Chapter Seventy-Three
"What have we got?" asked Trapper as he walked to the light box in the operating room.
"Severe endocarditis with aortic stenosis. But look at this area here," said Gonzo, pointing to the left side of the heart.
"Looks like the left coronary artery is compromised," said Trapper, leaning closer to the film. "How old is this kid?"
"She's eleven."
"How's her teeth?"
"Dental hygiene was good, so I don't think oral bacteria caused this. The valve problem could be congenital. Any infection would attach itself to the weakened valve and spread."
"How did this get this far without anyone noticing?"
"Her parents are homeless," said Gonzo. "The husband lost his job, and they live in their car with two other children. They didn't see the symptoms until there was blood in her urine."
"Well, they may have waited too long," said Trapper with a frown on his way to the operating table. "Is she ready?"
"Blood pressure one forty over ninety; pulse ninety-three."
"How much blood has she had?"
"She's halfway through the first unit."
Holding his hand out for a scalpel, Trapper said, "Let's open her up and see what we've got."
When Trapper and Gonzo exited the emergency suite it was late in the afternoon, and they still had to see the parents who were waiting anxiously.
"Mr. and Mrs. Keller? I'm Dr. McIntyre. This is Dr. Gates. Your daughter has a severe infection in her heart. It started with a deformed valve between the heart and the aorta which is a primary artery. Because the valve was weakened, infection set in and spread to the rest of her heart, and this caused necrosis in another artery." Based on the confused look on the parents' faces, Trapper continued in more lay terms. "The artery developed small holes which led to internal bleeding. We've replaced the valve and we've tried to repair the holes, but there are other areas of her heart that have also been compromised, so we'll be watching her closely. For right now, she's stable, but that could change at any minute."
"You mean she could die?" asked the father.
"I'm not going to lie to you," said Trapper. "She's still in serious condition. If we can keep her stable for the next forty-eight hours, we'll take another look. But I have to warn you, we may have to start looking for another heart if we can't clear up the infection."
The mother moved her hand over her mouth crying, "How did this happen? She's always been a healthy child."
"Mrs. Keller," said Gonzo. "We think the valve was deformed from birth. Has she been ill recently with a fever?"
"She had a cold…we all had it."
"It was more like the flu," Mr. Keller added. "We were all achy and nauseated."
"That could have been the trigger," said Gonzo.
"You folks try to get some rest. It may be a long wait. Please stop by the nurse's desk and leave your contact information. We'll call you if anything changes." Trapper watched as the Keller's walked away, Mrs. Keller in tears and leaning into her husband. He waited until they turned the corner at the end of the short hall before he went to the locker room to shower and change.
Leah had just hung two paintings on the bare wall to the right side of her desk where a table and two wing chairs sat before she began to go through a box on her desk. Her office was much like Trapper's, but a bit larger, although it didn't have a private bathroom. A window behind her desk looked out over the courtyard between the annex and the main hospital. Her walls had been painted a sand color and white crown molding encircled the room. The wing chairs were upholstered in dark blue, green and burgundy material that matched her drapes. She also added live plants and two sculptures that had been retrieved along with the paintings from her storage unit containing her belongings from her former LA home.
She had pulled a framed picture out of the box, and had slowly sat down, staring at the picture just before Trapper opened her door.
"You're still here?"
Moving the picture against her, she turned away and covered her mouth with her hand.
Trapper proceeded to her desk and leaned over. "Leah?" When she didn't answer, he moved around the desk and knelt in front of her, slowly taking the picture out of her hands.
Turning the frame around, Trapper studied the unusual picture of three figures silhouetted against the sun with the ocean in the background; a man with a little girl sitting on his shoulders and a boy standing in front of and against him. "Did you take this picture?"
She nodded, bowing her head into her hands, and wept. "Oh God, I miss them."
Setting the picture on her desk, Trapper drew her out of her chair as he stood and guided her head to his chest as he held her.
"I'm sorry," she whispered.
"You have no reason to be sorry. I wouldn't expect this to ever completely go away."
"I thought I would hang a few pictures of them on the wall. Maybe I shouldn't."
"I don't know. Maybe you should. It might help you to get to a point that you can smile at the memories."
She touched his face in thanks, and stepped away, moving the picture back to the box. "Maybe later for these," she said, sniffling and using the handkerchief Trapper gave her to wipe her eyes. "Have you been in the same surgery all this time?" She walked to the coffee pot, holding it up. He nodded, and she poured two cups and moved over to the wing chairs.
Trapper sat down and crossed his legs. "Thanks," he said, taking a sip of his coffee. He was still pondering how to answer her question about the surgery, considering what he had just walked in on, but thought he would forge ahead. If she was going to continue working in a hospital and be involved with him, she would hear about his surgeries often enough.
"Yes, heart surgery…aortic stenosis and severe endocarditis that's compromised the rest of her heart."
"Sometimes getting old can be rough."
"She's not old. The valve problem is probably congenital."
"How old is she?"
Scratching his ear, Trapper grimaced. "Eleven."
Leah sucked in a breath as her chin quivered. "Oh. How is she?"
"Not good. We may have to look for another heart if we can't clear up the infection. Then again, we may not have time to find a heart if she needs one. The damage is extensive."
Setting her coffee cup down on the table with a shaking hand, Leah turned away again.
"Are you still seeing Sandler?"
"Occasionally," she sniffled.
"Maybe you should call him." She shrugged without looking back at him. "Listen, I'll be staying awhile to keep an eye on Jenny." She looked at him with furrowed brows. "My heart patient. Why don't I find someone to take you home?"
Shaking her head, she said, "No," and offered a frail smile. "I have a few more things to do. I'll just call a cab when I'm ready. But while you're here, would you mind looking over this contract and see if you find anything glaring?" she asked, taking the contract off the desk and handing it to him. "I used the hospital's standard contract for interns as a guide. If it looks okay, I'll leave it on the hospital attorney's desk tonight for review so I can get it to Frieda tomorrow. And speaking of Frieda, do you want to tell me what all that was about in the cafeteria today?"
Trapper had begun looking through the contract and stopped, raising his head and looking forward uncomfortably.
Noticing the expression, Leah said, "Ah, come on. It can't be that bad. I've never seen you run when an attractive woman paid attention to you."
"Paying attention is one thing. Your friend, Frieda, is a…" He smiled uneasily and snorted. "Well…she's a tart."
"She's not really my friend, though she tries. She's a little…forward…for my tastes. What'd she do?"
"She invited me to lunch…in her hotel room," he said, looking up from the contract with raised brows.
"That's not what had you hiding in a corner," said Leah, biting her lip to keep from smiling.
Cutting his eyes quickly at her, and then going back to the contract, he said, "She goosed me."
"She goosed you?" Leah repeated, unable to forestall the amused look on her face.
Taking a deep breath and flaring his nostrils, he stood and laid the contract back on the desk with a sarcastic smile. "I'm glad my embarrassment brightened your day. This looks all right to me. Just make sure legal approves it," he said, heading for the door.
"Just a minute, Mister," she said sternly, rising from her chair. Walking up to him, leaning into his chest and looking up," she asserted, "Your behind is mine. No one gooses it but me. You can relax. I steered her toward Gonzo."
An eyebrow shot up at the same time the corner of his mouth turned up. "Oh. I can't wait to see this," he said before he kissed her and left.