REBIRTHDAY chapter 17

Walkabout the hospital

Photo by Peter Callaghan/MinnPost

The following day, a group of nurses gathered at the workstation on the pediatrics units, including Gwen, who was listening sympathetically to a tall male nurse in jade-green scrubs. He stood stoically, gripping a heavy backpack at his shoulder, a head taller than the women ringed around him in their pediatric blue.

Paige skirted the group slowly, making for Natalia’s room, as Gwen said, “It’s never easy, and I’ve been working this unit for 25 years.” The other women murmured their agreement.

“Hold on, she’s the twin,” Gwen said, switching to a loud, clear voice. “Paige? Honey, can you come here?”

The circle broke open to let Paige in next to the male nurse. Gwen rested a hand on Paige’s shoulder, saying, “This is Jaden. He works in the PICU. He was with Chase overnight.”

“Oh,” Paige said, “hi.” All of them went quiet. “Did his family make it in time?”

Jaden nodded. “They’re all still up there now.”

“You were his nurse?”

“I was.” He pressed his fingers against his reddened eyes and let out a long sigh. “We extubated at 7, and he went quickly after that.”

Paige, who didn’t feel anything except bewildered, asked, “What time did he die?”

“7:34 AM.”

Paige glanced at her phone. It was 8:18 AM. She had no context for how quick Chase’s death was. A sensation swept from the back of her head, over the top, to her face and cheeks. A shudder passed through her.

She wanted to say something like “I’m glad his suffering is over,” but her body betrayed her. Inside the ring of troubled faces, Paige contracted into a small creature. Her mouth and eyebrows drew together and the brimming edge of her tears distorted her vision. Her shoulders ached at the wing blades. She had to open her mouth to breathe.

“He was supposed to get a transplant, too,” she tried to say, through her thickening airway. She kept talking, though she had no control of where her voice broke. “Him and Natalia were supposed to get it at the same time.” A wet sob, like sheepish laughter, racked her chest. Paige bowed to the floor, stood up, and doubled over once more.

“I’ve got you,” said Jaden, dropping his bag to take her by the elbow, placing a flat warm hand onto her back.

“Oh my God,” Paige said. “This hurts.”

Gwen took her other side and Paige folded into the overlapping shadows of the two tall nurses. Someone pushed tissues into her hand. A wheely chair prodded her into a seated position, and she began to weep.

Gwen dropped to eye level, gesturing for the others to carry on with their work. “I’ve got her,” she said, glancing up to Jaden. “You must be exhausted, Jay. Go home.”

Once she’d caught her breath, Paige said, “Thanks for telling me right away.”

Gwen had quietly resumed her computer work, typing forcefully at the low desk inside the station. “I know better than to hide something like that from you,” she said, eyeing Paige. “You need something to nibble on? Want a graham cracker?”

“I’m good,” Paige said, getting up.

Outside Natalia’s door, which was still closed, Paige took her time rubbing hand sanitizer into her palms and between her fingers. When she opened the door, she found Natalia staring at the ceiling.

“Hey,” she said, lightly. “What’s your white count?”

Natalia sat up. “Is he gone?”

Paige dropped her hands to her sides. “I just met the nurse who was with him when he died.”

Natalia rested her head back on her pillow.

“I’m sorry, Nattie. I’m so sorry.”

Natalia pointed to the whiteboard, which had been updated with the latest white count. “It’s three point five,” she said. “Normal range.”

“Oh, wow,” Paige said. “Wow.” She sat down. “That’s amazing.”

“Where’s Mom?”

“I think she’s getting her mammo done, finally,” said Paige. She rubbed her damp hands on her jeans. “Do you want to talk about Chase?”

Natalia’s face was stony and her hands were folded across her chest. “Here’s something: if my counts hold, in three days, the strict isolation is over. I won’t even have to wear a mask.”

“That seems abrupt.”

“And then, they’re going to ship me out of here.”

“That’s a good thing, though, right? The transplant is working. You’ve wanted to go home for months.”

Natalia exhaled forcefully from her nose. She raised her knees. “It feels unsafe out there.”

“I can see that.”

“But I don’t want to stay here either.” Natalia’s dark eyes went to Paige. “Especially now.”

It was day eleven. Natalia paused at her door. A mask dangled from her wrist.

Paige waited for her outside by the candy jar. She tossed a butterscotch to Natalia. “Let’s go.”

Natalia sucked on the salty candy, raising her wrist. “You’re sure I don’t need this?”

