DB Lazarus
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17. Critical Care - I
🕑 Added 2024-10-27 04:00:03 +0000 UTCBeep. Beep.
I blinked. Fluorescent lights came into focus.
Beep. Beep.
“You’re awake.” Before I could turn my head, he said, “don’t. You aren’t ready.”
I stopped. “What happened?” Everything was so foggy.
“Burns.”
That would explain why he didn’t want me to move. But would that explain why I couldn’t feel anything below my neck?
He didn’t let me dwell on the thought. “How much do you remember?”
I couldn’t remember a fire, but a memory trickled in. “A CT, a stroke code, lightning. Was there an explosion?”
There had been pain, and then…dinosaurs? Clearly my memory was suspect.
“Close enough. We need to discuss a few things, but first, tell me your name and birthdate.”
“Daniel Burkhart. 10/17/90.”
“Where are you?”
“A hospital.” Even without the beeping keeping time to my heart rate, I didn’t need more than a glance to recognize the drop ceiling and fluorescent lights hiding behind their diffuser. “Probably an ICU.” If I was this badly burned, where else could I be?
“Good enough. The date?”
“I…I don’t know.”
“Not unexpected.”
“It was about June 16th or 17th when I was last awake.”
“It’s not quite that date anymore.”
He didn’t elaborate, but the snark couldn’t hide the sadness in his voice.
“How long have I been out?” My voice quavered, “and how bad is it?”
“Not as long as you think, and the burns are…extensive.”
“Disfiguring?“ It slipped out. I wasn’t vain, but then I had never expected this. I had a job that was patient facing.
“Possibly. Your face was spared, but you have full-thickness burns over 75% of your body, and…there are other complications.“
“Is that a nice way of saying I might not survive?“
“Yes.“
Silence lingered. I exhaled the breath I had unknowingly been holding. I closed my eyes. How many times had I been in his position? “Is this where we talk about how much I want done?”
“If you want. You are just learning about what happened.“
“No. I had thought about this before.“ I had. See enough people dying, and it made you question your own mortality. I long ago decided what I wanted.
“Okay.“
I took the invitation. “I am okay with resuscitation and intubation if there is a reasonable chance of recovery. But if I’m not gonna be functional, then nothing heroic.“
“What do you mean by functional?“
“I need to be able to do my job.“
“That’s a high bar. There is a lot to life besides being a doctor.”
“Is there?”
“Yes.”
“Not for—“
I stopped abruptly. Was that still true? I had thought medicine was my passion. Helping people was what I had dreamt about since being a kid. The thrill of figuring out the complex cases was just a bonus. But could I still say that when I decided to leave it behind?
I stewed in the silence he gave me. I had been growing tired, fighting to bite back snippy comments at nurses’ and residents’ mistakes. I had been ignoring the signs. I hadn’t wanted to admit it, but at some point, I burned out.
I winced as I let out an involuntary snort at my pun. I was in really bad shape if a stupid pun could hurt that much. Was this life’s way of saying I should consider another avenue? Pretty extreme, though mom always said I had a thick skull.
It pained me to say it. “I could perhaps find a lower standard to shoot for. But I would need to be able to fulfill a purpose.”
“And that would be?”
“Being able to help.”
“Not necessarily with your hands?”
My snort hurt. “No. They were failing me as it was.”
“That is helpful. I probably dove it this too quickly. Typically, I have this conversation when the end is clear. We just don’t have too much time.” The beeping in room sped up. “Things are bad, but not as bad as you may think. You are not out of options. You have two, well technically three, options, though I doubt would choose doing nothing. These two are more than most really. You’re lucky in someways. You have a specialist who could help you. She is good, but…”
“No guarantees. My other option besides letting this…specialist continue to work?“
“It is an experimental procedure. Outcomes would be mixed. You would recover physically, but you wouldn’t be able to do your job well or at all.”
“At all?”
“You would be able to all your normal activities, but there is a high chance that high-order processing would be diminished. In that case, you would struggle as a doctor and any other jobs of a level.“
I tried to wrap my head around how that could happen, and I couldn’t. “How would that work?”
“Your injuries are not just superficial. You also have diffuse nerve, muscles, and organ damage. It is amazing you are doing as well as you are. Most would have still been unresponsive at this point, but as I said, you were lucky you had access to a woman with her skills.”
“Can I wait to see if I decompensate before enrolling in the trial? Are the inclusion criteria strict?”
