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Meeting at the ER

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The ringing phone woke John from a dead sleep. He blindly reached toward the noise and squinted at the relatively bright light to answer.

"...'lo?" he grunted.

"Dr. John! Dr. John! Mareilla's sick and we're in an ambulance going to the hospital!"

It was Bertille Lopez -- known to all as Tilly, Mariella's mother. John was instantly awake.

"What's wrong?" he asked calmly.

"She has this awful fever, the EMT said it's 103.5, and she has these lumps... she's had a sore throat and can't swallow anything," she said frantically.

"What did the EMT say?" John asked, grabbing for some clothes.

"With her condition and the fever, that she needs to go to the hospital," Tilly replied.

"Which hospital?" John asked patiently.

"Good Hope, on the East side," Tilly said.

"She'll be on good hands there," John soothed. "I'll be there as soon as I can. Okay?"

"Dr. John, she's so sick, I can't lose her," Tilly whispered.

"You take a deep breath and let the doctors help her," John said firmly. "You need to be strong again for her. Can you do that? Take that deep breath for me."

John heard Tilly take a breath, hold it for a count of five and then let it out in a long, drawn out huff.

"Better?" John asked.

"A little," she admitted.

In the background, John heard the paramedics talking that they were at the hospital.

"Okay, I should be there in about twenty minutes," John promised. "Can you hang on that long?"

"Yes," Tilly replied.

"Call me if you need anything," John said. "But you know the drill. They need to admit her and ask all the questions. Do what you can to help Mari."

"Okay," she said.

"See you shortly," John said.

He grabbed some clothes and went into the bathroom. He splashed some water on his face to help him wake up. He grabbed his phone, wallet, and keys and then detoured back to the kitchen for a bottle of water and a diet cola. He'd need the caffeine eventually and there wasn't time for coffee.

The only good news was that in the middle of the night, visitor parking was mostly empty and he got a decent space near the main entrance to the hospital. He knew it would be easier to park here than to take a space near the ER entrance.

John showed his Department of Social Services ID to the guard.

"Meeting a client," he explained.

The guard took a brief look and handed John a visitor's badge. "Know where to go?" he asked.

"Going to ER," John said.

"Go down this corridor to the end, take the elevator down one floor and there's signs," he directed.

"Got it, thanks!" John waved.

John showed his ID to the nurse at the intake desk. Not too many people waiting -- hopefully that meant the ER wasn't too busy. "I have a client who's mother is expecting me," John said. "Mariella Lopez. She came in by ambulance and is probably still getting checked in."

The nurse poked at her computer. "She's not in the system yet," she said.

"The mom came in with the ambulance," John said patiently. "They were unloading when I talked to the mom, so I know they're here. If they aren't, I'll come right back out."

The nurse eyed him tiredly. "I'm supposed to wait until the patient is in the system."

"And I'm going to go back there and help mom answer all the questions so we can get Mari into the system," John replied. "Call for someone to go in with me, if you want."

"I'll go with you," she decided. She looked over to the security guard. "Taking this one back to meet his clients. Be right back."

"Okay," the guard nodded.

The nurse took her security badge and opened the door to the ER. "Ambulance entrance is this way," she pointed.

They got half-way across the room when Tilly came flying up and wrapped her arms around John.

"Dr. John, I'm so scared," Tilly said. "Mari is so sick and I didn't know what to do!"

John hugged her briefly and then disentangled them. "Where's Mari?"

"She's back here!" Tilly went to the back of the ER. John looked back and the nurse from the triage area was gone, assumedly back to her post.

Mari was still on the ambulance gurney, wrapped in blankets and looking wan. The eight-year-old was small for her age, a result of her four year battle with cancer. She looked even smaller than usual.

"Hey, kiddo, how are you?" John asked, taking a hand gently.

"Not good," she rasped. "Hurts."

"Okay, you wait there and we'll see about getting you into a room," John said.

She nodded and closed her eyes in misery.

Tilly stood next to John, vibrating energy and wanting to help but knowing there was nothing she could do for her child.

John dropped am arm over Tilly's shoulder. "Okay, now we wait. You should be used to that by now."

"I... I'm just so scared that it's come back," Tilly whispered, as if saying anything too loud would make it real.

"We don't know that," John soothed. "It could be anything. So we have to hold on. Okay?"

"Okay," Tilly said softly. But she leaned into John.

