Keep Your Mouth Shut And Wear Beige Part 20

"Try. Chug some water and try. Hit the bowl if you can." The emergency room might want to a.n.a.lyze her stomach contents.

She bent over the bowl. She coughed and gagged, but didn't regurgitate. Rose knelt next to her, scooping her hair out of the way.

People had gathered around: Zack, Claudia, the restaurant manager, and Finney, little Finney. He was terrified. His eyes were wide, and his face was so pale that his freckles stood out.

"Oh, for G.o.d's sake," I snapped at Claudia, "take him inside. He doesn't need to see this."

Annie gagged again and then gave up, collapsing against Rose. "Oh, Mom . . . I don't feel good."

"Come on, Finney," Claudia said. She touched him on the shoulder, getting him to turn, but as they started to walk, she let her hand fall.

No, no, no. I wanted to shriek at her. Put your arm around him. Take his hand. Do something. He's scared to death.

Rose was stroking Annie's hair. "Should I try to make her gag?" she asked me softly.

"I don't think it's worth it."

"Please tell me what happened. I have to know."

Of course she did. And not just for her own peace of mind. She would need to tell the emergency room.

Annie was now feeling too lousy to care what anyone said. "She overheard us talking in California," I said to Rose, "and she's been getting ADD medications from other kids-"

Rose gasped.

"So when the photographer told her to concentrate and focus, she thought a pill would help. But it seems to have been something else. We don't know what."

"Is there any chance . . ." Rose couldn't bring herself to say it.

"That she's done lasting damage to herself? Not from a single dose. She's not hallucinating. I don't think it was anything illegal." I heard the wail of the ambulance siren.

"Is there anything I can do, Mom?" It was Zack.

The restaurant manager was already at the edge of the parking lot, flagging down the ambulance. For a moment, the linen-service truck blocked the turn into the lot, but the manager slapped the panel of the truck with his palm, and the driver gunned his engine, pulling into traffic. "Get their purses. Rose will need her insurance card. And see if you can get Guy on the phone. I'll tell him what's going on."

The ambulance personnel were quick and expert. They took her vitals and eased her onto a gurney. "Is she a minor?" the lead guy asked. "Is one of you her mother?"

"I'm coming with you," Rose said to them; and then to me, "You'll take care of Finney?"

"Absolutely."

"Okay, then," the EMT said. "If you have everything, let's go."

"My phone." Rose was trying to think. "My purse."

"We have them. Let's go." He took her arm, urging her forward.

Zack handed me his phone, and as the ambulance pulled away, I spoke to Guy. "She'll be fine," I kept saying. "It was probably just a bad reaction to some medication."

"The hospital's in Southampton. I'll get there as soon as I can, or do you need me to come get Finney?"

"No, we have him. We'll get him home."

The photographer came up to me and handed me Annie's shoes. She must have kicked them off. "Tell Ms. Postlewaite I'll be here tomorrow. That's what we were supposed to do anyway . . . and I hope the girl is okay. I might have been too demanding. It was hard not to think of her as a professional."

"But she's not."

"It was frustrating for everyone." He wasn't going to take any more of the blame.

Zack picked up the empty bowl, and we started walking back to the restaurant. "She OD'd on something?" he asked.

I didn't want him to think the worst, so I explained. "How often does that happen?" I asked. "Kids buying Ritalin and Adderall from other kids?"

"It happens in college, but honestly, at a private high school"-both Annie and Zack attended private schools-"kids who need prescriptions have them, and everyone knows that if you don't need them, they don't do much for your concentration. If you just want to stay awake, there's cheaper ways. People will grind them up and snort them to get high, but it doesn't sound like Annie was doing that."

"No, she was genuinely self-medicating, which is still stupid and dangerous . . . as this incident showed."

"Why didn't she have a prescription? Why didn't her folks make her take all those tests? You made me."

I wasn't sure how to answer that. "They did have her a.s.sessed a number of years ago, but-"

Before I could finish, one of the waiters came running out of the restaurant. "The little boy. Something's wrong with the little boy."

Thirteen.

I.

kicked off my shoes and raced across the parking lot. Zack pa.s.sed me, then paused at the door, holding it open, letting me go in. I felt my dress catch on something. I yanked it free.

The restaurant was dim. "He's in there. In there." The waiter pointed to the private room, and I heard Claudia trying to calm Finney.

The room was full of tables and chairs now. Finney was in a corner, sitting on the ground, his back to the wall. He had his hands to his face. He was hyperventilating. "Mommy," he whimpered. "Mommy."

