Chapter 6: Touch and Go

San Luis Obispo, California

October 30, 2000

Doctor Patricia Gamble was a stocky woman, in her mid-forties and built like a Mack Truck. She had dark hair, large hands, large breasts, and a very straightforward demeaner. Had he met her on the street, Jake would have found it much easier to believe she was an MMA fighter than a highly skilled general surgeon with eighteen years of experience at her profession. At 7:30 PM that evening, she came into the ICU room where Jake had been admitted. She was dressed in green scrubs and had little blue booties covering her shoes. She introduced herself to Jake, Laura, and Celia without making any mention of their celebrity status.

“Doctor Renfro, the hospitalist tells me you are mostly stabilized by this point,” she said, “and I agree with that assessment.”

“I still feel pretty shitty,” Jake replied, and this was true. His entire right chest ached steadily despite the IV Demerol they had given him and he felt as weak as a kitten. His head, however, was much clearer and he was no longer violently shivering.

“You are still pretty sick,” Gamble told him matter-of-factly, “but you’re no longer flirting with septic shock. Your lactic acidosis has resolved after the fluid, your fever is down to an almost reasonable thirty-eight Celsius. You’re still tachycardic, but only at a hundred ten or so, and your blood pressure and oxygen levels are back in the low end of normal.”

“He’s getting better then?” Laura asked.

“He stabilizing,” Gamble corrected. “He still has the underlying issue. He still has a significant leukocytosis indicating significant infection.”

“Leukocytosis?” asked Celia.

“Elevated white blood cell count,” Gamble said. “It was still eighteen thousand as of the last draw.”

“Ahh, of course,” Celia said, thinking why didn’t you just say elevated white blood cell count? Why do you have to put an incomprehensible medical name to it?

“In addition, Jake, your inflammatory markers are almost off the chart. That means your body’s immune system is launching a furious attack on this infection but is losing the battle currently. We are still going under the assumption that this is MRSA we’re dealing with here and MRSA is a tough bug to take down. The Vancomycin and the other non-beta-lactam antibiotics we’re giving you will start knocking it down to some degree, but you’re going to need some help from me and my team.”

“Surgery,” Jake said, resigned. “Doctor Ford and Doctor Renfro already told me this.”

“They were correct,” Gamble said. “I’ve reviewed all your imaging studies while I was prepping for this case. The MRSA established a pretty good beachhead in your body once it got inside. It spread to multiple places from there. The CT shows pockets of gas and pus all around the surgical site itself, but that’s not all. It has also established itself in the chest cavity, the lung tissue, and caused a fairly significant osteomyelitis to your second and third ribs.”

“Osteomyelitis?” Jake asked wearily. “What is that?” It did not sound like a good thing, whatever it was.

“Basically, an infection of the bone,” Gamble told him.

“And all of this infection is the MRSA?” Celia asked.

“That is the presumption,” Gamble said. She then looked back at Jake. “In order to give your body and the antibiotics a better chance of getting rid of the infection, I need to go in there and drain all of the purulent areas and debride as much of the infected tissue as I can without causing permanent damage.”

“Debride?” Jake asked.

“Cut away,” Gamble explained. “In the case of the osteomyelitis, I would scrape it away instead of removing the actual bone. It appears on the CT to only be on the outer surface of the structures. As for the lung tissue, I would have to cut some of it away, but mostly on the outer surface. It is not so extensive that I would have to remove part of a lobe.”

“You’re going to take away part of my lung?” Jake asked, just for clarity.

“The outer surface, yes,” she said. “It will heal over time and you should regain full functionality of the organ.”

“Should?” Jake asked.

“The best I can promise,” she said without emotion.

“What if I did not get this surgery?” Jake asked.

“I would not advise that,” Gamble said. “The infection will likely spread further without surgical intervention and you will end up much sicker, perhaps even lethally sick. Even if you survive, it is inevitable that we will still have to go in at some point and remove diseased tissue. At that point you would likely lose part of your upper right lung lobe, pieces of those two ribs, and your recovery period would be a matter of a year or more instead of a few months like we’re looking at now.”

“He will get the surgery,” Laura said firmly.

