson walked back to the Midway porch where Bob was sitting taking in the late day sun. He and Tyson looked each other over before dismissing any thought of introducing themselves. It was like two snakes converging in the desert: neither wanting to meet, but both willing to share the territory.

"You need to stop thinking out loud in front of a patient. For Christ sake, you're going to scare her." Luka shouted as he stormed out of the clinic… again.

"Well she should be scared. This is not the common cold we're talking about."

"And we are not in the states with millions of dollars of diagnostic equipment at our feet. She doesn't need to know that right away."

"Need a second opinion?" Carter was standing on the porch steps between the two other men stretching his back and wincing. "Or should I say, third?" Taking off his sunglasses allowing them to hang around his neck, Carter's grin erupted as the woman recognized him. "Luka, I think I have to take back what I said about her and guns. Maggie Doyle is a proficient gun handler." Carter and Maggie embraced and laughed aloud as a bewildered Luka looked on. "Boy, it's good to see you, Maggie."

"What the hell brings you to this wasteland, Carter?" Maggie asked as she consciously put herself between the two men, her back squarely to Luka's face.

"The Carter Foundation is sponsoring the camp and Luka is setting up the clinic for the Alliance. How long are you here for?"

"I finished my commitment with a schistosomiasis research program deep in the middle of the continent, so I'm yours for as long as you need me, I guess."

Luka rolled his eyes. "Can we get back to our patient? Carter, we have a patient with ITP - bruising, petechiae, oral/pharyngeal blood blisters, fatigue, low grade fever, slightly elevated heart rate - but there's a catch. She's on Bactrim, had several courses in her lifetime. Can't rule out drug allergy, but it just doesn't fit the mold."

"How long has she been in Africa?"

"Six months."

"Liver and spleen involvement?" Carter asked.

"Slightly enlarged on palpation, not specifically tender yet." Luka was puzzled with Carter's line of questioning. "What are you getting at?"

"Luka, remember when we got back to Chicago after our stay in the Congo? What one hematologic anomaly did we both exhibit?"

Luka nodded as he saw where Carter was going. "Anemia."

"I think we may be seeing a secondary reaction brought on by the Bactrim in response to anemia."

"Megaloblastic Anemia - a folic acid deficiency," Maggie interjected catching on, "her diet probably had little in it."

"So what do we do?" Luka wondered, "we don't know how low her platelets are. I'm not sure we can risk a transport. She already has some spontaneous bleeds in the back of her throat and behind her kidney"

"From what you say, I would bet on her count being under 10,000." Carter put his hands on his hips as he struggled to balance the needs of the woman with what they could offer without killing her first. "Let's see what steroids do tonight, keep an eye on her output - once the liver is involved the kidneys usually step in line - and treat her anemia. And let's get everyone that came from outside the country on a supplement. Use the prenatal vitamin packs we got from the manufacturer if we have to."

"If we had an accurate platelet count we could determine whether it's safe to transport her," Maggie added.

"I know," Carter looked between the two other doctors and at Bob and Tyson before digging into his next thought. "Look, my sister has a distributor lined up to sell us a piece of lab equipment similar to a VetScan, which she uses in her clinic. It does in-house blood chemistries on thirteen different values. With donated rotors, we can essentially have our own lab here."

"Vet? Is this veterinary equipment?" Luka asked.

"Well, the VetScan is, yeah. It's the same type of unit that the army uses in field hospitals. The unit she has in mind is used. It's been modified for human use. Getting a brand new unit would be cost prohibitive and in this climate, a gamble."

"And how much does this machine cost?" Norman asked.

"With the computer system needed for human conversion and the A/C for the office, somewhere around $40,000."

Norman chortled as he cleaned his glasses… again. "Quite wasteful for a refugee clinic, don't you think."

"Who is this creep?" Maggie blurted. She got straight into his face forcing him two steps backwards. "Do you even know what you're talking about?" Nearly dropping his glasses, Norman turned and tripped up the steps into the mess hall.

Carter was going to enjoy having his old friend there, if only he could mediate Luka's differences with her. The three joined Norman for dinner in the Midway, Maggie and Carter lagging behind Luka. "What's with Tall-Dark-and-Brooding?" Maggie muttered.

Carter couldn't help but to smile just a little as he quickly realized he was in the middle. "Give him time. He's an excellent doctor."

"Yeah? That's what he said about you." Maggie halted for just a moment as she thought to herself. Those two aren't………. Nah.

At dinner that night, Carter introduced Maggie to the table while Luka distanced himself for the sake of sanity. When Todd walked toward the table with his plate Carter waved him off, pointing to a table at the far end where the other volunteers sat.

