CHAPTER TEN
Tuesday, 7:49 p.m.
Fox RiverMedicalCenter
Despite his insistence, Trish refused to let Dumenco go outside for a walk. “You have to take care of yourself. Rest, conserve your strength.”
“Take care of myself!” he said, partly amused, partly outraged. “I am dying-I am already dead. What does it matter? I wish to go outside and breathe the air, see the trees, listen to the river.”
Finally, she agreed to take him in a wheelchair. Grabbing their coats, she wheeled him out onto the sidewalks where he could watch the stars.
The hospital was surrounded by ancient oak trees that had shed brown and yellow leaves on the cropped grass and across the pavement. Acorns and dry twigs crunched as she pushed the wheelchair. Dumenco’s eyes were bright and alive, drinking in the details like a condemned man savoring his last meal. In a way, Trish found the comparison very appropriate.
The air was chill with autumn, the sounds of the town somewhat quiet. Aurora was one of those midwestern cities that all but rolled up its sidewalks and went to sleep after business hours. A soft wind rustled the oak trees above. Dumenco looked up, then stared at the sky as the stars seeped into the eastern twilight.
“Thank you,” he said. “I will remember this for the rest of my life… such as it is.” Dumenco seemed to be making a wry joke, and Trish didn’t know how to respond. She marveled at the thoughts that must be swirling behind that high forehead.
Long ago, she remembered seeing him in his element, talking to him over in the Ukraine during the days of her post-Chernobyl research. Georg Dumenco had been such a different person then, in control of his life, uncovering the secrets of the universe. Even then, he had been buried in his research for the Soviet government, unwilling to talk about it.
Living in the shadow of Chernobyl, Dumenco had been terrified of radioactive fallout, afraid of its effect on his family. She had not been surprised to learn of his defection to the U.S.
Those experiences in the Ukraine had affected her life, driving her to a deep suspicion at the complacent way many scientists viewed radiation use and exposure. Trish vented her own frustration and alarm through her work in the PR-Cubed. She had also kept in occasional contact with Dumenco himself and followed his work in Fermilab, had even visited him shortly before his accident.
And now she had to attend him as he died from the very thing he feared the most.
Dumenco appeared to be resigned to his fate, interested in what would happen to him from a coldly analytical point of view. “I want to know all the details, my dear lady,” he said. Under the light of the sidewalk lamps on the hospital grounds, he looked at the reddening skin of his hands, his swollen joints. He licked his dry and cracked lips, which were already purple from hemorrhages underneath.
“It’s not going to be pleasant, Georg,” Trish answered, distracting herself by pushing him along. “Maybe it’s better if you don’t know.”
The sidewalk sloped gently downhill, toward the Fox River that curled slowly across the farmlands. Joggers ran by, with steam puffing out of their mouths. A young couple sat on a bench, looking out at the dark river, more absorbed in each other than in the scenery.
“Of course it won’t be pleasant,” he said. “This is death. It’s not supposed to be pleasant. But I’m also a scientist, and I have what you might call a morbid curiosity as to the sequence of events. I am, after all, about to experience them far more intimately than I had ever wanted to know.”
Trish swallowed hard, trying to act professional, to look at him as a patient rather than a human being she admired. At least she had dragged him away from his intense scrutiny of the recent accelerator results.
“If this helps you to prepare… there’s nothing I can do to help you.”
“I understand that, my dear lady,” Dumenco said. “But knowledge is still more comforting than ignorance.”
“You might not say that in a minute,” Trish said, but her faint edge of humor became brittle. “Within the first hour or so, you started experiencing what we call the ‘prodromal’ syndrome, erythema or redness of the skin, fever, nausea, weakness, cramps, and diarrhea. We treated those effects with intravenous fluids to prevent dehydration, antiemetics to control the nausea and vomiting. Fortunately, we haven’t had to use vasopressors to constrict blood vessels and keep your blood pressure up to a safe level. So far the IV fluids have been enough.”
She continued, focused on the lighted sidewalk ahead, listening to the crackle of dry leaves under her shoes, under the wheels of Dumenco’s chair.
“Your bone marrow is also destroyed, your immune system ruined. Your number of white blood cells and platelets are both going down already, and your body won’t make any more of them. That means you won’t be able to resist infections, and you’ll bleed easily- especially inside your body. Although no more red blood cells will be made either, that really doesn’t matter. Even the high radiation dose you received didn’t much affect the ones you already have, and red blood cells usually live for three or four months. But you won’t be around long enough to become anemic. Bone marrow transplants were tried at Chernobyl, but in most cases did not prove to be helpful.”
Dumenco shuddered. “My family is… not available as bone-marrow donors, even if it would help.”
Trish knew that Dumenco’s wife and children had not come with him when he fled to this country, and their whereabouts were in question. Trish had been contacted by a member of the PR-Cubed, a Ukrainian in fact, who had been searching for Dumenco’s family, citing a study on family effects of Chernobyl survivors. But she had no information to give the man, despite his persistent questions. Dumenco had never spoken to her about what had happened to his family. She expected they had succumbed to something more terrible than radiation, back in Eastern Europe.
She turned back to the problem at hand, as if reciting a report. “We can do nothing to alleviate the central nervous system damage you received. Your symptoms may include apathy, fatigue, apprehension. You’ll be unsteady, your hands will shake, your ears will ring constantly. As you degenerate, you may suffer from convulsions of increasing severity. I anticipate… death will follow from respiratory arrest.
“And even if the radiation injury to your brain isn’t severe enough to kill you, in a few days the damage you received to your immune system and the lining of your intestines will probably make you go into septic shock. When that happens, treating you with powerful antibiotics might keep you alive maybe a day or so longer- but it would just be delaying the inevitable.”
He swallowed hard. “At least my hair won’t fall out.”
“No, that would take a few weeks.” She hesitated. “You won’t last nearly that long.”
When she finished, Trish felt ashamed of what she had done. Instead of telling him in gruesome detail, she should have had a better bedside manner. Dumenco could have been made to feel comfortable and at peace.
At times she let herself get carried away, especially with the Physicians for Responsible Radiation Research, thinking more about abstract social solutions instead of individuals like Dumenco. Sometimes Trish knew she went too far; she acted without thinking, then had to face the consequences.
“How do you know all this information?” he asked. “From test animals?”
“Treatment of radiation exposure is not an exact science. Every case is drastically different,” she said. “We have a lot of general mortality data from Hiroshima and Nagasaki, but many of those victims died from flash burns and infections, lack of proper medical treatment- not directly from the radiation. These are more controlled circumstances.” She noticed her voice growing flatter, like a lecturer instead of a compassionate doctor.