October 26, 1997
Dr. Alan Quartermaine was trying to enjoy the solitude of very early Sunday morning rounds in the SICU. Unfortunately, concern for his nephew's wife, Carly; his cousin's wife, Marla; and even Lucy Coe; weighed a bit too heavy on his heart for him to completely enjoy anything. Then there was the issue that apparently Dr. Boardman had refused to place a percutaneous endoscopic gastrostomy tube or PEG on the burn unit the evening before insisting that although the patient had no enteral access it could certainly wait until Monday. Obviously, it couldn't so he was going to somehow need to get that accomplished before seven so he could pick up Kirk and Alli from their early morning swim practice by 7:30. Monica had gone to swim herself so she had taken them, but Alan was almost certain that she would not be done in time to pick them up.
"Dr. Quartermaine, line 4 is for you," the SICU unit clerk's voice pulled him from his thoughts.
"Hello, this is Dr. Quartermaine," Alan said after picking up the phone. Hopefully that was the nurse manager on the Burn Unit letting him know that he could use the Burn OR to place the PEG tube in their patient.
"Good morning, Alan, Matt Mayes here. I spoke to Dr. Boardman yesterday, but ID is adamant that Hickman needs to come out and I guess that his calls are forwarding to you now," the Bone Marrow Transplant Unit attending's voice boomed through the phone.
Alan could only shake his head. Technically his colleague Dr. Boardman should be on in-house call for at least another two hours until seven o'clock AM, but he sensed he was probably just supposed to clean up his mess first and then potentially call him out on his behavior later. "I apologize, Matt, but I haven't received change over from Mark yet. However, if you give me the patient's name, I'll be happy to help," he said.
"The patient is Emma Lutz. She had a Hickman placed by Dr. Boardman right before her stem cell transplant two weeks ago. Now she is growing MRSE from the Hickman. Dr. Boardman didn't want to pull it yesterday but now she is septic and on pressors, so Dr. Martin thinks that it absolutely needs to come out, but we need some other form of central access.
"Why was Dr. Boardman reluctant to pull the line yesterday. Is she thrombocytopenic or coagulopathic?" Alan asked.
"No, her platelets and coagulation studies are normal. She seems to be almost completely engrafted so this could be a successful transplant unless she dies from sepsis," Dr. Mayes said.
"Ok, so if it has only been in for a little over two weeks, I should be able to pull the tunneled line at the bedside. I can put a temporary central line in on the other side first if you want," Alan offered.
"Now, that sounds like a plan! A plan I wish Dr. Boardman could have gotten behind yesterday," Dr. Mayes said.
"I'll be over in about twenty minutes. Can you have nursing get me a triple lumen kit and a suture removal kit with plenty of chlorohexidine ready at the bedside?" Alan asked.
"Of course! Dr. Rousch takes over inhouse call at 7AM so I want to get this taken care of before I go off. I'm sure you can understand since if your colleague held himself to the same standard, we wouldn't be having this conversation," Dr. Mayes said.
He had a point. But Alan felt it inappropriate to agree, at least aloud. "Ok, well I have a few more inpatients to see and then I'll be over," he said instead.
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Jason Morgan stood at the East facing floor length window in his Penthouse as the first glows of faint light gave way to nautical twilight. Although his internal clock sensed it was already after six o'clock in the morning it was only quarter past five thanks to the observance of daylight savings time. As he looked out towards the horizon and debated his next move, he acknowledged that perhaps Robin had a point when she had called the window his thinking spot. Of course, he had found the idea absurd at the time.
August 24, 1997
Jason Morgan appreciated the silence as he stood at the floor length window in Sonny's Penthouse watching the sun crest the horizon. He felt gentle arms wrap around his waist from behind—his girlfiend, Robin Scorpio.
"Somehow I knew I would find you here. This is definitely your thinking spot," Robin said.
Jason shrugged his shoulders instinctively. "What?" he asked.
"Kind of like the docks is for Sonny. The place you go to think. Or in Sonny's case think, brood, and rehash," Robin explained.
Jason shrugged his shoulders again. What was he supposed to say?
"Don't worry, you don't need to explain. Perhaps it's better if you don't anyway. I just want you to know I'm here and I support you all the way," Robin whispered.
Jason supposed his cousin Ned would comment on the irony that the conversation he was remembering had occurred almost exactly one month after Robin had begged Sonny to fire him for his own safety but also almost exactly one month before he had decided to break up with Robin for her own safety. Or maybe not. Perhaps Ned only readily saw the irony in his own life.