"That wasn't nice, Richie Rich," Maggie chided him with a slight bump of the shoulder and a sly smile.

Carter managed to screw his face up as he swallowed his food. "No. I need this small amount of time without the wonderkid."

"Aw… he looks so lonely. What's his story?"

"Comes from a load of money. He's clumsy, overeager to please and obviously only here to appease his father who sent him here in exchange for a large tax write-off."

Maggie stared through him. "Sounds like someone I once knew."

"And where is our Mr. Tyson?" Toomay asked.

"I believe he took his dinner to his room. I think he's a little overwhelmed," Carter said as he thought to himself how overwhelmed he had been earlier in the day himself. "And afraid of our Dr. Doyle."

"He is not," countered Maggie.

"Oh, but he is." Carter winked and moved one cheek away from Maggie to allow for the jab he was certain he'd get.

As usual, Bob sat on the steps just outside the door. "Bob," Carter called out, "we know you're out there. Why don't you join us."

Bob stood facing the diners. "Thank you, I think. But for now," he pointed a finger at Othiamba, "I'd like to borrow Lurch over there." Downing his last bite, Othiamba glanced around the room first at Sean, then Carter and Luka, for their go-aheads before leaving with Bob.

"Don't worry, Othiamba," Carter announced with sarcasm, "you're in good hands with Bob. If you're not back by nightfall we'll send Norman after you."

The familiar cast of doctors and workers congregated on the porch of the Midway after the dinner hour for one last night of calm before the first big busload of refugees poured in the next morning. With not much to share, they enjoyed the mysteriously mosquito-less evening in relative silence. Sean sipped coffee on the steps. Toomay sat in the doorway as she dried the just washed eating utensils. Todd reclined in a chair writing a letter. Maggie propped herself against the post. Carter and Luka sat on the edge of the porch at the far end away from the others, almost reflexively together, yet apart. Wind tussled their ungroomed hair and gave them a refreshing breeze as it invaded the openings in their well worn, rarely washed garments. Between gusts there was no mistaking the sound of drums and voices in the distance, barely audible but not ignored. A celebration for a visiting dignitary, Othiamba had explained earlier in the day.

Carter was focused on Mbuto, Joseph, Tolo, as well as other refugee and missionary children playing with the soccer balls off to the side. Their laughter carried across the excessively dry environment and if Carter watched their faces close enough he could see that their echoing voices lagged behind, the distance being the only barrier. The pitter-pat of the drums, the voices, the haunting melodies, gave him pause as he felt a fleeting connection and absent mindedly rubbed his wrists that had once been strangled so severely by rope. His head dropped into his chest as he fought to catch his suffocating breath against the hollow reminder of their captivity. With his overly deep breath he straightened his back away from the invisible force behind him.

Luka shivered then closed his eyes as a wave of déjà vu crossed him causing him to take a sharp, deep breath. Cocking his head to strain his ears in the direction of the village he put himself in a dark, smothering hut, his only connection to the outside the faint voices and change in weather he had experienced through consolation. The porch floor boards beneath his left hand enveloped his momentary lapse of location as the feel alone broadened his sense of enclosure. Without thought, he put his right hand in front of him, almost pushing out at the air, just as he had done to catch the warmth of the sun as the beams crept between the loose boards of the hut.

"Think about it much?"

Carter caught Luka off guard as he opened his eyes and brought his hand back to his lap.

"Every day," he smiled apprehensively, looking down into his lap. "You?"

"I kind of store it with the other not so pleasant memories that deserve to be shelved but not shredded. But… I don't know," Carter spoke quietly as he shook his head, "something just… I got this…"

"Feeling?" The two finally looked at each other as their private conversation became almost telepathic. "I know. Me too. It's always there, but not like this. It's almost as if he…" Luka lost himself in thought, not wanting to even mention the name.

"But he's not here. We're free, Luka."

"I know. So is he."

Maggie looked on at the two men as they sat next to each other obviously lost in thought. What was it about those two? Luka's hand stretched out at no one as Carter arched his back. Again with the back discomfort, she thought. Whispers, sighs… certainly not talking about the Bulls.

"What are you two looking at?" Maggie's voice startled both doctors whose eyes focused ahead of them.

"The sunset," they answered in unison, squinting through the harsh rays of the setting sun. Like the glow of an impressionist's painting, the brilliant orange and pink hues from the sky hung over the bright green tree tops at the edge of the airfield slowly fading into the black brush strokes of impending nighttime as a pair of headlights headed towards them.