Heaven Can Wait.

jimsonShe gave her name as “Heaven” to the woman at the intake window. The nurse who called her five minutes later asked if that was her first name or last name, and Heaven simply looked puzzled. “It’s my name,” she said. The nurse shrugged. “What brings you in today?” the nurse asked. Heaven replied that she had a bad stomachache. She had come into town with her boyfriend “Rain” and they had stopped at a coffee hut. “The coffee can’t be organic” she said, “That must be what’s causing the stomachache.”

The nurse asked if “Rain” was in the waiting room. “No,” she replied, wincing through gritted teeth, “he doesn’t do hospitals. He says that Western medicine is for fools and charlatans.” After checking her blood pressure and listening to her lungs, the nurse scrawled a few notes on the form and placed it in a plastic hanger next to the door. “The Dr. will be in shortly,” she said as she left the room. A few minutes later, as Heaven sat staring at the walls, Dr. Simon came in, smiled and sat down opposite her. “What brings you in to see us today?” He asked. “Isn’t it all written down on that clip board” she responded, visibly annoyed and a little uncomfortable.

Dr. Simon responded that he preferred to listen to the patient’s first before checking with the notes. Haven’t replied that “seems like a waste then for that nursed asked me to send questions.” Dr. Simon reached up and grabbed the clipboard, looking at the notes the nurse had made. He took a stethoscope out of his pocket, sat next to Heaven on the table and asked her to breathe deeply. Then he placed the chest piece of the stethoscope in the middle of sternum and told her to breathe normally. Dr. Simon had read the nurses notes, and wondered if Heavens heart rate had slowed at all. It had not. Listening, Dr. Simon turned toward the clock hanging on the wall, and began to count. Turning to Heaven, he asked if she felt dizzy? Yes. She felt dizzy since having coffee at the Coffee Hut that morning. “They must’ve put something in the coffee, some chemical. It certainly wasn’t organic,” she stated matter-of-factly.

Dr. Simon thought to himself that if heaven had been drinking triple espresso for the last 24 hours straight, she probably wouldn’t have a heart rate of 140. Not at her age. No..Something else was going on. But what? Dr. Simon picked up the phone and asked for the nurse, who came in almost immediately. “We need to get some blood work,” he said to the nurse. Handing her a form, he continued “Please send this down to the lab”. In a few minutes a young woman in a lab coat appeared, and Dr. Simon left the room. The phlebotomist sat down opposite Heaven and asked her roll up her sleeve. Rolling her eyes, Heaven proceeded to explain to the young lab technician “drawing blood from people was not natural.” The phlebotomist simply smiled and nodded her head in agreement.

Alone in the exam room, Heaven took in her surroundings. A calendar hanging on the wall displayed the month of June, and a large photograph of kittens. There was a laptop on a nearby table, and a number of cabinets that she could only imagine held any form of artificial medicine that would only make people sicker. Like vaccines. Rain had explained to her that vaccines were nothing more then a chemical still made to enrich corporate pharmacies and profit “the man.” She had been a freshman at a private college in Vermont studying literature and poetry. That’s where she met Rain. He was a junior at a nearby agricultural college and was at her campus doing some recruiting for a demonstration he had organized against extended logging in the area. It was love at first sight, at least for Heaven. When he left campus, she went with him. It was not until spring break that her parents know she was no longer enrolled. Not only had she not contacted them, she had simply not come home since Christmas.

When she did finally contact them, she had informed her parents, both college professors in Connecticut, “her eyes had been opened to the falsehoods of education, and the dysfunction of American society”. She would no longer participate in the “American nightmare of capitalism and consumerism”. She also informed them that her name was not Karen Kim; she had been given a new name, one that more closely aligned with her “cosmic identity as a child of the Earth mother.” Her parents were shocked, and dismayed, but there was little they could do. They told Heaven to please stay in touch, and if there were anything that she needed, she’d only ask. As second-generation Korean emigrants, the Kim’s had tried to raise their daughter as an “American”, rather than as a Korean-American. Mr. Kim’s mother often complained of the leniency with which they were bringing up your daughter. Perhaps Nana was right.

As she sat fuming about the artificiality of American medicine, Dr. Simon came in the room. “Feeling any better?” he asked. Heaven shook her head, then grab her stomach and vomited violently. Dr. Simon quickly opened the door and called for the nurse. The blood work would not come back for a few hours, but clearly whatever Heaven had, it was getting worse. The nurse called registration, and inquired that availability. A few minutes later, I want to and from patient registration came in to collect information, and Heaven was admitted at 1:45 PM. “I have to tell Rain what’s going on” she insisted. “Did he have a cell phone?” the nurse asked. Through extreme pain, heaven commented only that Rain said phones “distanced people from each other.”