“It is not a trial.”
“You said it was experimental.”
“It is. You just wouldn’t be receiving it through a trial.”
Alarm bells went off in my head. “What stage of research is it in?”
“Early.”
“Has it been tested before?”
He shook his head. “We would be skirting the rules administering it to you, but…you are a special case.”
“Special? I am just a resident.” I was not some big donor.
“A resident who saved a man who has access to significant resources.”
“Really?” I whispered. Of all things, that guy in the CT was some sort of secret billionaire? He was wearing a wizard’s costume.
“This clearly not-FDA-approved treatment will allow me to survive without any physical limitations, but it may affect my mind. How?”
“The mechanism is too complex to explain now.”
“Why don’t you just try me?”
“It is also proprietary.”
Code speak for this line of questioning is done. “Fine. “What are my chances of survival without it?”
“I would estimate at survival at 50%, but full recovery, no more than 25%.”
“What is the range between full recovery and death?”
“Anywhere from needing full care to minimal disability.”
“And if I take it, I will have a guaranteed full physical recovery with the potential of diminished intelligence?”
“If it didn’t have the guaranteed chance of recovery, I wouldn’t be offering it to you. And just to make clear, this is full recovery—no scarring.”
“None?”
“None.”
It sounded like a miracle, well, near miracle. Every medicine had a cost, but full recovery? It sounded impossible. Five years ago, I wouldn’t have believed something like this could exist, but then I saw CAR-T cell immunotherapies melt away cancer in some people with metastatic illness. I just had to risk my mind.
Could I? I wanted to help. If I closed my eyes and plugged my ears, I could even make myself believe that I could make more of a difference in Pharma than working as a practicing clinician, but I might not even be able to that. My mind has always been my greatest asset.
“Tell me. Just how many strings were pulled for this?”
“Many.”
“This wouldn’t happen for anyone else?”
“Correct.”
Damn. I closed my eyes and blinked back tears. It had to be special treatment. I hated the injustice when VIPs cut in line. Medicine shouldn’t be limited to those who could pay even if it was still in the earliest stages of research.
“It isn’t fair,” I whispered.
“You worked hard. Trained for years. You saved a man. And we both know that life isn’t fair.”
No, it wasn’t, but it didn’t mean medicine shouldn’t be. It drove me insane when colleagues would say that “X terrible disease” couldn’t happen to a nicer guy. Did being a bad person justify a terminal illness? We treated those people who needed help regardless of background without prejudice.
“Think of it as a reward.”
Except that there were greater heroes out there than me who might benefit. I wouldn’t be curing cancer, but someone out there might.
“Give it to someone else, someone who has less of a chance.”
“I don’t think that is possible.”
“Will giving me this medication help with your research?”
“No. Quite the opposite actually.”
“How—never mind, it doesn’t matter. I can’t do this. Put the resources towards something else.”
“That might be able to be arranged, but are you sure?”
“I might have been able to give up medicine for a chance, but not if I am getting special treatment.” I would never be able to live down this gift, especially if my way to give back was lost.
He snorted. “You are willing to die for your principles.”
My mom’s words echoed in my head. “How can you be so smart and so dumb at the same time.”
Thick skull, mom. Thick skull.
“You said this specialist was good. I am willing to gamble.”
A chair scooted back. Our conversation must be done, but I couldn’t end it this way. “Can you let my benefactor know how deeply I appreciate his offer. “
“I will.”
“Is he doing okay?”
“Not full strength, but he is recovering.”
“Also, thank you for waking me up and giving me a choice. Many wouldn’t have taken the risk.”
“I thought this conversation would be important to you. Now, I will let her get to work.”
In the periphery, a tall, dark-haired man with broad shoulders that filled out the white coat walked towards the exit of my room. Each click of his heel on the floor hammered in the gravity of my choice. I closed my eyes. I had tossed away a guarantee without even knowing this specialist for a job and principles.
The clicks stopped. I opened my eyes to find that he had stopped at the entrance to the room. He turned, and I got my first look at the man. His face radiated warmth and compassion. He pointed with his head. “You should pay attention to her work. I think you will find it enlightening.”
Following his heterochromatic eyes, I looked up. A pair of hands with long, slender fingers appeared at the top of my vision. I squinted. That green was not a traditional color. Too dark.
My eyes widened. Those weren’t gloves—
***
Comments
Pete
Thanks for the chapter!
