Complications Squared

"Assault"/huntemann                                                                                                                                             Page 394

Chapter Six
Scene [3]

Complications Squared

New England Medical Center, Boston, MA
1998/11/23 20:00 Monday [Don]
         I went to NEMC after work to check on Kimee. Her new resident is Stephanie, and her current nurse is Gayle. They had been relaxing the gowns and masks protocol for the last few visits, but this time Gayle said, “Full suit-up required. She has been moved to isolation booth number 10 to fight a difficult to treat infection and we have to be more strict.”

         Oh, no. More complications? I said, “Is it something we brought in?”

         “No, probably not. MRSA1 is usually a hospital only infection.”

         This was our first encounter with Methicillin-resistant Staphylococcus aureus (MRSA). Kimee’s premature birth left her immune system compromised and vulnerable to this scourge. New isolation procedures were started. We can't hold her without a gown, mask, and gloves. I wondered, how alien will it feel to Kimee if every touch is through a rubber glove. My heart ached again.

         It was late when I got home that night. Thank God for answering machines. My lack of communication skills can be overcome a bit if I have time to digest a comment for a few minutes. There were two messages on the machine.

         The first, at 12:16, was from someone named Erin. She said she was from the Essex County Juvenile Court in Lawrence, and needed Nina's and Neil's Social Security numbers.

         Who is Erin? I don’t recall anybody named Erwin. And why does the court need my other children’s SSNs?


         The second, at 14:29, was from Faith Coddon, Kimee’s Lawrence DSS case worker. She wanted to setup an interview with her supervisor, Maurine Pringle, sometime after Thanksgiving.

         Her supervisor? We met Faith at the first Juvenile Court hearing in October. She seemed to know all about the case. Why do we need her supervisor now?


         I called both Erin and Faith back, but being so late, both went to [VM] after a few rings. Since Erin said she was with the Juvenile Court, I figured I should try to comply with her request. But, it didn’t feel right to leave the kid’s SSNs on an unknown [VM].

         Well, maybe not completely unknown. The answer tags did agree with who they said they were. I said I will try later.

         I left my work number on Faith’s [VM], though, in case she can’t get me at home tomorrow.

* * *

The faces change, the doors revolve,
If ‘I’ could help, the crime to solve.
But who am I, Bridget or Renee,
Have I become, someone else today?
                                                 Renee’s Song

Mary Immaculate Nursing Home, Lawrence, MA
1998/11/24 18:17-19:00 Tuesday [Don]
         I came directly from work for my first supervised visit with ‘Bridget’ at MI. I arrived a bit early, so had to wait in the lobby until Maura got there at 18:29.

         I had signed in as a visitor for Renee. Maura signed in as a visitor for Bridget Williams.

         Renee was hot, wet, and awake in bed. She cried when I came in. Her hair was fixed in two braids.

         I flexed her hands, fingers, wrists, toes, feet, ankles, legs, and knees. The TV was on but the picture is fuzzy. Her roommate, Nell, wanted it off.

         Maura didn’t talk much at all. She seemed cold and aloof and just sat in the one available chair reading some papers from her briefcase.

         I wasn’t aware of it, until I got home and played the answering machine messages, but there had been a significant court hearing that afternoon. Maura was silent about it.


         Our guardianship attorney, Michelle LaBrecque, had called and left a [VM] message at 16:07.

         Ferne and I got home at about the same time, so we listened to her report together.

         “The Lawrence Eagle Tribune (LET) newspaper lost their argument today to release the Probate Court documents. They (all the media) now know who the legal teams are and may be calling you. I would like you to call me tomorrow morning to discuss what to say.” She also listed a few of the players who had been there. Maura was one of them.

         Ferne said, “Wow, more media?”

         I said, “And that darn Maura knew all about it... but didn’t say a word at MI.”

         I was beginning to really dislike Maura.


Courts
1998/11/25 10:00 Wednesday [Don]
         I called Michelle and thanked her for the report last night.

         It turns out the LET was trying to use their first amendment rights to make more of the story public. It was a rush appeal and the attorneys were given little notice in advance. Michelle’s office called her while she was in her car on her way to another appointment. She didn’t have time to get a message to us.

         But, the appeal ran square into the state rules protecting rape victims. The whole question of who Renee is and revealing her background was blocked. Thank goodness.

         However, the coverage of what the police were doing about the case cannot be stopped. Except for the police procedures to withhold comment to protect an investigation in progress, we’ll be vulnerable to what the newspapers print (and that could be anything).

         Damn. I wish I had been there. I’d like to have heard that argument.... No, on second thought, that would have made me into another target. It’s bad enough.


NEMC
1998/11/25 11:32 Wednesday [Don]
         I called NEMC to check on Kimee. Mary is caring for her. Renee (nurse) says she is doing better, but may have to go back on the breathing machine. The antibiotics will last for 7 days (3 to go), but we can hold her if we dress in the gowns and masks. The tube is almost back in place for them to start feeding again.


NEMC
1998/11/26 19:30-21:00 Thursday [Ferne and Don]
         Ferne and I visited Kimee. She is still on antibiotics and the CPAP. Her nurse today is Ann. Ferne and I were able to stroke her through the hand hole ports in the Isolette. Without the vent tube down her throat, she can make small cries. Unfortunately, those were the only sounds she would ever make.

         She is back on intravenous nourishment, too. Her feeding tube is so tiny that it got curdled this morning shortly after they started using it, so they took it out. They will try again in fluoroscopy tomorrow.


