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Someone had brought Primanti’s. That made today the best shift all month. Never mind that Frank never actually got to finish a sandwich; the few bites he did get were heavenly, and he had been riding that high for the last two hours. His spirit couldn’t even be crushed by the asshole heart attack faker that just wanted to get off work for the day—Frank poked him full of holes, took half a liter of blood, and sent him on his way with the doctor’s note.
He had just taken another bite of his sandwich (he thought it was his, hard to tell when everyone had to abandon theirs halfway done) and was watching Perlah run after a screaming child when his vision blurred. He froze, putting the sandwich down and instantly tuning into his body. There was a slight pounding in his temple, and a clamminess settling over his skin. Shit.
He stood up carefully, his vision tunneling, and focused on Dana at the central desk. He felt his limbs moving, and maybe he was walking normally, but he couldn’t think about it with his heart slamming in his chest. “Dana” he said hollowly. “It’s happening.”
“Huh?”
“Seizure,” he said simply, already feeling his words slurring. As soon as the symptoms started, it was a race against time to get somewhere safe.
It took a second for it to register with Dana, but the next second she had him by the elbow, guiding him…somewhere. “McKay, with me! Whitaker, find Robby and get him here right now.” Frank swallowed. Right now. Because that was all the time he had. Dana pushed him backwards, a bed cutting him off at the knees, and he tried to lift his legs, but they had gone heavy and lame. “He has epilepsy,” Dana explained over his head. “He’s going into a seizure. Get some blankets on the bed rails.” Her hands were working too quickly for him to track, until he felt the pinch of an IV, and a prick on his finger. Glucose test, he thought, glad that he was keeping up.
“Frank, you still with us?” Cassie said quietly, rubbing his shoulder. Dana lifted his feet onto the gurney and they laid him down on his side. His body had gone slack in the last thirty seconds.
“Yesh,” he slurred. “Wayyt…befurr drrrug. Four mints…”
“Wait four minutes?” Dana repeated, tapping him on the cheek. “Wait four minutes before we give rescue meds?”
Frank’s words were lost behind his numb lips. “Mmmhmmph.”
“Blink twice if you want us to wait four minutes before we give the meds.” Frank blinked as hard as he could—once, then twice, his eyelids staying closed for longer than he liked. When he forced them open, Robby was there, crouched down in his vision.
“You’re safe, Frank,” he said firmly. “We’ve got you.” Dana tucked the suction tube into his mouth and put an oxygen mask over his face; someone clipped a pulse oximeter to his finger and then slid their hand into his. Robby’s face was a foot away, distractingly close. “Don’t fight it. Just let it happen. We’ve got you. You’re safe.”
Frank felt tears sliding down his face as the seizure started, small tremors rattling his body. All he could do was stare into Robby’s eyes, watch his mouth form words that no longer make sense, and wait for the world to fade.
He could never remember when the seizures actually started, he just knew it happened, because he would wake up fighting nonexistent enemies. His chest was heaving, heart pounding somewhere around 200 bpm, arms swinging at the body looming over him. “Frank! Frank, easy. You’re safe” Strong hands caught his wrists and held them close to his body, like he was hugging himself.
Frank bucked again. “Hnngg,” he keened, wheezing for air.
“Just relax,” someone else said. A woman—Dana. She was dabbing at his mouth with a wet wipe. “You’re okay.”
“He’s shivering,” the other voice said—Robby. “Get his temp and get a blanket on him.”
Everything ached. His jaw, the shoulder he was lying on, his back. It felt like when he ended up on the bottom of a dogpile playing tackle football with his 7 older cousins, and it was too fucking familiar. Frank shifted, trying to push off the mattress so he could lie on his back instead of his side. His arm was useless. “On your back?” Robby asked. Frank humphed in confirmation. Dana’s small hands were on his head, Robby controlled his shoulders and back, and a third pair of hands adjusted his legs as they shifted him onto his back.
Cassie. He could see her now, standing on the other side of the bed. “I’ll get a gown,” she said softly. Frank looked down to see strings of vomit on his chest, and could feel cold wetness between his legs. Losing bowel control was pretty typical for his seizures, but didn’t make it any less embarrassing.
Frank still felt like he was swimming underwater, even as he was slowly coming back to the present. “Aaaadivann?”