“You’re off strict iso. When it drops off, it’s off.”

Natalia felt stuck in place.

“Fine, wear it if it makes you feel better.”

“No, I’m not going to wear it.”

“Good,” said Paige, with an impatient gesture. “Vamanos.”

Hospital air streamed over Natalia’s face. The passed the workstation. When Natalia smiled at the nurses, all of them looked up from their work to smile and wave back.

“Maren told me tomorrow’s the day,” said Gwen, coming out from her private office. “Are you excited or what?”

“So excited,” said Paige. Natalia followed her quick gait past Chase’s old room. Paige had met the girl who lived there now, a 9^th grader named Asja with beta-thalassemia, who needed a transplant so she could produce red blood cells again. She was 14 years old, Paige said, and already she had signs of heart failure.

“Did she tell you all that?” asked Natalia.

Paige nodded solemnly. “The girls always want to talk about their stories,” she said. “Her brother is traveling back from college to give his blood sample.”

“Everyone here ends up with a transplant, it seems like,” Natalia said, as she pushed the smooth metal button on the wall. The double doors opened outward, with a whoosh of air that tickled the back of her head, on to a broad, busy hospital corridor. To their left, the glare of the skyway absorbed the flow of fast-walking medical personnel.

They quickened their pace to join the crowd. “I can’t wait for you to see our bedroom. You’re going to freak out,” Paige said.

Natalia stopped. They were halfway across, over the street. She went off to the side, to a railing mounted against the floor-to-ceiling windows. They shot straight down, several floors, to the street.

Leaning her forehead on the glass, Natalia looked giddily down at the double yellow lines diving beneath them and the passing cars.

“It wasn’t very hard for me, the whole thing. I mean, it was hard, nobody likes barfing. But it wasn’t torture.”

Paige leaned against the glass, bracing her wrist on the railing. Her hair flew into her glasses and she blew it off. “We were lucky there were three of us full sibs.”

“No, I mean on a higher level, a bigger level.”

A young resident stopped by. “I’m sorry,” he said. “Is everything alright?”

Natalia came off the wall with a smile. “I’m fine, thanks.”

“Should I call for a wheelchair, or?”

“Oh, no,” said Paige. “She’s supposed to walk more.”

His concern did not abate.

“I’m discharging tomorrow,” Natalia said. “I probably should already be at home. It’s all good.”

He backed away reluctantly, and they set off to the other side, into the darkness of the connecting building that housed the Infusion Center. They passed through another set of doors to the long rows of chemo recliners, to televisions set up at each IV pole. Paige scanned the room as if she’d entered a house party. “This is where Maren sees all her follow-ups,” she said. “Your blood draws are going to be in here.”

They strolled down the long line of people under blankets wearing stocking caps and watching iPads. These nurses wore purple scrubs and spoke into the ears of their elderly patients. Many of the people under the blankets looked too old to be on chemotherapy. They slowed at the nursing station, which nestled in a horseshoe of private, glassed-in patient rooms, many of which had privacy curtains inside. Nearest them, a heavy-set man sat on an exam table, staring blankly toward them. His whole chest moved with each breath.

The nurses and doctors carried on with their tasks, some flustered, or easy-going, or serious, stopping for an extended bull session or tensely nodding along as a patient talked on past their appointment time.

A familiar voice said, “Impressive red count today, Mr. Larson.” Dr. Lonergan was entering one of the private rooms in her roomy lab coat. Paige recognized her a moment after Natalia had. “Should we go say hi?” she asked, but Natalia said, “Nah. Let’s keep walking.”

They went back past the chemo chairs to the dark hall, back across the skyway to the hospital. Natalia stayed with the flow of traffic, passing the pediatrics floor, to another unit, another set of doors that led to a mirror-image unit on the opposite corner of the hospital tower. Inside these double doors, the same round unit appeared, only these nurses wore navy scrubs and the bright wall art of the pediatrics floor was instead neutral-toned, farm-themed framed artwork. Instead of a Child Life Room, there was a TV lounge with a few visitors seated in armchairs.

“Hi,” call out one of the nurses, a skinny lady in her forties. “Can I help?”

“Getting our steps in,” said Natalia, suavely.

“Not to be nosy,” said Paige, “but what floor is this?”

“We’re cardiac surgery, mostly,” said the nurse. “We get some cardiac ICU step downs, caths, stuff like that, too.” In the room adjacent to her, a woman held a red pillow next to her chest while the TV droned.

