logged into the system, relieved her brand-new passwords worked without a hitch, and quickly entered Mark Kennedy’s name to access his current medical record information. He was a fourteen-year-old who’d just entered his freshman year at a boarding school. He’d been brought in for nausea, vomiting, severe headache and stiff neck, complaints he’d had for the past two to three days.
Bacterial meningitis? Or the less severe viral meningitis? She hoped the poor kid had the less serious type but was afraid it was more likely he had bacterial meningitis, given his history of being a freshman in boarding school. They needed a lumbar puncture to make a definitive diagnosis. Had one been done? She scrolled down to read the notes, seeing there was a notation about the LP being performed. The name of the ED attending physician, Dr. Gabriel Martin, registered just as a deep male voice behind her said her name.
“Holly?”
Her heart leaped at the familiar sound of Gabe’s voice. She had to brace herself before turning to face him, knowing the smile on her lips couldn’t possibly be reflected in her eyes. “Hello, Gabe. How are you?”
The shock on his face didn’t make her feel any better. “You’re back?”
“Yes. I moved home a few weeks ago. My mother has some kidney failure as a result of her diabetes.”
“I’m sorry to hear that.”
They stared at each other for a long moment, the awkwardness painful. Hard to believe they had once been friends. A friendship she’d helped to ruin, long before Gabe had walked out as the best man on her wedding day.
“It’s good to see you.” His statement was polite but the reserved apprehension on his face said just the opposite. “Welcome home.”
“Thanks.” She hadn’t been prepared to see Gabe again, assuming he’d moved on with his life and his career. Since he was still here at the Children’s Medical Center, his career obviously hadn’t changed. On a personal level, though, she suspected they were both very different from the carefree residents they had once been. She swallowed hard and looked over toward the isolation room. “Is Mark Kennedy your patient?”
“Yes.” Gabe appeared grateful to get things back on a professional note. “He’s a fourteen-year-old boy who just moved into a boarding school dormitory six weeks ago. His symptoms are pointing to bacterial meningitis.”
She nodded. “I agree, although we need to isolate whether the source is Neisseria or Streptococcus. I’m leaning toward the latter, since it’s often the cause of dormitory-related infections. Do you have the results of his lumbar puncture yet?”
“No.” Gabe glanced at the computer terminal, which still displayed Mark’s information on the screen. “When I reviewed his history and examined him, I requested he be placed in isolation. Several of the nurses may have been exposed, though. If he does have bacterial meningitis, they’ll need prophylactic treatment.”
“Of course. You’ll need treatment, too.” She turned toward the isolation cart, opened a drawer and pulled out a face mask, gown and gloves. “Have you started him on antibiotics yet?”
“No. I thought I’d wait for your recommendation first. Especially as I don’t know the type of bacterial infection we’re fighting.”
“Start him on broad-spectrum antibiotics,” Holly advised, trying not to notice Gabe hadn’t changed much. Tall, with dark brown hair, bright blue eyes and broad shoulders, he had a rugged attractiveness that she’d always been drawn to. Maybe there were a few more wrinkles around his eyes, but otherwise he looked good. Too good. Distracted, she focused on the situation at hand. “Mark has already had symptoms for almost three days. I’m worried he’s going to take a turn for the worse if we don’t get a jump on this.”
Gabe nodded, agreeing with her recommendations. “I’ll get the antibiotics ordered right away.”
“Great.” Once all her protective gear was in place, Holly stepped into the patient’s room, leaving Gabe to enter the antibiotic order in the computer.
“Hi, Mark. Mrs. Kennedy.” She felt bad for the patient and his family, and could empathize with how it must feel to end up with an infectious disease. “My name is Dr. Holly Davidson. I’m the infectious disease specialist here.”
“Yes, Dr. Martin told me he was calling in a specialist.” Mark’s mom looked upset, her eyes red as if she’d been crying. “Is my son going to be all right?”
“I hope so. We’re going to start treating him immediately.” She approached the bed, shifting her attention to the patient. Gently, she placed a hand on his arm. “Mark? Can you hear me?”
The boy was very lethargic as he opened his eyes and slowly turned his head toward her. “Yeah,” he whispered.
Her stomach clenched. The poor boy was much worse than she’d originally thought. There was no indication in the record that he was this out of it, so maybe his neuro status had only just started to deteriorate. “Mark, we’re going to need to start an IV in your arm to give you antibiotics.” As she spoke, his eyes slid closed and he didn’t respond. She hid a flash of panic. “Mark? Are you all right?”
“Yeah.” He answered without opening his eyes.
She felt for his pulse, reassured herself that it was beating steadily beneath her fingers. She turned toward his mother. “Mrs. Kennedy, Mark seems to be getting worse. I’m worried the infection is affecting his brain.”
Mrs. Kennedy’s eyes widened in alarm. “What does that mean?”
“Just that the sooner we can start the antibiotics, the better.” As she finished speaking, a nurse came into the room carrying IV supplies. As she finished her exam, the nurse prepared to place the IV catheter into the antecubital vein in Mark’s arm.
“Mrs. Kennedy, I’m worried about you and your family. If this is a bacterial infection, as we suspect, it’s highly contagious. You’ll need to wear a face mask to help protect yourself from getting sick.”
The woman paled. “Contagious? What about the rest of my family?”
“I’m afraid they may need treatment, too.” Holly made her tone as reassuring as possible. “The good news is we can treat all of you so you won’t get sick. How many siblings does Mark have?”
“Two younger sisters. They’re only five and seven, children from my second marriage.”
“All right, we’ll make sure everyone gets the medication they need. And we’ll probably need to tell the school too. His roommates may also need antibiotics.”
The nurse placed the IV in Mark’s left arm, the boy barely flinching as she slid the needle into his vein. Once the IV was running, Holly hurried out and grabbed more protective gear for Mark’s mother, helping her to put the items on.
The mask was the most important piece, and Holly reiterated the need to keep the face mask on at all times.
Gabe walked into the room, carrying the mini-bag of IV antibiotics. The nurse took the bag from his hands and hung it on the IV pole, reprogramming the pump accordingly.
“Please, take a look at him. I think his mental status is much worse,” she said in a low tone.
Gabe
