For those thinking I'm heading in a certain direction with Kori's illness and thought you'd have an edge due to knowing my clinical background, you're likely going to be wrong.
I wrote this and half the next chapter about a week or so ago. Sorry it took me so long to post. It's been a difficult week.
Disclaimer, reiterated: I do not own DC Comics nor Warner Brothers, the Teen Titans, or the characters this AU (alternate universe) fic is based on. I do, however, own the plot.
New Characters:
Dr. Leonid Kovar (Red Star) – ER Attending Physician, new to ER (usually there's new staff in July which is also when all the new interns and residents come. In my story it's late summer, early fall. See below for further editorial on going to the hospital in July, August and September.)
Definition: Hyperemesis Gravidarum (HG): HG is a severe and intractable form of nausea and vomiting of pregnancy. It is a diagnosis of exclusion (that is, after other illnesses and causes have been ruled out.) While nausea and vomiting occur in the majority of all pregnancies at some point, HG is an extreme form. HG generally leads to weight loss, nutritional deficiencies, fluid imbalances, abnormal electrolyte levels and an acid-base imbalance. In its most severe cases, it leads to significant weight loss that impacts the embryo/fetus negatively and can even lead to pregnancy loss. It is life threatening to the mother as well, with potential complications of acute renal failure, cardiac arrhythmias, seizures and death. The incidence of HG among pregnant women is up to 2%. (BTW, for shits and giggles, I checked what Wikipedia had on HG; it was a particularly poor entry. I've said it before, I'll say it again, don't get your science from Wiki)
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Double Take
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Chapter 76
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"Sweetheart... God, what did I do to you?"
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"You did the breaking of my heart..." Kori said as she closed her eyes and turned her back to Richard.
Richard reached out to touch Kori, wanting nothing more than to take her into his arms but he couldn't. He couldn't bare the idea that she might reject him. He knew she might have more to say and he didn't want to distract her. He also knew Kori had seen him with Barbara in the ER, but what actual damage had he done to her psyche?
"It was not the kiss itself. I am not that naïve-"
"Naive, no Kori, of course not... Do you think there was an ongoing affair?"
She ignored his question. "Nor am I as naïve as I was even those two months ago. I did not offer you the appropriate level of sexual intimacy that is expected between couples. I understand that you had needed the more. You told me as much-"
"Kori, I-"
Kori put up her hand to stop him but did not turn around, "Do not interrupt, Dick. I am explaining my mental state that day. If you were, if you still are only having sexual relations with Barbara, it might have not been as damaging, but it was the intimacy I saw, the closeness you and Barbara shared when you were injured... that is what was painful. The last thing I remember concretely was Barbara coming up to me in the hallway of the ER explaining that she was there to take care of you because you said I was... that you told her I was the 'too sleepy' to be there for you."
She choked back a sob, turned back looking at him briefly and then, taking an unsteady step and sitting on the bed, her eyes dropped to the floor as she started speaking again. "Not only was there another woman in your life that you were so close to as to have them assist you during an emergency that you felt no need to call me, but if I had some sort of rival, how could you have told her that I was too tired to be there for you? You are American but you know my culture. We spoke of marriage, we were only putting off our formal engagement because of Barbara's need for treatment for her addiction– something ironically enough I refused to see as so many others do as a weakness, and within hours you allowed her to view me as rutha? I do not understand. Why would you chose a weak mate?"
"Kori, no, I-"
There was a knock on the door. "Room service."
"I'll be in the bathroom, I do not feel well."
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After the bellhop set up breakfast, Dick tipped him absently and sent him on his way and Dick waited for Kori.
Kori wasn't certain why she was feeling so much worse all of a sudden. Maybe it was nerves or her profound sadness as well as confusion over the situation. Getting the truth out was hard although she berated herself on harping on things that really weren't at the heart of the matter between the two of them. Why was she concerned about her appearance to Barbara? Did the rivalry really matter? They finally got a chance to talk and they didn't straighten things out about Richard's mother's ring, or Kori's letters, or if either of them had even meant for them to actually break up.
Yes, she was feeling better about really expressing herself, but it seemed the more she wanted to speak up about being strong and independent, the weaker she felt. Was she coming down with something, or was it the whole situation? She wasn't thinking clearly, she just was feeling so physically and emotionally compromised, she was beginning to understand that, she'd have to mention it to Richard when she got out of the bathroom. The last thing she wanted to deal with was more GI upset, but her body definitely wasn't cooperating.
At this point, was she sick and that was why she was emotional, or was she emotional and that's why she felt so sick?
Vomiting much of the day before including in front of Richard was bad enough and she was wondering about why she was so crampy. Was it gas? Menstrual cramps? The timing was odd for that... It didn't really feel like she was getting diarrhea, it felt more generalized, that is she was feeling it all over her abdomen, than that. Anyway, if that were the case, after all that vomiting, was there anything left in her system to poop out?