Claudia moved aside and I knelt in front of him. "No, Finney, it's Darcy." I eased his hands from his face, unb.u.t.toned one of his cuffs, shoved up his sleeve, and looked at his inner arm. It was covered with thick red welts.

I looked back at Claudia. "What did he have?"

"Nothing. Just water. He was so upset. I asked the hotel for some water. They gave me the bottle. It was fine. Look." She lifted an empty plastic liter. It was the same water they'd brought to Annie. It had a little bunch of cherries on the corner of the label. "It's all natural. It says so. It's all natural. It couldn't have been the water."

All natural . . . Why don't people understand that "all natural" doesn't always mean "good." This water was cherry-flavored; it would be sweetened with corn syrup-I didn't even have to look at the label. "It couldn't have been the water," Claudia said again. She thrust the bottle at me, wanting me to see. "It couldn't have been."

I waved it aside. "Read the fine print and see if you can still say that. He needs the EpiPen." I was already going over the procedure in my head . . . Form a fist around the tube . . . ninety-degree angle . . . as I reached for- It wasn't there. Finney wasn't wearing his f.a.n.n.y pack. I conjured up an image of him outside under the linden tree. He had been in his blue s.h.i.+rt and gray slacks. He hadn't had the f.a.n.n.y pack on. "Zack, Zack . . . did Finney take his f.a.n.n.y pack off in the car?"

"I don't know." Zack tried to remember. "I gave him the flowers . . . we put them in the car, he took off his blazer . . . no, no, he didn't have it on then. I'm sure of it." He thought again. "But he had it on when we got here. He was playing with the zipper."

So it was at the restaurant. "Somebody . . . everybody," I shouted, "we need to find a small black f.a.n.n.y pack. Try the kitchen, the main dining room. We have to have it. And call another ambulance."

The hives were getting worse. Finney was coughing, spitting up some clear phlegm. "Finney, sweetie . . . do you know where your f.a.n.n.y pack is?"

His eyes were darting around. He was frightened and confused. He couldn't remember. "It's okay," I murmured. "It's okay. We'll find it."

But what if we didn't?

I looked around the room, hoping to spot it. The door to the kitchen was swinging open and closed as people rushed around, looking for the little pack. Claudia was over by one of the windows, pus.h.i.+ng aside the drapes, tilting back a chair, then pus.h.i.+ng the drapes aside again. She knew something.

"When did he take it off?" I demanded.

She faced me. "During the pictures. The photographer said it was ruining the shot. And there was a table here, right here." She pointed to the floor in front of the window. "I put it there. It was right in plain sight."

"Then, for G.o.d's sake, go find out what happened to the table."

Why hadn't I gotten the second EpiPen from Rose? We'd gotten out of the habit because my father carried one. But Dad wasn't here.

It was getting harder to keep Finney calm. He was poking at his throat as if he was having trouble breathing.

Zack came back through the swinging door. "It doesn't look good, Mom," he said bluntly. "They dropped the dirty linen on that table, and the linen service has already taken it away. n.o.body remembers a f.a.n.n.y pack."

We had to keep Finney breathing until the ambulance got here. The danger with anaphylaxis is that the tissues in the airway can swell, blocking the intake of oxygen. I got behind him and lifted his arms. "Listen to me, Finney. We're going to play a game. Make your chest big. Zack is playing too. See if you can make your chest as big as he can."

I didn't have to prompt Zack. In an instant, he was in front of Finney and drawing deep full breaths, inhaling and exhaling loudly. A dark-haired waitress joined him. And Finney, this sweet little boy, did his best. "That's right. That's great. Now let's try again."

What if his airway closed? What would happen to the family? And Rose-how could she ever live with herself, knowing that she had forgotten to give me his EpiPen?

I felt motion at my right arm. It was one of the waiters. He had brought the restaurant first-aid kit back inside. "Dump it out," I said. "See what we have."

I was glad to see that there were gloves. I kept talking to Finney. His breaths were getting smaller, and he couldn't concentrate. He kept looking at his arms. The hives terrified him. If I hadn't been holding his arms, he would have clawed at them. He was starting to thrash, gasping and wheezing. "Call Grandpa," I told Zack. "His number is in my cell phone." But I didn't know where my cell phone was, somewhere in my purse, somewhere outside.

Zack already had his phone open. Apparently he had the number. I heard him talking to Dad. Then he put his phone on speaker and set it on the ground where we both could hear it.

The waitress was still trying to get Finney to play the breathing game.