“Open-heart,” the nurse whispered.

“Whoa,” said Natalia. “So all these people have had a surgery?”

“Yup,” said the lady. “Or a cath.”

“A heart cath is when they stick a balloon into your heart,” Paige said, in a low voice.

“You want to see one?” asked the nurse. She showed them how the catheter—a plastic tube conveniently stowed behind her computer—went up through a vein in the groin, through the vena cava, into the vessels of the heart. A tiny balloon inflated when she pressed her thumb on the attached syringe.

“Feel it,” she said, holding the catheter at Natalia. “It’s tough,” she said.

“Oh my God. That’s wild.”

The nurse nodded, acknowledging Natalia’s bald head. “You’ve been through some procedures too, I’m guessing.”

“Oh, yeah, but nothing like open heart surgery,” said Natalia.

“She had a marrow biopsy and a transplant,” said Paige. “She’s being modest.”

“Marrow?” asked the nurse. “You need a mask?”

“Her ANC is 500,” said Paige, with a satisfied look.

The nurse drew a beady eye at Natalia. “Congratulations,” she said. “Do they still ring the bell over there? When you’re all finished? Or do the clap line?”

“Oh God,” said Natalia. “I hope not. So cringe.”

The nurse clicked her mouse several times, now only half-listening. “It’s nice,” she said. “People like it.”

They left her to her charting and loitered outside the unit near the lady’s room. “I know,” said Natalia, “let’s surprise mom.”

“It’s not much to see,” said Paige, “but sure.” She led Natalia down to to a substreet level tunnel, through a series of stairwells, up to the front desk of the Ronald McDonald House. An old man, popeye-like in bearing and hairstyle, greeted them with a tight jaw.

“Hey John,” Paige said. “Is Mom around?”

He hiked his thumb back. “She’s in the kitchen.”

Sara gave a start when they trounced in on her.

“Nattie, what are you doing here?”

“Having a small adventure,” said Paige. “Don’t freak out.”

“I’m not freaking out.”

“We’re going to the cafeteria,” said Paige. “You want to join us?”

Sara took her mug out of the microwave and poured a little creamer pot into it. “Did either of you tell the nurses where you were going?”

“No.”

“Hell, no,” said Natalia.

“Paige, call the desk and tell them I took her out, before they call Child Protective Services on us.”

Paige obliged. As she explained to Gwen, her eyes got big. “Oh snap! Today? That’s great.”

“Mom,” she said, switching to speakerphone.

“We’ve got a bed shortage,” said Gwen. “Maren told me, if you guys were amenable, Natalia could go home now. Since she’s doing so well.”

Sara swallowed, pursed her lips. “Well, uh, yeah. We’ll need to pack up her stuff.”

“No worries, you think about it. But you’d be doing me a favor, we have a lot of sick kids waiting for a room.”

She disconnected. Sara looked to Natalia. “What do you say? You want to sleep at home tonight?”

Natalia ran her finger over her browbone. “Do I have a choice?”

“Of course you have a choice—”

“Little kids,” Paige said, imploringly. “Sick little kids.”

Snow was imminent again; salt streaked the interstate in long white trails. Natalia rode next to Sara in the passenger seat, muffled deep in the hood of her puffer coat.

“Are you warming up yet?” Sara asked, noting the seat warmer lights, which were all on.

“Um, yeah. I’m actually a little overheated.”

“Oh shoot, I’m sorry—you can make it however you need it—”

“It’s okay,” Natalia said, turning down the fan. “You can chill. It’s an eight-minute ride.”

“I thought we’d have some warning before they sprung us out of there.”

Maren had met them with discharge papers after Natalia and Paige wandered over to Sara’s room at the Ronald McDonald House.

“Am I in trouble?” she’d asked Maren, who looked confused.

“No, dear. Why would you be in trouble?”

Natalia, looking slightly guilty, said, “Oh, nothing.” Paige raised her eyebrows.

“We’re in a crunch for beds, something I didn’t foresee, honestly. I was telling Dr. Lonergan yesterday in clinic, “you know, Natalia looks great.’ And you’ll be coming in every few days for your blood draws anyway—”

“Is Dr. Lonergan okay with you being my main doctor?” Natalia asked.

Maren seemed surprised. “We’re all a big team. She understands.”

