Cutting for Stone - Abraham Verghese [258]
They saw Thomas Stone seated on the side of my room closest to the window, his head resting awkwardly against the bed's safety rail, his eyes closed as if in sleep. In the seventy-two hours since he sent the telegram, my condition had worsened. Thomas Stone opened his eyes, suddenly aware of them. He stood up, bedraggled, stiff, and somewhat shrunken in his borrowed scrubs, relieved but apprehensive. Worry lines ran into his eyes, and his face was drawn and pale under his shock of white hair.
The two old colleagues and combatants had last seen each other in a delivery room, moments after my birth and our mother's death. That was also when Stone had last seen Shiva: in Operating Theater 3, held tight in Hema's arms.
The bedside table and the ventilator blocked Hema's approach to the near side of the bed. She circled to where Stone stood, her eyes on me.
“He is ‘critically ill’ from what, Thomas?” Hema said, referring to the two words in the telegram that had most frustrated her. Her tone was professional, as if she were asking a colleague about a patient; it allowed her the pretense of being calm when inside she was quaking.
“It's hepatic coma,” Thomas said, responding in the same manner, grateful that she'd elected to converse in the language of disease, a fallback which allowed even their son to be reduced to a diagnosis. “He has a fulminant hepatitis. The ammonia level is very high and the liver hardly functioning.”
“What from?”
“Viral hepatitis. Hepatitis B.”
Stone let down the bed rail and the two of them stood over me. Hema's hand reached behind her for the tail end of her sari, the part that went over her shoulder. She brought it to her mouth.
“He looks anemic, not just icteric,” she managed to say at last, clinging to the idiom of medicine to describe my pallor and jaundice. “What's his hemoglobin?”
“Nine, after four units of blood. He's bleeding from his gut. His platelets are down and he isn't making clotting factors. The biliru-bin is twelve, and his creatinine just today is four, rising from three yesterday …”
“What's this, please?” Shiva said, pointing at my skull. He stood across from Thomas Stone, the bed between them.
“An intracranial pressure monitor. Goes into the ventricle. He has cerebral edema. They're giving him mannitol and adjusting the ventilator settings to keep the pressure down.”
Shiva looked skeptical. “It goes through his skull, through brain into the ventricle just to measure? It does not treat?”
Thomas Stone nodded.
“How did this begin?” Hema asked.
As Thomas Stone recounted the sequence of events, Shiva freed the bedside table and found slack between the bed and ventilator. He let down the bed rail on his side. Moving with the slow efficiency of a contortionist, he slid under the tubes and wires. Deepak entered in time to see Shiva lying on his side next to me, his head touching mine. His being there looked both precarious and entirely natural. All Deepak could do was stare, noting, however, that my intracranial pressure tracing, which had done nothing but go up for three days, went down.
No sooner had Deepak introduced himself than Vinu Mehta, the gastroenterologist, filled the doorway, panting from taking the stairs. Vinu had been an internal medicine resident at Our Lady when I was a surgery resident. After specializing in gastroenterology he'd joined a lucrative practice in Westchester but wasn't happy and had returned to the salaried staff of Our Lady.
“Vinu Mehta, Dr. Madam,” he