Chapter 9: Rui (part 1 of 3)

  "As you can see by comparison with yesterday's image," I said while clipping another vellum scroll onto the oversized projector, "the lesion has decreased in size again and the oedema around it is now negligible. If you're still searching for a source of the febrile spikes, I'd probably suggest looking elsewhere."

  I was standing in front of a room full of Intensivists, on my third day back from a mandated sick leave and attending to my weekly turn as the advisor for the ICU's daily Radiology rounds. It was an earlier start to the morning than most days and I hadn't been sleeping well lately, but that wasn't why I was in low spirits.

  "Agreed," Dr Rivera, who happened to be taking a sabbatical from his usual duties as a Triage supervisor by filling in to helm the ICU this week, chimed in from the seat closest to the projector. He then turned to the rest of his team. "Poh-Leng, please run it by Pathology again, see if they could do another full work-up. Oh, and might as well get in touch with Endology too, ask if they've got any other ideas for a change of antimalads. Okay, let's move onto bed ten, Ruixi Tao."

  I felt a wave of nausea at the mention of the name, even though I knew it was coming. It passed quickly, but I was nevertheless left feeling light-headed. My hands went up to my collar, adjusting it, and I felt a waft of hot air humidified by sweat. Oblivious to or wilfully ignoring my reaction, the Intensivist in charge of Lucy began her summary while I turned to the projector to change out the scrolls.

  "23-year-old female. Day 15. Maladous sepsis on the background of left above-knee amputation..."

  Each word felt like a body blow. I shut them out and focused on my own task. I switched out the vellum scrolls with ones depicting Lucy's chest and abdomen—they were taken no more than two hours ago by the overnight duty Radiologist. I stood staring at the images, yet not actually seeing anything. After a while, I became aware of Dr Rivera's voice repeating the same phrase several times.

  "Rui?"

  I turned around in a daze to find the whole room of doctors, students, and scribes staring up at me with a mixture of concern and irritation. How long had I been standing there unresponsive? I cleared my throat and half-turned my body back to the scrolls, viewing them critically for the first time. I took another twenty seconds or so to scrutinize the images and collect my thoughts, aware of the eyes on me and aware that some of them had been averted in discomfort. "Um, diffuse bilateral consolidation is unchanged from yesterday. Nil identifiable foci. New small pneumothorax in the right apex. Left perirenal abscess has reduced in size post-insertion of percutaneous drain. Drain is in good position."

  The room was silent for a few moments, as if they expected me to say more. I turned to Dr Rivera with a searching look. He gave a quick glance around the room before taking over. "Right, Rui, thanks. Poh-Leng, go tell them to change the bag now and keep an eye on that drain output. If we're not seeing much movement by the time morning rounds are finished, we pull it out. Okay, main thing with her now is this pneumonia business. Rahim, you keep that air moving but it might be a good idea to get the Pulmonology guys to come and have another look. Oh, and please sort out that pneumothorax; might be why she was desaturating overnight. Overall, I think she's close. We get her oxygen up, wean her off ventilation, then she should be well enough to rehab in the wards. Okay, thanks everyone. See you guys in there."

  The intensivists filed out of the room one by one, followed by the students and scribes. Some of them gave me an awkward nod as they passed. Others simply kept their eyes on the floor or a notebook in their hands. I turned to start gathering the vellums I had brought in for the meeting.

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  Fifteen days. That was how long my sister had been in the Intensive Care Unit, an isolated corner of the hospital manned by a rotating cast of five doctors, each attuned to a different Quintessence. Their main role was to stabilize a particularly unwell patient, going back to the basics of physiology to ensure that the heart pumped blood and the lungs breathed air, while seeing that the rest of the organs also didn't fail. In other words, keep the patient alive long enough and trending in the right enough direction to eventually continue their treatment in the wards. Compared to other departments in the hospital, they had fewer patients to look after, which meant that the attention each patient received was proportionately more comprehensive.

  Most patients who needed intensive care were there for a few days at most and were transferred out when they were well enough—or sent to the morgue if things kept going south. Fifteen days, while not remotely the longest amount of time someone could survive a stay in ICU, was worrisome to say the least. Since her lengthy and controversial operation, Lucy had been beset by a number of niggling infections and complications. She was past the worst of it now, and as Dr Rivera had said, should be close to leaving ICU. Yet, after weeks of being bedridden and having gone through a veritable gauntlet of illnesses, it would be a long road back for her to feel like herself again, if that were even possible. Besides, her leg... and that was when I stopped myself. No good came of thinking about her leg.

  "Rui, a word?"

  I hastily brushed away a tear and turned around, startled to find that there was someone left in the room. It was Dr Rivera, normally the Triage supervisor and possibly the most well-respected staff member at the Central. He was stocky, at least a head shorter than me, but he had a commanding presence about him, not unlike Prisha the Lancer. He had kept a respectful distance from me while I wallowed with my back turned to him, but he sidled up to me now and put a companionable hand on my shoulder. "How are you holding up, son?"

  I was genuinely surprised by this tender display. Though I didn't know him well, I had always pictured Dr Rivera as a no-nonsense leader of men—he of the military haircut and a permanent frown. I supposed the picture wasn't wrong, but now he showed me a different side to him. Feeling embarrassed and hoping that my eyes weren't too obviously red and moist, I tried to deflect. "Yes, of course. Sorry about earlier. I was still reading the images and must have been too—"

  "Never mind all that," he cut me off while gently patting me on the shoulder. "Listen, you didn't have to do this, you know. I could talk to Malhotra and maybe he could take you off the roster."

  "No, it's alright, really," I said, trying and failing to put on a cheerful smile. "The other guys on the team already covered for me while I was away. Besides, I need to be doing this. It's part of my training."

  He nodded, though his trademark frown deepened somewhat. "She's going to pull through, you know. I have no doubt about that. It's just a question of when, not if."

  I nodded back, fighting back another set of tears. I would have been happy if he had left it there, but he seemed to have more to say.

  "She's had a more difficult course than we would have expected. We think it's because of the Aquatic nature of the Jungle-hound's toxins—don't play well with your sister's Igneous constitution. But we've got Terrene technicians in there working round the clock to counteract. Improvement is slow, but it's there. You'll have your sister back, Rui. I promise."

  I was both appalled and heartened by this report. As painful as it was to reflect on Lucy's plight in any fashion, it felt oddly comforting to think about it in academic terms. We knew what was ailing her, and we knew how to fix it. That was the only thing I could hold onto. All things considered, that needed to be enough.

  "Thank you, Dr Rivera," I said, my voice shaking despite my best efforts. "I appreciate it. Really, I do."

  He gave me one last squeeze of the shoulder—a more painful one than he probably realized—and walked out. I also needed to reel myself in and face the day. I picked up the pile of vellums, dabbed at my eyes a few more times, and took a deep breath before heading out of the meeting room.