“Shit.” I leave the front desk, and I run to the closest supply closet, grabbing a set of scrubs. No one says anything further about me not being on shift. I shouldn’t be treating anyone right now. I’m not allowed to storm into the hospital, get changed, and then start messing with patients; that’s not how the system works. Chief Allison isn’t in the building, though, and I must look frantic and harried because the nursing staff and other doctors keep any objections they might have to themselves.
The ambo still hasn’t arrived by the time I’ve changed and gone outside to wait for Millie. Damn it, this is taking too long. Zeth appears by my side. “Michael’s still looking,” he says. The crash team waiting on the ambulance cut wary sideways glances at the huge, tattooed guy now waiting with us. I forget how imposing he must look to people when he first meets them.
“Okay. Fuck, I hope he gets here soon. She’s going to need him.”
“She’s got you,” he says. “That’s more than enough.”
Lights and sirens, then. An ambulance screeching into the car park, hurtling towards us at seventy miles an hour. The driver slams on the brakes just in time, bringing the vehicle to an abrupt stop less than a meter from the hospital entrance. Chaos ensues.
The EMTs jump from the van, shouting out Millie’s stats. Her tiny body is transported out of the ambulance and rushed inside. I run with the crash team, taking in everything the EMT is shouting: erratic pulse. Pupils fixed and dilated. At least seventeen minutes of continuous convulsions in the field. Famipentol administered, to no effect. Maximum dosage limit reached.
The famipentol should have knocked the seizure on the head. Millie should be awake by now. We can’t give her any more. If we do, not only could it cause severe damage to her internal organs, but it could also send her into coronary failure as well. It can’t be risked.
“Push sodium valproate. Someone page neuro, tell them what’s going on. We need a consult right away.” An intern, one I don’t recognize, takes off down the hall, sneakers squeaking on the linoleum as he skids and disappears around a corner, on the hunt for a phone.
We take Millie into a procedure room. Standard protocol is observed. Millie’s hooked up to a heart monitor. Her levels are recorded. I have a nurse push clobazam, but that doesn’t seem to have any effect, either. Millie remains on her back on the gurney, the heels of her feet hammering against the padding and the sheet, head tipped back, jaw locked, eyes rolled up into the back of her head. She’s in trouble. Big, big trouble. God, she looks so tiny and helpless as the seizure continues to contort her fragile little body. This episode has already lasted too long. Wanda called me forty minutes ago at least, and for a six-year-old to be seizing like this for such a long time? I don’t want to think about what it means. I can’t even think about it, because if I do I’ll have to admit the truth: that I know all hope is lost.
Dr. Mike Margate, head of neurology, shows up almost immediately. He assesses Millie, his movements confident, however the look on his face is far from it. “Left pupil’s blown now,” he says. “Could be an early sign of brain herniation. We’re not going to know what’s going on in there until we give her a scan, but we can’t keep her still for that.”
Dr. Hamid, a new member of the intern’s program, looks wrecked by this news. “What about sedation? Can’t we knock her out?” he asks.
Margate sends a glance my way. “Dr. Romera? Care to explain to Dr. Hamid why sedation is a bad idea in this case?”
“She’s already had everything we can give her. Her system’s flooded. If we sedate her, it’s going to be too much for her body to take. Her respiratory system will fail.”
“Exactly.” Margate runs a small wooden paddle up the sole of Millie’s right foot, waiting to see if her body responds in anyway. It’s difficult to tell if there’s any natural reaction, since her body is still shaking so violently. He frowns then, bending down, peering closely at the side of Millie’s ankle. “When did this show up?” he asks. “Does she have any other marks on her body?”
It takes me a second to see what he’s pointing to: a tiny red mark on the inside of her leg, just above her ankle. It looks like a rash, though the mark appears to be on its own. Hands are on Millie, then. Four people quickly cut her pajamas from her body, leaving scraps of the Power Puff Girls printed fabric scattered on the floor. Everyone pores over Millie’s tiny frame, scanning for more red marks.
I see one low on her ribcage, again all by itself. “There. Shit.”
An intern raises his hand, a wary look on his face. “Does this mean…does this mean bacterial meningitis?”
Margate shakes his head. “Not bacterial. Check her charts. Is she on Lamictal?”
I already know that she is. “Yes,” I answer. “For sixteen months.”