It was another twenty minutes before anyone approached them. "Sorry, it doesn't look busy but we've got like three MIs and someone with a bad reaction to a food allergy."

"It is what it is," John said calmly.

The admitting person, Minh -- according to the name tag, asked all the same questions they'd been through endless times with Mari's cancer treatments. Tilly had fortunately remembered to bring "the green file" that listed all of Mari's doctors, her drugs, and a summary of her treatments. John had helped Mari prepare that when he found her fumbling the answer to those questions early in their working relationship.

"Dr. John is on her HIPAA release form," Tilly pointed out. "So he can help me answer questions."

"Okay, then. We're going to move Mari to Exam room twenty-two," Minh said.

John and Tilly followed the EMTs and nurses to the room, and they gently moved Mari to the bed in the room. The EMTs waved good-bye as they left the room.

Tilly helped Mari change into the hospital gown that had been left for her. John stepped out of the room for a moment, to give Mari some sense of dignity.

John set the bed so Mari could lay back but also see her mother. He put a pillow behind Mari's head and made sure she was warm. ERs tended to be cool, so John automatically looked for some extra blankets.

The nurse took Mari's BP manually and then wrapped the automated system around Mari's arm.

"Okay, I'm Kalinda, and who are you?" she cheerfully asked.

"Mari," she whispered.

"Well, I can guess, but what brings you in tonight?" the nurse asked.

"Mari is a cancer survivor, but only in the last year," Tilly started. "She was doing fine but yesterday she complained about feeling achy. I gave her Tylenol and she went to bed early. She's been achy all day today, has a miserable sore throat, and she started running a temp about 100 at dinnertime. I called the doctor's service then, and they said if her temp went up at all to take her to the ER. Her temp went up to 102 and so I called an ambulance."

Kalinda looked at John. "Are you the father?"

John showed her his DSS ID. "Tilly and Mari are clients," John said. "I'm here to help and provide moral support. I'm on Mari's HIPAA paperwork already."

"Good," Kalinda nodded. "We're going to start with the usual suspects. We'll take blood samples first and start running them. I'm going to do a basic physical exam and then we'll get the doctor to come and look at you. Okay?"

Mari nodded.

"I'll bet you're a pro at this," Kalinda said as she got the equipment and vials she'd need. "I'll bet you're tired of blood draws, aren't you?"

Mari gave a wan grin and nodded again.

"Well, I think I'm pretty good at this, so I'm going to make this as painless as possible," Kalinda went on. "I have to leave a port in, in case we need to give you some meds. I'll bet you're tired of that, too!"

Mari rolled her eyes but John saw her grin.

Kalinda was good as her word, taking blood with minimal fuss.

"Open wide," Kalinda directed. Mari opened her mouth. "I'll bet that's sore!" she said. "Let me get a swab and send that down, too." She extracted a long swab from a drawer and took that sample.

John looked at Tilly, who seemed to be holding on. These were the same procedures they had seen before, which was good.

"And a temp while I'm here!" Kalinda put a thermometer in Mari's mouth and waited. "101, so that's not good," she commented.

"It was 102 earlier," Tilly offered.

"Good to know," Kalinda said, making a note in the chart.

"Well, we're at the 'wait' stage of 'hurry up and wait' part of this visit," Kalinda said. "Someone from radiology will be here to take a chest x-ray, just to make sure you have no problems. I can't hear anything, but the doc will want to double check. We need to get the results of the blood test and the doctor needs to see you."

Mari nodded.

"You can sleep, if you can," Kalinda said. "Mom and Dr. John can make themselves comfortable."

"You warm enough?" John asked. Mari nodded. He looked at Tilly. "Can mom get a blanket, if we're going to be here for a bit. It's cool in here."

"Sure! Not a problem!" Kalinda said. "Watch TV if you want."

John turned the TV on low, finding the Home Improvement network. Mari had her eyes closed and he knew that the shows would distract Tilly. Even for re-runs at 4 AM, it would give her something to focus on.

It was another hour before there was a tap on the door and a doctor walked in.

"At least it's not the news," the man said, glancing at the Property Brothers show.

John looked up into the bluest eyes he had ever seen. Even tired as the man was, there was a level of competence that radiated from him.

He went first to Mari. "Hey, little one, you need to wake up for me," he said softly. "I'm sorry, but I need to check you out."

Mari stirred and opened her eyes. She tried to talk, but nothing came out.