“At four minutes, like you wanted,” Dana said, checking the IV. “Want me to call Abby?”
“Mmmno, not…yet. ‘m fine.” Frank knew that he would be held for observation for a few hours, there was no use pulling Abby away from work to come sit and stare at him. Besides, he was exhausted; he’d be asleep now if there weren’t so many people poking at him.
“You up for some tests?” Robby asked. Frank shrugged. “I’ll take that as a yes. Follow the light.” His penlight traced a back-and-forth pattern. “Close your eyes and hold your arms out in front of you...okay… keep your eyes closed and lift your left leg.” Frank lifted. “And your right? …now your left again. Okay. Left arm, resist my pressure. Uh, good. Right arm.”
Frank opened his eyes in frustration. “Whass goin’ on, Robby?” He glanced over at Dana, who had paused her charting to watch over the rims of her glasses.
Robby was frowning. “There’s weakness in your left side.”
Frank lifted his hand…or tried to. It hovered a few inches off the mattress before he let it fall back. He tried his leg next, and it didn’t move at all. “Shit.” His heart rate jumped with anxiety, making the monitor beep.
“Try your right side again.” Frank lifted his arm and leg obediently—the right side was fine. “It’ll resolve in a few hours,” Robby promised. His words were casual, but Frank could see in his eyes that the paralysis was freaking him out just as much. “Anything else hurt?”
“Shouullderr.”
“We can get you some ibuprofen.” Robby nodded at Dana, who was already preparing an IV bag. “It’s been a while since your last seizure. Intern year, right?”
“Yeah.” Frank closed his eyes; he could sleep for a year after a seizure and still be tired. It was like trying to keep his eyes open with a hundred-pound weight pulling them shut.
“Have you ever had paralysis before?”
“Once.”
Cassie poked her head back in, tossing the gown on the bed. “Do you guys need me for anything else?”
“No, we should be good.” Robby picked up the gown, holding it awkwardly.
Frank was staring between Robby and Dana, deciding who he wanted to help change him. Well, nurses always got the gross tasks, so maybe Frank could give Dana a break today. “Robby?” he asked clumsily, the word tripping out of his mouth.
“Of course.”
Dana slipped out as Robby pulled the blanket back and carefully untied Frank’s shoes, setting them neatly on a cart. With his good hand, Frank started tugging down the waistband of his scrubs and underwear, but could only get them a few inches off his hips, because the abs on his left side weren’t working any better than his arm and leg. He sighed in defeat and let Robby slide them over his butt, then flipped the blanket back over himself immediately. Robby looked away politely as he handed Frank some wipes and a soft dry towel so Frank could clean himself off.
When he was done, he dumped the used wipes on the end of the bed and pulled up the bottom of his shirt, wriggling to get it over his elbows. “Hellpp,” he said quietly, giving up when his shoulder began to cramp with the effort. Robby turned back around and wordlessly tugged the shirt off, taking care to guide Frank’s chin through the mouth of the scrub top.
Frank snatched the gown quickly, sensitive to how naked he was…in the middle of his workplace, of all places. In front of his boss. With his good hand, he guided his left arm through the armhole and pulled the gown up, then stuck his right arm in and tried to spread it over himself beneath the blanket. Robby did up one of the shoulder snaps that had popped open. “Do you want me to get it tied? And…underneath you?”
Frank’s ass was bare against the bed. He didn’t love that. But he didn’t love the indignity of this process either. “Yeah,” he finally admitted. He raised himself as best he could on his right hand, and Robby worked the gown underneath him to the left side, tying the ties. Frank’s head was pounding; his heart rate was escalated just from the effort it had taken to change clothes. He leaned back into the pillow and closed his eyes.
“I’ll let you sleep.”
“Wake…up?”
“Every hour.”
“Call Abb…laturrr.”
“Will do. Just rest. We’ll check on you soon.”
The first time Robby had woken Frank up, there had been no change in the paralysis.
The second time Robby had woken Frank up, there was still no change, but he had to pee.
“I have to pee,” Frank announced as Robby checked his pupil size again.
“Push back on my hands,” Robby said in response, pressing down as Frank tried to lift his arm. He couldn’t. “And with your leg.” His legs were hopeless; the chances of him being discharged today was pretty much zero. “Urinal or Foley?”
