19 December, 2015

“What floor?”

“Second,” I reply, my voice tight.

The paramedic does a 180, turning away from the stairwell, and marches towards the elevator, four fireman in tow. I reluctantly follow.

“It’s really slow,” I say, guiltily glancing at the heavy packs and resuscitation gear they are carrying. I stare at the floor, black heavy boots making the men seem larger than life.

We crowd into the elevator, the cables bowing under the weight. The paramedic makes a lewd joke and playfully hugs one of the burley firefighters. The change in tempo feels absurd.

Thirty minutes earlier, Lyra had woken up for the second time in as many hours — which in itself was not unusual, but this time, it felt different. In the ten months we’d known her, she’d shown herself to be a goofy and curious adventurer, and a happy night owl. Often awake during the night, but mostly good natured.

This was different.

The tone of the crying was sharper, and when she did take a break she was tense, twitchy, and scared. At first I wondered if it was a night terror, but when my usual strategies of rocking, bouncing, pacing, and singing, failed to calm her, I took her to see Tessa. Normally a visit with mama takes the edge off, but not this time.

We took her into the bathroom, thinking a shower might calm her down. In the bright light she looked grey, her lips dark purple, and the skin on her legs was mottled.

“OK, let’s take her to the hospital. Try to stay calm,” I said, grabbing my jeans.

“Should we call 9–1–1?”

I didn’t even respond. Something in the tone of her voice. I started dialing.

“9–1–1. What is your emergency?”

When I arrive back at our apartment, Tessa is standing in the bathroom. Lyra is looking over her shoulder, quiet now, and wide-eyed. The paramedic takes one look at Lyra, says something to his colleagues, grabs her, and says, “Let’s go!”

Tessa and I follow. The dog is locked in our bedroom, lights are left on, and I don’t grab a jacket or my wallet.

We clamber into the boxy SFFD ambulance. I sit on the gurney and hold Lyra; Tessa sits behind us. The paramedic straddles my legs and hooks her up to a monitor, handing me the oxygen cannula to hold near her face. He radios ahead to UCSF Children’s Hospital — luckily only a mile drive away — reading off the vitals: high heart rate, fast respiration, low blood oxygen, cyanotic.

The ride feels painfully slow and bumpy. We’d done the same journey 10 months earlier, with Tessa leaning over the backseat of our Subaru, almost in the trunk, heavily in labor. That had been in daylight; this was dead of night.

The urgency tastes different.

We are wheeled into the emergency room. Lyra is taken from me. I struggle to dismount from the gurney as the ambulance driver tries to collapse it. I eventually lurch off the end, just about managing to keep my feet under me.

Half a dozen people surround the table, Lyra’s tiny body in the center, naked except for a diaper. Tessa is bent over Lyra, whispering in her ear, telling her that she’ll be OK and that all the people are here to make her feel better. She already has oxygen tubes stuck to her face and new monitor pads on her chest. Two nurses are starting to look for veins, hunting with bright lights. A tall, thin doctor stands at the head of the table, observing. He’s wearing mottled cow-skin scrubs.

I stand behind Tessa, one hand on her shoulder. All I can do is watch.

Lyra is screaming and her wide eyes lock on to mine, unblinking. I feel a tightness in my chest and warmth in my temples. When she moves her eyes back to her mum I swallow the feeling and wonder if it would be inappropriate to take photos. This is my coping strategy, to distance myself through a lens. I realize that diagnosing my detachment is in itself a way of detaching. I take a breath and silently promise Lyra to be present.

Time inches by.

The nurses are having problems finding a vein. They try with lights on and off, apply heat packs, and use an infrared vein scanner that belongs in a sci-fi film. After poking and probing they eventually manage to insert a cannula. They splint and wrap her arm. They start drawing blood. They’re taking so much, two full vials already, but the blood isn’t flowing readily. One nurse is massaging — almost squeezing — Lyra’s arm while the other sucks with a syringe. They take a urine sample, but not much comes out. It’s bright and cloudy.

Her heart rate is still high, but her color has returned. The cow-garbed doctor nods at two respiratory specialists waiting in the wings and tells them they won’t be needed.

She’s getting fluids through the IV, and now that people are messing with her less, she’s crying less. She mostly seems frustrated, pulling at her oxygen tubes and wanting to sit up.

The cow-doctor is standing at the foot of the bed now, still observing, always on the edge of the action. I walk over to him and ask him what he thinks it is.

“If I had to make a bet: a UTI, bacteriosis, possibly a febrile seizure as her temperature spiked. Maybe that affected her breathing, leading to the cyanosis. We’ll know more when the labs come back.”

We’re in an exam room, Lyra happily pulling tissues out of a box while hooked up to a megadose of IV antibiotics. The latest diagnosis is a bacterial urinary tract infection, including kidneys, that spread to her blood. Long, scary words: Pyelonephritis, Bacteremia, and Vasomotor Cyanosis.

As I watch her I’m left amazed at how resilient yet fragile the human body is, at how an otherwise healthy body can deteriorate so quickly.

It dawns on me that that the marvel of modern medicine isn’t just for the weak and the sickly. That otherwise healthy people can be hit by a bad dice roll, and we’re still lucky. Even in the US access to medical care isn’t guaranteed, here the infant mortality is way higher than it should be.

After the initial discharge, we had one more scare, which led to an overnight stay at UCSF, but Lyra bounced back quickly. We left the hospital thankful for the amazing emergency workers and hospital staff, but sad for the kids and families who would be spending Christmas there.