Cary
Subconsciously,
I had known since Nick stepped onto the bus that night that something wasn’t
right.
Maybe it
was that his coloring seemed off. His
face was always really red by the end of a concert, but this time, only his
cheeks were flushed. The rest of his
face, especially around his lips and eyes, was white. He was out of breath and looked exhausted,
and I knew he had pushed himself too hard.
Looking
back, I should have just taken his vitals right then and there on the tour
bus. I would have realized that he was
in trouble and saved him the embarrassment of blacking out in the bathroom,
naked. I could have spared myself the
awkwardness of finding him that way, too.
But
instead, I let his stubbornness win, yet again, and figured I’d let him relax
and get some rest before I bothered him about blood samples and all of that
again. It could wait until morning, I
thought, as I watched him walk off to the bathroom. I waited until I heard the tub filling to
change out of my clothes and put on my pajamas.
There was a double sink outside the bathroom door, so I washed my face
while he was in the bath. As I stood
there at the sink, I could hear him sloshing around in the tub. It was hard not to think dirty thoughts, as
much as I tried to keep myself from picturing him naked.
Stop it, I scolded myself, as I patted my face dry. When I lowered the towel, my reflection in
the mirror was smirking back at me. I
looked away, turning to hang my towel back on the bar.
That was
when I heard the thud.
As my heart
leapt into my throat, my head whipped towards the closed bathroom door. “Nick?” I called, and when there was no
answer, I immediately grabbed the door handle.
I was filled with dread, expecting the door to be locked, so you can
imagine my relief when the knob turned easily in my hand.
I peeked my
head around the door, really not wanting to walk in on him naked, but when I
saw his bare feet just lying there, I knew I had no choice. I threw the door open wide and rushed in. He was slumped on the floor, just in front of
the tub, a towel draped loosely across his waist. He must have been getting out when he’d
fallen – or passed out, more likely.
“Nick?” I
said again, dropping down onto my knees next to him. I was relieved to see that he was already
starting to come to. As I hovered over
him, his eyelids fluttered and then opened.
His blue eyes looked dazed and disoriented. “Nick,” I repeated, trying to get him to
focus on me.
He blinked
rapidly a few times, and finally, the confusion in his eyes cleared. He looked right at me and muttered, “You need
to take me to the hospital. Something’s
wrong.”
It made my
blood run cold to hear him to say that.
It was like he was finally admitting defeat, accepting that his
condition was outside of his control, and even though that was a good thing, it
scared me. Whatever he was feeling, it
had to be bad for him to want to go to the hospital. I could see it in his eyes. He was scared, too.
“Okay…
okay, hang on…” I looked around and
spotted his robe, draped over the closed toilet seat. I grabbed it, bunched it up, and wedged it
under his legs, to elevate them a bit. I
found a clean, folded towel and slid that under his head, to give him some
cushion. I didn’t think I should try to
help him up from the floor just yet; if he passed out cold again, I wouldn’t be
able to move him on my own. “Lie right
there… don’t move… I’ll be right back.”
As I
started to get up, his hand shot out and caught my arm. “Don’t call an ambulance,” he begged. His voice was weak, but firm.
I let out
my breath and looked at him in disbelief.
“You just said to take you to the hospital. How else do you think you’re gonna get
there?”
“We can
take a taxi…”
“You are
unbelievable,” I said, exasperated, as I pulled myself out of his grip and
stalked out of the bathroom.
“Please,”
his voice drifted after me. “It’ll draw
too much attention…”
He was
right, of course. Loyalty to him
overweighed my better judgment, and when I picked up the phone, I dialed the
front desk instead of 911. “I need you
to call us a cab, please, immediately,” I told the clerk who answered. When I hung up the phone, I got my medical
bag and hurried back to Nick. I had more
training than any EMT and enough basic equipment to monitor him until I could
get him to the hospital.
“How do you
feel?” I asked, as I sank down next to him again. “What’s wrong?”
“My heart’s
racing,” he murmured, putting his hand on the left side of his chest. “It has been ever since the show.”
I took out my
stethoscope and slipped it into my ears.
