After the fluids and soup, I excused myself to use the bathroom.

“Uh, wait,” said Mervyn apologetically. “With you so on the edge of dehydration and receiving IV fluids, we need to monitor the color and quantity of your urinary output a while. I’ll set a catch tray under the seat so I can track it.”

I peed in the plastic tray; my urine was surprisingly dark still. I caught my pale and shaky reflection in the mirror as I washed. Removing my mask, I brushed my teeth and hair but did so bracing a hand on the countertop.

Mervyn watched me return to bed in quiet appraisal, and then I heard him dump the catch tray. There was flushing and running water, and he returned.

He was shaking his head and holding up a finger. “You need the second bag. I’ll flush your port and get it going for you now. We can do your lung physio while it runs in.”

Once the bag was dripping into the tubing, Mervyn had me breathe more steam, again coaching me carefully to slow down and breathe more deeply. I didn’t want him to take his comforting hand off my back, but eventually he did.

He fixed me a second bowl of water, and this time, wonderful hand placed on my breastbone, coached me to exhale as strongly as I could for as long as I could. Then his phone buzzed repeatedly and he excused himself.

“Alan, thanks for getting back,” he said, moving to the door.

I once again got snippets from the hallway, although much bigger ones because Mervyn wasn’t whispering into the phone.

“Just not looking good.”

“Malaise, very fatigued, pallor, slightly unsteady when up. Consistent with the history but making me uncomfortable.”

“No. No evidence of jaundice.”

“….Very dark after a liter. Starting a second now. May be nothing but…feel better…serum chems for LFTs and renal…think…”

“Thanks, agree.”

“Agree that wouldn’t hurt.”

“Okay, red, gold, purple, and green, got it.”

“Two more liters? Just in case?”

“No.”

“No, no, hectic low-grade of some seven days’ duration, resps high normal, little tachy, BP fine.”

I heard the brushing sounds of Mervyn leaning against the wall, after which I could hear more clearly.

“Persistent unproductive cough. Consolidation, rhonchi, no rales. Yes, we’re inhaling steam and doing chest PT.”

“Breathing exercises.”

“Yes, I agree.”

“Yes, I know how. I’ll add percussion.”

“Today? Her abdomen is soft after initial guarding and the bowel is diffusely tender to light palpation, worse in the colonic flexures.”

“No, I don’t know. Denies in the absence of deep palpation.”

“No, I purposefully withheld deep palpation this morning. I performed it last night and she was very uncomfortable.”

“Last night? Murphys absent. Rebound absent. Bowel sounds present. Non-rigid but voluntary guarding. Right colon tender from the hepatic flexure down, with a persistence of pain after palpation that left her in distress. On percussion, the area was generally dull with occasional tympany.”

“IBS spasms and mesenteric adenitis? She described consistent pain and a new pain that worsened with inspiration. I administered a warm water enema and the ascending would not fill without deep massage and gravity. I suspect the bowel was in spasm. She reported lessened pain after the area filled and was less ill-appearing.”

I was proud of Mervyn for reducing my having an orgasm to being “less ill-appearing.”

“Uh-huh.”

“No, no.”

“She’s very prone to colon pain and slow transit. For now, I’d recommend that antispasmodics and opioids are considered contraindicated outside of dire need.”

“This morning she described an ache and denied pain, but today she does not lie flat unless requested and has other visual signs of voluntary guarding.”

“Denies nausea but very little appetite. I’m working with the chef to get more calories in.”

“Mild, denies. It looked raw a few days ago but has largely resolved.”

“Normal if enlarged from scarring, with big crypts. Maxillaries tender, little discharge.”

“A headache she describes as mild/moderate.”

“I know.”

Yes, I know.”

“I know. I’m encouraging her. Her oral intake is very poor despite encouragement. Her sinus and neck node pains exacerbate upon swallowing, and drinking can trigger long coughing spells.”

“Okay, good idea. We’ll try that.”

“Sclera non-icteric. Pupils equal and reactive.”

“No…. I don’t want—I’m running in saline via peripheral line, and there’s a risk of syncope. I’m not leaving her. I should be here if she needs to get up.”

“Sorry, I meant please courier the kit and tubes here and I’ll draw while the courier waits.”

“Yes, okay. Thank you. When they come back, can you see her if we need?”

“Yes, yes.”

“I know.”

“I know.”

“No, I don’t think she needs a CT. With her history it’s so unlikely to be an acute abdomen. It could break trust to bring her in, but I’ll keep watch.”

“Yes.”

“I’ll tell her.”

“Yes, I’ll palpate deeply once daily and watch for signs. I just wanted to spare her obvious—“

“No, no, I know. I will.”

“Some analgesia if the labs allow? GI too irritated for NSAIDS. I’m just talking Tylenol, OTC.”

“Yes, many prior episodes of tonsillitis, then she aged into sinusitis with infection going quickly into the lungs. Maybe 8 prior courses of azithromycin.”

“Very stoic. I think her ‘2’ is some people’s ‘7’? But she’s extremely worn out. I’d just feel better with tabs on organ function. Okay, thanks again, Alan. You’re a prince and I owe you.”