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After about ten or twelve minutes, Richard was getting concerned, but didn't want to pressure Kori. Maybe she needed more time to think. She wasn't feeling well, that was obvious. Also, they hadn't had too many arguments but she wasn't one to just hide from one. But maybe this time she was, but given the topic, that seemed counter-intuitive. And why was she was so overly sensitive about appearing weak, appearing rutha? He wasn't sure why she was so worried about it. Also, if it was her intention to get back together, there were so many other things to worry about. Maybe she was testing the water,just being cautious.
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Kori knew she really should have been listening to her body more; she definitely concluded it was whatever illness she had that was making her emotional. GI upset, cramps from gas, definitely that. How embarrassing. But it was more than that too... some referred pain. She was quite uncomfortable. She needed to discuss it with Richard, she was very concerned she was getting sicker. That telltale 'feeling of dread' they have you ask your patients about: it often heralds in terrible things.
Should I mention any of this? But Richard's my... or was my... at least he is my friend and a doctor, but... still...
She was getting a sheen of sweat, and not from exertion. She wasn't passing anything. Her skin was flushed; yes, something was going on.
X'hal, that telltale feeling of dread...
Increase in temp and fast, not a temp break... reality is getting disjointed... well, just time... how long have I been in here?
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"Kori, are you all right?"
Kori jolted awake. Or just more awake. That towel rack had felt so cool on her face when she pulled away from it she was bereft of it's coolness but then the pain hit from leaning on it for ten seconds... or was it minutes?
"Kori?"
She looked at her hands, they were shaking and mottled in shades of white, gray and almost violet...
"Um..." Her voice was a whisper, her mouth was dry. She inspected her rumbling abdomen, not sure why her attention was brought there. It seemed to be somewhat distended, it had some of that same mottled appearance, not as drastic... her mind started to put together a clinical picture but before she could really grasp onto anything, the fog returned to her mind.
"Kori...?"
...
"Star?"
"Richard?"
"Kori, I'm coming in."
"That is... a good idea."
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"I am mentally here... not dissociated... just weak," she said first as her eyes met a concerned Richard, "but I am on the toilet... and I am not feeling well... at all." She belched, grimacing at the taste in her mouth. "Something is quite wrong I fear."
"Do you have a plan?" he said softly, "where to next?"
"I better do the lying down. Can we figure out..." her eyes slipped shut for a second and she started to fall against the towel rack again before she shook herself awake, "what might be the wrong with me?"
"Of course we can figure it out, and I won't leave your side until we do."
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Richard helped Kori get up and pulled up her bottoms. After she shuffled out of the bathroom, he picked her up and carried her the rest of the way back to bed and laid her down on her back, alarmed at her condition and the rapid decline; there were obvious and startling changes that had happened within the last half hour.
Just looking at her he knew the hospital was the obvious choice and wasn't going to waiver on it this time.
"Kori, we need to get you back to the ER, I don't like how your symptoms are changing."
"I agree... was going to say the same... maybe unrelated to yesterday... or not... X'hal, I am much more fatigued now too..."
"Can we make it in my Escalade or do you want me to get EMS?"
"I can lay down... in the back..."
"Star, one thing, can you promise me something?"
"Hmm?"
"Let me stay with you, no matter what."
"'Course, I promise... paper?" Kori smiled.
Richard handed her a piece of the hotel's stationary and a pen and Kori wrote down for the ER staff that 'All medical information can be discussed with my Richard Grayson, MD. Signed, Kori Anders, PhD.' and dated it.
Richard read it and cocked a brow. "My?"
"Yes... We did not do the discussing... Richard... I do love you."
Richard picked her up in preparation to carry her to his vehicle. "I love you too, my Kori."
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The trip to the hospital was a nail biter for Richard, but for Kori, she seemed to sleep through the ride, only groaning occasionally, passing gas, belching, and repositioning in the back bench seat to get comfortable. Richard called ahead to the ER and to Rachael, but did make sure that Rachael was aware that Kori had given him the okay to be with her.
He did worry about Galfore. He figured that as long as things weren't dire, until they had a diagnosis, he wasn't going to contact the ambassador. He did touch base with Bruce and let him know that Kori was still ill and had mixed feeling to hear that no one else was sick from Bruce's jet. If there was someone else sick, it might be a bug or food poisoning, something simple and short term or at least a lead on what could be wrong. Now it was just a set of symptoms and up to the ER staff to figure it out.
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When they arrived at the ER, Richard pulled into the ambulance bay and things happened very quickly. The ER tech and the new attending doctor, Dr. Leonid Kovar, met Richard's SUV with a stretcher and scooped Kori up and brought her right into one of the trauma rooms. Not that she was a trauma patient, but those rooms are equipped to handle anything up to and including cardiac arrest and surgical procedures.
Once Richard had parked and made certain she was registered, he went back to see her. He was met by Dr. Kovar. He handed him Kori's note.
"Kori wants me with her. I've been with her all night."
