The Return(74)

“What do you want to know?”

“Can you give me a quick run-through about her case? Just the highlights.”

“For some of this, you might want to speak with the neurologist or the orthopedist.”

“I will if I need to,” I said.

She nodded. “As you know, she was admitted with a head injury and compound fractures to her arm. The head CT indicated a subdural hematoma. She drifted in and out of consciousness, and we kept her under close evaluation while we waited for the storm to break. The hospital here doesn’t normally operate on heads, so we transfer those out. But the helicopters were grounded, roads were still flooded, and there was concern that the transport would further increase her risk. Meanwhile, the fluid continued to build, and her condition grew steadily worse. We finally made the decision to perform the craniotomy at our hospital, and fortunately, a neurosurgeon from Vidant was able to make it down here despite the storm. The operation went well. Callie’s confusion and dizziness almost immediately subsided and she’s been conscious ever since. She’s no longer slurring her words and has full motor function, too.”

“She seemed okay when I spoke to her.”

“I thought the same thing yesterday. But you should speak to the neurologist if you need more information on those issues. My impression is that he’s pretty confident about her recovery.”

“How about her arm?”

“The ortho was finally able to get to that on Sunday and it ended up being rather complex and it took longer than he’d anticipated. Again, though, he said it went well and he’s confident. You’d have to ask him more about that, though.”

When she didn’t add more, I asked, “And?”

“As you can imagine, there’ve been a lot of physicians and specialties involved in her care. Emergency, neurology, orthopedics, and now oncology.”

“When were you brought in?”

“Sunday evening,” she said. “Prior to undergoing treatment for her injuries, she had the usual battery of tests and there were some problems with her blood work. She had low red blood cell, low white blood cell, and low platelet counts, and she needed a transfusion. Because we couldn’t find any internal bleeding, there were worries she might have leukemia, so here I am.”

“Which explains the bone marrow biopsy.”

“It’s been a very hectic few days with all the doctors and procedures, and we’ve all spent some time with her. And that’s the other problem.”

“Why is that?”

“Because she told us different stories,” Nobles said, “and no one knows the truth. For starters, she said she was nineteen, but I don’t believe that for a minute. She looks like she’s fifteen or sixteen. She also told me that her parents had died in an automobile accident last year, that she doesn’t have any other family, and has been on her own ever since. On the other hand, she told the orthopedist that they’d died in a house fire. It didn’t add up.”

“Maybe she was confused.”

“Maybe early on, but not by Sunday. She was fine—she could add, knew who the president was, knew the day of the week, and everything else. During that round of questioning, she also mentioned that she was from Tallahassee.”

“She told me she was from Florida, too.”

“I’m from Tallahassee,” Nobles emphasized. “I grew up there, went to Florida State, and lived most of my life there. When I asked her what high school she attended—just chatting, you know—she said George Washington High. I’d never heard of it, so I checked my phone and realized it doesn’t exist. I asked about a couple of other places—the Alfred Maclay Gardens Park or St. Marks Wildlife Refuge—and though she acted like she’d heard of them, I could tell she hadn’t. So I asked if she really was from Tallahassee and after that, she stopped answering my questions. I need to know whether she has family, though, and she won’t tell me anything. But she’s going to need a bone marrow transplant sooner rather than later, or there’s not going to be anything we can do for her. We need to find her family.”

“How bad is the leukemia?”

“I’m sorry,” she said, quickly shaking her head. “I wasn’t clear. Callie doesn’t have leukemia. The biopsy shows that she has aplastic anemia.”

“Is that better or worse than leukemia?”

“Six of one, half dozen of the other. Basically, aplastic anemia means she’s not producing enough new blood cells, and in her case, the disease is very advanced, so it’s a crisis situation. But let’s back up a second. How much do you know about bone marrow transplants?”

“Not as much as you do, I’m sure.”

She smiled. “It can be an arduous process to find an appropriate donor, but basically, in the first step, we try to find donors with matching human leukocyte antigens, or HLAs. There are six major antigens, and with the best donors, all six of the antigens match. Five is less good, four is a possibility but riskier, et cetera. Anyway, after I got the results of the biopsy, I ran Callie’s HLAs through the marrow registry, and the best matches we have now are a couple of threes. She needs a better match, which usually means family.”

“Does Callie know yet?”

“No,” she said. “The results came in earlier this afternoon. She knows that a transplant is a possibility, though. After I leave here, I’m going to share the results with her and hopefully, she’ll tell me something about her family. I mean…how can she not have any family? She’s too young not to have anyone, right?”