About thirty hours after entering the hospital, Joel Dergan opened his eyes and wondered where he was. His head ached and his brain felt like there was a fog over it. When he tried to speak, he became aware of the endotracheal tube in his throat. Oh shit, I’m in the ICU, he realized.
A nurse entered the room and Joel groaned inwardly when he realized this was Sandy, a nurse he recognized. He was in his own hospital. Nurses he worked with on a daily basis were taking care of his body, changing his catheter, bathing him, etc.
Sandy noticed that Joel’s eyes were cracked open and she smiled brightly. “Well, good morning, Dr. Dergan,” she said. “How are you feeling?”
The question infuriated Joel because he wasn’t able to answer with the tube in his throat. He watched as she walked over to the side of the bed and changed his urine bag. God, this is embarrassing.
Joel wanted to find out when the endotracheal tube was coming out. He made a motion to Sandy, gestured at the tube, and raised his eyebrows. Sandy laughed, “Now just be patient, Dr. Dergan. I’ll give you some more sedatives if you’re feeling uncomfortable, but Dr. Petrovich isn’t ready to extubate you yet.”
Dr. Petrovich? Ugh, at this rate he’d be extubated by next fall. He glanced over at the ventilator settings and saw that he wasn’t requiring much support and his oxygen saturation was fine. He didn’t need the vent. Joel tried to get a grasp on the tube with his hand, although he was still weak and it was difficult. He put both hands on the tube and began pulling.
“Dr. Dergan, what are you doing!” Sandy cried. “Do I need to put you in restraints?”
But Joel was determined and he had pulled out the tube before Sandy could stop him. He started coughing, but he mostly felt very relieved at not having air pushed into his lungs. Sandy put her hands on her hips, “Dr. Dergan! I can’t believe you!”
Joel shrugged and smiled weakly. “Sorry,” he said. His throat hurt like hell and he winced as he said the word.
Sandy sighed. “Doctors are the worst patients. I’ll get you something for your throat. And I’m going to tell Dr. Petrovich what you did.”
When Sally left the room, Joel took the opportunity to look around. He had been in so many ICU rooms since he started working in medicine—it felt strange to be on the other side of things. He was disturbed by the fact that he didn’t see his wheelchair in the room, but he hoped it was someplace safe. His head was clearing a bit, but he still couldn’t remember how he got here. Had he called 911? How long was he out for?
When Mark Petrovich entered the room, he was frowning. “Joel…” Petrovich said. “Sally told me you self-extubated…”
“Come on, Mark, you know I was ready,” Joel said. His throat burned with each word, but he tried to ignore it. “I’m breathing fine.”
“Still… it wasn’t your call to make, Joel.” His brow furrowed. “How do you feel?”
“Pretty awful,” Joel rubbed his eyes with his forearm. “Mark, what happened? I can’t remember anything.”
“You went into septic shock,” Petrovich explained. “Your urine and blood grew out E coli.” He shook his head. “You’re a quadriplegic… I would have hoped you’d be more careful. You could have died, Joel. If your friend hadn’t brought you to the hospital…”
“My friend?” Joel raised his eyebrows.
“Dr. Manning,” Petrovich clarified. “She’s been sitting out in the waiting room for the past two days. I don’t think she’s left for more than an hour or two.”
Joel couldn’t conceal his surprise. “Kyra? She’s the one who brought me here?”
“That’s right,” Petrovich confirmed. “She’s the one who called for the ambulance. She saved your life.”
How about that? After her attempt to destroy his career, Kyra had jumped in and saved him. It was true that of everyone he knew, Kyra was the only one resourceful enough to get into his apartment without him opening the door for her.
“Do you want to see her?” Petrovich asked.
Joel shook his head. “No, not now…” He hadn’t seen himself in a mirror, but from his own experience with intubated patients, he imagined he looked really awful. He wanted a chance to get cleaned up before he saw Kyra. He at least wanted to maintain one small shred of his dignity. “When am I getting out of here?”
“Be patient, Joel,” Petrovich said with a smile. “Don’t worry, we can’t wait to get you out of here too.”
After Petrovich left, Joel leaned back and stared up at the ceiling of the room. He couldn’t believe he had ended up in the ICU—how stupid was that? He wasn’t a healthy young person anymore; he had a severe physical disability that put his health at risk. Another few episodes like this and his kidneys could suffer permanent damage. He knew that his own independence was precarious and any major health problem would probably be too much for him to handle on his own. He had to start taking better care of himself, otherwise he was going to end up like those quads from nursing homes with the stage IV ulcers on their buttocks.
While Joel was deep in thought, Kevin Parker, one of the residents Joel had worked with last year, entered the room. Joel groaned inwardly. This was going to be awkward, especially knowing how eager Kevin was.
“Hi, Dr. Dergan,” Kevin said. “You look much better. We were worried about you.”
“Hi, Kevin,” Joel said. “Yeah, I’m feeling fine. You don’t have to examine me.”
“You know I do,” Kevin said. “Unless you refuse.”
Joel sighed. “No, it’s fine… go ahead.”
