Dr. Lodi, a sharp-eyed woman with a sparkling diamond chip in her nose, shooed the nurse out of the examination room and proceeded to take all my vitals and prick my finger herself. I rattled off my history as she jotted on a chart. She left, returning after twenty long minutes.
“Your hemoglobin and hematocrit are low,” she announced. “Which would indicate anemia. This is not that uncommon for young women. Usually you can be treated with iron supplements. I’ll need to do some follow-up tests to check your iron and ferritin levels. While the dizziness and fainting can be associated with anemia, the tingling and numbness in your extremities—the neuropathy—is not usually connected. Have you ever fainted before?”
“Not that I can remember. Although stress does make the tingling worse.”
“Were you under particular stress last night?”
I hesitated. “My mother called.”
“Ah. Any other symptoms besides fainting, after the call? Any general symptoms you’ve noticed lately?”
“I feel tired, I guess. I don’t sleep great, but I never have. And I have headaches sometimes. A lot.”
She looked down at her notes. “You said you first noticed the tingling when you hurt your ankle skiing? But you never went to see a doctor?”
“No. I wrapped up my ankle and figured it would work itself out.”
“All right. Lie back, please.”
She did the routine full-body poking and prodding, then patted my arm and picked up my file. “Hang here with me for a little longer?”
I nodded, and she stepped out. When she returned, she had a strange look on her face.
“So your blood smear is showing something that concerns me. Some cell abnormalities. Have you noticed any changes in your nails lately?”
“Not really. What is it?”
“Something that’s been on my radar recently. Let me look at them.”
I held out my hands.
“Okay,” she said. “Can you open your mouth for me?”
She pulled down my lower lip, then, after a moment, stepped back and spoke.
“Truthfully, Meg, I think the anemia is a symptom of a larger problem. You have white spots, sometimes called Mees’ lines, on your nails and a bluish discoloration in a line along your gum. These findings, along with the tingling, the fainting, and general fatigue, lead me to believe that you may have lead poisoning. Of course, this would have to be confirmed with further blood tests.”
I was dumbfounded. “I can’t believe this.”
“Lead can absolutely affect your body on a cellular and molecular level, months, even years, after exposure. In the brain, for instance, it can block certain channels, interfere with neurotransmitters and synapses as well as protein kinases, which would cause fatigue. The peripheral neuropathy, or the tingling and numbness you feel in your extremities, is caused by this effect on your peripheral nerves. We’ll need to do a heavy-metal screen to confirm it, of course.”
I felt short of breath.
“I’d like to talk about any exposure you’ve had to lead in the past few years. I’m wondering, in particular, if you were exposed to lead-based paint or dust on that ski trip. Were you staying in an older resort, one built before 1978?”
“I think so, yes. And they were remodeling. Not our floor but some of the others.”
She put my file aside. “I would like to admit you into the hospital for the night. I know it may sound extreme, but given your symptoms, I’m suspicious that your blood-lead level will not only be elevated, but will be in the acute range, which requires urgent treatment. Also, in the hospital, I can get results from your heavy-metal levels quickly and simultaneously begin chelation therapy.”
“What’s that?”
“It’s an IV infusion of EDTA with dimercaprol. These agents have a clawlike effect on lead, grabbing and binding it so that it can be excreted through the kidneys. Initially you will probably receive several infusions in a week, then we can retest your levels and be able to adjust the schedule. Once we determine that you have no problems with sensitivity to the medication, these infusions could be given at home with a visiting infusion service.”
The medical jargon was whizzing right past me. But it sounded good, and Doro had sworn by Dr. Lodi’s skill, so I nodded like I understood it all.
“Koa is actually qualified to handle the treatments. We’ll check your other levels too, tonight, but I’ll probably recommend dietary changes as well, to ensure you’re getting plenty of calories, as well as iron, zinc, calcium, vitamins C and E.”
I must’ve looked like death, because she patted my knee comfortingly.
“The most important thing is you’re no longer being exposed to the source. The effects of lead poisoning can sometimes be ameliorated, but in light of the movement of lead in the body, whether it’s gotten into the bone, it could take up to a year.”
I sighed, feeling the weariness from the past couple of days wash over me. And I had thought Frances was the biggest poison in my life. What irony.
“Megan?”
I snapped to attention. Dr. Lodi was studying me.
“Okay,” I said. “Hospital. Let’s do it.”
The St. Marys hospital was less than a five-minute taxi drive away—a quaint little brick building nestled in a grove of palmettos on the far side of town. It reminded me of an old-fashioned schoolhouse.
“You don’t have to stay,” I said to Doro, on my way to the bathroom to change into the flimsy gown the nurse had given me.
“I want to. Any special requests?” she asked. “I’m going on a snack run.”
Something about the way she said it, the motherly way she assumed she would take care of me, and I would let her, touched me. I didn’t move, letting the unfamiliar prickle of pleasure wash over me.
“No, I’m fine.”
“Nothing?”
I shook my head, and she gave me a little pat.
“See you soon.”
A nurse and tech came to draw blood and to insert the IV for the chelation, and when Doro got back I was channel-surfing from my bed. She had an armful of plastic bags, and, after asking if the coast was clear and closing the door, she emptied them on my bed. I surveyed the stash with wide eyes. There was a stack of magazines; a rainbow of candy bars, chips, and nuts; and enough mini-bottles of bourbon to get the entire hospital staff hammered. It looked like a ten-year-old had robbed a combo five-and-dime/liquor store.
“Wow,” I said.
“For me, not you. Oh, also, I picked up these.” She fished out two shot glasses emblazoned with a picture of Ambletern. “Official collectors’ shot glasses of Bonny Island. They sell these gems all over St. Marys.”
She poured a shot for her and filled mine with water.
“To answers,” she said.
“Answers.” I clinked my glass against hers and threw back the lukewarm water. I fell back on the sad excuse for a pillow and heaved a sigh.