Sara exited off 1-35, the soaring part of the interstate that dives southward toward the river, but before it crossed, she edged off to the St Clair Avenue exit, peeling away, into a wooded neighborhood. They passed the snowy park with the pickleball courts, now dismantled and lined with plastic in preparation for hockey season. The two stoplights went their way, allowing them clear passage to Warwick street. Dirty cars huddled up and down the block.

Sara pulled in so Natalia’s door was centered on the sidewalk, grinding the tires against the curb.

“Don’t tell your Dad I did that,” she said, readjusting the angle of the car. She cut the ignition. A soft sigh escaped Natalia’s cocoon. She turned to Sara, owl-like, inside the outer shell of the hood. A fuzzy pink beanie was pulled down almost to her eyes.

“Now what do I do?” she asked.

“Go ahead, go in. I’ll get all the bags. And be careful on the ice.”

Natalia picked her way over the sidewalk and disappeared into the screened-in porch. Sara took the duffel bag and a cardboard box out of the trunk, balancing it on her cast from beneath.

Inside, the smell of old house and scrambled eggs hit her in a humid wall. Natalia was seated in the dining room in front of a plate full of omelet and hashbrowns. A steaming mug had been placed into her hands. Balloons trailed around invisible paths on the ceiling.

Izzy and Paige unloaded Sara’s arms. Izzy removed the clothes to the basement while Paige took out the binder and slid it into the built-in buffet at the end of the room.

Cristina was in the kitchen. “That was so fast,” she said. “We found some eggs,” she said, “but I’ve still got to Lysol the bathroom.” Her eyes went to Natalia. “Look at you. I think you may have actually grown on chemo. Is that even possible?”

“Eat this up,” she said, pointing to the food. “It’s hot.”

Paige pressed her cheek next to Natalia’s and snapped a selfie. “Just wait until you see upstairs.”

Natalia took down her hood and removed her beanie. The refrigerator clicked on from the kitchen.

“Is this coffee?” she asked, sniffing.

“It’s hot chocolate,” said Paige.

“Can I get something less sweet?” Natalia said, setting the cup down.

“Who are you?” asked Paige.

Cristina looked to Sara. “Is caffeine okay?”

“If you’re tired, maybe a nap,” said Sara.

Natalia nodded. “I am pretty dead.”

They took her upstairs all together, crowding the narrow stairs. The room that Natalia and Paige used to share had been cleared out, painted the color of whole milk, and hung with gauzy curtains. They moved the full-sized bed over from Izzy’s room. Paige moved her clothes and books over to the other room. Over the bed, a painting hung, an impressionistic blur of heads and dark braids and knees and sundresses on a grassy plain.

Natalia, on seeing all this, pulled back. “What?”

Paige sprung into the room. “We thought you should have more space, and you know, pretty soon, Izzy’s going to find a place to live off campus.”

Natalia shook her head. “Izzy, are you positive?”

“Yes,” Izzy said, tilting her head back to the painting. “You see that?”

“Is that yours?” Natalia said. “It’s so bright in here. It’s so pretty.” She sat on the bed and immediately melted onto her side. “I love it.”

“Get in,” Sara said, as Paige pulled down the covers and tucked her in. Natalia’s eyes fluttered shut.

Sara cut the light and left the girls in there, Izzy by the door, Paige on the shaggy rug she’d picked out, and Natalia, cradled on her side under the deep covers.

Downstairs, Cristina made Sara an omelet, which she at eagerly. Cristina joined her at the table. “Did she like it?”

“I think so, yeah.”

Cristina smoothed the lines around her mouth with her thumb. Her shoulders relaxed. “When does your cast come off?”

Sara laid her fork down on the empty plate.

“I think I’m supposed to go in next week.”

“Want a ride?”

“I’ll take a ride, sure.”

Cristina wore wine-red lacquer on her nails. She stacked the remaining plates, crushed a napkin and dropped it on top.

Her hands encompassed the mug Natalia had left undrunk. “You,” she said, “are the heart of this family, Sara.” She weighed the cup in her hands, leaning forward into the table. “You hold us all together.”

“No one person is the heart,” Sara said.

“No, it’s true,” Cristina said. “I know sometimes I say too much. But I hope you know deeply I feel that you’re my daughter.

“Oh,” Sara said. She blinked until the stinging in her eyes died down. “I don’t know what to say. You know, I’ve always thought of you as the glue that holds our family together.”

“Not anymore,” Cristina said, balancing the cup on top. “I was happy to be the middle of the family in my day. But now it’s your turn.”