I didn't want to leave Kori in the proverbial balance, so here's a quick update, more soon!
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.
Occam's Razor: The line of reasoning where the simplest answer is the most often correct; in medicine, you look for the fewest possible causes that will account for all the symptom. This leads to the old medical adage: 'when you hear hoof beats and you're in Kentucky, think horses, not zebras.'
Hickam's Dictum: "Patients can have as many disease as they damn well please". Meaning: statistically speaking, when faced with a complex medical problem, it is much more common for a person to have more than one common ailment to account for multiple symptoms than one rare ailment that accounts for all of one's symptoms.
More Medical definitions this chapter:
Intubated: when a tube is placed in the mouth or nose through to the throat to create an artificial airway
White count: White Blood Cell count; increases when there is an infection
Albumin: serum albumin is a protein of plasma; necessary for maintaining osmotic pressure, keeping fluids in the vessels.
Gram stain: a lab test that divides bacteria into two groups: gram-positive and gram-negative; most antibiotics treat one or the other group
Ambu Bag: rubber bladder that hold air and attaches to a mask, when squeezed, forces air into the patient's lungs.
Double Take
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Chapter 78
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Dick's world crumbled. How the heck did Kori go from barely conscious but stable to crashing like that? He knew she was sick, really sick, sicker than Kovar apparently could see, and he knew Rachael saw it, but somehow Dick took her lead, letting his guard down. He fell into the role of 'the loved one'. Was Kori going to die because he allowed himself the luxury of caring about the relationship and not her well-being?
No.
He could figure it out. He joked about being where he was today by riding on Vic's coattails but he was at least as bright; he'd just stopped wanting to work as hard. Dick also spent far less clinical time since becoming an ER attending than his friends, but he knew his medicine.
"Kitten, I need Kori Anders' lab results."
"Dickie-poo, I really shouldn't give you those-"
"And I really don't care right now. I know you're the Unit Clerk today, check her chart and she did indicate things could be discussed with me. Go!"
"You're so weird about her!" Kitten went off in a huff, ignoring all protocol and just printed out the labs. They hadn't arrived more than five minutes earlier and the docs working on Kori were still looking them over when Dick got them.
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"I'll have to hold off on the cut down in the neck while she's being intubated, can I take over on the femoral Dr. Roth?" Xavier Red asked his colleague.
"Yes, thank you, I'm almost there but why don't you canualize the femoral vein and then close for me?"
Roy called out, "We have the updated labs."
"I'll take'em" Rachael said.
"White count increasing, albumin low, gram stain positive..."
"Anesthesia's here."
"She's still breathing but with poor effort, I wanted you guys to intubate her and get her on a vent to protect her airway."
"What's wrong with her?"
"We're figuring that out."
Rachael looked at Kori's distended abdomen. "Does that look like a surgical belly to you, Red?" Rachael pushed on it and the belly rippled from where she pushed.
As a plastic surgeon, Red would have trained a full surgical residency before his specialty training. A 'surgical belly' would mean one distended and needing to be operated on, such as for an appendicitis. "No, that's just ascites. She was vomiting yesterday. Liver failure? No, that makes no sense. Here I've got the line in. I'll close and move to the neck when I'm done."
"Her liver function's not too bad except for the albumin. Great job, thank you. Jesse, Kori needs albumin hung, and as soon as we get another line I'm still going to need fluids, let's restart them at 100cc/hr."
"What about antibiotics?" Red asked.
"Damn, I forgot, can you get a sample for culture when you do the jugular cutdown, then I'll get the antibiotics started. Something for gram-positive, I have to check her allergies."
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Dick was wracking his brain.
Stop focusing of how sick she is and that you could lose her and solve the problem and save her. The ascites was odd, and the low albumin was making it worse but didn't necessarily cause it. The low albumin was from all the weight loss/lack of protein intake probably since before she left for Paradise island and Greece. So we are dealing with more than one thing, of course: 'Patients can have as many disease as they damn well please'. So that's one. Second, nausea, diarrhea, fatigue... may or may not be related to the current crisis of bacteremia, gram-positive, ascites, systems collapse... Biphasic diseases...? The nausea was the first part, this was the second...
And then it occurred to him: INTERPOL was talking to her about her sister. Her sister is a terrorist. She was at the G20 Summit. Biological weapons. Some have pretty long incubations periods...
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Dick burst into the room, "Anthrax!"
Rachael looked at him, "Dick?"
"I saw her labs, GI anthrax presents as-" he took a look as they were still working quickly around Kori. She was intubated with a breathing tube being assisted manually with an Ambu bag by Roy, as the respiratory therapist set up the ventilator. Xavier was just closing the cut down incision over her right jugular vein, Jesse was hanging a container of albumin and there were spent blue sterile packs strewn about, plenty of refuse and discarded bedding kicked into corners; there was no time to pick it up.
White lab coats, pocket references, stethescopes were hung on backs of chairs. Rolling IV polls hung with Kori's old IV's still attached, only removed and pushed out of the way as each one failed.