Kevin placed his stethoscope on Joel’s chest. After he had listened, he put his hand on Joel’s shoulder, “Can you sit up for me now?”
“Actually, no, I can’t,” Joel said. “I can roll over, if you really want. But my lungs are fine.”
“You were just on a ventilator an hour ago,” Kevin pointed out.
Joel sighed. He hooked his wrist into the left sided railing, trying to roll himself over, but he was still feeling much too weak and his wrist slipped. After his second failed attempt, Kevin helped him by supporting his right shoulder. He still wasn’t able to roll completely on his side, but enough for Kevin to listen to his back. “Sorry,” Joel said. “I guess I’m still not back to 100% yet.”
The next thing Kevin did was pull up Joel’s gown to examine his belly. His first instinct was to feel self-conscious about his gut, but then he found something else to feel uncomfortable about. Until that point, Joel hadn’t realized that he had been wearing a diaper. But now he could clearly see the blue plastic diaper, which was fresh enough to have been changed earlier that day. It made sense, considering he couldn’t really control his bowels and it wasn’t possible to do his bowel program here in the ICU, but it killed him to think of Sandy changing his diaper.
Kevin was pushing the diaper down to get a good feel of Joel’s pelvic area. He wanted to mention to the resident that he didn’t wear diapers all the time and this was just because he was sick, but he didn’t want to call more attention to the situation. What he really wanted was for Kevin to get the hell out.
“Any pain?” Kevin asked him.
“I can’t feel pain down there,” Joel said.
“Do you feel me pressing?”
“Not really, no,” Joel said. He was sure Kevin could extract from that other things that he wasn’t able to feel.
Last, Kevin checked his legs. He was wearing TED stockings and compression devices on both legs, which fortunately concealed them. The only part of his legs that were exposed were his feet, which were inverted and in plantarflexion—a classic quadriplegic pose. Kevin checked the pulses in his feet and let it go at that.
“Do you know where my wheelchair is?” Joel asked.
“Huh?” Kevin stared blankly.
“My wheelchair,” Joel repeated irritably.
“Oh…” Kevin glanced around the room. “Uh… I don’t know. Maybe it’s in storage somewhere…”
Joel sighed. “Listen, did you talk to a Dr. Manning?”
Kevin nodded. “Yeah, she’s tough. Even tougher than you are, Dr. Dergan.”
Despite everything, Joel couldn’t suppress a smile. “Can you ask her to come in here, please?”
As much as he wanted to avoid seeing Kyra right now, he knew it would help to have her as an advocate, especially since nobody seemed willing to listen to him. He also was anxious to know how he had ended up here.
A few minutes later, Joel saw Kyra’s slim figure entering the room. Her hair was mussed and she was wearing no make-up. She looked like she had been up all night. She looked awful, but she also somehow looked more beautiful than he had ever seen her. Her eyes were slightly bloodshot and she rubbed them, “So you pulled out your endotracheal tube, huh?”
“Have you ever been intubated? It sucks.” He licked his lips self-consciously. “Thanks for getting me to the hospital. I appreciate it. You didn’t have to stay here.”
Kyra shrugged, “I wanted to make sure you were okay.”
“Well, I’m okay,” he said.
“Are you?”
She rounded the side of his bed and bent down to look at the bag of urine that was draining. “It’s clear,” Joel said.
She picked his vital signs off the wall and scanned them quickly. “Temperature to one hundred point five last night,” she said. “Although it was one hundred and five when you came in.”
“It was?”
Kyra pulled the curtains and sat down at his bedside. “Any suprapubic tenderness?”
“I wouldn’t know,” Joel said tightly. He quickly moved his arm over his abdomen to block her. “The resident already examined me.”
“The resident,” Kyra snorted. “Why don’t you let a real doctor take a look?”
If he wasn’t still feeling weak, he might have been able to resist her. She lifted his gown, once again revealing his soft gut and the blue diaper. “Satisfied?” he said.
“Stop being such a baby, Joel,” she said. “Do you think I can’t examine you objectively like a professional?”
He watched as she pressed on his belly with much more skill than Kevin would probably ever have. He couldn’t feel it, but he could almost imagine the touch of her soft fingers. She took her time, gently palpating the four quadrants of his pale, fleshy abdomen. “I can’t exactly do sit-ups,” he said, blushing slightly. “My abdominal muscles are completely gone.”
“Well, you never had a six-pack,” she pointed out.
“Yeah, but I was a lot better than that,” he said.
“It’s a quad gut,” she said with a shrug. “To be expected, right?”
Her fingers slid under the plastic of the diapers, palpating his bladder. He inhaled sharply as she pressed. “Pain?” she asked.
“No…” He looked away. “I’m not really comfortable with you seeing me like this, Kyra. I know I’m a mess right now, but I’m not usually…”
Her fingers disappeared deeper into the diaper and he swallowed hard. He wanted to ask her what she was doing, but he couldn’t get the words out. He was anxious about what her hand might encounter down there, yet he couldn’t ask her to stop. Their eyes met.