"That's okay," he said. "I'm Dr. Rodney, and I need to take a look at you. Okay?"

Mari nodded.

He looked over her BP and O2 readings on the monitor, and unwound his stethoscope. "Okay, I need to take a listen. Heart first." He loosened the top of the gown and listened to her heart. "And now the lungs, breathe in for me, count to three and then long exhale out." Mari did as directed. "Okay, I need you to sit up," Dr. Rodney directed. Tilly came to the side of the bed to help Mari sit up. "Breathe in and out again.... okay, one more time."

Tilly helped settle Mari back into the bed.

"Are you her mom?" Dr. Rodney asked.

"Tilly Lopez," she introduced herself.

"And you?" Dr. Rodney focused on John.

"Dr. John Sheppard, from DSS," John said. "Part of the Pegasus program. We support..."

"Single parents of children with cancer," Dr. Rodney finished. "It's a great program."

John was surprised. The doctors that worked with the program were familiar, but he hadn't run into anyone outside the program who knew anything about it.

"Dr. Rodney McKay," he introduced himself.

"Oh!" John said intelligently. "You..." founded that program. McKay was the leading pediatrician in the region and he had single-handedly raised half the funds needed to fund the program. Single parents didn't always have a support system to help them when their child had cancer, so the program paid for DSS workers like John to help with all the bureaucracy that goes with cancer treatment.

"Ix-nay on revealing secrets!" Rodney pointed a finger at John. "Or I'll tell on you!"

John was stunned. No one was supposed to know.

Mari giggled.

"Oh, looks like someone is feeling better!" Rodney said.

Mari shrugged.

"Okay, let me double check," Rodney said. He got a tongue depressor. "Open!" He peered into Mari's mouth. "Oh, yuch!" he winced. "That's gotta hurt!"

Mari nodded.

"Okay, one more thing," Rodney said. "I'm going to feel here, around your neck," he said. He gently palpitated the nodes around her neck.

"This one's simple," Rodney announced. "Bad case of strep throat," he said.

Tilly all but collapsed in relief next to John.

"Because your immune system is still faintly wonky from your cancer treatments, I'll order one round of IV antibiotics to give you a jump start, and a script to take more at home," he said. "Take them until they're gone," he looked at Tilly seriously.

She nodded. "Mari's good about taking her pills."

"Good to know," Rodney said. "Once she's finished with the drip, you can go home. No need to admit her."

"Oh, thank you!" Tilly sighed.

John knew there had been enough nights in hospitals that being able to go home was the best news.

"You'll be fine!" Rodney promised. He looked at John. "Dr. Sheppard? I supposedly get off at noon. Come back and take me to lunch."

"Uh... sure!" John stuttered.

"And you can leave the wild animal on your head behind," Rodney grinned.

John blushed as he ran a hand through his hair. "Hey! It's the middle of the night. You're lucky I have clothes on!"

Rodney leered. "That's an interesting image!"

"Gentlemen! Behave!" Tilly grumped.

John looked at Mari, who just grinned at him.

"Okay, let me get the orders in, so you can get out of here," Rodney said brusquely.

"Where should I meet you?" John asked.

"Text me when you're in the lot," Rodney said and rattled off a phone number.

John nodded.

Kalinda came back at that point, with a flurry of activity. It took another two hours before the IV was complete, the discharge papers were ready and Mari was finally ready to go.

"Okay, take her to the ER entrance," John directed. "By the time you get there, I'll pull my car around."

"We can take a taxi!" Tilly protested.

"Nah," John said. "If I take you home, we should be able to swing by the pharmacy for that script, and you'll have it right away. It's not a problem!"

"Thank you!" Tilly said.

It was 10 AM before John finally got home. He called into the office that he wouldn't be in today at all and set an alarm for 11:15 before dropping onto the bed. It wouldn't be enough but it would be better than nothing.

Only because he really wanted to meet up with Rodney, John fought to wake up when the alarm went off. A quick shower helped him wake up more and he pulled into the hospital parking lot at exactly noon. He shot a text off to Rodney to let him know he was here.

Fifteen minutes was the reply.

Damn. For that, he could have swung through a drive-through and gotten coffee. He had tepid water that he drank, only because it was there.

John saw Rodney coming across the lot and got out to wave so that the other man saw him. Rodney made his way to John's car.

"Figured you for something other than a mom-mobile," Rodney snarked.