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In the 4 West ICU Lucy Coe struggled to pull in a breath as her heart seemed to want to pound out of her chest and her body redefined the limits of how bad one could feel. Her head swum and she helplessly pulled at the mask Dr. Quartermaine had placed over her face. "I'm…in…a…bad….way," she huffed.
Dr. Monica Quartermaine readjusted the mask but ultimately ensured it was secure. "Your chest x-ray looks like pulmonary edema. Your lungs are full of fluid and that is making your breathing uncomfortable. I ordered some IV Bumex but right now you really need this oxygen. Please try to leave it in place, your saturation level goes very low when you remove it," she said. Then she laid Lucy's hand down at her side and patted it a few times for good measure.
Lucy fumed internally at Monica's patronizing pity. Unfortunately, she lacked the ability to process a retort much less the ability to get the words out without gasping. By the time she gathered the strength to attempt anything Monica was gone, likely on her way to harass other patients. Some newby nurse Lucy was unfamiliar with pushed something into her IV after informing her it was Bumex or something that sounded equally absurd. Then she too slipped out of the room leaving Lucy to sweat, heave, and pant. Surely life couldn't get any worse! Or could it?
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Dr. Alan Quartermaine removed the guidewire through the brown port of the Subclavian Vein Central Line he had just placed in Emma Lutz. "Let me just get this sutured in place Mrs. Lutz and then we will get the Hickman Catheter out," he said.
"Your mother is right; you really are such a sweet boy," Emma said.
Alan focused on tying his surgical knot. There wasn't really a good response to that comment so perhaps he could just pretend he hadn't heard.
"I remember I was so jealous of Monica back in the day. It was positively painful to attend your wedding," Emma continued.
Alan used the scalpel to cut his suture and then threw a final tie. He had no recollection of Emma Lutz attending his wedding. He wasn't sure he had even realized who Emma Lutz was in December 1975 when he and Monica had married. He had been twenty-three and a second-year surgery resident. Monica, always the quick study, had been eighteen and six months away from graduating from medical school.
Although Emma was only a year or two older than his older sister, Tracy, he supposed she had known his mother through the Junior League and perhaps she had been invited for that reason.
"But, you know, everything happens for a reason. I met my Charlie on my way home from the reception. Your mother was kind enough to call me a cab after my date went off with one of the other guests," Emma explained.
"I'm glad it all worked out," Alan said as he cut the final suture. What else could he say?
"You know, in a way it has. When I was younger, I was so enamored with the glamorous glorious life I thought everyone else was living. Charlie and I never came from money or ever really had a lot of our own, but I have another chance at life now because some random person I'll never even know donated me their bone marrow. I am going to put this second chance I've been given to good use. I promise," Emma said.
"I'm sure you will. So, I am going to call for an x-ray to make sure this line is in good position and then we will pull the other one," Alan said as he started to remove the sharps from his line kit.
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In the CCU, Dr. Monica Quartermaine looked at Marla Quartermaine's 12-lead EKG and then back to the long rhythm strip the nurses had handed her. Neither were good and she felt her face twist into a frown. It was probably far less than ideal for her to be so involved with a patient that was technically a relative, at least by marriage. But the combination of Dr. Larmon in the ED and Dr. "I prefer to phone everything in from home" Devlin on call for Cardiology was also far from ideal so she was where she was. So, she took a deep breath and handed the strips back to the nurse. "That has to be complete heart block. Let's start an Epinephrine Drip at 0.1mcg/kg/min and see if that improves the heart rate and blood pressure. If it does, we'll go to the cath lab and put a transvenous pacemaker in. If not, if we can't get the transcutaneous pacemaker to capture, we're going to have to do it bedside," she said with much more steadiness in her voice than she felt in her heart.
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Ned Ashton stood at his sink in their En-suite bathroom brushing his teeth and debating whether it was safe to leave his wife to go to health club. As he rinsed his toothbrush, he once again wished he knew Carly better. His aunt had advised him not to leave her alone and he was starting to understand why. As much as Carly tried to minimize things it was painfully obvious that she was still very ill. He wanted to help her, but he also didn't want to make everything awkward and uncomfortable, and he was afraid that was exactly what he was doing.
When he stepped back into their bedroom, he was surprised that Carly's eyes were open. Despite that, and the fact that she had theoretically slept around twelve hours thanks to the time change, she still looked exhausted. "I'm sorry if I woke you, honey, how are you feeling?" he asked as he lowered himself gently onto the bed and laid a hand on her back.