“Huh?”
“To pee. Think you can handle the urinal? Or should I get someone to place a cath?”
Frank considered the logistics. “Tilt the bed up a bit, I can do a urinal.” Robby stepped outside to grab one, and tossed the plastic container to Frank, who bobbled it (because of the one-handedness) but caught it. The peeing process wasn’t…easy, per say, but he made it work, and got it back upright without spilling a drop. He wasn’t going to get any more urine on himself today, thank you very much. “Done,” he called.
Robby came back in and snapped on a glove to remove the Hazardous Bio Waste. “You need anything else?”
“You took some bloods, right? Any results?”
“Sodium, glucose, potassium, all normal, but your white count is slightly elevated, 12000. Feeling sick at all?” Frank shook his head. “You have any idea what caused the seizure?”
“No. Came out of nowhere. Thought it was under control.”
“Hm.” Robby sat on the stool and clicked through Frank’s chart at the computer station. “Have they been triggered by something specific in the past?”
“Sometimes. But also sometimes, nothing.” Frank yawned, the perpetual post-seizure tiredness hitting him again.
“Do you want to try to do some more tests? EEG? MRI?”
“They never find anything.” Epilepsy had been a frustrating condition from the start; it had started with no clear reason, and often struck out of the blue.
“And you took your daily meds?”
“Yes,” he hissed. There was an alarm on his fucking phone just to remember them.
Robby shot him an impressive side-eye. “You want to go back to sleep?”
“Sorry. Yeah.” Frank rubbed his face with his good hand. Jesus, this was going to be a long day.
The third time Robby woke him up, he brought a jello cup and Frank’s cell phone. “Time to call Abby.” He went through the neuro tests first, and grimaced politely when there was no change. “Are you nauseous at all?”
“No.”
Robby wheeled a bedside table over the bed and opened the jello for Frank, then set the spoon beside it. “Eat that. Tell Abby to page me when she gets here and I’ll fill her in.”
Frank grabbed his phone and unlocked it, staring for a moment at his kids’ cute little faces on the homescreen. He pressed Abby’s contact and listened to it ring.
“Hello?”
“Hey,” he answered, mouth suddenly dry. “How’s your day going?”
“Just finishing something up and then I’m going to pick the kids up from my mom’s. How’s yours? Something happen?” He didn’t usually call her, so that alone was enough to signal something was off.
He took a deep breath. “Yeah, babe. Uh, first off, I’m okay. I’m fine. But I had a seizure.”
“Oh, Frankie,” she exhaled. Not worried, not pitying, just understanding. They had been here before.
“Yeah. And, uh, there’s a little…my leg isn’t working right now.”
“The Todd thing again?”
“Todd’s paralysis, yeah. So, I have to stay here for now. Probably overnight.”
He could almost hear the wheels in her brain turning, the measured breath she took to stay calm. This was one of the reasons he loved her; she was good in a crisis. “I’ll call my mom; she can keep the kids overnight. I’ll be there in…30 minutes.”
“Find Robby when you get here.”
“Yeah.” He could hear her rustling around now, probably powering down her laptop and cleaning up papers. “Okay. I’ll be there soon. Frank—you’re okay?”
“I’m okay,” he confirmed.
“Okay. I love you. I’ll be there…yeah. I love you.”
“Yeah. See you soon.” He hung up and stared at the jello cup. A child’s snack, for someone that had to be cared for like a child. Sighing, he grabbed the spoon and scooted the table closer, taking a bite. Abby had never made him feel like a burden, ever, but it was hard not to feel ashamed when people had to help him change clothes, or eat food, or pee.
Abby liked to throw “in sickness and in health” back in his face, and “you would do the same for me,” whenever he got mopey. Sometimes it worked, sometimes he just put on a docile smile and thanked her and tried to ignore the tightness in his chest thinking about the day she would realize…Frank stabbed at the jello with his spoon, angrily breaking up the smooth glob into tiny smaller globs, then shoved the table away when his eyes started to feel hot and wet. He closed his eyes quickly, pressing his hand over them to stop the frustrated tears.
He didn’t realize he fell asleep. But the fourth time Robby woke him up, Abby was with him.
