Part One Hundred And Sixty
But three days later, George found herself wondering just how she had managed to feel so sensuously ecstatic as she had with John and Jo on the Wednesday evening. It was Saturday, and she had been for another session of chemo the day before. She had felt a little lightheaded on returning home on the Friday evening, but it wasn't anything she couldn't handle. But by Saturday evening, she would have wholeheartedly given up the fight for life if she had so much as been given the option to do so. Nothing, not even water would stay down any longer, and she couldn't help but question as to why her stomach was still in tact. She had tried taking some of the anti-sickness medication in tablet form earlier in the day, but that like everything else in the past twenty-four hours had returned with a vengeance. John was with her, but he could do very little to make her feel better, and if George had been honest, she would far rather that he didn't witness this side to her cure. Had Jo been available, she would have done what Ric and Zubin had asked of her, and given George the medication by injection which had resided at the back of the fridge since George's chemo had begun some weeks ago. But Jo wasn't anywhere near. She was in York, spending the weekend with her two sons who were at university there. Having felt comparatively okay the night before, George had assumed that she would remain so for the entire time that Jo would be away, telling her to go and see her children, and not to worry about her. She wouldn't be making that mistake again, George thought to herself as she tried to curtail the pain and misery associated with persistent vomiting. But John couldn't simply let her suffer, when a possible solution had just occurred to him.
Karen was at home on the Saturday evening, doing nothing more exciting than tidying up her flat after a hard week's work, and sorting through the mountain of post she had received, most of it junk mail. When the phone call came, she far too readily put down the bank statement, thinking that she definitely needed to get herself a life if the simple ringing of the phone could make her smile. "Karen, its John," Came the familiar voice over the wire. "I need your help." "What's happened?" Karen asked, her brain immediately switching back onto red alert. When John had explained the situation to her, Karen simply said, "I'm on my way," Before switching off the phone and picking up her car keys.
When she arrived a short while later, John opened the door to her in a state of utter relief. Karen would be able to help George where he couldn't, that was something he could be infinitely sure of. "How is she?" Karen asked as she moved into the hall. "Still the same," John replied, and Karen could see just what a toll the worry for George was having on him. "What did Ric give you for this?" Karen asked, her former professional role coming back so easily that John briefly wondered why she'd left that profession in the first place. "I'll show you," He said, leading her into the kitchen, where he'd retrieved two separate bags of medication from the fridge, one quite obviously containing more than injections. Picking up this particular pharmacy bag, Karen read the words, "Only to be administered by a qualified professional," On the label. "Okay," She said, putting the bag back down on the table. "We'll come to that one if necessary." Opening the other bag, she found several pre-packed syringes of Cyclozine, and briefly reading the instructions, she asked, "Is this what Jo was taught to give her?" "I think so," John replied, not having been there when this had taken place. "Well, this is easy enough to give her," Karen told him, moving towards the stairs.
When she walked into George's en suite bathroom, Karen was more than a little alarmed to see just how ill George actually was. "You don't look too good," She said by way of greeting. "Bloody, understatement of the, century," George said with difficulty. "The Cyclozine has to go in the top of your thigh," Karen told her as she undid the packet. "Is that all right?" "As long as it works," George answered miserably. "I really don't care." Kneeling down beside her, Karen lifted the corner of the nightie George was wearing, and without any hesitation whatsoever, pierced her skin with the hypodermic needle, depressing the plunger of the syringe, allowing the medication to enter George's musculatory system. After laying the syringe and its empty packet aside, Karen gently began rubbing circles on George's back. "The only way you're going to stop heaving," She tried to explain. "Is if you try to relax." "Easy, for you, to say," George replied bitterly. "I know," Karen told her reasonably, not remotely phased by George's temper. "But try to take slow, deep breaths, and I promise you it will happen."