Pushing his hand out of the way, I pressed the diaphragm to his chest
and moved it around until I could hear heart sounds. They were strong, but fast and
irregular. Frowning, I reached into my
bag and pulled out the watch I always wore when I was on duty at the nursing
home to check pulses. I watched the
second hand, counting beats as I listened.
In fifteen seconds, I counted fifty-some beats. Even when I rounded down to do the math in my
head, the number was alarmingly high.
“You’re
having an arrhythmia… an irregular heart rhythm,” I explained to Nick, trying
to keep my voice calm so he wouldn’t panic any more than he already was. “It’s a form of tachycardia… rapid heartbeat. Your heart rate’s over two hundred right
now.”
“How bad is
that?”
I
swallowed. “Well… normal’s anywhere
between sixty and a hundred beats per minute.
Your heart’s going double that.”
“Holy
shit,” he breathed, his eyes going wide.
“Is that… is it gonna kill me?”
For the
first time, I saw it in his face: not
just a flicker, but a full-on expression of fear that he was going to die. It made my own heart skip a beat, as if an
invisible hand had reached up and squeezed it still for a second. “No,” I said firmly, taking the stethoscope
out of my ears. “But you do need
treatment… medications, to slow your heart down. The cab should be here soon. Do you think you can stand up?”
“Yeah…” he
said uncertainly, lifting his head. I
helped him sit up and put his robe on, and after he’d been upright for a few
seconds without blacking out, I ducked under his arm to support part of his
weight as he tried to stand. He swayed
unsteadily for a moment, holding onto me, and I kept my arm around him until he’d
gotten his balance.
“Nice and
slow,” I said, as we walked out of the bathroom. “Tell me if you feel like you’re going to
pass out again.”
“I’m
alright,” he replied, though he sounded uneasy.
“My heart’s just pounding…”
“I
know. Sit here for a minute,” I said,
guiding him to the edge of the bed. I
left him there and went over to his suitcase, digging through it to find him
some clothes. “Try something for me,” I
said, as I held up a pair of shorts.
“Hold your breath for a few seconds.
Then cough, really hard.” I
waited until I heard him cough. “Did
that help?”
I glanced
over at him; he was looking back at me like I was insane. “I don’t think so.”
“Okay…” I rummaged around deeper in the suitcase and
pulled out a plaid, button-down shirt.
“Then try this: clench your
stomach muscles and bear down, like you’re about to have a BM.”
“Have a
BM?” he repeated flatly. “Is that nurse
code for ‘take a huge shit’?”
I
smiled. “Uh-huh. Just do it.”
I snuck another peek over my shoulder at him, in time to see his face
scrunch up. It was eerily reminiscent of
his facial expressions in the “Quit Playing Games” video, all those years
ago. The thought made me want to laugh
and cry at the same time. “Any change?”
I asked hopefully, as I brought his clothes over to the bed.
“I don’t feel
any different…”
I picked up
his wrist to check his pulse again. It
felt just as fast as before. Oh well, it
had been worth a shot; sometimes vagal maneuvers helped. “Then we really do have to get you to the
hospital. Here, put these on,” I said, dropping
the clothes on his lap. “I’ll turn
around if you promise not to pass out again.”
Finally,
some color came back into his cheeks.
“Yeah, alright…” he muttered, standing up slowly. I made myself turn around while he got
dressed, praying I wouldn’t hear another thud from him collapsing again. I was relieved when he finally said,
“Alright… I’m decent.”
He sounded
somewhat calmer, which made me feel calmer, too. “Okay… I’m gonna grab my bag, and we’ll head
downstairs.” I got my medical bag from the
bathroom and slung it over one shoulder, remembering to slip my wallet and room
key into one of the outside pockets. It
wasn’t until I saw myself in the mirrored wall of the elevator that I realized
I had forgotten to change my own clothes.
I was wearing a black tank top, no bra, and red pajama pants with Betty
Boop all over them. Really classy, Cary, I thought, rolling my eyes at my reflection.
If Nick had
even noticed, he didn’t make fun of me for it.
In fact, he didn’t say anything the whole elevator ride. In the silence, I could hear his breathing –
it was fast and shallow, like he was on the verge of hyperventilating. I reached out and took his hand, squeezed it
hard. “Hang in there,” I said, hoping to
reassure him. “You’re gonna be alright.”