“Yes, he will,” Celia added.

“That is certainly my recommendation,” Gamble said, “but I do have to go over the risks of the procedure as well.”

“What are the risks?” Jake asked.

“As with any surgery involving general anesthesia, there is a small risk of complications from that itself,” Gamble said. “Complications up to and including brain injury and death. In addition to the possible anesthesia complications, just the act of cutting into your body entails the inherent risk of further infection, post-operative complications, and blood loss. We will, of course, type and screen you and have blood available, but I do have to explain the risks.”

“You would make a terrible salesperson, doc,” Jake told her.

“I am ethically and legally required to explain the risks versus benefits to you before you consent to the procedure,” she said simply, without cracking so much as a smile at his joke. “In addition, there is the small risk that by removing the diseased tissue we might inadvertently spread the infection to other parts of your body. We will take every precaution to avoid this, but it is a possibility. There is also the risk of causing another pneumothorax or a hemothorax or both when I remove the tissue from your lung. This is a bit higher of a risk than the other things I’ve mentioned. If it occurs, you will need another chest tube until the lung is healed.”

“I understand,” Jake said. “But if I don’t get the surgery, I might die or end up sicker than I am now.”

“You might die,” she confirmed. “You will end up sicker than you are now and we would still have to go in and perform the surgery eventually anyway.”

“Well then,” Jake said, “I guess we should do it.”

“A wise decision,” Gamble said. “I’ll have one of the nurses come in with a consent form for you to sign. We’ll have you on the table for the first case in the morning.”

“Looking forward to it,” Jake said with a sigh.

Shortly after Dr. Gamble left, Laura and Celia both hugged and kissed Jake good night as visiting hours were over. They climbed into their cars and drove to Casa Kingsley on the cliff. Caydee was already in bed for the night when they arrived. Meghan, dressed in her long t-shirt, her legs bare, her boobs bouncing around freely, was watching TV and sipping a glass of wine when they arrived. Laura updated her on Jake’s condition and the plan.

“I’m going to take my stuff to the guest room,” Celia said.

“I’m going to take a quick shower and get into my nighty,” Laura said. “I didn’t have time to take one this morning for obvious reasons and ... well ... I really needed one if you know what I mean.”

Celia smiled at her. “I know what you mean,” she said. “I didn’t shower either but I didn’t need one as badly, if you know what I mean. I’m just going to change into my jams and probably make an early night of it.”

“Okay,” Laura said, a little disappointed. “I have some phone calls to make so everyone who matters is updated. I’m definitely going to need a drink while I do that. After that, I’ll probably hit the bed too. It’s been a really long day.”

“A drink does sound rather nice about now,” Celia said thoughtfully. “Maybe I’ll join you in that. What can I make you?”

“I need the big guns,” she said. “Goose and tonic. A double.”

“I’ll have it ready for you when you come out.”

“Thanks, love,” Laura told her.

She went to the master bathroom and stripped down to her birthday suit, tossing everything in the laundry hamper. She could smell the odor of stale sex secretions radiating off of her nether region and she felt sad. When would she smell like that again? Jake was going to be out of commission for a while (maybe forever? a dark, awful part of her mind asked). She turned on the tap and brushed her teeth slowly, her mind worried about her husband and obsessing about all the things that could go wrong tomorrow.

She showered the smell away and washed her hair, her mind continuing to worry the entire time. After toweling off and blow drying her hair and combing it out, she walked naked into the bedroom and opened the dresser drawer where her underwear were stored. She pulled out a pair of green bikini panties and put them on. She then got one of her long night shirts from the walk-in closet. It was the red and black checkered one with the short sleeves. It was loose-fitting on her and the hem fell to just below her knees. She pulled it over her head, leaving her own boobs free and clear. She rarely wore a bra when she was home though she would not be caught dead without one in public. She pulled on a pair of red socks to keep her feet warm (she would take them off when she went to bed) and then pondered for a moment taking the birth control pill she had neglected to take that morning. She decided to just wait until tomorrow and resume then. Missing one pill would not make her fertile. And, her mind insisted on reminding her, it isn’t like you are going to be doing anything that could result in pregnancy in the near future anyway.

