Chapter 11
"Excuse me. Gentlemen?"
"What? Huh?" Chuck started awake. Taking a deep breath and opening his eyes wide, he glanced around, realizing that he had fallen asleep in the chair next to Gary's bed. He self-consciously checked to see if he had drooled while dozing. He searched for Crumb, and wasn't surprised to see him still standing in the corner, eyes glued to the heart monitor.
"Hi, I'm Dr. Nielsen. The nurse told me that you were here, and I wanted to catch you before you left."
Chuck stood and turned around to face the voice. He greeted the tall, balding doctor with an outstretched hand. "Nice to meet you, Dr. Nielsen. I'm Chuck Fishman and-"
"Fishman?" Dr. Nielsen's eyebrows shot up in puzzlement. "I thought you were Gary's brother."
Chuck's eyes opened wide, and, gulping, he flicked a glance towards Crumb. The older man was rolling his eyes and shaking his head at Chuck's gaffe. Chuck cleared his throat, "Uh...we're step-brothers...sort of."
Dr. Nielsen held his hand up, a half-smile on his face. "Hold it. I really don't care if you are related or not. That's the hospital's rule, not mine. Anyway, Mr. Fishman, if you and Mr. Hobson could step out in the hall with me for a moment, I'd like to discuss Gary's condition with you."
"Mr. Hobson is here?" Chuck asked, looking behind the doctor in hopes of seeing Gary's dad.
"Aw, jeez, Fishman." Crumb snorted.
Dr. Nielsen gave a short laugh. "So, I take it you aren't Gary's dad, either."
Crumb shook his head. The gig was up. Holding out his hand, he introduced himself. "Zeke Crumb. I hated to mislead you, Doctor, but Hobson's real parents are traveling, and we can't reach them."
Chuck bit his lower lip, hoping they weren't going to be tossed out on their ears.
Dr. Nielsen nodded, clasping Crumb's hand. "I understand. However, I'm in kind of an awkward position, here. I shouldn't discuss a patient's condition with anyone but the patient's family."
"Look, Doc, other than his parents, we're all the kid's got." Crumb gestured towards Gary. "We're almost like a family," Crumb finished gruffly, studiously avoiding Chuck's astonished gaze.
Dr. Nielsen sighed. "Let me see if I can get Gary's permission. If you'll wait in the hall, I'll be right out.
Chuck paced restlessly outside Gary's room. "Sorry, Crumb. I should have kept my mouth shut."
Crumb pursed his lips, his hands in his pockets. "Forget it, Fishman. The truth would have come out sooner or later."
Chuck shrugged. "Yeah, I guess." He ventured closer to Gary's door, craning his neck to see what was taking the doctor so long. The doctor was adjusting some equipment attached to Gary's finger. Chuck still couldn't believe how sick Gary looked. Even though he had been warned by Crumb, he hadn't been fully prepared to see his buddy lying so still, all his energy being consumed in the effort to breathe.
Seeing the doctor headed towards the door, Chuck pulled his head back around, not wanting eavesdropping to be added to his list of crimes.
Dr. Nielsen approached Chuck and Crumb, his expression neutral. "Gary did grant me permission to discuss his condition with you both, though the sooner you could reach his parents, the better."
"W-what do you mean?" Chuck said, in alarm.
The doctor sighed. "I just don't like the way things are going right now, but let me begin by explaining Gary's condition."
Chuck swallowed hard.
Crumb lifted his chin up slightly, then nodded. "Okay, Doc."
"As you know, Gary has a severe pneumonia. We've cultured the bug causing it, and, as I suspected, it's a pneumococcal pneumonia."
Chuck glanced at Crumb, shrugging. He hadn't a clue what the doctor was talking about.
The doctor continued. "Now, normally, a guy Gary's age probably wouldn't get this bug. It occurs most often in people over sixty-five, but Gary has had a splenectomy, and the spleen is involved in fighting infection. Without it, his natural defenses were lowered, making him susceptible to the bacteria."
"Can you treat it?" This really doesn't sound good, Chuck thought, frightened for Gary.
"Oh sure. It's fairly simple to treat. We just give antibiotics like penicillin. The problem is that it moves so quickly--within hours--that by the time Gary was brought in most of his right lung was already full of pneumonia."
"So, what happens now?" Crumb asked, arms crossed in front of him in a determined stance.
"We continue treating him with antibiotics and try to maintain his oxygen level until the penicillin starts winning. Unfortunately, it can take up to five days for the drugs to begin to win the war." Dr. Nielsen rubbed the back of his neck. "The problem is, I'm not sure how long Gary can continue his fight."
Chuck and Crumb shared uneasy glances, Crumb being the one to voice their fears. "I don't understand. It's been three days already. That means in just two more days, he should start to get better, right?"
The doctor nodded. "Yes, but Gary's been breathing at a clip of forty-four to forty-eight breaths a minute for a couple of days now."
"Forty-eight is bad?" Chuck felt clueless in medical matters. It seemed to him that the more someone breathed, the better off they were. "What's normal?"
"Forty-eight is definitely not good," Dr. Nielsen explained. "Twelve to sixteen breaths per minute would be considered normal."
Crumb cleared his throat, "Uh, Doc, what will happen if Hobson's breathing doesn't get any better?"
"The way he's going at some point his body will be too exhausted to continue. If that happens before the meds kick in, he'll go into respiratory failure."
"What does that mean?" Chuck felt his stomach clench. He really, really didn't like the sound of this.
"It means we would have to insert a tube and put him on a ventilator to help him breathe. That comes with a whole new set of risks, which include lung damage, that I'd like to avoid if possible."
Chuck blanched, remembering Gary's condition after the Sears Tower bombing. How Gary had hated it. Not being able to communicate had nearly driven him crazy. "Do you think it will come to that?"
"I don't know, Mr. Fishman. Right now, his oxygen level is still very low. If it gets any lower-well-", the doctor bit his lip and shook his head, "let's just say that any lower and it's not compatible with life. We already have him on one hundred percent oxygen. The only way to give more is to put him on a ventilator. By adding pressure, we can hopefully increase the oxygen level in his blood."
"And what if you can't?" Crumb asked quietly, his gaze boring into the doctor.
The doctor took a deep breath before answering. "Let's hope we won't have to deal with that scenario, Mr. Crumb."
Crumb nodded, smoothing a hand over the top of his head, "He's a tough kid. He'll come through it."
Chuck cleared his throat nervously. He had to know. "Dr. Nielsen? Would...could--stress have made Gary sick?"
Dr. Nielsen cocked his head to the side in thought, "Hmmm, I'm not sure. It could have helped to lower his immunity. There are studies out there that claim that stress plays a factor in many illnesses. It could have, I suppose."
Chuck crossed his arms; turning away from the doctor. He didn't risk a glance at Crumb; afraid of what he would find in the old cop's eyes.
