Dr. Monica Quartermaine guided the transvenous pacemaker catheter into the right ventricle and confirmed capture before deflating the balloon and locking the catheter in place. She sutured the pacing wire to the skin and then reached for the sterile dressing and applied it over her cordis insertion site. "Can we get a Chest X-ray and another 12-Lead EKG before we move back to the Cardiac Critical Care Unit?"
"Sure," Anne Mathers, one of the Cardiac Procedures nurses, said.
"Also start weaning the Epinephrine. Now that the pacemaker is in, she should be able to come off of it. I'm going to step out and dictate a procedure note but grab me when radiology is here so I can view the image on their box," Monica added as she started to remove her sterile gown and gloves.
"I'll bring you the EKG in a minute. Were you going to go talk to the family?" Anne asked.
"I will, after we get the EKG and Chest X-ray," Monica said. Maybe it would be easier then. Maybe…
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In the Quartermaine kitchen, Edward Quartermaine sat in the breakfast nook with his wife and frowned at the steel cut oats in his bowl. His daughter in law might consider oatmeal with fresh berries an acceptable breakfast. He did not!
Across the table his beloved, Lila, beamed at him as she ate her oatmeal. "Monica makes the best oatmeal in the slow cooker. Perhaps if I had made better use of the slow cooker when the boys were younger, we wouldn't have needed to hire a chef," she mused.
"You raised Tracy and five growing boys. You have nothing to apologize for," Edward said. He had enjoyed having a personal chef.
"Monica also has nothing to apologize for. In fact, she has so much she should be proud of!" Lila said pointedly.
Edward wondered if silence was his best recourse. Perhaps he should also wonder if there was a reason that his granddaughter Emily had basically dragged her father out on a Sunday morning long run almost the moment he stepped through the door. The there was the issue that Alan and Monica's remaining children had chosen to take their breakfast outside to eat on the East Patio by the pool. Were his grandchildren trying to avoid him?
Normally Edward would dismiss that question as ridiculous but so much had happened in the past week and the thought lingered. "I have never suggested that Lila!" he finally said.
"Perhaps. More importantly, have you ever told Monica how much of an asset she is to this family?" Lila asked.
"Monica knows I appreciate her," Edward said.
Lila gave him a pointed look. "Does she?" she asked. She paused for a minute and then she said, "Now, do we need to reaffirm that Ned has appropriately placed his family at the top of the priority list and that you will not do anything to alter that delicate balance?" she asked.
Suddenly Edward realized it was much less that his grandchildren were avoiding him as that they were giving their grandmother the opportunity to interrogate him. "Sometimes I think you give me far too little credit, my dear," he said.
"Just see that you remember that Carly and the baby will be Ned's priority," Lila said. Then she brought another bite of her oatmeal to her mouth.
Resignedly, Edward realized he had no choice but to do the same.
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Lucy Coe had never felt so miserable. She lay exhausted, panting, and too weak to move, in a gown drenched from all the sweat pouring off her. She clutched at her swollen belly as it twisted itself into knew knots and expelled more putrid contents while the room spun, and she smothered. Basically, she felt like death warmed over, with an emphasis on the warmed part. She was burning up and so uncomfortable. Why couldn't she just die and get it over with?
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Rexford Stanton sped along I-95 in his jaguar. As much as he had enjoyed his long weekend in Pine Valley, at the Valley Inn, it was time that he returned to Port Charles and pretended to be a devoted husband. It was such a shame that his cell service had been so poor that he hadn't been able to retrieve any of his messages until he arrived in Port Charles. Or at least that was his story, and he would stick to it.
It was tempting to stay away longer. Especially since his niece's messages suggested that Lucy was still being a whiny wimperer but he needed to maintain the plausible deniability of his original cover story which required him to return by Sunday afternoon. So, he was returning. He just wasn't happy about it.
XXXXXXXX
Katherine Bell groaned as she moved position. Her muscles ached but it was the indignity that she was being treated like a common drug addict that was truly mortifying. Dr. Monica Quartermaine had, had the audacity to lecture her on how fortunate she was to be alive the day before. Today she had informed her that she could transfer out of the ICU to one of the Stepdown Units. Then, she had promised that someone from social work would be by to help set her up with treatment resources for her amphetamine dependence. As if she had an amphetamine dependence! She had just miscalculated the dosing why couldn't anyone understand that? Surely, Nikolas would, right? He would have to!