She sighed and walked back into the entertainment room. Meghan was still watching TV, something called Taxicab Confessions. She seemed quite engrossed with it. Celia was at the bar. She was now dressed in a pair of royal blue silk pajamas—her bra quite plainly missing—and her hair was down. Her big feet were bare, her toenails badly in need of a fresh coat of paint. She still looked sexy as hell, Laura thought fondly. She had a highball glass in front of her and another one sitting in front of the empty chair.

“Thanks, love,” Laura told her, picking up the glass. She took a healthy drink of it, relishing the bite of the alcohol and the feeling of warmth as it made its way to her stomach. “I’m going to go to the office and make my calls.”

“Fun times,” Celia said with sympathy. “I’ll go hang out with Meghan until you’re done.”

Laura went to the office where the security system was monitored. She looked at the display automatically, seeing that the system was armed and set for “occupied night mode” (which would allow bedroom windows to be opened), both at the main house and in Elsa’s quarters. She then checked the video feeds, seeing that all cameras were in night-vision mode, the gate was closed, and nothing was moving on the road or on the property.

Satisfied that everyone was safe (except Jake, her mind reminded her once again, he’s having a major surgical intervention in the morning) she sat down at the desk and turned on the IBM desktop computer that was installed here. Once it booted up, she opened up the list of contacts that had mostly replaced their personal phone book—though that book was still kept in one of the desk drawers as a backup. She started with Pauline, giving her an update on the situation and explaining about Jake’s surgery in the morning. So far, none of the media outlets had gotten a sniff that Jake was back in the hospital so Paulie had not had to issue any statements. That would likely change very soon as word spread from hospital staff to their friends and loved ones and then out into the community from there. Next, she called Mary and conveyed the same information. Mary promised to update Stan and Cindy. Her next call was to Nerdly, who promised to let Coop, Charlie, and Matt know what was transpiring. She then called Elsa, who promised to update no one. She thought about calling her brother Joey and Steph Zool of Brainwash to let them know what was happening—at this point no one had even told them that Jake was back in the hospital—but decided she did not have the energy. She had consumed more than half of her drink by this point and was starting to feel sleepy. She was also feeling a lot of churning emotions—fear for Jake and anger at Jenny Johansen the two most dominant—and telling the story over and over had not helped.

She put the computer into sleep mode, took her drink, and walked back to the entertainment room. The TV was now off and Celia was alone on the couch. “Did you chase Meghan away?” she asked as she sat down next to her.

“Her show ended and she said she was going to do some reading before she went to sleep,” Celia said. “She said to let you know that she’ll be up in time to take over Caydee duty when we leave. I’m assuming we’ll be going to the hospital right after breakfast.”

“That’s right,” Laura said. The first surgical case, Dr. Gamble had told them, would be at 9:00 AM, which meant they would be wheeling Jake to pre-op at 8:30. Visiting hours started at 8:00 and she planned to be there before they wheeled him away. “Meghan really is a godsend.”

“I don’t know if I would go so far as to label her a godsend,” Celia said. “You two pay her every week even if she doesn’t have to watch Caydee at all because one or both of you are home. I would hope she would be available to do her actual job when you need to cut out to go visit Rev in the hospital.”

“I know all that,” Laura said dismissively. “I’m just glad she’s here to help us through this. She never complains or whines or says no to us if we need her to work beyond the normal hours or on a weekend.”

“True,” Celia allowed, “and she really does love Caydee. Caydee loves her as well.”

“Her mom keeps telling her that one of these days we’re just going to kick her out of here because we won’t need her anymore.” She shook her head and took a drink of her drink. “As if we’re that cold.”

“Moms can be overbearing at times,” Celia said with a grunt. “Trust me, I can sympathize.”

“Yeah, me too,” Laura said. “Only on an entirely different level.”

“Still no contact with any of your family?” Celia asked gently. “Other than Joey and his bunch?”

Laura shook her head. “Nothing since Joey called my mom during his visit three years ago while I was pregnant. They have our phone number and address if they want to use them. I thought maybe they would get in touch when they heard that Caydee had been born or that Jake had been shot, but...” She shook her head again “Not a word. Not to me, not to Joey.”

