Chapter 3

While EMTs were assessing Charlie's condition in the bathroom, Don ran back downstairs and found the doctor's appointment card. Obviously whatever this joker had done today had gone horribly wrong. He phoned the doctor's service and told them it was an emergency, gave them Charlie's name and his own cell number. Then he disconnected and waited six agonizing minutes at the bottom of the stairs for the doctor to call him back. By the time the phone sounded, the EMTs were carefully lowering Charlie down on a stretcher. Don wanted to lend his weight to the effort, but he knew these guys were trained for this sort of thing and had their own rhythm — he would only be in the way. So he backed away from the stairs and took the call.

"Eppes."

"This is Dr. Reynolds. I received a message from my service regarding Charles Eppes?"

"Right. I'm his brother. Charlie has a high fever and is vomiting some weird-looking stuff…EMTs are here, they're going to transport him to…"

"Huntington," the doctor interrupted. "Tell them to go to Huntington Memorial. I have privileges there, and their Emergency Department is top notch. I'll meet you."

Don disconnected again and relayed the information to the EMTs, who nodded. He pulled his car keys out of his pocket. "Dad, I'll drive…" he started to offer, but Alan, holding one of Charlie's hands, waved Don off with the other.

"I'm going with Charlie," he said tersely. "You've done enough already."

Don, walking on the other side of the stretcher with a hand on Charlie's shoulder, almost didn't hear him, at first, but as they reached the back of the ambulance and he stepped aside again to allow the EMTs some room, the words registered. He had done enough already? Did his father think this was his fault, somehow? He looked at his father, but Alan was being helped into the bus by an EMT. He settled on the bench near Charlie's head and Don could see his lips moving, but he couldn't hear what he was saying. Alan didn't look up again before the doors were shut and the driver was sprinting for the front of the ambulance, and almost before he could process what was happening, Don was standing alone in the driveway, watching the flashing red lights recede down the street.

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He had hit every red light between Charlie's house and Huntington, and even though he had run every one he safely could, the ambulance arrived long before Don did. He found a place to park and jogged into the ER, searching for his father.

He found him sitting forlornly in the waiting area.

"Dad." Don sat next to him.

"They wouldn't let me go back with him," Alan complained. "They said I should wait."

"Is his doctor here yet?"

"I don't think so."

Don inhaled a deep, steadying breath. "He's going to be all right, Dad."

Alan didn't answer. He hadn't even looked at Don, yet, and Don could feel the anger radiating off him. He squared his shoulders. Okay. Okay. If being angry at Don helped his Dad get through this, Don could take it. He wished he didn't have to, though…he could use a little reassurance here, himself. He found himself sitting right next to his father, wishing his father would show up and talk to him.

He was considering the absurdity of that when he saw a man headed down the hall in their direction. Determined stride, stethoscope around his neck. Don stood up. This had to be Charlie's doctor. Alan stood beside him. The man reached them and offered Alan his hand.

"Jim Reynolds," he said. "I'm Charlie's gastroenterologist." He led them to a more secluded section of the waiting area . "Let's sit," he said, and Don did, because suddenly his knees felt weak. A doctor looks at you and says "Let's sit", and whatever is coming next can't be good.

Alan finally sat as well, and then the doctor took a chair. "I've seen Charlie," he started, and looked at Alan. "Your son?" Alan nodded silently. "He's being prepped for emergency surgery now," he stated plainly. "He has developed a perforation of an ulcer, and is leaking acid into his abdominal cavity. A massive infection has already set in."

Alan gasped and Don heard himself protest. "But I had just checked on him a few minutes earlier…"

Dr. Reynolds nodded. "These situations can develop very quickly. The resulting pain and fever are sudden and intense. I'm sure you were keeping a close eye on him after today's procedure."

"What happened today?" asked Don. "He's been sleeping, not talking when he is awake, so we didn't really get the details…"

"I performed an upper GI endoscopy. It was intended to be diagnostic only, to determine the cause of his recent GI distress. But once I was in, I saw several gastric ulcers, one of which was actively bleeding. We used cautery on that ulcer. Until we open him up, I can't really tell you if that ulcer began to bleed again and perforated, or if it was one of the others…"

"I don't understand," interrupted Alan. "When did he get ulcers? How?" He answered his own question. "He's under too much stress."

"Actually, Charlie's lifestyle is definitely a contributing factor to his ulcers — and it's not just his stress level I'm concerned about. We talked about his sleep patterns and diet, as well. During today's procedure, my lab processed a tissue sample for bacteria, and there is an active h pylori infection; I believe this is the root cause. I sent him home with a prescription to begin treatment for that. As far as the biopsy, those results will take up to a week. We'll sample more tissue for biopsy during his surgery, since we'll be in there anyway."

Don felt his heart plummet to his toes. No matter how long he lived, he never wanted to hear that word again — especially in connection with another family member. He looked at his father and saw that the color had drained from his face, so dramatically that the doctor became concerned.

"Mr. Eppes? Are you all right?"

Alan seemed to be struggling to speak. Don placed a hand on his father's arm, but Alan shrugged it off, finally managed to whisper. "Biopsy?"

The doctor frowned. "Yes, it's standard procedure in these cases…perhaps I should get you some water…"

Alan shook his head, but didn't say any more. The doctor still looked pretty concerned and confused, so Don spoke up. "It's just that…there's a genetic factor. Our mother…"

Dr. Reynolds' face softened. "Of course, I'm sorry. Charlie and I did discuss his family history; I didn't mean to frighten you. I assure you, Mr. Eppes, this is standard procedure. As I mentioned, Charlie has several contributing factors that have led to his ulcers. I don't expect the biopsy to reveal anything else."

Alan nodded, and his face regained some of its former color. He inhaled shakily. "What sort of surgery will he have?"

Dr. Reynolds seemed more comfortable with this line of discussion, and his businesslike manner resumed. "We're going to try a laproscopic procedure to close the perforation with sutures," he started, "and get a better look at the entire abdominal cavity. If we determine mid-procedure that we could do a more thorough job with a conventional open surgery, we may decide to switch. The laproscopic procedure actually takes longer than the conventional method, but Charlie's recovery time would be greatly reduced. I'd say 4 or 5 days of postoperative discomfort versus two weeks or more."

"Then you can fix everything — he'll be all right?"

Dr. Reynolds smiled briefly. "Charlie's prognosis is very good, Mr. Eppes."

Don found himself immediately disliking this guy's tone of voice. "But what?", he asked, and his father glanced at him and then back to the doctor.

"You must understand…Charlie has had a bleeding ulcer for an unknown amount of time, and now a perforation. He's lost a great deal of blood. He will need transfusions. He's in an extreme amount of pain. The combination of blood loss and pain has made him very weak, but he still has a major infection to fight off plus the original h pylori infection. Charlie is very ill, I don't want to downplay that." He saw Alan paling again and hurried on. "But he's young, and aside from the ulcers in good physical shape. That will help."

Alan suddenly reached out and grasped the doctor's wrist. "You're doing this surgery?"

The doctor nodded. "Along with Huntington's surgical staff on call tonight."

Alan held onto his wrist and squeezed a little, locking eyes with the doctor. "Please," he said, but he found that he couldn't finish the sentence. He just looked into the doctor's eyes with his own watery ones and said it again. "Please."