Courts
1998/11/27 08:47 Friday [Don]
         I called for Faith Coddon again but she is out today. Her supervisor, Lori Ortiz, will be in shortly. I promised to call back in a half hour.

         I thought her supervisor was Maurine Pringle. The cast is growing. More musical chairs?


Courts
1998/11/27 09:10 Friday [Don]
         I called for Erin again, too, but she will be out until Monday. I left Neil's and Nina's SSNs with her workmate.


Courts
1998/11/27 09:35 Friday [Don]
         I called Lori Ortiz, Faith’s new DSS supervisor, as I had promised. I said, “I’ve been trying to return Faith’s call last Monday. Do you know what she wants?”

         Lori said, “Communications are being hampered. Both in clarity and frequency.”

         I apologized, “I’m sorry, but we both have to work and phone tag may get in the way.”

         “No, no. We understand that. It’s not with you. It’s with other officials and the public. Our superiors insist we clear all reports to the court through the area director, Linda Carlyle, and the central office in Boston.”

         Humm, is that why you replaced Maurine Pringle? “Okay... how does that effect us?”

         “I think it would be wise if we got together to discuss things openly. When could you meet Faith and I here in Lawrence?”

         “My wife is working, but I could do it today.”

         “Faith is out of town.”

         “The soonest I could arrange another day off myself would be Thursday. My wife can’t get off without a couple of weeks notice, though.”

         “Just you would be fine. Lets make it Thursday at 9:00 in our office in the Bay State Building on Lawrence Street.”

         She gave me directions.


Courts
1998/11/27 10:07 Friday [Don]
         I called Maura to arrange another visit with Renee. She had a conflict for tonight. So we set it for 18:30 Saturday.


Personal
1998/11/27 11:21 Friday [Don]
         Life goes on. Well, some life goes on. I still don’t like driving the van, with my address and phone number plastered all over it, to the courts, DSS or any place where the press might be.

         I made an appointment, 1998/12/02, with Tim's Transmission to fix the Sunbird. And how much is that going to cost me?


MI
1998/11/28 18:30 Saturday [Ferne and Don]
         Ferne and I visited ‘Bridget’ at MI with Maura. Her air supply is an Oxygen canister with an atomizer for the moisture. Her sputum is very thick... should have more moisture. The mask is too small and upside down... do they even look at what they are doing?

         Maura said, “Medicaid will not pay for Renee’s leg PT. They assumed it would be of little use, she will never use them again.”

         I said, “It’s not just about use. She get cramps. I can feel the tightness in her legs and feet. It goes away when I flex her.”

          “They will pay for her arms and hands. Maybe once or twice a week.”

         Who the f*** are these people? Making a decision that will allow such pain without even examining her? “We visit her a lot more than once or twice a week. And, on almost every visit, I can feel her cramps.”

         “There is no way we can cover your visits so often.”

         Who’s side are you on? “How about if Ferne came alone?”

         Maura didn’t answer.


NEMC
1998/11/29 12:00-14:20 Sunday [Ferne and Don]
         Ferne and I visited Kimee in Isolation booth 10. She is now 4 lb 2 oz.

         We brought her a cassette player and some piano music.

         The nurse said, “We’ll disinfect it first, then put it into her Isolette and change the tapes for her. You won’t be able to take the tapes back home again, though. They might carry the MRSA.”

         Dr. Geoffrey Binney, her current attending physician, gave us a detailed report of Kimee's condition. I scribbled as fast as I could:

         1. The antibiotics schedule was completed. She is not any more susceptible to infections than other premature babies except for the tubes and wires into her that leave a path for infections. The MRSA infection is just one more problem that happens to some preemies in hospitals. I thought you took people to hospitals to be cured... not infected.

         2. The soft tissues at the top of her throat are too weak to remain expanded for her airway to work properly. She was getting a little tired on the CPAP, so they put her back on the vent. The source of the cries and squeaks the other day?

         3. The feeding tube is in place again and they are using it, current rate is 3 cc/hr (calculated for 50 cc/kg of body weight per day). There will be other possible solutions to the feeding problem in the future (surgery to restrict her stomach inlet to reduce reflux, and a "G" tube directly into her intestine). She is becoming more like her mother.

         4. She has developed some tremors... that’s not good. If the tremors get worse, they may complicate her future development. If you hold her arms, they go away. Her body may become more rigid, too. She may develop tractures. PT and OT will help. Again, more like her mom.

         5. Her head has stopped growing. For preemies her size, it should grow about 1 cm per week. The stoppage may be due to her previous brain swelling. That has now abated. They are watching this closely. It may resume growing with the better feeding through the tube into her intestines. A head too small? Any other deformities?

         6. Dr. Rossman is her neurologist.


Story
1998/11/29 21:00-01:10 Sunday [Don]
         I had been generating a lot of notes since October. They are all over the place in Steno Pads, Appointment Books and loose papers. The original reason to keep notes about Renee has changed. It is no longer just therapeutic for Ferne and I. We now have two patients, two courts, three attorneys, and dozens of legals and medicals to keep track of. And they all intersect. The logbooks alone aren’t enough.

         I thought it was a good idea, at the time, to developed a PC recording system. I transcribed all the loose papers, phone notes and this last Steno Book to date into it. I will transcribe the other 3 logbooks I have as they become available and I have time. That is, if I ever get back logbook #3 from Town Manor.


Pages: 12
Words: 2,131

Footnotes
1  http://en.wikipedia.org/wiki/Methicillin-resistant_Staphylococcus_aureus