“I just can’t conceive of abandoning a daughter like that,” Celia said.

“Neither can I,” Laura said. “And over something as stupid as religion and media lies.”

“Their loss,” Celia opined.

“I suppose,” Laura said with a sigh. “They’re missing out on a very cute granddaughter and a very wealthy daughter and son-in-law.” She shrugged. “It’s probably just as well. Jake would definitely not get along with them, or they him. And I really wouldn’t want Caydee to be influenced by them in any way.”

“That is a good point,” Celia allowed.

Laura sat down on the couch next to Celia. She sipped from her drink and then set it down on a coaster.

“Seriously, Teach, how are you doing?”

“I’m scared,” she said simply. “Not as scared as I was when I first took him to the hospital, but still scared. He’s very sick and has to have surgery in the morning. Just when I thought the worst of this whole Jenny Johansen thing was past us, this happens. The doctor said it will take months for him to recover. Months!”

“Yeah, I guess they’ll have to put the whole Intemperance reunion on hold, right?”

Laura shrugged again. “I wasn’t all the wild about the reunion in the first place,” she said. “In my opinion, the less Jake hangs around Matt, the better.”

“Matt does have that effect on people.”

“Yes, he does,” Laura said. “Anyway, we don’t know how well Jake is going to recover from this. The doctor said it’s unlikely that he would lose his arm, but he didn’t say it was impossible.”

“No, he did not say that,” Celia agreed. She had been there for the discussion and had not liked the way the doctor had danced around that particular enquiry.

“And even if he doesn’t lose his arm, what if he loses some of the function of his hand? The doctor didn’t even say that one was unlikely. He said it was possible that motor nerve function to the hand could end up being impaired. Impaired. What the fuck does that mean? Jake needs that hand to play his guitar! He would be devastated if he wasn’t able to play anymore. Absolutely devastated. Yes, he would still be able to sing, but he uses the guitar to compose with. I don’t think he would be able to write any more songs if he lost some of the function in that hand. He’s a melody-first composer. He always has been.”

Celia set her own drink down and scooted over on the couch until she was in contact with Laura. She put her arm around her shoulders and pulled her against her, giving comfort. “I’m a melody-first composer as well,” she told her, “It would be very difficult for me to write a song without being able to strum it out on my guitar. Maybe even impossible.”

“You see where I’m coming from then?” Laura asked, her mask of composure starting to break now.

Celia nodded. “I see where you’re coming from,” she told her, “but it doesn’t do any good to worry yourself sick over what might happen. It doesn’t help the situation in any way. It just gets you all wound up and Caydee will pick up on it and it will cause her stress as well.”

Laura thought that over for a moment or two and then nodded. “I hear you,” she said softly, letting her head rest on Celia’s shoulder. Celia stroked her hair and rubbed her back through her nightshirt. They stayed like that in silence for the better part of ten minutes before Laura broke the embrace.

“Feeling any better?” Celia asked.

“Yes,” Laura said. “Thank you for being here with me.”

“I’m always here for you, Teach. You know that.”

Laura gave her a smile. She then picked up her drink and downed the remainder in one big gulp. “I’m gonna try to get some sleep now,” she said. “I don’t know if I’ll be able to do it, but I need to at least try.”

Celia hesitated for a moment and then asked quietly, “Do you want me to hold you until you fall asleep?”

Laura looked at her and then nodded. “I would like that,” she said.

Celia chugged the rest of her drink down and they carried their glasses to the sink for Elsa to wash in the morning. They then went to Caydee’s room to check in on her. The little girl was sound asleep, breathing softly and regularly, one leg sticking out from beneath the covers of her big-girl bed. Laura reached down and stroked her hair a few times, not worried about unintentionally waking her. Caydee was a sound sleeper. A bomb going off outside wouldn’t wake her.

“Sleep tight, Caydee girl,” Laura whispered to her. “Don’t let the bedbugs bite.”

Celia smiled and reached down to give that red hair a few strokes of her own. Her maternal calling was quite strong as she felt the silky hair, smelled the odor of no-tears shampoo, heard the sound of gentle breathing. “Mommy and Daddy love you very much, Caydee,” she whispered. “See-Ya does too.”

