The phone ringing woke me, and I jolted awake.
“There’s a five-year-old boy here with a fever of 41.5,” I heard Gali on the line.
“I’m coming up.”
It was two in the morning.
“How long has he had the fever?” I asked the anxious mother as I entered the ER.
“Since last night.”
“Has he vomited?”
“No.”
“Is he taking anything?”
“No – just gave him acetaminophen.”
“Did you go to the clinic?”
“Yes, yesterday. The doctor said if the fever gets high and I can’t get it down, to come back.”
I examined the boy gently and saw that his tonsils were coated with white follicles.
“He has acute tonsillitis,” I told her.
The penicillin skin test Gali did was negative. She gave the injection and a fever-reducing syrup. I asked that he not be discharged yet and that she keep monitoring his temperature, and I went back down to rest.
A pounding on the door jolted me awake. I wondered why no one had phoned. I got up and opened.
“Come quickly to the ward,” said a voice from a figure I didn’t recognize.
“Did something happen? Why didn’t you call?” I rubbed my eyes.
“You didn’t answer,” the messenger apologized. “The patient in Internal is showing signs of agitation,” she added.
I splashed water on my face and flew up the stairs to the ward, to her room.
Two men I didn’t know were by her bed. I asked them to step outside.
“A few minutes ago, the monitor started beeping. The pulse was fast and irregular,” the ward nurse said.
“What did you do?”
“I checked all the connections – everything was fine. Blood pressure was 60 over 100. I asked the nurse in the Maternity Ward to call you.”
“Good. Give me isoproterenol,” I said. The tracing showed a supraventricular arrhythmia.
Before I could push the isoproterenol through the IV, the patient began moving her limbs involuntarily.
I struggled with her so I could hold the IV arm steady – keep the vein open.
She nearly overpowered me. The nurse brought a bandage, and together we tied that arm to the bed.
Suddenly the patient calmed down, but her heart rhythm remained irregular. I injected the isoproterenol. Its effect was almost immediate. The rhythm returned to normal, but I was still uneasy.
“Call the on-call physician,” I said.