"Carry clients around fairly regularly, need a back seat for that, and the rear space for wheelchairs and such," John said. He wasn't going to admit to the Camaro he had in storage, that he didn't drive as often as he'd like.

"Huh. Good point," Rodney admitted.

"Where do you want to go to lunch?" John asked. "Anywhere they have coffee is fine with me."

"How about Russell's?" Rodney asked.

"Sure," John agreed. It was a local, upscale steakhouse that also did lunches. John had been there for dinner several times.

"Mari make it home okay?" Rodney asked.

"Yeah, we were able to get her script and she's back in bed," John said. "Her mom's also feeling better about the whole thing."

"Good," Rodney replied.

"And, if I may ask, why is the city's leading pediatric oncologist doing an overnight rotation in a local ER?" John had to ask. "I would think you'd be, like, busy already or something."

John could see Rodney blush. "It's something I started doing years ago," he admitted. "Pediatric oncology has its own challenges, and sometimes it's nice to treat kids who are just sick from something I can help them with."

"Like Mari and her strep throat," John said.

"Exactly!" Rodney exclaimed. "And it's good for me to see relatively healthier kids, so I have a baseline for the really sick kids I see all the time."

"Do you do this often?" John asked as he pulled into the parking lot for the restaurant. He pulled up to the door for the valet parking.

"Once a month, and I rotate among the local hospitals," Rodney admitted. "Like you say, I do have a day job."

The young man took the keys and John discreetly handed him a ten dollar bill.

Following Rodney into the restaurant, John noted the broad shoulders and the enticing rear end. He put a firm lid on his libido, this was just lunch.

They were quickly whisked to a table by themselves in a small room.

"Not sure we need all this," John commented as he took a seat.

Rodney waved a hand. "I've worked with Russell for a number of years and I have a serious citrus allergy, so it's just easier for the staff to pay attention to if I'm in a private room."

John was about to ask when Rodney nodded. "Yes, I carry an epi pen, and I've made sure the staff here has training on using it," he admitted. "But I've never had to, which is fortunate."

"Good to know," John nodded.

"Everything is good," Rodney waved at the menu.

"Been here for dinner," John said. "It is a good place to eat."

"And Russell's been good to the community, so I've been glad to support his restaurant," Rodney said.

A waiter came in with water and a bread tray. He took their orders and left them alone.

"So. Now what?" John asked.

"For one thing, I wanted to meet you for a while," Rodney said. "You've lasted the longest in this Pegasus project and have had the largest number of clients. For that alone you should get a medal or something."

John shifted in his chair. "Just... don't really want anything special," he said. "It's a good project and I've been glad to help a lot of people with this."

"But you were there at the beginning and you've kept it going," Rodney said. "Some months, you've been the only person working on the project."

"It's not easy, although I don't have to tell you that," John admitted. "And, well, it gives DSS a way to work with me that's to their benefit and mine. I try to recruit some of the new hires into the program, at least for part of their case load. It's a good experience for some of them and lets them into social work with a good experience, instead of throwing them fully into routine cases that they can't always do anything about."

"You have a personal reason for doing this," Rodney said slowly.

John hesitated. He hadn't had anyone question this in years.

He nodded. "A cousin of mine. It was him and his mom, just the two of them. I was in high school at the time and since they were on my mother's side, and she had died a couple years before that, no one was looking out for them. My aunt did what she could, but between needing to work to have insurance and trying to take my cousin to doctors and for treatments... well, my cousin died and my aunt died shortly after. I now think the exhaustion, and the heartbreak, was the cause of her death. When I realized what happened, I decided that if I can help anyone, I would."

Rodney sat back and peered closely at John. "It's you, isn't it?" he asked softly. "You funded the other half of this project!"

"No one else has put that together, you know," John admitted. "And I'd appreciate if you didn't tell anyone. The lawyers handled the money thing, and will continue to do so."

"You're a Sheppard Industries Sheppard, aren't you?" Rodney asked in amazement.

John nodded. And was saved from having to say more when the waiter brought in their salads.

Rodney fussed with his salad for a moment before putting his fork down.

"I'll keep your secrets," Rodney promised solemnly. "You're doing amazing things here and I know there are kids who have survived their cancer because of the support system the project offers to them. I'd never risk losing that."

"Thank you," John whispered.

"Now," Rodney said, putting a fork to his salad, "is that hair thing you have going on real or do you do that on purpose?"

John laughed.

Maybe he could do this.