Over the next few hours, heavens condition went from bad to worse. The stomach pain continued to increase, and her heart rate remained at 120. When the nurse came to take her blood pressure and pulse, she noticed heavens respiration was rapid and shallow. Dr. Simon was called at 3 PM, and came to Heaven’s room to check on her. Her breathing was rapid shallow, her heart rate remained high, and her ankles were swollen. Dr. Simon asked Heaven if she felt dizzy? “Yes, very dizzy.” She was showing signs of congestive heart failure. When the lab results finally came back, they were puzzling at best. Liver functions were normal, hematocrit, calcium, D3, all normal. He was missing something. But what? The next most likely cause would be a parasitical infection. Had she managed to use the bathroom? The nurse picked up the bedpan, and said “yes, slightly.” I stole smear was taken and sent to the lab with the words “RUSH” at the top of the form.

At 5:55, the charge nurse came in to change the Saline bag, and noticed that Heaven was mumbling. “I’m sorry sweetie, she said, did you say something?” Heaven did not seem to hear her. The nurse spoke louder, this time Heaven turned to her and said “I am telling Rain about what you are all doing to me.” “Where is he?” she asked. “He’s right here” she replied angrily. The nurse went to the phone and called Dr. Simon. Heaven was hallucinating. This was a new symptom, and one that pointed him in a better direction. He wondered if this illness was the result of some sort of psychedelic drug. But while Dr. Simon and the charge nurse were standing at the foot of Heavens bed, the convulsions began. Dr. Simon looked at his watch; it was 7:10 PM. At this rate, he thought to himself, would Heaven be alive in the morning. Whatever this was, it was progressing fast and time was running out. Suddenly, Dr. Simon left the room, and picked up the phone in the nurses station. He called Dr. Michael Griffin at the local public health office. Dr. Simon had attended a presentation on how medical practice and public health can work together to solve medical crises. He called being impressed with Dr. Griffin’s approach to disease and illness, and his background in epidemiology. The phone at the public health office rang several times before the answering service picked up. Dr. Simon explained who he was and what he needs to do, and was asked for a contact number.

Epidemiology is the science of solving medical mysteries. Where disease starts, where it’s going, and how to intercept it. This sickness was indeed a mystery. And having no real medical history or background on Heaven, Dr. Simon was at a major disadvantage. One he hoped could be at least partially remedied with some help. At 9:05 PM the phone at the nurses station rang, and Dr. Simon was paged. The voice on the other end simply said “Hello Dr., this is Michael Griffin from the public health office. How can I help you?”

After a brief conversation of Heavens symptoms, Dr. Griffin had some questions of his own. As an epidemiologist, Dr. Griffin was trying to focus on a multifaceted approach to disease, one that included environmental implications. After Dr. Simon explained what was known about heaven, Dr. Griffin agreed the background history was very limited to, but this was enough to go on. Where did she live? What does she do? More importantly, what were the symptoms and in what order did they appear?

Dr. Simon proceeded to explain that the symptoms had appeared as stomach pain, then stomach cramping, followed by vomiting, hallucinations, and finally convulsion. Dr. Griffin looked at his watch. It was 9:22 PM, he was less than 10 miles from the hospital. He would be there in half an hour. Dr. Simon asked what he thought, and Dr. Griffin said that he had no idea. Dr. Griffin called back almost immediately, and asked if a stool test had been done? He was particularly interested in the results of the Keto-bile acid concentration. Dr. Simon checked the results. They were not listed. “Do you have the results from the blood work? He asked. When Dr. Simon read the results of the CBC, Dr. Griffin asked about the results for Reticulocytes and Ferritin? “Not done” came the response.

At 10:16 PM, Michael Griffin parked in the lost across from the main entrance. At 10:19 he was at the nurses station, and Dr. Simon was paged. Dr. Griffin was led to Heaven’s room, where two nurses and Dr. Simon had collected. “Is she sleeping? Or is this coma?” he asked. “How could you know that?” one of the nurses asked. “Because this is poisoning,” he responded. Now they had to figure out what kind. And they had to hurry. As Dr. Simon and Dr. Griffin review the lab results, a nurse from the unit came to the waiting room. “There is a young man downstairs who says his name is “Rain”, and that he is Heaven’s “life mate.” Should I send him up? Both doctors said, “Yes.”

