There were lots of places Chase would have been glad to see a familiar face, but ICU wasn't one of them. And yet there was Renfield, intubated and ventilated and surrounded by beeping monitors. They'd discharged the kid last night; he'd been fine. Chase sighed, and picked up the patient's chart.
"I saw him being brought in," Foreman said behind him, and Chase turned, happy enough at the sight of this particular face. "His mother said he just suddenly got worse. Sweating, vomiting—"
"Insects?" Chase interrupted, shuddering briefly. Foreman grinned.
"Not this time, no. Just blood. But by the time she got him to the hospital he was convulsing, and he lost consciousness. His BP's way below normal. We're waiting on arterial gas results, but my guess is, he's overdosed on something again. The whole thing happened quickly—if the mother's account is accurate, it's been less than an hour."
"But why?" Chase asked. "What happened?"
Foreman shrugged. "Maybe he missed you." Chase snorted, but once he had the results of Renfield's bloodwork in his hands he saw that there'd been an element of truth in the remark: this probably wasn't an accidental overdose. The kid's blood CO2 content was below 8 mEq/1, suggesting his blood had become dangerously acidic. "Salicylic acid poisoning," Chase muttered to himself. "The idiot's tried to off himself with aspirin."
He tersely ordered further blood tests to determine Renfield's precise serum salicylate levels; in the meantime, airway-protected gastric lavage would remove any undigested aspirin tablets, and blood transfusions would begin to restore his blood pressure.
Chase worked quickly, his demeanour misleadingly calm, his every move efficient and to the point. He looked focused and competent; he felt chilled, and disturbed, and somewhere beneath it all, guilty. He hated this kind of case, hated being confronted with someone so young, and yet so miserable that suicide seemed preferable to life. He automatically deflected his thoughts away from himself at that age, but that left him confronting the not much more comfortable thought that this might be, in some measure, his fault: he should have stuck with his instinct that there was something more wrong with Renfield than simple insecticide poisoning. The coincidence of the surname and the bug-eating seemed less like a prank now; even teenagers didn't overdose in an effort to be funny. There was something sinister here, some underlying delusion or obsession.
But for now, just keeping the patient alive took precedence over everything else. Intensive care wasn't the place for dwelling on underlying emotional issues, thank God. The coma indicated the kid's central nervous system had been affected, so barbiturates were off the board; succinylcholine would be safer, since the patient wasn't hypoglycaemic—precise blood readings would be damned useful, though. Absorbed in the swift minutiae of a situation that would cause the average person to panic, Chase calmed from the inside out, his occasional quickly shouted orders not an indication of distress but of purely purposeful energy.