Legacies

1.

"How's it going, Hector?"

Little Hector Lopez looked up at Alicia from his hospital bed but didn't smile.

"'Kay," he said.

She'd admitted him to the pediatric service on Friday due to intractable vomiting, but he'd been holding down fluids since yesterday afternoon. He looked better. Still had a fever, though. His spinal tap had looked negative, but the culture was still pending. So were blood and urine cultures. She hoped this turned out to be a simple gastrointestinal virus, but his practically nonexistent CD-4 count deeply worried her. Just to be safe, she'd shot him up with some IV gamma globulin.

"How're you feeling?"

"Thith hurtth," he said, pointing to his splinted left arm where the IV tube drained into an antecubital vein.

"We'll take that out as soon as you're better."

"Today?" he said, brightening.

"Maybe. Your fever's got to come down first."

"Oh."

Alicia turned to Jeanne Sorenson, the nurse who was accompanying her on rounds today. The big blonde was barely twenty-five but already a grizzled veteran of the AIDS war.

"Who's been in to see him?" she said in a low voice.

Sorenson shrugged. "No one that I know of. His foster mother called—once."

"All right, then," Alicia said. "Who's Hector's buddy on this shift?"

"We haven't assigned one yet."

Alicia suppressed an angry snap. "I thought we agreed that all my kids would have one buddy per shift," she said evenly.

"We haven't had time, Dr, Clayton," Sorenson said, looking flustered. "It's been hectic here, and we figured he'd be out in a couple of days, so—"

"Even if it's one day, I want them assigned a buddy. We've been over this, Sorenson."

"I know that," the nurse said, looking sheepish.

"But apparently it didn't sink in. You know how scary a hospital is for an adult, so imagine yourself a child confined to bed in a place where a bunch of strangers have taken your clothes and sneakers and started sticking needles in you and telling you what you can eat and when you can go to the bathroom. But at least most kids can count on a mother or father or someone familiar showing up and lending a little reassurance. Not my kids. They've got nobody to fall back on. Their support system is a black hole. Can you imagine what that's like?"

Sorenson shook her head. "I've tried, but…"

"Right. You can't. But trust me, it's terrible."

Alicia knew. She'd been hospitalized a few weeks into her first year at college—for dehydration secondary to a viral gastroenteritis very similar to what had brought Hector here. She was in only two days, but it had been an awful experience. No boyfriend and no close friends, no one to visit her or even ask after her, and damned if she was going to call home. She'd never forgotten that feeling of utter helplessness and isolation.

"So that's why they need someone on every shift who'll come in and talk to them and smile and hold their hand every hour or so, someone they can count on, just so they don't feel so damn alone. It's almost as important as the medicine we pump into them."

"I'll get on it right away," Sorenson said.

"Good. But don't do it for me. Do it for him." She turned and rubbed Hector's bristly head. "Hey, guy. That buzz cut looks as mad as ever."

Now she got a smile. "Yeth. It'th—" He coughed. He tried again but interrupted himself with more coughing.

"Easy, Hector," Alicia said.

She sat him up and parted the back flaps of his hospital gown. Pressing the head of her stethoscope against his ribs, she listened for the soft cellophane crinkle that would herald pneumonia. She heard nothing but an isolated wheeze.

Alicia checked Hector's chart. The admitting chest X ray had been negative. She ordered a repeat, plus a sputum culture and gram stain.

She stared down at his bony little body. She didn't like that cough one bit.