Dad asked me a few quick questions, then said in a voice made calm by years of experience, "Let's hedge our bets and a.s.semble things for a cricothyroidotomy."

Knowing that other people could hear him and not wanting to alarm them, Dad had spoken in technical code. A cricothyroidotomy is a tracheotomy done outside a hospital setting; you make an incision and insert a tube directly into the patient's trachea. It is a dangerous procedure, especially on a child. Their airways are small, and if you do it wrong, if you overpenetrate, you can do a lot of damage.

But, without the EpiPen or intubation equipment, it might be our only option. I would need a tube and a scalpel. Combat medics carry cricothyroidotomy kits, but there was little in the restaurant's first-aid supplies that would help.

"What do you want me to get, Grandpa?" It was Zack, talking into the phone.

"Go into the kitchen and get a knife, a small one. It needs to be sharp." Dad could have been talking about the weather, his voice was so calm. "And, Darcy, find a tube of some kind. A refillable ballpoint pen will be your best bet, the smaller the better."

A narrow gold pen appeared in my field of vision. "Take it apart," I said to whoever was holding it.

The headwaiter volunteered that he and the chef had CPR training. I nodded, but I knew that CPR would do no good if the air couldn't reach Finney's lungs. The manager of the restaurant was talking on his cell. I hoped he wasn't calling his lawyer.

He wasn't. "I called to get a read on the ambulance. Some jerk was trying to follow the first ambulance and caused an accident behind it. So traffic's backed up and our ambulance is having trouble getting through. It's going to be another ten minutes, at best."

Dad had heard that. "Keep your eye on his fingernails and lips, Darcy."

"His lips are white."

"You'll want him on a table, supine, with a rolled towel under his shoulders. You'll want to hyperextend his neck." Zack scooped Finney up and laid him on the table, stretching him out, holding him down. The waitress with dark hair had heard Dad and had rolled up a clean tablecloth. We tried to slip it under Finney's shoulders, but it was too big. The waitress unfolded it, rerolled it Finney was hardly struggling anymore. He was still breathing, but with a labored, croupy sound. His lips were gray. I looked down at his fingernails. "Dad, his nails are blue."

"We've got alcohol wipes, Grandpa," Zack said. "And Mom's putting gloves on."

"Good. Swab down Finney's neck. Now, Darcy, get on his right side. Someone should hold his head, but not you, Zack; I may need you. And is there anyone who can monitor his pulse?"

The manager went to the end of the table and clamped his hands on either side of Finney's head. The dark-haired waitress silently moved into place, picking up Finney's wrist.

Dad had me palpate Finney's neck. I found the thyroid cartilage. A finger's breadth below that would be the cricoid cartilage. That's where the cricothyroid membrane was.

"You're going to cut twice. The first is the skin. Put your left forefinger on the thyroid cartilage and make a transverse incision, maybe an inch, through the skin over the cricothyroid membrane. Stay in the midline as much as you can."

The little knife was warm. Someone had sterilized it with boiling water. "Darcy?" I heard Dad say.

It's just skin. It's not Finney. It's just skin. I cut. Finney flinched, but my helpers were holding him tight. Bright red blood crested over the incision. "Okay," I said.

"How's his pulse?" Dad asked.

"Steady." It was the first time I had heard the waitress speak.

"Good. This incision is transverse again, very small, just big enough for the pen. Leave the knife in."

The blood kept me from seeing anything, but in my mind was suddenly every detail of a picture from one of my old textbooks. I cut into the cricothryoid membrane. I felt a little pop. "Okay."

"Zack, are you wearing gloves?"

"Yes, Grandpa."

"Then pick up the tube and be ready to give it to your mother. When you're ready, Darcy, release the thyroid cartilage, take the tube in your left hand, and rotate the knife ninety degrees with your right, then insert the tube in the incision-it should slip right in-and pull the knife out."

Rotate with my right hand, insert with my left. I could do that.

And I did. The pop was a little louder.

Finney's chest rose sharply as his lungs pulled in air from the makes.h.i.+ft pa.s.sage. It had worked.

I felt like sinking to my knees, in prayer, in exhaustion, but I had to keep holding the pen.

Finney wasn't reacting to the pain from the incision. The relief of being able to breath, the life-giving oxygen filling his lungs, must have overridden the pain sensors.

Dad was having Zack wrap gauze from the first-aid kit around Finney's neck and the base of the pen. I wondered when Zack had put gloves on. I hadn't told him to. I watched him as he slipped the roll of gauze under Finney's neck. His hands were steady.