"And you will be made aware of her situation, but during work-up, you wait in waiting room like all other family members and friends. Do not worry. She is most resilient, like her people."
That statement made Dick angry. What did this new guy know about Kori or Tamaranians? "I don't know who you think you are, but Kori and I are close, she wants me here, and I know just how strong she is; and as for the Tamaranian people, I lived in Tamaran for four years, so you don't have to reassure me about their resiliency."
"Dr. Grayson, you are not doing the work up, I am, but I have called in Dr. Roth. I saw Kori yesterday, and wanted to be called in such an event."
"Why am I being left out of this, Dr. Kovar? I'm on staff!"
"Dr. Grayson, I came in July. You were on leave of absence. You are not on staff. I believe there is... conflict of interest. Go back to waiting room. Let us take care of Miss Anders. Please. We will call when you can visit. You do not want publicity for her or for you. But I will let you know I was discreet about the hCG. I am running it under a dummy chart. I drew the vial myself".
Dick was shocked, why was there an assumption of pregnancy? "hCG? There's no way-"
Dr. Kovar had heard more than a few rumors about Dick and Kori. "As, precaution. It looks like HG, you have to admit, I could not ignore the symptoms, no one looked into it yesterday-"
"HG, hyperemesis gravitarium? So you just drew a pregnancy test on a patient with the presumptive father in the waiting room without discussing it with me."
"No, I did a dummy folder to protect Kori's privacy and yours."
"She's not pregnant." But what if she dissociated and did have sex. No... Oh God... What if she were raped?
"We'll know in twenty minutes."
"Twenty minutes? I'll go to the outpatient pharmacy, grab a home pregnancy test, pull some urine out of her foley bag and we'll know in two whether or not she's pregnant. What about her discomfort and symptoms until then? And are you looking at anything else?"
"We can't do anything until we have the pregnancy test back, we can't harm the-
"Right – you can't harm Kori either, not just a baby that DOESN'T EXIST! You have to keep working her up! Something else is happening! Anyway, she's sicker, too out of it for HG! At least let me sit with her if she crashes!"
"Very well, Dr. Grayson, I will let you sit with her, but she is not very arouseable at this point. You know policy. Please stay out of the way when we need to do our job."
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"Dick calm down!" Rachael said as she entered Kori's room. Not a minute before Kovar had left him there alone with the barely conscious Kori, being monitored continuously by video, EKG, oxygen saturation, to name a few. She also had two IV's, one running wide with IV fluids and one capped.
Dick ignored Rachael's snapping at him and grabbed on to her like a life line, hugging her tight. His eyes were moist when they separated. "Rachael, she..."
"Looks sick, yeah."
Dr. Kovar knocked once and walked in simultaneously. "You were right, Grayson, hCG negative, so now we move on-"
Rachael took a step forward, "What? Tell me you were at least looking for something else!"
"Woman, thirty, childbearing age, nausea, vomiting, severe weight loss, distended abdomen-"
"Recently out of the country, never sexually active, febrile..." Rachael countered. "Why do you think I didn't even draw a pregnancy test yesterday?"
"I see, let me find the rest of the laboratory tests and have some other tests run on the vials..." Kovar said with a nod.
"You do that doctor." Rachael snarled.
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"What do you think, Dick?"
"Food poisoning, although Greece isn't a place you'd worry about things like that too much. I spoke with Bruce, no one else from the plane was sick."
"But all that weight loss beforehand?"
"Unrelated, stress maybe..."
"Cancer?"
"God Rachael, please don't say that!"
"Kovar's not necessarily going to look for it-"
"I know, but..."
"Dick, she was probably stressed and didn't eat, maybe it's just some gastritis and a bug or something now. I'm acting department chair with Vic on his honeymoon and I will pull rank on Kovar, but let's give him more than a twenty minutes."
"Okay Rachael."
"As I see here from Kori's note, your her designated 'Richard'," she smirked at him, "which means something - I'm glad, so just go hold her hand, and let me go see what the results show." Dick gave Rachael a hug and she noticed he was shaking a bit, "She'll be fine, Dick."
"God I hope so."
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To be continued...
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Please review...
Word of advice: avoid elective procedures from July until at least Early October. (Just the other day you wouldn't believe the things I taught a med student and I was the patient there in for a pre-op visit for surgery that I certainly woun't have before October 15...) Not that things will go wrong necessarily, it's just that things take forever because the house staff: the interns, residents and fellows, that is all the doctors in training, are being questioned on every single order and move by whoever is supervising them. It's a frustrating yet fun time to be a nurse. Sometimes they try to be Mr. or rather Dr. Big-pants (that never flies where I come from). Sometimes they think they know more than me (an intern knowing more than a seasoned nurse at a major academic medical center... aaah... try again); oh, and guess what, it is my job to check all of your orders before giving ten times of a normal medication; but kudos for ordering the right medication. Here's your cookie! Now go to sleep in your call room dear child; I'll page you if I need you. (It's where I honed my awesome Mommy skills.)