“Frank,” she whispered sweetly, hugging him as his eyes blinked open. “I’m here. Robby told me what’s going on with your leg.” Frank glanced down and flexed his muscles…and it moved. Just a twitch, but it felt like a victory lap. Anxiety he didn’t know he had been feeling was released in a tired grin.
“I think it’s happy to see you, baby,” he huffed.
Robby rolled his eyes and stepped closer. “Resist my—”
“Yeah, I know.” The light pressure from Robby’s hands were enough to keep his leg flat on the bed. Frank smiled. “It’s still not great, but it’s progress.”
Robby softened. “You need anything? Otherwise I’ll leave you two alone for a while.”
“Need some uninterrupted sleep,” Frank murmured.
“I’ll be back in an hour.”
When he was gone, curtain closed behind him, Abby took his numb hand and held it up to her face. “You sure you’re okay?” He tried to move one of his fingers to stroke her cheek, but the best he could do was nudge the knuckle against her skin.
“It was a weird one,” he admitted. “Going to take me a bit longer to bounce back. Sorry.”
She kissed his hand, still held in hers. “No place I’d rather be.”
“I know you had a long day, and with the kids and everything, you’ve been going non-stop.”
“Yeah, so it’s nice to slow down and spend a few hours with my husband.”
His wife was perfect. He felt tears pricking at his eyes again, emotionally wrought after his afternoon. “I love you.”
“Hey, hey,” she laughed gently. “None of that until you’re fully alert and I know it’s not the Ativan talking.”
“It’s not,” he insisted, but his eyes were being drawn shut again. “It’s me. I love you so much, Abs.”
“I love you too. Now, go back to sleep. I can tell you’re exhausted. I’ll be here.” Her hands carded through Frank’s hair, soothing him to the most peaceful sleep he’d had all day.
The fifth time Robby woke him up, it was with a hard sternal rub to his chest. “Frank, wake up!” Waking up. Why did that feel like a foreign concept? Everything hurt. That was normal after a seizure. But…his seizure had been hours ago now. He tried to breathe, but the air got stuck in his lungs, and a cough burbled out of him. “He’s aspirating,” someone said, and Frank was unceremoniously rolled onto his side, a plastic tube shoved between his lips.
He fought it, trying to paw at the intrusion, but a warm hand caught his wrist. “Frank, open your eyes for us.”
“Frankie, please.” Oh. Abby was here. His eyes creaked open. Immediately there was a penlight, flicking up and down in front of him, and in the back of his mind he knew he should be following it, but things were all happening at once and he was…scared. A little terrified, if he was being honest.
“Abbbb…” he managed.
The scrubs in his line of vision were shoved out of the way, replaced by his wife’s sweet, worried face. She touched his cheek. “You’re okay, Frank. You had another seizure.”
“Nnnnn…” Another one?
“Yeah.”
Shit. A second seizure in…Frank’s blurry mind couldn’t remember how long it had been since the first, but…that wasn’t good.
“Dana, take bloods and set a foley to get a urine sample.” A foley? Frank groaned.
His head felt like it was stuck in a vice. He tried to close his eyes against the intrusive brightness, but a hand was shaking his shoulders. “Stay awake, Frank. Follow the penlight. You know the drill.” …did he? Know the drill? He squinted at the light, trying to watch it move. “Pupils are sluggish but he’s following commands.”
“Is he still paralyzed?”
“Probably.” That was Robby, Frank’s brain supplied. He glanced around the room. Abby. Robby. Dana. “Frank, can you lift your arms for me?”
Hmmm…he was staring at the ceiling, but he knew where his arms were, right? Maybe…his thoughts drifted, eyes closing again. “He’s still coming out of it,” Robby said somewhere over his shoulder. “Doesn’t mean he’s paralyzed. Here…” Someone, must have been Robby, pulled the blanket aside; he could feel the cold air on his feet. “No response on his left.” Then there was pressure on his right foot, an instrument drawn sharply over the sole. “See how his toes curled? That’s the reflex. Not paralyzed on the right. Same as before.”
“Frank, I’m gonna put the foley in. You’ll feel me touching your thigh.” Dana’s voice was soft and warm. “Cleaning first, with some betadyne.” A small part of him relaxed when he felt her fingers, and learned that his penis wasn’t paralyzed. But he tensed again immediately as the pressure started, the catheter traveling up inside him. “Sorry, kid,” Dana murmured. All he could do was groan weakly.
