Susannah stuck her head out the door and asked Dave to order some French toast for Thomas. Viki was sitting in one of the chairs, watching her "two guys," as Sam was praising Thomas' ability to build the Lego castle. Susannah sat down next to Viki. She stretched her feet out in front of her. Thomas looked up from the toys and wrinkled his nose. He made a face and asked, "what smells and tastes so funny?" Without warning, as his respiratory muscles contracted, Thomas let out an involuntary scream and fell to the floor. His eyes rolled back in his head. His face was livid. It turned red and then a grayish blue, as did his lips, as his breathing stopped. His jaw clamped shut and he appeared to grimace. Thomas' body became rigid. His back arched and his entire body was gripped by spastic muscular contractions. Alternate contractions and relaxations of the muscles threw his body into violent agitation. Thomas was having a seizure.
*****
"Sam! Don't hold him!" Susannah instructed when she saw Sam was about to try to lift Thomas to him. "Get Connie and Marcia in here," Susannah called out loudly. They heard Dave calling for assistance. Susannah quickly rolled Thomas over on his side. She did that to make sure his airway stayed open and he didn't aspirate any saliva or vomit. "Let me have a pillow" she called to Viki. Susannah placed the pillow Viki handed her under Thomas' head so he wouldn't injure it. She then stood by, timing the seizure.
Connie and Marcia came in, along with Dave and Carl. They too just stood by. Viki and Sam both stared in horror as Thomas' body continued to shake violently.
"Susannah, do something!" Viki pleaded.
Susannah was still timing the duration of the seizure and quickly said, "We have to wait for the seizure to stop. Please try to stay calm."
Thomas' bladder released itself and a puddle of urine formed underneath him. He vomited. The seizure lasted two minutes and fifty seconds. To Viki and Sam it seemed like it had gone on for an hour. Finally, the muscular contractions and relaxations stopped and Thomas' body lay still. His breathing returned to normal. He was unconscious. Susannah noted the duration of the seizure out loud. She ordered Connie to do vitals on him and asked Marcia to get an IV setup. Susannah checked Thomas' eyes. His pupils were reacting normally. His blood pressure was normal, for him. His heart rate was slightly elevated. That was to be expected. The beat was regular. He was not presenting with any symptoms of a stroke, aneurysm or low blood sugar. Susannah gave orders to discontinue the Zyprexa. She ordered blood work done on him and ordered a cardiac monitor be placed on him. Susannah checked his pupils and listened to his heart, one more time. She told them to get Thomas cleaned up and moved to the bed.
Susannah stood up and looked over toward Sam and Viki. Sam had his arm around Viki's shoulder. They were both pale as ghosts and both were trembling. "His vitals are within normal range. He is not in any danger right now," Susannah quickly let them know. She then continued, "Thomas just had a generalized seizure . . . a tonic-clonic seizure. You may be more familiar with the term grand mal seizure."
"Has he become epileptic?" a terrified Sam asked.
"I can't make that diagnosis after one seizure. It may be an isolated event. Seizures are one of the more uncommon side effects of Zyprexa, it usually only effects patients who already have a seizure disorder. Just in case, I'm discontinuing that for the time being." Susannah turned to Marcia. "Find out who's on in neurology and cardiology." Susannah turned her attention back to Sam and Viki.
"Why isn't he awake yet?" Viki asked as tears escaped from her eyes.
"He will be shortly. He will probably be very sleepy and confused when he wakes up. He will most likely have a headache and you may notice some focal motor involvement."
"Focal?" Sam asked. He looked dazed.
"I'm sorry . . . some movement in an isolated area of his body . . . an arm or leg . . . not generalized like in the seizure he just had. He may also feel even more depressed than usual. That is all normal. Let's sit down," Susannah suggested.
"I don't wanna sit down! Just tell me what's going on with my kid!" a frantic Sam barked.
"I will. You both need to stay calm. I don't want Thomas or any of them to wake up and find you both so upset," Susannah stated gently.
Sam and Viki looked at each other with desperation in both their eyes. "Dear Lord! I had a feeling I should come back here this evening," Viki declared.
Sam took some deep breaths to try to calm himself. They were having minimal effect. He was frightened and angry that this had happened to Todd. He and Viki sat down and were ready to listen.
"I know how terrifying a generalized seizure is to see. I need you to know they usually cause no damage to the person, unless they bite their tongue during the seizure or hurt themselves falling or by banging into something."
"When Todd had pneumonia, a seizure almost killed him. His heart stopped," Viki reminded Susannah.
"Todd was in heart and renal failure then. I see no changes in the condition of Todd's heart at this point. I am going to have cardiology check him out. I have also called in a neurologist. His regular doctors are probably not here now. If it becomes necessary I will call them. He can't have a full neurological workup until he is awake and fully alert."