When George had eventually calmed down, enough to stagger unsteadily to her feet, Karen rose with her and put out an arm to steady her as she swayed. "Just take it slowly," Karen persuaded her. "Your blood sugar and blood pressure have probably gone through the floor." George leaned against the sink as she cleaned her teeth, trying to keep her eyes off the mirror image of her far too unhealthy features. But as Karen put out an arm to help her back to bed, George said, "I've got to have a shower. I feel disgusting." "Absolutely not," Karen replied firmly. "I give you five minutes before you're flat on your back because you've fainted, and that's probably being uncommonly generous." "What do you suggest I do then?" George demanded acidly, finding it far easier to take out her frustrations on Karen than she had on John, though she didn't know why. Looking over at where John stood in the bedroom doorway regarding her thoughtfully, Karen had an idea. "John, please could you fetch me a bowl of warm water and a glass of ice?" "Sure," he said, feeling at last that there was something he could do to help. As John went downstairs to fetch the required items, George moved back over to the bed, perching on the edge, trying to summon up a little more strength than she currently had. "Lie down before you fall down," Karen told her affectionately. "Actually, that's not a bad idea," George said as she slumped back onto the pillows, admitting a certain amount of defeat if not conceding to it fully. When John returned, he handed the washing-up bowl full of warm water to Karen, who placed it on the flat expanse of duvet on George's left. As she took the glass of ice cubes that he'd been holding, she thanked John and gave him a look that quite clearly asked him to leave them to it.
When John had retreated downstairs, Karen said, "Sucking ice is the quickest way to get at least some fluid back inside you." "I'll take your word for it," George replied dismally. But as she watched Karen retrieve a soft sponge and some shower gel from the bathroom, she felt all her defences rise up in protest of her situation. "You can't be serious?" She said as Karen squirted some of the shower gel into the bowl of water. "Perfectly," Karen replied matter-of-factly. "Because I am not giving you any opportunity to black out and crack your skull on the edge of the bath. Okay?" "No, it's not okay," George responded bitterly, the tears running helplessly down her cheeks. "I feel so feeble and pathetic." "I know," Karen said, reaching forward to remove George's nightie. "And just because you need looking after at the moment, you are not feeble, and you are not pathetic, I promise you." "You wouldn't just sit back and let someone do this, would you?" George asked, determined to get her argument across if nothing else. "Not in a million years," Karen said with a smile, beginning to run the moistened sponge over George's face. "I'd probably be the most cantankerous patient going." "Well, there you are then," George insisted, admitting only to herself that the scented water did feel wonderfully refreshing on her boiling hot body. "Would you prefer that John were doing this?" Karen asked, beginning to run the sponge all over George's feverish skin. "Good god, no," George replied in horror. "What about Jo?" "Even if she had it in her mind to attempt such a thing, I wouldn't let her," George replied confidently. "So why let me?" Karen asked with a certain amount of real curiosity. "Because whilst I can win most battles," George replied without a shred of hesitation. "This one, much to my sincere irritation, I can't." "That's honest, I suppose," Karen said dryly.
When George reached for the glass of ice cubes on the bedside cabinet, and Karen yet again squeezed the water from the sponge, Karen raised the subject of George's alternative medication. "John showed me another bag of injections, with a label on it saying that it should only be administered by a fully trained professional. What's that all about?" "Ric told me that there may come a time when I would need something far stronger than the Cyclozine. He gave me something that could if necessary be administered by my GP. Why?" "I just wondered," Karen replied, reaching for the bath towel that she'd laid on the bed beside her, gently drying George's freshened body before retrieving a clean night-dress from the chest of drawers. "Do you mind if I talk to Ric about this?" Karen asked, after pulling the nightie down over George's head. "No, I don't mind," George replied with a yawn. "Just don't let him persuade you that I need to be in hospital." "Well, I'll try," Karen said, not promising anything. "But I might be tempted to agree with him. Now, go to sleep, and I'll come and check on you later."
When Karen appeared downstairs and poured the bowl of water down the kitchen sink, John came into talk to her. "Is she all right?" He asked, putting the kettle on for some coffee. "She will be," Karen replied, thoughtfully looking at the other pharmacy bag on the kitchen table. "But I need to talk to Ric about her." "Karen, thank you for being here," John told her earnestly. "I wouldn't have known how to help her." "I'd do anything for George, you know that," Karen told him quietly. "Besides, you forget that it used to be my job, many moons ago." Picking up the cordless phone, Karen sat down at the kitchen table as John began to make them some coffee.
