25
Tuesday, June 6, 2006 – 4:02 p.m.
Aspen Memorial Hospital – ER
Maisie’s tiny arm rested on the bed rail as the nurse prepared to give her a second shot. Karen stood off to the side watching while the nurse cleaned the area with an alcohol swab and then primed the needle. Ejecting air from the syringe, she gently inserted it into Maisie’s arm and depressed the plunger. The fluid slowly disappeared into her body.
“There you go sweety. That should take care of the pain from your headaches for a while. Dr. Slaterbaugh also prescribed some of these little guys.” Holding out her hand, the nurse handed Karen some pills. “This is a couple of day’s worth until you can get the prescription filled. They’re only a short-term medication, but they should help in the long run.”
“Thanks,” Karen said.
“Thank you,” Maisie said in her sweet, childish voice.
“You’re welcome,” the nurse said sidestepping the doctor entering the room.
“How’s my favorite patient?”
Maisie’s face lit up as Ken walked up to her bed.
“Papa,” she cried out, a huge grin playing across her face as she reached out to give him a hug. “Where have you been?”
“I’m sorry Maisie. I would have been down sooner but I’ve been working on some things in my office. I also had some other patients who needed my help.” Maisie gave Ken a crushing hug squeezing him tightly for several seconds.
“Well,” Maisie said letting go of Ken, crossing her arms and giving Ken a silly scowl, “you should have come and seen me. I’m more important. Or don’t you care anymore?” Maisie gave Ken a playful sad face indicating her attachment to him.
“Now Maisie,” Ken said, “you know that isn’t true.”
Maisie gave him a silly grin. Ken turned and looked at Karen. “How are you doing?”
“Better. I’m just glad Maisie’s not hurting like she was. That just scared me.”
“I understand. With the shots that we’ve given her, she should be pain-free for a few days. As I mentioned earlier, those pills the nurse gave you shouldn’t be used unless Maisie feels another bad headache coming on. Moreover, as I said before, bring her back in a couple of weeks. I want to see how she’s doing. Also, if the headaches persist and she continues to have these extremely painful headaches, bring her in so that I can run some other tests.”
“Okay. We’ll certainly do that.” Karen looked worn out and bedraggled from the mentally and emotionally exhausting day. Still, she looked much better than when she’d arrived earlier that morning.
Ken glanced over at Maisie. She smiled at him and said, “Will I get to see you again since I’m going to be leaving?” Her eyes were beginning to look tired and she was having a hard time keeping them open. A subtle flutter of concern rippled through the back of Ken’s mind. I hope this isn’t the start of another terrible episode he thought. Then, reassuring himself, he reasoned that these injections were different from the IV bags used on Benita and Hank. The possibility of tampering with a needle would be more difficult and challenging than with an IV bag. He was sure it was nothing. Still, Maisie had shown signs of increased tryptamine levels, although not as high as Benita and Hank.
“How about I call you and see how you’re doing? Then maybe I can drop by or you could come see me.”
“Okay, that sounds fine,” Maisie said as she yawned. “I’m going to rest for a little bit. I’m really tired.”
“Okay Maisie. It’s probably the medicine. Go ahead and rest for a little bit and then you and your mom can go home.”
Maisie half nodded as she drifted off to sleep.
“Should she be that tired?” Karen asked.
“It’s not unusual. Given the pain this morning, which in itself can wear you out, plus both doses of medicine and lying in bed all day, plus talking about your dad, I’m not surprised that she is tired. Give her a half an hour or so and then if she’s not awake we’ll wake her and you can take her home.”
“It’s been a long day,” Karen said reaching up and rubbing her face with both hands. Yawning she said, “Thank you for all your help, especially letting her call you Papa and all. That really helped.”
“You’re welcome. She’s a sweet kid and smart. I’m sure she’ll do fine.”
Ken’s concern was beginning to climb. He didn’t want to see Maisie suffer as Hank and Benita had. I hope that it was nothing.