"So you think this may be a one time thing caused by the medication?" Sam asked.
"I don't know. It's a possibility, but it really is rare for this to happen in patients who do not have a previous seizure disorder. What concerns me is that Thomas had the sensation of a bad taste and smell. That is called an aura. That is usually more common in epileptic seizures than in ones caused by medications. Even so, that is not conclusive."
Viki and Sam's heads were spinning. They were both thinking that this was all Todd needed in addition to everything else. "How will you determine the cause?" Viki inquired.
"Most likely neurology will order an EEG and another CT scan, possibly an MRI and a PET scan."
"They didn't order those tests when he had the two seizures during the pneumonia," Sam pointed out.
"We knew the cause of them. The Baby was out and he had what is called febrile seizures. The high fever he had caused them." Susannah hated to alarm them further. However, they needed to know. "Todd has sustained many injuries to his brain in his short lifetime. Just from what records I have, there were many incidences of major trauma to his brain. There was the blow to his head that caused the hearing loss in his right ear, a concussion caused by banging his head into the wall when he was in prison, the injuries he probably sustained falling from the cliff in Ireland, the concussion he got when Téa hit him on the head with a shovel, the concussion caused by driving Téa's car off the road, another concussion when he slammed his head into the doors here at the hospital. Also, we have no idea how many injuries to the brain Todd received as a child. According to Doctor Evans' records Todd had two concussions. We don't know for sure how many times his brain may have been injured by Peter. It is possible that some scar tissue from one of those incidences can cause epilepsy to develop."
Sam and Viki were devastated. Sam took Viki's hand and patted it. He turned to Susannah. "Could it take this long for those old injuries to cause seizures?"
"Yes. It could take years for injuries to cause seizures. It's not likely the injuries from childhood are causing this, but it is not entirely impossible either."
"I don't understand. Todd has recently had MRIs and CT scans?" Viki voice was filled with desperation.
"They weren't looking for that, specifically. Even now, those tests might not reveal the problem. It is a difficult diagnosis. If the seizures continue, they might be considered idiopathic. That means no obvious cause can be found. I know it's easy to say, but please try not to get crazy over this. It may be an isolated seizure. I have stopped the neuroleptic for the time being. If it is the cause, it is unlikely he will have another seizure. Let's not borrow trouble. We'll wait and see what neurology finds and . . ."
They all turned when they heard a low moan come from Todd. After being in a postictal state for eighteen minutes, he was coming to. Todd's eyes had opened but he was not focusing on anyone. Susannah didn't think it was Todd. He seemed to be able to see. She thought perhaps it might still be Thomas.
"Thomas! Try to look at my finger. Susannah held up her index finger. His eyes moved sluggishly. He could not focus on her finger. "Can you hear me?" Susannah called out. He continued to look around, without moving his head. He did not respond to Susannah's question. He closed his eyes and fell back into a deep sleep.
"Can't he hear you?" Viki pitch was near hysteria.
"I'll be on duty all night. I'll come in to check on him later. Doctor Anderson will take over tomorrow," Doctor Wells assured Sam and Viki.
Doctor Williams, Todd's cardiologist, was still at the hospital. He came in and examined Todd. He checked the monitor. "His heart doesn't seem to have been affected by the seizure. I would like to do another echo on him in a few days just to make sure everything is all right," Doctor Williams told them. "Try not to worry. I’m sure the echo will reveal nothing new," he added.
Viki and Sam started to calm down a little. Todd slept peacefully. If it weren't for the equipment, he would appear to have just fallen asleep. Sam went out to the hallway to call Téa and Blair and let them know what happened. When he returned, Viki would go call Kevin. Both Blair and Téa insisted on coming to the hospital, as did Kevin. Sam could hear the panic in Blair's voice and the sorrow in Téa's. Kevin did not sound much better. They were all told there was no need for them to come to the hospital, as there was nothing to be done for Todd right now and he was not in any danger. Nevertheless, they all insisted.
*****
Kevin was the first to arrive. Susannah was in with Todd. He took his mother in his arms and held her tightly. "What did Susannah say? Is she sure he's not in danger?" Kevin asked.
Viki repeated what she had been told.
Téa was the next to arrive. They could tell she had been crying. "Could this be a result of what he's been through the past couple of days? Did the memory he had because of me cause this?"
Susannah, who had joined them in the lounge, assured Téa that it had absolutely nothing to do with Todd having a memory of abuse. She patiently explained about the possible causes.
It didn't take Téa long to make a connection between old brain injuries being a possible cause and her hitting Todd over the head with a shovel. "Ay dios mio! I did this to him. I hit him with a shovel. He was unconscious for a long time. He was dizzy afterward. I did this to him!"