His body came back under his control in pieces. His shoulder first, aching with every heartbeat. His hand next—his right one, anyways—squeezed in both of Abby’s. His groin, wet again. He had reached his limit on embarrassment for the day, and needed…he needed to get out. “Uhhhhp,” he slurred. “Sturrrs.”
“Up?” Robby said quietly, pausing his typing.
“Uhhpsttirs.”
“Upstairs?” Robby glanced at Abby, who shrugged.
“Neurrro.”
“Oh. You want to be transferred to neuro?” Frank gave him a shaky thumbs up.
Dana patted his foot. “I’ll call them, see if there’s a bed.”
“You want to get out of here that bad?” Robby asked, half-joking. If only he knew what it felt like to be poked, prodded, and watched, to lose control of your bowels twice in front of friends, to not be able to advocate for yourself while people touched you.
Frank turned his neck, twisting against the pain and looking to Abby. “Yeah,” she breathed. “He does.” A tear dripped down Frank’s nose, and she brushed it away. “Dr. Robby, I think we could use some privacy.”
“Sure thing.”
Frank started to cry in earnest, and Abby moved closer to hold him. “It’s okay to be scared. You’re going to be fine. We’re going to get through this.” She was crying too, but kept whispering to him. “I’m here for you, and I love you. You are so strong. You’re a good father, and a good doctor.”
“Srrryyy.”
“There’s nothing to apologize for.” She was so soft. Everything about her, tender. Safe. “It’s okay to cry, love. Let it out. I’ve got you.”
When his eyes finally ran dry, she helped set him back upright on the bed, adjusting his arm when his shoulder pulled and he winced. Someone, Dana probably, had brought in a spare gown without him noticing. Abby helped him out of the sweat-dampened gown and into the fresh gown, her hands warm and familiar against his skin. “Thannnksss,” he whispered. She had brought him back down to earth, grounded him in reality again. It sucked, but it wasn’t hopeless, just frustrating. “Get Rob.”
“Robby? Okay. I’ll be right back.”
He barely had time to suck in a full breath before Robby opened the curtain, penlight already out. “Do you know what day it is, Frank?”
“Monnday.” At some point he must have hit his mouth or bit something, because his lips were still swollen around the edges of his words.
“Right.” Robby traced a few patterns with the penlight and hummed in satisfaction. “You’re tracking again. Feeling more with it?”
“Yeeeah?”
“Okay. Try to lift your leg?” Frank focused all of his energy onto his left leg, and thought he felt it shaking. “Hey, that’s good! Good progress. Doesn’t seem like you lost anything in the second seizure. Arm?” He could move it better, but his fingers were still numb. “Progress,” Robby repeated.
“Hurts.”
“I can up your ibuprofen and add some naproxen. Any nerve pain? Or is it just muscular?”
“Mussscllle.”
“I’ll bring some heat packs too.” Robby hesitated. “They don’t have a bed for you upstairs. But we can move you to a private room, instead of the curtain.” Frank nodded, and Robby laid a hand on his shin. “I’ll be right back. Just hang in there.”
Abby planted herself in the chair next to him again. “Frank?” She asked quietly. “How bad is it? Two seizures in the same day, and the paralysis?”
“Itsssfine. Take lon…longer to heeaal.”
“If you tell me not to worry, I won’t.”
Frank hoped he was smiling, and hoped it was reassuring. “Don’worry.”
Robby came back with the painkillers and heating packs and positioned them on Frank’s sore muscles, then kept up a steady stream of conversation as they wound through the halls of the ED. There were suspiciously few people, but Frank did notice Dana standing guard at the desk. His hero.
Once they got him in the private cubicle, Robby hit the light switch, leaving the room dark, lit by the dull glow of the heart monitor. “Rest now. And don’t ever do that to me again.” Frank smiled as he fell asleep.
The sixth time Robby woke him up, he had news. “Hey you two. Frank, you have a kidney infection.”
Franks stared at him, not fully awake. “No, I don’t?” Well, at least he could talk again, even if his brain needed a second to wake up again.
“Elevated white cell count, and the urine cultures came back positive. It’s not a bad infection, but it could have caused the seizures. I have antibiotics for you. What do you think about cutting back on the ibuprofen, since the kidneys are involved?”