For a moment, he was completely lost in the past. But when Kyra pulled her hand away, everything came back to him. He wasn’t a cocky young surgery resident anymore. He looked down and saw his flabby gut still exposed and the blue diaper. Nothing attractive there. What had Kyra called him the other day? An incontinent quadriplegic. Wearing a diaper. It was stupid for him to imagine something was there that wasn’t.
“So do I check out?” Joel asked, looking away from her.
“Yes,” she said.
“Great,” he said. He pulled his gown back down over him. “Then you can help me get the fuck out of here.”
“Joel…”
“Look, everything you said the other day was true,” he said. “That girl, Ann… she was only interested in me for the grade. I just fooled myself into thinking it was something more than that because… it’s been so long.” He took a deep breath. “I guess you did the right thing by talking to the Doug Howard about it.”
Kyra’s brow furrowed. “What are you talking about, Joel? Who’s Doug Howard?”
“You know, the medical student director,” he said. “Come on, Kyra… I know you’re the one who blew the whistle on us. He told me about it right away.”
She shook her head. “I swear to you, Joel, I never said anything to anyone. I wouldn’t do that to you. I was just trying to scare you.”
“Yeah, sure.”
“I’m serious,” Kyra said. “When have I ever lied to you? Besides, if I were going to tell someone, I wouldn’t have told the medical student director. I’d go straight to the department chairman. That’s where the money is, right?”
Kyra had a good point. The department chair was the obvious person to tell. The only person who would think to go to the medical student director first would be… a medical student.
Oh god…
Did Ann rat me out?
Now that he thought about it, it made perfect sense. She was angry at him for how he had treated her that night and during rounds in the morning. It was hard to think of Ann as being so vindictive, but most med students knew how to be cutthroat when it came down to it. Maybe she thought this would give her some extra leverage when it came to her failed board exam.
“Joel,” Kyra began, “I want to apologize for what I said to you the other night. I was angry. I didn’t mean it.”
He didn’t feel like hearing her phony apology. “What part didn’t you mean?” he asked. “The part about me being an incontinent quadriplegic? That’s obviously true. The part about no woman ever being interested in me? That’s true too. I haven’t had one real date since I got injured.”
Kyra was quiet, looking down at her hands.
Joel finally broke the silence: “Do you know where my wheelchair is?”
“I left it in your bedroom,” Kyra said. “I can get it for you before you leave.”
“I’d rather have it at my bedside,” he said. “I mean, how would you feel if you knew you couldn’t get out of bed?”
“Joel, stop being this way…”
“What way?” He stared into her blue eyes. “You know how I feel? I feel like the last six years never happened. I’m in the goddamn hospital again and you’re looking at me like you feel sorry for me. I don’t need your pity, Kyra.”
“I have never pitied you,” she said.
“You’re lying.” He turned away from her. “Why don’t you just go? I don’t need you here. I may be a quadriplegic, but I can manage fine on my own.”
“Fuck you, Joel,” Kyra said, her eyes filling with tears. “I’ve been in this hospital for two days, worrying about you. I’ve been sleeping on the fucking floor. I am so fucking sick of your self-pity. Why don’t you just accept the fact that I love you even if you’re in a wheelchair or you need a diaper or whatever else I don’t know about?”
Joel stared at Kyra, processing her words. Before he could respond, she bent over him and pressed her lips against his.
The feel of Kyra’s lips was soft and familiar. He felt like he had been waiting six years for this kiss. He tasted her tongue in his mouth and the parts of his body that he could feel broke out in gooseflesh. He felt her fingers toying with his hair, pulling him closer to her. He remembered their first kiss, back when they were surgery residents. How much he had wanted her. He still wanted her. More than anything.
She tugged at the string in the back of his gown, releasing it. She continued to kiss him as she plucked at his nipples, tracing circles around them. “Since we first talked, I’ve been reading on the internet about sex in quads,” she told him. “I probably know more about it than you do by now.” She did something with his nipple that caused every hair on his body to stand on end. He moaned. “You like that?”
“Yes, yes…”
“Haven’t you always wanted to have an orgasm in an ICU bed, Joel?”
Kyra lowered her head over his left nipple, sucking and tasting him. It felt more amazing than anything he had ever experienced in his life. He was trying to keep the noise level down, but he suddenly heard an alarm go off.
“What was that?” Kyra asked.
Joel looked up the monitor, still trying to catch his breath. “My heart rate,” he said with a grin. “It went up and set off the alarm.”
Kyra stifled a giggle as she managed to get him covered again by the time Sandy came into the room to check on him. He was relieved that Sandy seemed oblivious to what was going on. “Are you all right, Dr. Dergan?”
“I’m fine,” he said for what felt like the tenth time that day.
Sandy checked her watch. “Visiting hours are over, Dr. Manning. You should go home and get some rest.”
Kyra put her hand on top of Joel’s and gave him a gentle squeeze. “Okay, I’ll see you later,” she said.
“Yeah…”
He watched her stand up and walk out of the room. He could barely comprehend what had just happened in here. He had thought that he filled her with disgust when in fact she now seemed to want him just as much as she had before he got hurt. Unless he was badly mistaken, there wasn’t an ounce of pity in her eyes.