"Téa, we don't know for sure if the seizure was caused by an old injury or if the medication caused it. Even if it is from an old injury Todd has had many, many injuries to his brain. There is no reason for you to feel responsible," Susannah comforted her. She knew Téa would not stop blaming herself.
"Can we see him?" Kevin asked.
"Yes. He's in a very deep sleep. He probably won't know you're there," Susannah cautioned.
Téa and Kevin didn't care. They just wanted to see him. Téa especially wanted to be able to watch him breath and hold his hand. She believed that he would know she was there with him.
"Téa's going to blame herself for this. You know that," Viki stated after Kevin and Téa had gone in to see Todd.
"Yes, I know," Susannah answered sadly.
*****
Téa and Kevin were both in with Todd when Blair arrived. She had been delayed because she had to wait for the nanny to come back to the penthouse. "Now what did you do to him?" Blair accused the second she saw Susannah.
"Nothing was done to Todd, Blair! He had a seizure," Sam snapped angrily.
"Oh! He just had a seizure . . . for no apparent reason he just had a seizure. Viki, what is wrong with you? How many times does Todd have to almost die in this place before you take him out of here?"
"Todd did not almost die tonight! Blair, if you can't calm down I want you to leave. You're not doing yourself or Todd any good." Viki was forcing herself to keep her voice civil.
*****
Inside Todd's room, Téa lovingly stroked Todd's head. "Mi corazon. I love you so much. Please be all right." Téa lifted Todd's hand and held it. "Todd, I'm so sorry I hurt you. I did this to you. Can you forgive me? Oh Todd." Téa's shoulders shook as she began to weep.
Wanting to comfort her, Kevin took her in his arms. "You didn't do this to him, Téa. You heard Susannah. It could have been an injury from long before you met Todd or it can be one of the drugs he was given." Kevin held her tightly. "Téa, come on. You didn't do this to him."
"THE HELL SHE DIDN'T," Blair yelled as she walked into the room. "YOU'RE DISGUSTING! BOTH OF YOU! MY GOD! RIGHT IN FRONT OF HIM!"
Susannah rushed into the room. "I want everyone out of here, NOW!" Susannah had lost patience with Blair. She knew if she ordered Blair out of the room and not Téa and Kevin, Blair would become even more volatile.
"I'm staying with my husband!" Blair insisted.
"YOUR HUSBAND!" Téa yelled back. She immediately lowered her voice and said, "Blair, you're delusional! Maybe you should be a patient in this hospital? You have no legal rights where Todd is concerned. Viki is Todd's guardian and I am his wife. As a blood relative, Kevin has more rights to Todd than you do."
"Oh you would like that, wouldn't you? You and Kevin . . . acting as Todd's concerned family . . . all the while screwing around behind his back . . . laughing at him . . . plotting to get his money."
"Blair, this is too twisted, even for you! Nothing is going on between Téa and me, except in your dirty mind," Kevin stated loudly."
"My dirty mind! Maybe you can fool Sam and Viki, but I know all about you and this slut," Blair responded. Her voice was just as loud as Kevin's.
"That's enough!" Susannah was barely able to keep herself from shouting. "I'm not fooling around here. Either you all leave now or I will have security escort you out. Do I make myself clear!" Susannah spoke firmly. "I want all of you out, right now! Wait for me in the lounge area . . . all of you!" Susannah ordered.
They all looked down at Todd as he slept. For a moment they all felt guilty for fighting in front of him. They all felt ashamed of themselves. Téa and Kevin exchanged glances. Téa stroked Todd's head one more time and headed for the door. Kevin patted Todd's leg and did the same. They both gave Blair dirty looks as they passed by her.
"Blair!" Susannah pointed to the door.
Blair heard by Susannah's tone that she would have her thrown out if it came to it. "Don't worry, baby. I won't let them get away with this," Blair called out to Todd and also walked into the hallway.
Susannah checked the monitor. There was no change. She did vitals on Todd herself. He was stable. She told Connie she would be in her office with Todd's family and gave her orders to get her immediately if there was the slightest change in Todd's status. Connie could see that Susannah was furious. Susannah was so angry she could hardly see straight. She took a minute to calm herself. She hoped none of what was just said registered in Todd's brain. Susannah headed out to the lounge area near Todd's room.
*****
As soon as she approached the lounge area Susannah heard Sam and Viki's raised voices as they admonished Blair, Kevin and Téa for their actions. "I want all of you in my office NOW!" Susannah announced. They could tell by her tone that she was furious.
"I'm not leaving Todd!" Blair declared obstinately.