Maisie turned uncomfortably in her sleep. The monitors picked up their pace a little indicating some mental and physical agitation. Ken looked at them.
“She must be dreaming already. That’s pretty quick. She must have been tired.”
“She’s okay though, right?” Karen asked in a worried voice.
“I believe so. Increased brain activity and at times increased heart activity is very normal during a state of dreaming. Her brain is probably trying to sort out all of the day’s activities. That’s really, what a lot of dreaming is all about, sorting, re-organizing, and discarding unnecessary information and so on. It’s the brains way of avoiding being cluttered.”
Maisie’s EEG reading began to spike along with her heart rate and pulse. Now Ken began to worry. The nurse ran in to see what was going on.
“What’s happening?”
“I’m not sure,” Ken said. “The monitors just spiked indicating an overall increase in her bodily functions and brain activity.” Ken’s fears were solidifying in his mind. Not now! Not with little Maisie!
Maisie began to squirm more, her face contorting as if made of Play-Doh. She began throwing her head back and forth on the pillow as if trying to shake something out of or off it. Maisie kicked her feet and her arms began to flail. Ken’s concern turned to dread as he realized he was watching the same symptoms he’d seen in Benita and Hank. How was that possible?
Gently holding Maisie’s hand, Ken monitored her situation. Although she was in distress, she was not in immediate danger, although it could get there if prolonged.
Turning to the nurse, Ken asked in a more serious voice than before, “What has she been given in the last few hours?”
“Nothing out of the ordinary. I gave her her first dose of medicine this morning, then she ate some lunch and rested and then just a few minutes ago I gave her the second dose.”
“Both were shots, not pills?”
“Yes.”
“Any IV’s?”
“No doctor. You didn’t order any.”
“Where’s the needle you used just a minute ago?” Ken asked.
Looking around, the nurse snatched it off the tray next to the bed. “Right here. I hadn’t thrown it in the sharps container yet.”
“Good. I need it.”
Karen looked at Ken with pleading eyes. “What’s happening?”
“I’m not sure, but I think you’d better spend the night. I want to monitor this situation. Something definitely is off kilter. I’m going to need to run a few tests. You are certainly welcome to stay here too.”
“Thank you.” Maisie had settled down again. These episodes, Ken noticed, lasted only a few minutes. That wasn’t so unusual though. A dream or nightmare could last only a few seconds, but to the dreamer it could be exceptionally long and terrifying. The brain’s ability to create such elaborate stories complete with visual, auditory, olfactory and sensory clarity was truly amazing and yet not completely understood. Maisie’s EEG and EKG had dropped back to within the normal range. She appeared to be breathing normally and was no longer agitated.
“Should we wake her up?” Karen asked.
“I think she’s fine now. I’d rather let her rest.”
Ken was going out on a limb making that statement. He didn’t want to see Maisie go downhill like Benita and Hank. He’d never forgive himself. Karen’s trust in Ken was evident as she rested her hand on his. “Thank you for being here.”
Ken looked at Karen. “I’m glad I could help. I just wish it wasn’t under these circumstances.”
Karen smiled at Ken and looked at Maisie now sleeping peacefully in her bed. The nurse was checking her vital signs once again and making sure that none of the monitors had come off. She then picked up the syringe and handed it to Ken.
“Thanks.”
Looking back at Karen, Ken said, “I’m going to have Maisie transferred upstairs to the Neurology floor. That’s where I am most of the time. I’ll check in with you up there in a while.”
Smiling, Karen nodded in affirmation.
Turning toward the nurse, Ken asked her to arrange Maisie’s stay on floor five. Acknowledging his request, she finished what she was doing and left the curtained area. Ken turned to leave and smiled at Karen. She returned the smile all the while holding tightly to Maisie’s hand.
Ken turned toward the elevators and headed for the lab on the second floor. He was going to have this syringe tested for tryptamines as well. Something strange was definitely going on.
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