Rick joined Kelsey and Mitch for dinner at a steakhouse, and they did their best to avoid talking about the latest turn in Meghan’s health. Dr. Meyers sent a text, saying that Meghan was safely tucked away in ICU. After dinner, Rick said his goodbyes, wanting to head home and get some sleep before his shift in the morning.

Kelsey and Mitch drove home in silence. They were a few blocks away when Kelsey suddenly remembered something. “Mitch! Didn’t you pick up a shift tomorrow?”

Mitch groaned. “That’s right, I did.” He pulled into the driveway, parked the car, and leaned back into the seat. “Kelsey, I think this is the first time I didn’t want to go into work.”

She shifted in her seat so she could look at him better. “I can’t blame you, hon. Today has been hard.”

“I feel like I’ve failed her, somehow, Kelsey.”

“Now, enough of that! You aren’t to blame for a medication reaction. You did save her life,” Kelsey replied forcefully.

“Yes, but…”

She cut him off. “There’s no ‘yes, buts’. Let’s get inside.” She opened her door and stepped out of the car.

**********

Mitch didn’t sleep well that night, nightmares of Meghan’s allergic reaction replaying in his mind. Kelsey gave him an encouraging smile as he headed out the door to go to work. They had discussed her staying with Meghan while Mitch worked, but had ultimately decided for her to stay home and rest.

After clocking in for his shift, Mitch headed for the locker room to put his things away and fill his pockets with the requisite reference guide, stethoscope, and handful of pens that circulated through the ER staff as they “snitched” pens from each other on a regular basis. He affixed his nametag, sighed, and ran a hand through his hair while glancing in the small mirror taped to his locker door. He turned and came face-to-face with Bob.

“Admiring that hairdo, doc?” He joked. “You’d better hope your momma didn’t have the genes that make you go bald when you’re nearing my age.”

Mitch gave a half-hearted smile at the joke. Bob looked him over critically. “What’s the matter, doc? You look like you’ve gone through the ringer half-wet. Those gals of yours aren’t causing you too much trouble, are they?”

Mitch sat down wearily on the bench in the room. “Meghan had an anaphylaxis reaction yesterday and is in the ICU, Bob.”

“What?!” Bob sat down, shocked. “She’s going to be okay, isn’t she?”

“I hope so. She was starting to get a lung infection, so the antibiotics were switched to a cillin. She seemed to be doing fine when she suddenly sat straight up, said she couldn’t breathe, and…” He huffed and punched his leg with his fist.

“Were you able to get her intubated?” Bob asked quietly.

Mitch shook his head. “I couldn’t even visualize her vocal cords, she swelled so quickly. I had to do an emergency tracheostomy.”

“Have you checked on her?”

“No. Rick Brant shooed Kelsey and me home around 5 yesterday. I got a message saying she had been transferred up to ICU, but that’s the last I know.”

“I don’t think that Dr. Morgan has gone home yet,” Bob said, referring to the ER physician who had been on duty the previous night. “If she doesn’t mind, why don’t you go see Meghan before starting your shift? It’ll give you peace of mind.”

“Yeah, that’s a good idea.” Mitch stood.

“Hey, I’m full of good ideas. If you need another…”

“I know where to find you. Thanks, Bob.” Mitch headed out of the locker room and went in search of Dr. Morgan. He found her as she was coming out of Curtain 4. “Hey, Carrie. Got a moment?”

She looked over her glasses at him from the chart she’d been reading. “Sure. What’s up, Mitch?”

“Would you be so kind as to cover for me for half an hour? Meghan is in ICU, and I need to go check on her.”

Carrie Morgan sat down the chart on the edge of the ER desk. “Wait. She’s in ICU? When did that happen?” She was friends with Meghan.

“Did you know about her surgery last week?” Carrie nodded. “She was developing a respiratory infection, and they switched her antibiotic to a cillin. She had an anaphylactic reaction to it yesterday.”

Carrie gasped and covered her mouth with her hand. “Is she all right? You said she’s in the ICU.”

“I had to do an emergency tracheostomy and she was on a vent as of 5 pm yesterday. I need to go up and see what her status is.” He sighed.

“By all means, go! I’ll stay here until you get back. Let me know her room? I want to go visit.” She laid a hand on his arm. “Take as long as you need. I have no plans for today.”

“Thanks.” Mitch stopped by Bob’s desk area long enough to point upstairs. Bob waved him on, picking up a ringing phone and answering it.

Mitch made his way upstairs and was rung into the ICU by the unit secretary. He wound his way around the unit until he came to Room 742. He saw Meghan’s still form lying in the bed and hesitated outside. The walls between the rooms were solid, but the walls separating the room from the hall was floor-to-ceiling glass, with curtains that could be pulled for patient privacy. The curtains right now were pulled back, allowing Mitch to see her still form attached to the ventilator, wires and tubes everywhere. He swallowed hard.

“Doctor, can I help you?” A nurse came up beside him. He looked down at her name tag: Kimberly.

“Hi, ah, Kimberly. I’m Dr. Branston. Meghan is my sister-in-law.”

“OH, you’re Dr. Branston. I’ve been told that you may be by to see her.”

“Yes,” he nodded. “What’s the latest on her condition?” Kimberly gestured for him to follow her and led him around the nurses’ station to a couple of chairs. She pulled over Meghan’s chart and opened it. “She had the anaphylactic reaction yesterday afternoon that brought her to us. We’ve been continuing her IV fluids. She received two epi drips total, and then we were able to stop those. We continued the diphenhydramine drip until late last night. Most of the swelling and hives have gone away by now. Dr. Cooper from Pulmonology and our internist on-call, Dr. Anderson, conferred and have ordered her sedated probably through tomorrow. She has pneumonia, so they have her back on IV antibiotics.”