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Carly Ashton struggled to take in a deep breath, but she struggled even more with answering Ned's question. She was afraid to admit how exhausted and weak she still felt because she didn't want Ned to feel like he had to rearrange his life and despite her earlier unease at being discharged she realized that she really didn't want to go back to the hospital where Dr. Jones could pop in at any moment. So, she forced a smile and said, "I'm feeling a lot better, really. You should go to the Gym or whatever you were going to do and I'm going to rest a little more and then we can go to church and pray for the baby."
"Are you sure? Perhaps I should just go for a run through the neighborhood. I have been meaning to try out the fitness trail they added to the Songbird Sanctuary," Ned said.
"Port Charles has a Songbird Sanctuary?" Carly asked.
"We do! It's on Whippoorwill Way about a block away going in the direction of the church. When Grandmother was more mobile, she used to volunteer there. My mother still does some although last year it became one of Beth's dad's third wife's pet projects, so I think she has been quite selective in when, and with whom, she volunteers," Ned said.
Carly laughed but quickly regretted that as she felt breathless and weak. She attempted to hide that with another forced smile. "So, Tracy doesn't get along with Senator Kensington's wife?"
"I guess that depends on which wife. His first wife, Lillith-Jack and Beth's mom, was a few years older than my mother and I guess they were friends in school but then they both married young, followed their husbands away from Port Charles, and my mother's marriage didn't exactly last long or end well. They did reconnect once they were both back in Port Charles and my mother's life was more settled. They even campaigned together when Beth's father was running his first NY state senate race in 1980. Of course, that was probably partly because my mother was engaged to Mitch Williams who was running for Attorney General on the same ticket at the time. Unfortunately, Lillith Kensington died before the election due to Influenza complications," Ned said.
"I didn't realize Beth was so young when her mother died. Somehow, I thought she was in her teens," Carly said.
"She would have been in her teens when her stepmother Marlena Kensington died, in 1989. They were also very close so I'm sure that was hard," Ned said.
"But she doesn't get along with her current stepmother?" Carly asked.
"I guess that is a question for Beth to answer but I didn't have the impression that they were particularly close," Ned said.
That was a diplomatic response, but Ned's responses usually were. In some ways that was nice or at least nicer than having all of her shortcomings hurled back at her on the regular as she had experienced with Tony. But it led her to doubt that Ned would tell her if she was too much. Something Carly knew she often was in general. She had no idea how she fixed that, so she struggled with another deep breath. Then she said, "I'll be ok, if you want to go. Seriously, if I need anything I can just use my cell phone, right?" she asked.
Carly winced as she extended her arm and pulled the svelte candy apple red flip phone that Ned had given her the night before from the bedside end table and held it up as proof. Once again, she forced a smile to cover the exertion.
"If, you're sure. But maybe I'll just check out the fitness trail. There is nothing wrong with working out by lifting your own body weight," Ned said. He leaned over and gently kissed Carly's forehead and then he was gone.
Carly released a tortured sigh. She couldn't imagine that literally or even figuratively.
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AJ Quartermaine extended an arm for his cell phone and glanced at the clock. Who was calling him before seven AM on a Sunday morning? "Hello…" he mumbled groggily.
"Good morning to my favorite son, with driving privileges," Dr. Alan Quartermaine's voice came through the line a little too energetic and awake.
"I think I'm your only son with driving privileges," AJ said as he sat up in bed.
"That would also be true. Listen, your mother is on her way to the cardiac cath lab to put in a pacemaker and I am not going to be done putting in this g-tube in time to pick up Alli and Kirk from swim practice by 7:30. Is there any way you could do that?" his father asked.
"Uh, sure," AJ said. He absolutely could do that. He might not really want to do that, but he supposed there were certain benefits to being the oldest and certain responsibilities to being the oldest.
"Your mother and I appreciate that. We appreciate you!" his father said.
"Uh, thanks, Dad, but I think that is a bit too much exuberance for 6:30 AM on a Sunday morning," AJ said.
"Farewell, favorite driving son," his father said.
AJ shook his head. "I'm going to hang up now. So, I can get up," he said as he swung his legs over the side of the bed. He was suddenly wide awake. Perhaps that had been his father's goal. He shook his head again as he headed into the bathroom that connected his room to his younger brother, Kirk's room.