Shit. “It’s gonna suck.”
“Then we don’t have to.” Robby looked uneasy.
Frank rubbed his head. He relied on medication to control his seizures, so if his kidneys got damaged, he’d be screwed. “No, you’re right.”
“What’s going on?” Abby asked carefully. Sometimes Frank forgot she wasn’t a doctor; she spent enough time with him in the hospital.
Robby frowned. “Prolonged ibuprofen use can damage the kidneys, especially if they’re already susceptible, like they are when there’s an infection.”
“And if there’s kidney damage, it can affect how my seizure meds work,” Frank added.
Robby put the tablet down next to Frank’s leg and didn’t even need to ask before Frank tried to lift his leg and arm against Robby’s hands. “It’s getting better. Try lifting your arm and bending at the elbow…yeah, good. Getting some fine motor back.” He hung the bag of antibiotics and hooked up the IV, then checked the urine bag. He held it up for Frank to see—dark, cloudy. Kidney infection 101. Jesus.
Frank caught a glimpse of the ED through the open cubicle door and saw night shift people. “Wait, what time is it?”
“About 8:30pm.”
“What are you still doing here?”
Robby scratched the back of his head. “Thought you’d be more comfortable with me. Keep the coworker exposure to a minimum. That’s why you want to go upstairs, right?” Frank grimaced…he wasn’t wrong. “Besides, gives me a chance to catch up on charting and take that stupid HR training they emailed.”
Abby shook her head. “Go home, Dr. Robby.”
“I might,” he said ambiguously. “Get some rest.” Frank nodded and relaxed back into the pillow. In under a minute, he was out.
The seventh time Robby woke him up, he was in his street clothes. “Wake up, kid,” Robby said gently, rubbing Frank’s shoulder. “I got news.”
“Hm?” He squinted at the bright lights. Damn the ED and their constant need to see.
“Where’s Abby?”
“She went home to eat and grab some things. Check on the kids.”
“Neuro’s got a bed for you.”
“Oh? Does that mean you’re finally going home? Hung up the doctor clothes for the night”
Robby sat in Abby’s vacated chair. “Means I clocked off so I could keep you company. It, uh…it was a scary day.”
“I’m fine, real—”
“For me, not you. Well, I suppose, for you too. Sue me if I want to make sure you don’t die before you make it upstairs.”
Frank stared down at his hands, focusing on pressing his thumb to each finger to test the fine-motor. “It was that bad?”
“Watching my friend have back-to-back seizures? Yeah, it was bad.”
“Your friend?”
“My resident,” Robby corrected, but it was a joke between them now.
“Sorry.”
“Yeah, you should be.” The wry smile on Robby’s face let Frank know he was joking again. Robby took a deep breath and scrubbed a hand over his face. “The only thing that matters is you’re okay.”
“Getting there. You don’t want to do more tests?”
“Off-duty, remember? ‘Sides, Neuro’s going to do all that and more. They’re sending someone down for you.”
“Can you text Abby? My phone’s in the bag under the bed.” Frank’s fingers were still a bit too clumsy to text.
Robby bent down to fish the phone out of the patient belongings bag, held the phone up to Frank’s face to unlock it, and fired off a text to Abby. “Done.”
“Thanks. And, uh…thanks for taking care of me. Being there. You kinda spent the whole day with me.”
“You were sleeping for like 90% of it; I saw plenty of other patients.”
“Still. I was kind of freaking out, but every time I woke up, you were right there. It was, uh…nice.”
Robby cleared his throat, looking close to tears. “Of course. Uh, I’m going to go check when Neuro’s getting here, I’ll be right back.”
Frank could tell Robby was making an excuse so he wouldn’t start crying, and honestly…same. But Robby was halfway out the door when Frank felt a hint of panic at the idea of being alone. “Robby? Do you think you could, uh…stay? Until Abby gets back?”
“Right. Yeah. I’ll just text them, that’s fine.” He settled back into the chair.
Frank rubbed his eyes. “Sorry, it’s just that Abby’s gone, and before, I fell asleep, and woke up in status, and…it freaks me out, but I need to sleep like, so fucking badly.”
“Don’t worry about it.” Robby leaned forward, laying a hand on Frank’s knee. “Rest. I’ll be here when you wake up.”