Then the
elevator doors slid open, and my sense of calm evaporated. Staring out in dismay, I thought, Oh no…
The lobby
was full of people… most of them girls.
I recognized BSB t-shirts on a few and realized they were fans, either
just getting back from the concert or waiting to see if the Boys would come
down. If they saw Nick, they were going
to swarm us. Why hadn’t I thought to jam
that damn Celtics cap on his head before we came down? It probably wouldn’t have helped much, but it
might have delayed the moment of recognition and given us a head start.
“Shit,” I
heard Nick swear under his breath beside me.
I looked over at him; his face was pale and streaked with cold
sweat. I wasn’t sure how much longer he
could stay on his feet.
“Come on,”
I murmured, pulling him out of the elevator.
“Don’t talk, and don’t stop. Just
walk.”
I was still
holding onto his hand, and that gave me an idea. Dropping his hand, I cozied right up to him
and wrapped my arm around his waist, possessively, jamming my hand into his
back pocket. He naturally slung his arm
over my shoulders again, and I steered him towards the front doors. I tried to ignore the fans who cried, “Nick! Hi, Nick!” but I didn’t miss the dirty looks
they gave me as I hurried him right past them, to the taxi that was waiting
outside.
To the
casual observer on the street, we must have seemed inseparable, walking with
our arms around each other like that.
They couldn’t see how heavily Nick was leaning on me or feel the dead
weight of his arm on my shoulders.
To the cab
driver who eyed us in the rearview mirror of his taxi, we certainly looked like
a couple, holding hands in the backseat.
He didn’t know that my fingers were pressed against the radial artery in
Nick’s wrist, feeling every pulse of his racing heart.
“We need
you to take us to the closest emergency room,” I told the cabbie.
He gave a
quick nod. “That’d be Salt Lake
Regional,” he said, already pulling away from the curb.
“Thanks.” I looked over at Nick. He stared back at me, but neither of us
spoke. I didn’t let go of his hand, and
his pulse fluttered beneath my fingertips the whole way to the hospital. It was a silent, but short ride.
I was
relieved to see the words Salt Lake
Regional Medical Center lit up on the side of a large, light-colored
building up ahead, and when the taxi pulled to a stop underneath the overhang
that said EMERGENCY in red letters, I
thanked the driver again for getting us there so quickly and shoved a ten
dollar bill into his hand. “Don’t worry
about change,” I said, already opening the door. I scrambled out and then reached back in to
help Nick. Arm in arm, we walked into
the hospital.
It didn’t
take long to get medical attention. As I
was hurriedly explaining the situation to the triage nurse, she took one look
at Nick and recognized him, and the next thing I knew, he was being whisked
away in a wheelchair. I followed the
nurse who brought him to a small, private room and helped him out of the
wheelchair and into the bed. “He’s got a
port, for IV access,” I told her, before she had even unbuttoned Nick’s
shirt. “He’s being treated with chemo
for Stage IV lymphoblastic lymphoma.”
Even though
it made my stomach drop to hear the words out loud, it felt good to say them, to
finally be able to tell someone the secret I’d been carrying around for Nick
for the past six weeks.
The nurse
looked at me in surprise. “Are you his
caretaker?” I didn’t miss the way her
eyes panned down to my pajama bottoms, as she gave me the onceover.
Feeling
myself blush, I nodded. “I’m a CNP. I’ve been administering his outpatient
chemo.”
“Stick
around,” said the nurse. “The doctor
will want to talk to you when he’s taking a history.”
I stood
back and watched as she fit an oxygen canula into Nick’s nose and hooked him up
to the standard cardiac monitoring equipment – heart monitor and twelve-lead
ECG, blood pressure cuff, and pulse oximeter.
It was almost a relief to see him connected to so many wires, to know
that he was being closely watched and properly taken care of, and that the
responsibility was off my shoulders.
While she
was charting his initial vitals, a big, blonde man in a white lab coat breezed
in and introduced himself as Dr. Harrison.
“What do we have here?” he asked.
The nurse
barely looked up from her chart. “Mr.