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At New York's Penn Station, Simone Torres pulled her porter's case along the train platform as she waited for the Amtrack train that would take her to Port Charles. The upstate New York city was a little more than two hours north of Manhattan and about an hour south of the state capital, Albany. Despite having a population around 30,000 the port city which also housed the corporate headquarters for ELQ Enterprises was thriving. Or at least that was the public opinion. Simone herself had never been to Port Charles and hadn't realized that Carly even lived there until Ned Ashton had flown her out to Miami as a surprise for his bride to be, her purported best friend, Caroline Benson.
September 26, 1997
Simone Torres felt under dressed and out of place as Ned Ashton guided her into the lobby of the Four Seasons in downtown Miami. Apparently, he and her high school friend Caroline Leigh Benson were holding their reception at the Four Seasons and hosting their entire bridal party there as well. In some ways Simone was surprised to see Carly marrying into a family of so much wealth and privilege that they could basically commandeer a wedding at the Four Seasons no less basically overnight. In other ways she was almost shocked that Carly had told her husband to be that her wedding wish was to have Simone as her Maid of Honor.
"When I left Carly was having a late breakfast on the terrace with her mother. If you want to join them out there, I can get you checked into your room and have your bags delivered," Ned Ashton offered.
Despite the suddenness and surrealness of it all in that moment Simone was struck by Ned's awareness that his wife likely needed to be rescued from her mother. She wondered if the man was just perceptive or if maybe Carly was finally open with him. Perhaps there was hope….
So, she had rescued her friend, from her mother. Carly would have, and had, done the same for her. So perhaps, they were as close friends as Carly had led her husband to believe. Because when she had faced Virginia Benson on the terrace, Simone had remembered so much. Perhaps the point wasn't how close she and Carly were but rather that they were closer to each other than they were to anyone else. Simone was starting to see that which was why she had agreed to shuffle everything around to attend Carly's baby shower. It wasn't really about attending Carly's shower. It was about reminding Carly that there was someone else on the planet who got her.
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Dr. Monica Quartermaine inserted the laryngoscope blade into Lucy Coe's mouth and raised it to expose the vocal cords full of frothy secretions. "Tube, please," she called and then curled her fingers around the tube laid in her right palm and then inserted it through the vocal cords without shifting her view. She stood straight as she removed the stylet and inflated the cuff while the respiratory therapist ventilated a few times to confirm position through the colorimetric device.
"Initial ventilator settings?" the respiratory therapist asked.
"How about AC 400 20 100% plus 10 PEEP? Check an ABG in 30 minutes. Did anyone manage to reach Dr. Desai?" Monica asked. Sometimes she had the knack for being in the right place at the right time, or perhaps the converse depending on perspective since she suspected she was the last person Lucy Coe had wanted to see in what could have been her final moments.
"No, we tried to page him when she was saturating in the 80s on 100% mask, and he didn't call back but immediately after we paged, they called that code blue over on 10 North so I figured he might be over there and a bit busy. Fortunately, you walked in," Betsy Chilson said.
"She really didn't respond to the Bumex so he may need to consult Nephrology for dialysis. The problem is I still don't think we have a clear diagnosis. She seemed septic at presentation, but all of the cultures have been negative. Honestly, at this point, if I didn't know better, I would think she had received high dose IL-2 therapy and was experiencing capillary leak syndrome," Monica said.
"I'm starting to consider cholera," Dr. Martin suggested as he stepped into the room.
"I'm going to tell Alan you said that because he felt like an idiot when he ordered the PCR on Friday and it's negative. He also scanned her abdomen and pelvis yesterday and no abscesses or typhlitis or anything," Monica said.
"If he sent the PCR and that is negative then it's negative. It really isn't good to not have a firm diagnosis by hospital day five," Dr. Martin said.
"Agreed, but I'm not sure what else to consider. Perhaps atypical HUS but the peripheral smear was normal. My intern and I personally examined it on Thursday," Monica said.
"Dr. Desai called back. I told him that Dr. Quartermaine just intubated his patient so he's on his way over here now. I guess he was at that code, and they got ROSC which he doesn't exactly sound thrilled about," Traci Melton said when she stepped into the room.
Traci was another ICU nurse, but one Monica didn't know well, as she had recently transferred from Mercy Hospital. "Thank you," she said. What else could she say?