positive. Biting back a scream of frustration, she looked back at Scarlett, wanting someone to answer her.
‘They’re waiting for the results of the blood tests,’ Scarlett told her.
‘I thought they’d diagnosed meningitis?’
Scarlett nodded. ‘They’re treating her for septicaemia and bacterial meningitis but they haven’t identified the strain yet.’
Ruby knew that bacterial meningitis was more serious than the viral form and she also knew that the prognosis varied widely between the different strains of bacteria and between different people. What she didn’t understand was how Rose could have caught the disease.
‘How did this happen? How did Rose get sick?’ As she asked yet another question she wondered if they should be talking in front of Rose. She believed that coma patients could hear conversations going on around them but she figured Rose had probably heard everything else that had been discussed so far this morning.
‘No one can really say,’ Jake answered, ‘but the most likely scenario is that Rose picked it up at work in the after-school care facility. The bacteria can’t live outside the body for long so people need to be in close contact.’
Rose was studying to be a primary school teacher and her practical work plus her part-time job in an after-school care facility would give her plenty of exposure to all manner of bugs.
‘But it’s also reasonably common in young adults aged between fifteen and twenty-four so it’s almost impossible to tell where she came into contact with it.’ Jake shrugged.
Rose was twenty-one, six years younger than Ruby, and her age put her right inside the high-risk age bracket.
Ruby glanced at Scarlett as a realisation hit her. ‘Is it safe for you to be in here?’ she asked. Scarlett’s pregnancy was definitely showing but Ruby couldn’t remember enough about the disease to know if Scarlett was putting herself or her baby at risk.
Scarlett nodded in reply. ‘I’m fine. It’s passed through sneezing and coughing via droplets in the air.’ They both looked at Rose. Attached to the ventilator, she wasn’t doing either of those things.
‘Has anyone else from the school fallen ill?’
‘We haven’t been told but anyone she had contact with at school will be given antibiotics as a precaution, but there are other possibilities that complicate things further in terms of treating other people but don’t really affect Rose’s treatment. What the doctors need to do now is identify the strain of bacterium.’
‘Rose was out at a lunch for a friend’s birthday yesterday. She came home early and said she wasn’t feeling well and went straight to bed.’ Lucy added to Jake’s tale. ‘We assume she was already infected when she went to lunch but because there can be such a short period of time between becoming infected and presenting with symptoms it’s adding to the confusion. When she came home she had a temperature and a headache but it didn’t seem anything out of the ordinary. She didn’t complain about a stiff or sore neck or a rash. I didn’t see any of the red flags for meningitis so I just assumed it was a flu virus.’
Lucy was also a nurse but she worked in aged care, and meningitis wasn’t something she saw much of.
‘She got up to go to the bathroom around midnight and I heard her collapse. When I reached her she was having trouble breathing and that’s when I noticed the rash. I rang the ambulance and even though they arrived quickly, by the time we got to the hospital she had gone downhill rapidly. She was in cardiac failure, her blood pressure was too low to register and she had no pulse. The rash on her body was spreading before my eyes. I just wish I’d suspected something more sinister than flu to begin with.’
‘I’m not sure that anyone would have, Lucy. You know how variable the signs and symptoms can be and how often they’re missed.’
Jake’s words were meant to be reassuring but Ruby doubted anything would ease her mother’s conscience. Not yet. Not until they knew Rose’s prognosis and maybe not even then. But Ruby was grateful to Jake for being there to support them all. She knew Scarlett and Lucy would be struggling with the situation as much as she was and it wasn’t fair to expect Scarlett to support them all. They couldn’t expect Scarlett to have enough strength for all of them. Not always.
Ruby was pleased that Scarlett now had Jake to take care of her. No one was looking to lean on Ruby but neither was anyone offering a shoulder to support her. She had always rebuffed offers of help or support so she supposed no one thought she might need some now.
Before she could follow that train of thought any further they were interrupted by one of the ICU nurses and a trio of doctors.
‘The doctors want to do a lumbar puncture,’ the nurse explained.
Four pairs of eyes swivelled to the doctors.
‘Now?’ Lucy asked.
The doctors were nodding. Ruby wondered who they all were and what they did, but no one seemed to think it was important to introduce her.
‘We really need to identify the bacterium responsible for the infection as the outcomes can be vastly different.’ The doctor who spoke looked easily the more senior of the three. Balding and carrying some extra weight, Ruby assumed he was the specialist. ‘There are increased mortality rates and poorer outcomes with the pneumococcal strain compared to meningococcal. It’s fatal in about ten per cent of cases and one in seven will suffer a permanent disability.’
Ruby had heard enough now. She wished he’d stop talking.
‘We don’t know yet whether there’s any permanent damage to her heart and some of her other major organs are showing signs of stress. We’re hoping to minimise the damage to her vital organs and her extremities but we need to make a proper diagnosis in order to implement the right treatment.’
Ruby was feeling sick. She didn’t want to think about the consequences of Rose’s illness. She didn’t want to think about what else could go wrong. She wanted to believe that Rose would get better and that everything would go back to normal.
So much for being positive and grown up.
‘The next thirty-six to forty-eight hours are critical.’
And Ruby knew immediately what the doctor meant.
Rose had to get through the next two days if she was going to have any chance of surviving.
EVERYONE ELSE HEARD the unspoken words too and Ruby watched as Scarlett turned to Jake.
It seemed she was right, Scarlett couldn’t be expected to support them all. This was one time when she needed someone to support her. Lucy wouldn’t be able to lean on Scarlett, she had enough to deal with. Ruby might need to be the one to offer her mother comfort now.
As the medical team began to set up for the lumbar puncture Ruby found herself, along with the rest of her family, being ushered out of Rose’s cubicle.
The ICU had suddenly become a hive of activity and Ruby had to stop and wait as another patient was wheeled in and she was separated from the others
