Maggie & the Kidney Stone Lady

As if I needed more reminders of my imperfections, I had Maggie and the Kidney Stone Lady, forever. Little Maggie, the cute five-year-old from early in my career who came in with her croupy cough and low-grade fever, and whose chest X-ray was normal. She responded so well to racemic epinephrine, Tylenol, and humidified oxygen. The dark-haired girl with the big eyes whom we all watched gleefully sashay out of the emergency department so many years ago, smiling and happy, waving goodbye to me and the rest of the nursing staff . . . and who, just twenty-four hours later, died of overwhelming sepsis. How I sobbed for nights in my bed, racking my brain as to what else I could have done, what subtlety in her presentation I could have picked up on, and wondering if I had discharged her too quickly instead of keeping her around for observation. It was back in the old hospital; I was maybe thirty-two at the time. Years later I was still trying to drown the vision of her ghost in cheap vodka.

But Maggie kept appearing, following me—sometimes alone, sometimes alongside the woman with the kidney stone.

It had shown up on the CT scan. She was a diabetic woman with flank pain whom I had seen a few years back. She had a normal urinalysis and bloodwork, but her urine culture grew out E. coli. The result was reported to me by the microbiology lab the day after she, too, died a septic death. That tiny pebble, stuck in her ureter tube, blocked the flow of urine in its normal journey from kidney to bladder. This caused the retained fluid, teeming with bacteria, to sit and fester, permitting germs to feast on stagnant glucose and proteins. The bacteria multiplied exponentially, and the resulting soup of piss and pus backtracked up to the kidney, creating a bloated, infected organ, which in turn invaded her bloodstream, overwhelmed her defenses, and led to cardiovascular collapse and death.

I spoke with her husband after the funeral. She had done everything we told her to do, and the day she died he had been trying to cool her off all day at home in the bathtub.

Now, in her afterlife, she occasionally accompanied Maggie on excursions into my head, usually at night. Make that a double vodka.

I thought I had finally learned in sobriety how to put them in the past, encased in a box, and keep them there. Still, sometimes they found a way out to visit me. The program taught me how to at least limit their appearances.