Of Helicopter Rides and Bacterial Meningitis... (Epilogue)

By Rick Fischer

part one
part two

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At 1800 hours Private Méndez was brought to the dispensary by his platoon mates, after complaining of fever and flu-like symptoms for three days and having an alleged seizure episode 15 minutes prior to arrival, with no history of epilepsy. 'Alleged' was the key word there. Sanchez had served in the army for the best part of a year and he knew there wasn't anything a private wouldn't do to avoid some basic training. And the opportunity was just right. The only way to prove the existence of meningitis was a lumbar puncture. He didn't have the equipment to do that there. And if he started treatment there evidence of bacteria ever being there would be lost. But if he waited, he could lose another man. Sanchez was determined and this time he had the right antibiotic for the job. He started the man on ceftriaxone as soon as he could, gave him a doses of corticosteroid and rushed to the town's hospital in his Korea war ambulance. By the time of his arrival, Mendez had shown improvement in his neurological status. Sanchez was starting to doubt his decision upon arrival. "But, what now?" He thought. He couldn't stop treatment now, he had to carry on.

Upon arrival at the town's hospital, he was greeted this time by a young physician in his social service year too. But at the end of it. He had seen patients from the army base before. He knew it was difficult to get the truth out of them. Sanchez told him what had happened. In essence, it was all hearsay "He allegedly had a seizure, but I didn't see him and the description from his platoon mates doesn't really help. He was neurologically deteriorated when I checked him there, but seems frankly better now. But I already started ceftriaxone. After what happened this morning I was perhaps too eager to treat him." Said Sanchez, revealing exhaustion. After the physician had examined him, he said: "I know they tend to lie sometimes. He could have faked it, to get out a few days. It's difficult with them, all right. At the moment his neurological exam is normal, but you did give him a high dose of corticoid. May be that's why he's better. God knows. I don't want another dead soldier either. I'll back you up for the transfer, dude. Don't worry." Said the physician friendly. He called the regulatory center and reported the urgency. They had an isolation bed for him in San José's Central Hospital. Sanchez departed in the hospital's ambulance with the patient. He had pulsating headache, he hadn't eaten since the morning. At 1900 hours, he left for San José, yet again, this time by land. He was just staring through the ambulance passenger's seat window. He was feeling sick and sad. He couldn't trust his bosses, He couldn't neither trust nor protect his patients. He couldn't even protect his staff. Rifampicin and vaccines weren't there yet. "What the fuck am I doing here?" He thought, as he stared at the dark night.

At 2100 hours Sanchez arrived with the ambulance. The hospital was just or more overcrowded as the last time he had been there. When he entered and the triage nurse saw his fatigues, she just said "Another one". "Yes this time we got him on time" Sanchez replied. This time, it was a younger internist who took his patient in. He explained what had happened and why he had chosen to start treatment early. The internist scolded him for starting treatment without having culture samples. Sanchez didn't say much, but his face said "I don't give a single fuck" for him. On his way out, as he was waiting for some paperwork he noticed a nurse assistant. She was petite probably around nineteen, white skin, long deep black hair, brown big eyes, and thick lips. He decided to try and pick her up. The typical yellow stains on the index and middle fingers of her dominant hand pegged her for a smoker. "I'd like to see her blow", he thought. Being a physician was good for scoring, the uniform only made it even easier. He waited around and offered her a smoke in her break. As they both walked out to the parking lot, he got her cell number. They finished their cigs and, as they reentered the ER, he felt the pain on his head worsening. He felt light headed and then puked all over his boots. By the moment his head hit the floor, he was already unconscious.

When he woke up, he already was in an isolation room. His mouth tasted like vomit and his head hurt even worse. Diana, the nurse whom he had tried to pick up, entered the room shortly after. She reminded him of the event. He did remember vomiting but nothing else. He had had no fever, though. One lumbar puncture, one terrible headache, one neurology consult and two days later he was discharged from the hospital with 5 days further incapacity. Luckily for him, it was just food poisoning. In the end, he did receive the rifampicin treatment for the exposition and the vaccine. One week later, he was publicly congratulated by the army’s command for his actions in preventing a meningitis outbreak. "Preventing? Two cases is an outbreak. The dead boy and that Méndez recruit." He said to the same uppity female voice in Santa Fé. "Mendez didn't have meningitis, the cerebro-spinal fluid culture was negative, over" She answered with audacity. "Well of course it was fucking negative, the samples were taken after I started treatment, you dumb bitch!" He though. But all he said was: "Roger, out". He had already filed asking for his honorably discharge.

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thanks for reading folks! Comments are of course appreciated