“What are they giving her now?”

Kimberly flipped a couple of pages to the medication list. “She’s receiving Levofloxacin now.”

“Is she still on the vent?”

Kimberly nodded. “She’s still on the vent, but the settings are very low. Depending on how she’s doing this afternoon, they may start the weaning process this evening. Dr. Cooper said that he didn’t anticipate her being on the vent long, but wanted to give her lungs a chance to heal from everything and give the antibiotics time to work.”

Mitch took a deep breath in, then let it out in a whoosh.

“Actually, doctor, it’s good that you showed up. I see on Meghan’s chart that you or your wife are designated as powers of attorney for Meghan, is that correct?” Mitch nodded. “Dr. Anderson is recommending the insertion of a central line, and we need consent to do so.”

It was obvious that Mitch hadn’t considered the possibility of central venous access. He thought for a few moments before nodding. “Yes, I think that would be appropriate. I’ll sign the consent. Do you have the forms handy?”

“I’ll get them from the secretary. One sec.” She got up and walked over to the secretary’s station. They chatted for a minute, and she returned with the paperwork. “I guess I don’t need to explain them to you, do I? Feel free to read through them, and then I’ll need a signature here and here, and a date. Today is the 14th.”

Mitch accepted the paperwork and read through it before signing and dating the form. “Anything else?” Kimberly shook her head. “I’m going to go see Meghan for a couple of minutes if that’s okay.”

“Certainly, doctor. I think Dr. Anderson is around somewhere. If I see him, I’ll send him your way.”

“Thanks,” Mitch smiled. “I’d appreciate that.” He rose from his seat, rounded the desk, and entered Meghan’s room. So many wires and tubes! The room was quiet aside from the faint beeping of the cardiac monitor and the sound of the ventilator.

Meghan’s neck had been cleaned of residual blood and betadine. Bandages covered the area around her trach tube, plus another one covered the site where they had put in an external jugular (EJ) IV during her allergic crisis. A thin band of blue and white fabric secured the tube in place by wrapping around behind her neck.

She was in a fresh gown and covered in blankets from her chest down. Mitch could see that her broken leg had been propped up on pillows, and her catheter tubing snaked out from under the covers to drain into the bag hanging on the side of the bed. Each arm sported an IV, whose lines ran up to IV pumps stationed on either side of her bed. He counted 6 different bags of fluids.

Wires ran from leads on her chest and one finger up to the telemetry monitor, and a blood pressure cuff was wrapped around her left arm. He heard a puffing/hissing noise and saw that a sequential compression device was attached to her right leg.

He glanced at Meghan’s face. The nurse was right: most of the swelling had gone down, although he could see that her cheeks were still a bit puffy. She had some red splotches still, and her arms still had a few mild hives.

“She lives because of you,” a voice said softly. Mitch turned around to see a doctor standing in the doorway, watching him with interest. “I’m Dr. Anderson, the internist on-call today. You must be Dr. Branston.”

“Mitch,” Mitch offered, holding out his hand. Dr. Anderson stepped closer and shook it. “You can call me Sean. Kimberly said she has already given you a report on our patient, here, so I won’t rehash that for you.”

“Yeah, she gave me report. I’m noticing she’s still got some hives.”

Dr. Anderson nodded but took a look all the same. “I’ll give her another round of diphenhydramine, but it isn’t uncommon. Kimberly also said that you signed the consent for the central line. We’ll get that put in here in a couple of hours.”

“Anything else I should know about? How are her incisions? Are we giving anything to prevent blood clots? I noticed the compression sleeve.” Mitch ran his hand through his hair.

Dr. Anderson smiled kindly. “Her leg is fine. Her surgical incisions are doing fine. We aren’t noticing any signs of infection and they seem to be healing well, for 4 days post-op. She has full-blown pneumonia now, as Kimberly may have mentioned. Her latest urinalysis looks good, so no worries about a UTI from the catheter. She’s getting heparin daily while she’s here, and of course, the compression sleeve, to prevent blood clots.

“Dr. Cooper and I decided to go ahead and sedate her for a couple of days until we can wean her off of the vent. We want the antibiotics to have a good opportunity to fight the pneumonia, and having her fight to breathe would just wear her down too much, what with the anaphylactic reaction and all. Her vent settings are really low, and with Dr. Cooper’s oversight, I’m hoping we can start weaning her off the vent tomorrow afternoon.” Sean glanced at Mitch. “By the way – good job on the tracheostomy.”

Mitch smiled briefly. “Thanks.” He sighed. “My wife, Kelsey, will be wanting to see her. I’m on duty until 7 this evening. Do you think it’d be possible for me to bring her back around 8 tonight for a few minutes?”

Sean smiled. “I don’t see why not. I’ll talk to the nursing staff and let them know.”

“Thanks. I probably need to get back to work. Please call me if there’s any updates. I can be reached down in the ER, and I’ll leave my pager and phone numbers with your staff.”

“I’ll do that. Mitch, I’ve got her. I’ll take good care of her, so don’t worry, okay? We’ve got this,” Sean reassured the doctor.

Mitch nodded. They left Meghan’s room and went separate ways. Mitch stopped by the unit secretary and left his contact information, and headed for the elevator.