Caydee smiled a little in her sleep but did not open her eyes. She nestled into the covers a little tighter and went on with her slumber.

The two ladies left her room, leaving the door open. They went into the master suite and closed the door. Laura peed in the throne room, not bothering to close that door. Celia relieved her own bladder though she did close the door. They then turned off the lights and climbed into bed, Laura in the middle, on her left side, Celia behind her, spooning her.

As she felt the warmth and the soft femininity of Laura’s body against hers, Celia’s feelings of friendship and platonic love turned to sexual arousal. She had entered the room with the best of intentions—comforting a dear friend—but those intentions were quickly overrun by feelings of lust and wanting. Before she even realized she was doing it, her hand crept downward, onto the silky smoothness of Laura’s bare thigh. She began to stroke the flesh there.

“Just how much comfort are you planning to give me?” Laura asked her, her voice hopeful, not upset in the least.

“As much as you need, Teach,” Celia whispered back.

“I think I need a lot,” Laura told her, rolling onto her back.

Their lips came together and Celia comforted her the best she knew how for the next hour or so.

Jake had lain awake until well past one o’clock in the morning, his mind refusing to let him sleep as it worried about everything that could go wrong tomorrow. I could lose my arm, he thought, or the function of my strumming hand, or I could die from some fucked-up infection they can’t get rid of. His brain simply would not allow him to think optimistically, to consider the possibility that everything would work out in the end. Even if everything does come out okay, it’ll still be months before I’m able to tour again. Months!

And then the night shift nurse in charge of him—a cute brunette named Mandy—noted he was awake and anxious during her rounds and offered him some relief, but not the kind of relief that most attractive women tended to offer him.

“Xanax?” Jake asked.

“That’s right,” she said. “Dr. Gamble put it in your PRN orders for anxiety. I think you could probably use one about now.”

“Isn’t that like Valium?” he asked, remembering a discussion about Xanax at some point in the past but not who or when or where.

“It’s the same class of drug,” Mandy said. “A benzodiazepine, but longer lasting and more effective than Valium. It’s specifically designed as an anti-anxiety drug. It won’t give you any euphoric effects like the pain pills, but it goes to the part of your brain that worries about things and tells it to chill out.”

“Really?” Jake said, pondering that.

“Never tried one myself, but I’ve heard it works miracles for anxiety. Can I get you one?”

“Uh ... yeah, sure,” he said. “Let’s check this shit out. God knows I’m pretty freakin’ anxious right now.”

She smiled and left the room. Five minutes later, she came back with a little plastic cup in her hands. Inside that cup was a little oval pill, white in color. She also had a small cup of water for him to wash it down with as they had taken away his water pitcher at midnight to keep him from putting anything into his stomach before surgery. She went through the ritual of asking him his name and date of birth and then checked that information against his armband and her chart. She then handed him the cups. He dumped the pill in his mouth and chased it down with water from the second cup, letting it go to work on an empty stomach.

Thirty minutes later, he did not give a shit about anything. They’re going to cut me open tomorrow and scrape a bunch of infection off of my lungs and ribs and surgical wounds. That’s cool. He smiled as he pondered that. I might end up losing my arm or the function of my hand because of all this. That’s cool. Whatever will be will be. He scratched his balls a little bit and then broke wind. Jenny Johansen’s lawyer is playing the insanity card and she might get off with nothing more than a little stint in the psych hospital. That’s cool. We’ll just have to keep our eyes out for her. He smiled a little more and, for the first time in years wished he had a cigarette to smoke. Terrorist attacks against the US are on the rise and it’s been whispered that a major attack of some sort might happen in the near future. That’s cool. I’m sure they have their reasons.

While thinking about all of the things in his world and the world at large that were cool, he began to feel sleepy. At about two o’clock he drifted off to sleep. He barely woke up when the cute lab girl came in at 4:35 to draw his morning labs.

He was still dozing when Laura and Celia arrived at 8:00 AM. He pulled himself awake and happily discovered that he still did not give a shit about anything. That Xanax was a long-haul pill. Both women hugged and kissed him and asked him how he was doing.

