Comfort Zone

Chapter 2

The fifth floor ICU was arranged like a sun, with a large central nurses' station and small patient rooms jutting off it like beams. All the better for closer monitoring. A cheerful space, but there was no hiding its dark side: the sickest patients lay in its beds, only some of whom would ever leave.

Miriam greeted the nurses, checked the chart, washed her hands and approached the bed of her patient.

Though she tried not to play favorites, she adored Maria Velasquez, Ms. V, who huffed and puffed her way to every appointment with her oxygen canister in tow, who never missed the chance to thank her "doctora" and tell her stories of escaping Cuba, bad husbands and other malevolent forces.

At fifty she'd developed a lung disease called pulmonary fibrosis, which caused scarring and hardening of her lungs. On scans her lungs looked just like a honeycomb, but she'd defied the odds and outlived the doctors who'd warned her of imminent death. Though her condition had progressed slower than expected, even Miriam couldn't shield herself from the truth that the stiff honeycomb lungs were getting hard as week-old Cuban bread, as Ms. V said, and soon there'd be no more buttering them up. She'd been admitted every month or so for the past six months for a lung infection, and this was her worse one yet.

The lung specialist looked grim whenever Miriam consulted him, the heart specialist just shook her head ominously, and every other specialist had been hanging crepe for months, but Miriam was still looking for a miracle. She'd transferred Ms. V to the ICU that morning for more aggressive treatment.

Although she'd signed a DNR order, which forbade Miriam or anyone from pounding on her heart if it stopped beating, or pumping up her lungs if they took their last breath, Ms. V would accept the higher flow of oxygen and extra care the ICU offered. Some felt it was a waste of hospital resources to give a high level of care to a DNR patient, but Miriam didn't agree. How many times did she remind people that DNR did notmean Do Not Treat?

"How are you feeling, Ms. V?"

"A little better, doctora," Ms. V said. "Your magic cocktail seems to be working." Miriam was warmed by her patient's smile, though she could read the fatigue on her face.

She smiled back and gently helped her patient sit forward in order to listen to her crackly lungs. A few minutes later, stethoscope back in pocket, Miriam summed up the treatment plan to both patient and nurse and went back to the station to write her progress note, hacking through the electronic thicket almost cheerfully, picturing Ms. V in her office, the two of them laughing with satisfaction at another "robbed Mr. Death again" admission. Miriam looked forward to the whimsical way Ms. V would describe her ICU stay, and to the new Cuban recipe she'd likely bring her doctora.

"Antibiotic's not doing shit!" A loud voice behind her rudely shattered her fantasy. It wasn't about Ms. V of course, but Miriam startled nonetheless, turning around quickly to the two young doctors behind her. She noticed the nurses also looking up, annoyed, before she swiveled back to her computer screen to finish the note.

The voice went on, even louder. "Your patient's going down the tubes. Are you absolutely sure you put him on the right antibiotic?"

A quieter voice insisted he had reviewed the cultures carefully, but promised to recheck all the tests again. Miriam turned her attention away from the young doctors who were obviously just learning that patients didn't read textbooks. Sometimes they didn't get better when they should, and other times, fortunately, it was the other way around.

At any rate, Ms. V was the only patient she was following in the hospital, so Miriam was free to go home. No cooking tonight, she decided, and medical journals could wait for another day. Tonight it would be spicy Szechuan beef takeout and the juicy novel waiting for her right by her couch.