"Ric, it's Karen," She said when she got him on the line. As she began to explain what had happened and what she had done, leaving out nothing of George's present condition, John put a mug of coffee down in front of her together with an ashtray, receiving a smile in return. As he listened to Karen, he couldn't help but realise that she had excelled at the nursing profession just as much as she had done and was still doing in her current one. "Okay," Ric said when he'd heard all that Karen had to say. "For a start, the Cyclozine probably won't be enough to keep the sickness at bay. So, tell me what I put in that second bag, and we'll go from there." Taking a swig of her coffee, Karen began laying the contents of the bag out on the table. "There's a bottle of saline, several 14 gauge canulas, clean syringes, clean needles, surgical tape, alcohol wipes and several pre-packed syringes of something called Granisetron, which is a new one on me." "We use it a lot nowadays for chemotherapy patients, because it's a hell of a lot stronger than either Cyclozine or Metaclopromide. It's the best thing since sliced bread as far as anti-sickness medication is concerned." "Okay, but now you've finished extolling its virtues," Karen said with a smile. "What do you want me to do?" "We always start off with Cyclozine," Ric explained. "Because any friend or relative can be trained to give it as it's intra-muscular, and because no normal friend or relative can be given the responsibility of giving something via intra-venous access. However, you do appear to be the exception to the rule." "Aren't I always?" Karen commented dryly. "But are you sure I would be permitted to administer this?" "You're still a fully qualified nurse," Ric said succinctly. "So yes, without a doubt, though I would have trusted you to do it in any case." "Well, thankfully neither of us will get hung for breaking the rules. Is there anything I need to know about Granisetron?" "Other than that it can only be given once every twelve hours, no. Don't forget to flush the canula with saline before you inject the drug, and if she's still throwing up by tomorrow, I'm afraid that she'll have no choice, because I will want her in hospital right away. Let me know if you have any problems." "Thanks, I will," Karen replied, switching the phone off and lighting herself a cigarette.
As John sat across from her, listening as she talked to Ric and watching as she put the phone down and thoughtfully smoked her cigarette, one question rose plaintively in his mind, refusing to be banished from his conscience. "Would it be extremely uncharitable of me," He began carefully. "To ask whether you really know what you're doing?" "No, not really," Karen replied, a little surprised by his enquiry. "But I can promise you that if Ric didn't think I did know what I was doing, he wouldn't let me anywhere near what I'm about to do. I took my last refresher course a few months ago, so you have nothing to worry about." "I'm sorry," John said, feeling thoroughly contrite. "Don't be," Karen assured him softly. "You're worried about her, just like I am."
When they went upstairs a good while later, George was sound asleep. Sitting on the edge of the bed, Karen gently shook her shoulder. "George, I need you to wake up," She coaxed her quietly. Sluggishly turning over, George tried to surface from the fog in her brain. "I need to put a needle in the back of your hand, so that I can give you something far better than the Cyclozine," Karen explained. "Okay," George replied exhaustedly, not giving a damn what was done to her at this precise moment. Removing George's right arm from under the duvet, Karen first of all wiped the back of her hand with one of the alcohol wipes, sterilising the skin. After asking George to make a fist for her, she located the most prominent vein before swiftly and accurately inserting the needle of one of the canulas. Then, filling a clean syringe with clear saline, she flushed the canula, ensuring that it was in the correct place. "Why did you do that?" John asked, from where he stood watching her in the bedroom doorway. "To make sure there aren't any blockages before injecting the medication," Karen told him. Removing one of the syringes of Granisetron from its packet, Karen fitted the end of the syringe to the canula, and injected the drug that might keep George's stomach in an entirely peristaltic fashion for at least the next twelve hours. After replacing the cap on the end of the canula, she put a piece of surgical tape over the needle to keep it in place. "I'm going to give that half an hour to kick in," She told George after putting her hand carefully back under the duvet. "And then I want you to try having just a few sips of water." "That might take some persuasion," George said tiredly, not wanting to risk throwing up again any time soon. "But I suppose that nurses' training taught you how to do that too." "You can bet on it," Karen replied with a soft smile, brushing some hair back from George's face, and thinking that maybe she did still have what it took, maybe she did still possess that quality that had long ago seemed to come to her so naturally.