His breathing came in short gasps, and Duncan could hear crackles in his lungs, even without a stethoscope.
Rebel sat on the other side of Rafael, and she placed his hand in her lap, her fingers on his pulse. “He’s clammy, tachycardic, and I can hear fluid in his lungs.”
Her demeanor snapped him out of grandson mode and into doctor mode. “Where’s Jake? I need that kit.”
Lupe dashed to the door. “Here he comes now.” She pulled the door open as the young man ran through.
“Here it is.” What he set down looked to Rebel like a giant black fishing-tackle box with a red cross painted on it.
Duncan flipped the double clamps on it and opened it to reveal a stash of medications and equipment equal to any ER crash cart she’d ever seen.
“I’m going to call my mother and let her know,” Jake said.
“Dear God…not…your mother,” Rafael gasped.
“Just go for now,” Duncan said, and Jake hurried from the room but lingered in the doorway, his eyes wide.
Duncan extracted a stethoscope from the box, and Rebel fished out a pulse oximeter, a small monitor that fit on a finger to check the oxygen level and whether a patient’s condition required supplemental oxygen.
“Sat’s seventy-two—way too low.” That meant his lungs were full of fluid and oxygen wasn’t getting into his bloodstream the way it was supposed to.
“Get an IV in him. There’s a butterfly setup on the left side.” Quickly, Rebel got an IV access in the back of his right hand.
“Got it.”
As she dug into the kit for the proper equipment to administer the medication, she noted that the room had started to fill with people. Lots and lots of people. Migrant workers, whose lives and livelihoods depended on this man, showed up and stood at the threshold of the room. Others stood inside the door. All were grim-faced and staring.
Rebel began to feel uncomfortable with so many strangers staring at her. Fumbling with the packing of the IV insertion supplies, she dropped it twice before being able to open it properly. What was wrong with her? She was a skilled nurse, and she could perform an IV setup in her sleep. So why now were her hands trembling like she was a new nurse fresh out of school?
That little voice in a dark place in her heart told her she knew why. It told her she was beginning to get sick. Just like her family had. Just like she’d known she would.
“Do you think someone could make coffee?” she asked Duncan.
His gaze flashed to her, and he frowned. “Seriously? You need coffee now?”
She wanted to whack him one for his lack of insight, but she refrained. Given the circumstances with his distress over this grandfather’s sudden illness, she had to cut him a break. He wasn’t thinking as clearly as he normally would if he were in the ER with control of the situation. “N-o-o-o. It will give them something to do and ease the tension in the room, which is about to strangle me. We also need oxygen. Is there any sort of oxygen machine we could hook him up to?” It would give her a little space to control her own racing thoughts and steady her hands again before she put in the IV.
Duncan closed his eyes for a second as he realized her suggestion was brilliant. “Sorry. You’re right.” He’d been too focused to see a solution to the congestion in the house. Turning slightly, he spoke to Lupe in Spanish, and then to the people gathered in the room.
Lupe clapped her hands like a drill sergeant and shooed everyone out. One man stepped forward. “I get the oxygen.” He raced from the room, plowing through the rest of the crowd now that he had a mission to accomplish.
The atmosphere eased as people filed out, each offering a quick sign of the cross for Rafael’s recovery. Rebel could take a deep breath for the first time since she’d sat down.
“I’ll take your blood pressure, too.” She applied the cuff to his left arm and performed the short procedure. “One-eighty over eighty-five.”
“Give him a diuretic.”
“How much?” Rebel was already reaching for the vial. The tremor in her hands was less visible, but she still felt it on the inside, down in her gut.
“Twenty now, twenty more in thirty minutes if he doesn’t respond.”
Rebel dropped the vial in her lap, cursed quietly as she wiped the perspiration from her palms and picked it up in a tight grip.
“Don’t worry, Rebel. It’s an unexpected situation, but don’t worry. Take a breath, and we’ll get through this together.” Duncan gave a glance at his grandfather, who had not opened his eyes. “We’ll all get through it.”
Finally, she drew up the prescribed dosage in a syringe and administered it through the IV, grateful Duncan was putting the shaking of her hands down to nerves. He couldn’t know what she knew. Someday, she knew she was going to get sick, but it was like a time bomb, waiting to go off. Distraction and focus on the task at hand was the way out of her mental chaos.
“This will ease your breathing by pulling the fluid from your lungs, but it’s going to make you pee like a racehorse.” She gave him the information she’d give to any patient.
“If you…say…so.”
“I do.” She patted his knee, knowing he needed comfort, even if it was the last thing he’d ask for.
She glanced at Duncan. His gaze was glued to Rafael’s chest. She wanted to comfort him, too. This was what she did, what she was good at, and she shoved aside her own tremors to give them her best.
Leaning over, she placed a hand on Duncan’s arm until he looked at her. “He’s going to be okay.”
After placing a hand over hers, he gave a terse nod. Not that he didn’t believe her, but as a physician he knew too much. People who knew too much worried even more. They knew what could happen, knew the worst-case scenario, and always went there mentally. Plan for the worst, hope for the best, was her motto. Personally and professionally. She’d had her will made out for ten years now and had purchased life insurance with a long-term care rider for when she became ill. She just hadn’t expected it to be now.
A shiver made her twitch and their dash into the rain was starting to reveal its unforeseen consequences. Though the room should have been warm, she felt chilled. The effect of adrenaline only lasted so long and the kick she’d gotten was fading.
Duncan’s phone rang. “It’s Juanita. One of my sisters,” he added for Rebel’s benefit.
Rafael clucked his tongue, just as one of the men returned with a very dusty oxygen tank. If it worked, who cared what it looked like? Duncan stood and answered the phone, leaving them to the task of getting the oxygen hooked up.
After pulling a tubing package from Duncan’s kit, Rebel placed it on Rafael’s nose and turned on the tank. “Now take some deep breaths. Slow and steady.”
Amazingly, Rafael did what she said and slowed his breathing, though she knew it was very difficult.