Carter, age thirty, complains of rapid heartbeat with palpitations, shortness
of breath, fatigue, and syncope…” She
repeated all the information Nick and I had given her, including his cancer
diagnosis. Then she glanced up at me and
said, “This is his caretaker, Ms…”
“Hilst,” I
supplied. “Cary.”
The doctor
asked me a few quick questions, which I answered, and then focused his
attention on Nick. He listened to his
heart and lungs, palpated his chest and neck, studied his vital signs and the
rhythm on the ECG strip, and asked him all kinds of questions. “You’re having what’s called supraventricular
tachycardia,” he told Nick, “an abnormally fast heart rhythm. Have you ever experienced anything like this
before?”
“I’ve had
the palpitations before,” Nick admitted, “but not like this.” He filled Dr. Harrison in on his
cardiomyopathy diagnosis, which gave me another sinking feeling in my
stomach. I had assumed this episode was
related to his cancer treatment, just another side effect of the chemo, a
complication caused by him pushing his body past its limits. It hadn’t even occurred to me that it could
be his heart condition flaring up, though all of a sudden it seemed like the
obvious conclusion. Nick had never
really talked about his cardiomyopathy, at least not to me, so I hadn’t thought
much of it. Once I started, I couldn’t
stop. It scared me. I knew certain chemotherapy drugs could cause
damage to the heart muscle – or, in Nick’s case, worsen the damage that had
already been done. Had the drugs I’d
been giving him messed with his heart?
“What were
you doing when the symptoms started?”
“I’d just
gotten off stage. I’m a singer,” Nick
added, looking unsure as to whether this middle-aged man would have a clue who
he was or not. “I did a bunch of
dancing, too, though…”
“Any drugs
or alcohol before the show?” asked the doctor.
Nick shook
his head. “I had a few Red Bull shots,
but that’s it.”
The doctor
and nurse looked at each other. “Draw a blood
sample through his port and order a CBC, lytes, tox screen, and caffeine
level,” the doctor told the nurse.”
I stared at
Nick. “When were you drinking Red Bull?”
He
shrugged, his face reddening. “In the
dressing room, before the show.”
I wondered
how long he’d been hiding that little habit from me. He must have known I wouldn’t approve. Energy drinks like Red Bull are loaded with
caffeine and sugar – good for a rush of adrenaline, bad for a heart
condition. “Caffeine speeds up your
heart,” I told Nick, trying not to sound too exasperated with him, even though
I was feeling that way. “That might be
what caused this.”
I looked at
Dr. Harrison, and he nodded in agreement.
“There are a lot of things that can trigger SVT – caffeine and other
stimulants, certain medications, alcohol, stress, overexertion, dehydration,
changes in blood pressure, heart disease…
Given your medical history, it could be a combination of any of those
factors. Hopefully your labwork will
give us some answers; if not, we’ll run some more tests. In the meantime, we’re going to give you some
fluids and medicine that will hopefully slow your heart.” When he was done explaining this to Nick, he
turned to the nurse and said, “Run in a liter of saline and six milligrams of
adenosine, IV push.”
As the
nurse moved around to his left side to hook up the IV to his port, Nick looked
up at me. “Are you mad at me?” he asked.
For a
second, I was confused. “Mad at you?”
“For the
Red Bull?” He looked more sheepish than
scared now.
“Oh.” I thought about it for a moment, then finally
shook my head. “No. I think you’re kind of a moron, to load
yourself up on that much caffeine before a show, but I’m not mad at you.”
He actually
grinned. “Good.”
There was
so much more I wanted to say to him, about what he was doing to himself, but
this wasn’t the time or place. “We’ll
talk,” I added, smiling sweetly back.
“Later.”
The nurse
hung a bag of saline solution on the IV stand; it ran into an infusion pump,
which pushed it steadily through a thin tube that connected to Nick’s
port. The fluids would help, I figured;
he was probably dehydrated, from chugging Red Bull instead of water before the
show. That did annoy me; I was
constantly urging him to stay hydrated while on chemo, and he was more
concerned about getting himself all caffeinated so he’d have energy on
stage. As usual, his priorities were way
out of whack. It was no wonder his body
had started going that way, too.