The medical resident had been assessing a nearly naked Kori's when Dick came in, froze at the word 'anthrax'.
The room was silent except for the rapid beeps of the heart monitor and Roy's squeezing the Ambu bag every five seconds.
Dick blinked away tears and looked at up to Rachael, "We need to check the dose, she needs Cipro, I think it's 10 mg/kg every 12 hrs, there was literature that came out after 9/11 for anthrax..." he looked at the Chief medical resident who was shaking and gave her a smile, "oh, and regular precautions, it's not usually transmitted from an infected person to person..."
All those other lives, did Kori's sister try to kill Kori or everyone at the G20 Summit?
"Plus if it is anthrax, we should not mention it until confirmed, no sense causing... a... a... panic..."
"Dick?"
"Yeah, Rachael."
"Good job."
"How did she get it?" the medicine resident asked.
Dick didn't want to literally start an international incident. "Oh, she was out of the country. On a remote island."
Red looked up at Dick and said, "I'm just closing her here, let me get out of your way so you can say hi to Kori."
"Thanks Red. I'll be back in one minute, I have to talk to Galfore and Bruce."
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Galfore was on a call, which Dick thanked God for and quickly filled in Bruce. Because he wanted to keep things quiet, he still spoke to him in Tamaranean. "I'm certain Kori has GI anthrax. If I'm right, the other dignitaries at the G20 Summit are at risk. I remember what you said about INTERPOL and the Citadel-"
"You were paying attention to Kori's whereabouts and the fact that her sister is causing problems again."
Dick closed his eyes. "It's fatal up to 75% of the time. Some people have immunity from vaccination, most wouldn't. We need to contact INTERPOL and the CDC and-"
Galfore walked up looking concerned. "Good, your are here, there was news about some people that attended the G20 Summit have become gravely ill. It seems so long ago. Could it be the same thing Koriand'r has?"
"I think it might be. My assessment is that it's anthrax."
"Anthrax? Koriand'r has been vaccinated against anthrax. Tamaranians all are."
Dick paused. "The last vaccine she would have gotten would have been given would have been when she was maybe twelve or so? At best she has partial immunity, but not enough to prevent her from getting it apparently. I really need to be with her but Bruce, can you make some calls and pull me or Dr. Roth?"
"Richardgrayson, I am still uncomfortable with your relationship with Koriand'r-"
"Ambassador, with all due respect, no one else here figured out Koriand'r's illness but me. I just saved her life. I know you love her, and want what's best for her, but I love her too. So if you'll excuse me."
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To be continued...
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Reviews are always appreciated
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Special thanks to my big sister and hero, for letting me curbside her on partial immunity (it'll come up more later) and also who works (in a separate lab) at Fort Dietrick, Maryland the presumptive source of the anthrax in the 2001 letter attacks. She's a virologist, and therefore does not work with anthrax, a bacteria and had nothing to do with it. I actually wasn't even going with Antrax for Kori originally but didn't like how the other illness's symptoms played out in the story, so I changed it.
I differ to the experts too, lucky to get the world renowned ones.
The clinical scenes are still mine, the ER was my home away from home for some time, PM with questions.
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And announcing from a contest offered by Kryalla Orchid and me:
'GRAYSON PRESENTS:
Kryalla Orchid & Star of Airdrie's Writing Contest
A challenge to all you writers, readers, fanficers, fellow meepers and Gretchen fanboys out there.
Recently, and mostly due to the overwhelming horror of the new Red Hood and the Outlaws, Kryalla Orchid went hunting for good first kiss Rob/Star one-shots to refuel her romance engine. After devouring her supply of Julesfire (all bow down) and her favourites list, she was at a loss.
She had to write her own and poor Kry was so sad. Then, the spouse of my creator, the wonderful Star of Airdrie suggested perhaps there should be a competition to promote more Rob/Star first kiss oneshots!
I was chosen to host this meepfantastic competition!
A Competition for the best first kiss Rob/Star one-shot scenario.
The winners will receive a one shot of their own, any couple they like, any setting they like, to be written by either Kryalla Orchid or Star of Airdrie, winners choice of course.
They can be in any genre, horror, angst, humour, romance, drama. If I get a lot of submissions, I will most likely pick a winner for each genre.
If you'd like to enter, let me know and don't worry. You have until October 30th to enter the competition and post. You can submit up to three entries and the submissions need to be one-shots of at least 500 words. Extra points for spooky Halloween kisses! Results should be up by November 7th.
Each entrant will also get a review by Kryalla Orchid and Star of Airdrie, as well as placed in a community (which I will create).
I judge based on emotional impact, not grammar/spelling. I have no favourites (except if Gretchen enters). If you get in early and present me with a draft and ask for advice, I'll be quite happy to offer Kryalla Orchid and Star of Airdrie's services.
So get out there and have a go. Just have fun and write.
MEEP!