"You will come to my office now or you will not be allowed access to this unit again." Susannah tried to remain calm. "I want to speak with all of you, Sam, Viki, you too. Let's go!" Susannah headed for her office. Blair gave Téa and Kevin a dirty look and followed Susannah. Kevin and Téa looked at Sam and Viki. They looked ashamed of themselves. They all followed Susannah and Blair.
"Please have a seat." Susannah pointed to the sofa and chairs in her office.
"I'll stand, thank you. I'm not planning on staying here too long. Todd needs me," Blair announced.
"You will stay here for as long as it takes. NOW SIT DOWN!" Susannah raised her voice this time.
Blair glared at Susannah as she sat down in one of the club chairs, opposite the two Téa and Kevin occupied. Sam and Viki sat on the sofa.
"What just happened in Todd's room, in fact what happens almost every time the three of you are in one room," Susannah motioned toward Téa, Kevin and Blair, "is totally unacceptable. Blair, Todd could possibly have heard what you said."
Looking daggers at Susannah, Blair defended herself. "I wasn't the only one in that room who was shouting. They are making a fool of Todd. Don't you care about that! You're Todd's doctor. You're supposed to protect him. Maybe they did this to him to get him out of the picture."
Téa jumped up from her seat. "MADRE DE DIOS! YOU ARE CRAZY. YOU DO BELONG HERE AS A PATIENT, BLAIR. YOU NEED TO BE HERE EVEN MORE THAN TODD," Téa shouted.
Kevin stood up too. "IS THIS THE KIND OF CRAP YOU'RE FILLING STARR'S HEAD WITH?" Kevin also shouted.
Blair was also too furious to remain seated. "DON'T YOU DARE BRING MY LITTLE GIRL INTO THIS. I WOULDN'T WANT HER TO KNOW HOW YOU AND TÉA ARE HURTING HER DADDY," Blair shouted back.
"GET A GRIP BLAIR! YOU ARE BECOMING PARANOID. NO ONE IS HURTING TODD!" Sam added his loud voice as he leapt from his seat in anger.
"KEVIN AND TÉA ARE DEVOTED TO TODD. AT LEAST THEY'RE NOT RUNNING AROUND SNEAKING LOOKS AT HIS CHART!" Viki was next to shout. She remained seated. However, she was leaning forward and gripping the arms of the chair in fury.
"DORIAN WAS CONCERNED FOR TODD. MAYBE TÉA AND KEVIN SHOULD BE A LITTLE MORE CONCRNED FOR TODD INSTEAD OF EACH OTHER!" Blair shouted again.
"STOP IT!" Susannah yelled, more to be heard over their loud voices than out of anger. She realized that the pressure they were all under was really taking its toll. They all stopped suddenly and looked at Susannah. "I want you all to sit down and be quiet for a few minutes. I want you to take some deep breaths and pull yourselves together," Susannah ordered.
Blair started to say something, but from the look on Susannah's face, she stopped herself and sat down, like the others. After a couple of minutes they all seemed a little calmer.
Susannah began again. "I understand that you are all under a monumental amount of stress. I also understand that you all want what's best for Todd."
"Some of us do," Blair snapped sarcastically.
"Blair, if you have something to say or some concern we will discuss it, but please refrain from sarcastic innuendo," Susannah cautioned her and then continued. "I think all of you need do discuss what is bothering you and what you are feeling. You don't have to talk to me about it. I do think you really need to talk to someone. I am here for any of you now or whenever you feel the need to talk. I don't want any of you to minimize your feelings in this. Your pain counts and needs to be addressed. However, my first obligation is to Todd. It is not helpful or therapeutic in any way for him to hear you fighting near him or about him. I realize your nerves are frayed, but you all used very poor judgment when you argued in front of him that way. It is possible that he heard you. I want to say straight out that if that ever happens again, I will alert the staff not to allow the person who is responsible onto the unit."
No one said anything. They all looked a little ashamed. "I do think it might be a good idea, for the time being if you Blair, and you, Téa, scheduled times to see Todd when you know the other won't be around," Susannah suggested. Téa and Blair exchanged looks. Neither of them said a word. Susannah turned to Blair. "Would you care to discuss why you are so sure Téa and Kevin are having an affair behind Todd's back?"
Blair was taken back by Susannah's directness. "I don't think! I know!" Blair was adamant.
"You know! You don't know anything except what's in that warped mind of yours." Téa wasn't shouting. However, she did raise her voice again.
"Téa, I asked Blair a question and she has a right to answer it. I would like you to try not to interrupt each other. You will all get a chance to speak. If you like, I can give you each a pad and pen so you can jot down any comment or remark you take exception to."
Ever the attorney, Téa took Susannah up on it. Susannah went to her desk and took some note pads out of a drawer and some pens from a holder on the desk. She handed one to Téa. Sam also took one. Viki and Kevin declined. Blair took one too.