I looked at
the heart monitor; the waves were still double-timing it across the screen,
showing his heart beating at a rate of two hundred beats per minute. “I’m going to inject the medicine now. You may feel a little funny for a few minutes
after,” the nurse warned Nick. She
injected a syringe full of adenosine into his port, followed by a second
syringe of saline. I watched on the
monitor as his heart reacted to the drug; the EKG wave bottomed out and
flattened for a few seconds, then shot up and down in rapid peaks and valleys
again. Nick groaned in obvious
discomfort, his hand going to his chest, which was covered in electrodes. Whatever he felt, as his heart skipped a few
beats and then started racing again, it couldn’t have been pleasant.
“No
change,” said the doctor. “Let’s try
twelve milligrams.”
The nurse
shot him up with a double dose of the adenosine, and this time, while there was
still no change on the heart monitor, Nick reacted poorly. “Oh god… I feel really bad,” he whimpered,
clutching his chest. His skin was
flushed and sweaty. An alarm started
going off on the monitor, as his blood pressure dipped.
“He’s
dropped his pressure,” the nurse told the doctor.
“He’s not
stable,” was the doctor’s reply. “We’re
going to need to cardiovert him. Get the
defibrillator ready.”
My stomach
dropped again. “What? What’s going on?” I heard Nick’s voice rise
anxiously. I came up alongside his bed
and took his hand.
“They’re
going to give you a shock across your heart to get it beating normally again,”
I explained, squeezing his hand. I knew
how scary that had to sound, even though it was standard treatment for an
unstable patient with an arrhythmia like this.
It scared me, too.
“Fuck…”
Nick moaned, looking like he was on the verge of tears.
Another
nurse came in, and the two of them worked in perfect sync with Dr.
Harrison. One of the nurses squirted a
conductive gel onto Nick’s chest, while the other injected a sedative into his
IV line. If it did its job, he wouldn’t
remember the shock. I felt his hand go
limp in mine as the sedative kicked in, and the nurse who had given it placed
an oxygen mask over his face.
“Charge to
fifty joules,” said Dr. Harrison, as the first nurse set up the defibrillator
to synchronize the shock to the right moment in the cardiac cycle. If the timing was off, it could cause a
cardiac arrest by sending Nick’s heart into a more dangerous arrhythmia,
ventricular fibrillation. Just thinking
about it caused my own heart to race from anxiety.
The nurse
handed the doctor the defibrillator paddles.
“Charged to fifty.”
“Clear of
the patient, please.”
I let go of
Nick’s hand and stepped back out of the way, as the doctor placed the paddles
to his chest. While Nick’s heart took
the jolt of electricity, mine skipped a beat as I saw his body twitch, and even
though he was sedated, he let out another loud moan. Our eyes turned to the heart monitor, which
flatlined briefly as it registered the shock, then went back to its irregular
rhythm.
“Still in
SVT,” said Dr. Harrison. “Let’s try
again. Charge to a hundred.”
The nurse
adjusted the knob on the defibrillator.
“Charged.”
“Clear.”
I turned
away as the second shock was given, but I still heard Nick’s cry of pain. When I looked back at the heart monitor, I was
relieved to see the waves normalizing, spacing themselves out evenly across the
screen.
“Sinus
rhythm,” said the doctor triumphantly.
“Keep him on the monitor until we get his labs back, and we’ll go from
there.”
While the
nurses cleaned up, I went back to Nick’s bedside. The sedative was already wearing off. “Did you feel that?” I asked, putting my hand
over his again.
“What? No…” he mumbled, sounding a little out of it
still. I was glad to know the shock
looked worse than it felt. And if he had
felt it, he didn’t remember.
“How do you
feel now?”
“Tired…
chest hurts…”
I figured
that was from the shock and not from his heart.
The heart rhythm on the monitor was perfectly normal again. The danger had passed, and now all we had to
do was wait for his bloodwork to come back.
It would show if anything was off, but I suspected it was a combination
of dehydration and caffeine overdose that had done this.
“Just take
it easy,” I told Nick softly, deciding the lecture I had in store for him could
wait until later. After all the stress
his body had been put under, he was completely worn out. “You’ll feel better after you’ve gotten some
rest.”
He nodded,
letting his eyes close again. I held his
hand until he had drifted off to sleep.
***