“Mandy, the night nurse, gave me a Xanax last night,” he told them. “I feel just freakin’ fine right now.”

“That’s good to hear,” Celia said with a chuckle.

“Do you think she could get one of those for me?” Laura asked.

Jake chuckled, giving her joke more laughter than it really deserved. “You’ll have to ask the day shift nurse,” he told her. “Mandy is probably already home by now.”

“That’s a bummer,” Celia said. “In my experience, the day shift nurses are a lot more by the book. They won’t just hand out a controlled substance to a visitor.”

“A pity,” Laura said with a smile. “Listen, sweetie, there’s something we need to tell you.”

Jake grinned. “You got it on with each other again last night?”

“Uh ... well ... yeah,” Laura said.

“It just kind of happened,” Celia said, blushing.

“That’s cool,” Jake said happily.

“Are you sincere about that, or is that the Xanax talking?” Celia asked.

“I am completely sincere,” Jake said. “In fact, the very thought is causing a biological reaction down below. Do you want to see it?”

“Uh ... not just this moment, sweetie,” Laura told him.

“What a rip,” he said with a pout.

“How’s your pain?” Celia asked.

“Not too bad currently,” he said. “They lit me up with the Demerol just after the lab girl poked me. I should be good until pre-op.”

“That’s good,” she said.

They talked of other things for a bit. Laura told about everyone she had updated on his condition and their reaction to it. Celia talked about some new songs she had been strumming out over the past week. She was nowhere near the workup stage on anything but was at least getting the basic melodies and lyrics down on score sheets. Jake listened but had a hard time concentrating on what was being said. He mostly answered with “uh-huh” or “really?” or “that’s cool”.

At 8:25 an African-American man in gray scrubs entered the room. He introduced himself as Larry and said he was there to take Jake to pre-op. He told Celia and Laura that they were welcome to wait in Jake’s room or to come to the surgical waiting room and wait there.

“I’ll go to the surgical waiting room,” Laura said. “You can stay here, C, if you want.”

“I’ll go with you,” Celia said. “Once he’s in surgery we can go down to the cafeteria and get some coffee.”

Laura seemed grateful for the company.

They made their way through the corridors of the hospital to the elevator, went down three floors, and then made their way through more corridors until they came to a door labeled Pre-Operative Care Unit. Larry showed them where the surgical waiting room could be found. He then watched impassively as Laura hugged and kissed her husband and told him she loved him. He did raise his eyebrows a bit when Celia hugged and kissed him and told him that she loved him as well.

The two ladies walked away, heading for the waiting room. Larry opened the door to the POCU by swiping his badge on a little box mounted on the wall. As he pushed him into the unit, he said, “Uh ... that was Celia Valdez, wasn’t it?”

“It was,” Jake confirmed.

“You and she and your wife are ... uh ... pretty close?”

“Pretty close,” Jake agreed.

Larry made no further comment on the matter—at least not to Jake. He did tell multiple colleagues about what he had seen and heard before the day ended, however.

Jake was moved to a smaller gurney located behind a curtain in a room full of eight such enclosures. The pre-op nurse assigned to him was named Darla. She was in her mid to late forties, overweight, but cheerful and kind. She expressed to Jake that she enjoyed his music—the solo stuff, not the Intemperance stuff so much—and made a strange request of him. She asked him to sign his autograph on a urinal.

“A urinal?” he asked.

“Have you ever signed a urinal before?” Darla asked him.

“Uh ... well, no,” Jake admitted. “I’ve signed album covers, CD covers, guitars, t-shirts, more boobs than I could possibly even count, even a few butt cheeks, but never a urinal.”

“It will be a completely unique item then, won’t it?” Darla asked.

“You have a point there,” Jake said with a smile—he was still Xanaxing after all. “You got a sharpie and a pee bottle?”

She just happened to have both. She handed them over.

“I don’t have to actually pee in this thing though, right?” he asked carefully.

“Now that would be just weird,” Darla said.

“We wouldn’t want to get weird now, would we?” he said. He then signed the urinal, writing:

To Darla, RN. The best damn relief nurse I’ve ever met.