After berating Dr. Griffin and Dr. Simon about the fakery of modern medicine, Rain finally got down to asking how his life mate was doing. “I’m afraid not too well” Dr. Simon responded. Dr. Griffin asked if they might ask a few questions. Rain sat down at the table and agreed. At this point, Dr. Simon turned over the conversation to Dr. Griffin.

“Where were you and Heaven this morning and last night?” He asked. Rain responded “We are staying at the campsite with some friends. It’s over on the outside of town. It’s perfectly legal, is public land,” he began to grow defensive. Can you tell me if there were any chemicals that you may have come into contact with, especially Heaven, as you seem ok. Rain proceeded to explain that over the last few days the group had been resting, preparing for the upcoming demonstration against a logging company. He explained that some demonstrations can last days within weeks. Dr. Griffin sat back in his chair and thought for a moment. “Do you recall what heaven eight over the last few days?” He asked.

Rain explained that, unlike major agricultural corporations, Mother Nature takes care of her children. They didn’t believe in processed foods, with all their poisons. Rain had taken a course on natural food harvesting and he provided all that they needed from Earth’s bounty. Dr. with and asked if he might be more specific. “Heaven is switching over from a carnivore diet that she grew up with to a vegan diet. It is more healthy, and besides, meat is murder”. Dr. Griffin asked if he might remember what she had eaten the night before, or perhaps that morning. He replied that she had eaten some nuts that he had collected in the woods, and a big salad that she had made for herself out of fresh spring greens. Dr. Griffin asked if he had eaten any of the greens? The answer was no.

Dr. Griffin asked Rain if he could describe what these greens look like? Rain proceeded to explain that they were wild petunias, and that Heaven also boiled believes to make tea.

Dr. Simon turned to Dr. Griffin and asked if that could be the cause? Dr. Griffin thought for a moment. Many animals eat petunias, particularly those going along his back walk. He had often seen rabbits, and even squirrels munching on them. His wife Pamela had tried everything. Spring with a hose, mothballs, even mulch. Nothing seemed to deter them. Then a thought crossed his mind: what if they had mistaken some of the plant for petunias? Dr. Griffin asked if there was a computer handy, and within a few minutes, the charge nurse produced a laptop.

Dr. Griffin did an image search, and showed a picture of a flowering plant to rain. Is this what she had? “Yes,” Rain remarked, “like I said, petunia.” Dr. Griffin turned to rain and said “No. That’s not a Petunia, that’s Jimsonweed. It is a highly toxic alkaloid, and in a high enough dose it can kill.” Rain began to explain how Dr. Griffin was clearly mistaken, but by then, both doctors had left the room. Dr. Simon called out for the charge nurse, “Get me naloxone and thiamine immediately!” Dr. Griffin suggested taking Heaven’s glucose level. The nurse took a blood droplet and after a few seconds announced the results: 45. Dr. Simon immediately ordered Lactated Ringer’s solution. Although it had been nearly 13 hours since ingestion, Heaven had only passed one small bowel movement. Dr. Simon decided against gastric lavage and ordered Liqui-Char. Activated charcoal is far more effective if used within 30 to 60 minutes of toxic ingestion, but because of the lack of information available, hours had elapsed.

At 3:00 AM, with Dr. Griffin and Dr. Simon sitting bedside, Heaven’s eyes opened and she looked around. “I thought I heard Rain,” she said hoarsely. Dr. Simon explained that he had to get back to the campsite and prepare for tomorrow’s demonstration. Was there anyone else she wanted them to call? Yes. Could someone please call her parents? Heaven gave the number to the nurse, and she made the call. When Mr. Mrs. Kim arrived at the ICU, Heaven was eating breakfast. It was a visibly awkward visit, and Dr. Simon and Dr. Griffin excuse themselves from the room.

Dr. Simon turn to Dr. Griffin, and over his coffee cup asked, “How did you know?” Dr. Griffin explained that in epidemiology, one has to consider the environmental factors of any illness, infectious or otherwise, as a significant influence. In epidemiology, we use a mnemonic called “MIDNIT.” But unlike most in medical research, we add an “E” to Metabolic, Inflammation, Degenerative, Neoplastic, Infection, Trauma… Environmental.” Mr. Mrs. Kim left the hospital that evening with Karen alongside. She explained that the name Heaven no longer fit.

Jimsonweed poisoning is a fairly rare occurrence, but can be deadly. Adults consuming as little as 15 g of leaf fiber or 20 g of Jimson weed seeds can suffer deadly effects.

 

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