Chapter 23: Hematoclopus

It was good news and bad news when the ambulance pulled into the “bay” at County Medical Center. Leah watched the staff pull Nia through the automatic doors in a blur. But the bad news was that they wouldn’t let her stay with her little sister.

“Drew, you have to turn the car around. We need the legal papers from home because the cocksuckers here don’t accept me as Nia’s guardian. And they’re giving me bullshit about limiting her treatment until they have permission from her parent or parents! Go home, get the court orders, and then come back.”

As it happened, moving quickly was urgent because Nia had deteriorated so severely and so quickly. Ninety minutes after her admission, they were told that she was stabilizing, and that Leah could come to her bedside in intensive care “soon.”

At the 2.5-hour point, they upgraded her condition from critical to serious. They were told to wait another half an hour. Finally, after one more hour, a harried young doctor came and led them to a conference room.

“After we talk, you will be able to see her—that is, one of you. You have to take exceptional precautions, that is, a gown and mask. Nia has a severe infection that has triggered an overwhelming reaction in her body. This reaction is called sepsis, it is very serious.

I’m sorry, I don’t have a lot of time to talk because the department is slammed like always on a Saturday night. So, I’m going to give you a very brief rundown, and when she goes upstairs to Critical Care, they will be able to explain better and counsel you further.

“Do not expect her to be discharged for possibly two weeks from now. She arrived here in very critical condition. I believe that we have improved her from critical to serious but stable. Upstairs, she will be on a monitored bed in case she has another decline. Any questions?”

“How could this happen? She doesn’t have any injuries or wounds, as far as I know. She just looked sick, like she had the flu or something.”

“I’m sorry, you’re right. I’m out of order. Tania is one of the many girls who started menstruating at age 9. Getting your period that early is no longer uncommon. The problem is that she also has an imperforate hymen. Put simply, there is no opening to her vagina for the menses, the blood, to leak out. Instead, it’s just been collecting, it’s been trapped inside her vagina, a condition called hematoclopus. With me so far?”

After they nodded, he continued.

“The buildup creates painful pressure in her pelvis, and it puts pressure on her urethra; that’s the little hole where urine leaves the body. Because she couldn’t pee, urine was building up inside her bladder and backing up to her kidneys. These are all very painful syndromes, and the retained liquids promoted infection.

“Bacteria was like a wildfire and overwhelmed her natural defenses. That’s why now we’re diagnosing her as having sepsis. Nia needs monitoring and supportive care as we administer antibiotics.

“I really must go; I’m sorry. When she goes upstairs, there will be a hospitalist (an MD) who will manage her care. That doctor can explain further and can answer your questions. She’s improving already, so we can transfer her up soon.”

The doctor grabbed Leah’s hand for a moment then darted from the room.