TUSCAN BYWAYS

By Jo

PART SEVENTEEN:

They gave Marshall something to help him sleep and he passed the night without a single

incident of vomiting. Eden had spent the night on the couch in the waiting room down the

hall. There was no good place in his room she could sleep. Three or four times, though,

she'd gotten up and gone to his room, just standing there, watching him sleep. Things

he'd said, like finding out the baby's sex, let her clearly know he thought he might die.

"Please, God, please," she whispered softly, holding onto his bedrail. "Let him stay with

us. I need him so much. I...I just...I know that may be selfish, but I do. Please let him stay.

Oh, God! Please, please let him stay."

Ryan, Connie, and Edith had gone home for the night. Eden promised she'd call as soon as

there was any news at all.

Early the next morning Ryan showed up at Marshall's house and took Wadsworth out

for a long walk, had a cup of coffee with Sylvie and filled her in more on the details of

what was going on with Marshall.

Eden's back hurt and she felt stiff when she woke up. She went down the hall to the bathroom

to freshen up a little, then on quickly to Marshall's room. He'd been awake for a while, just

lying quietly, appreciating the lack of need to throw up. He was, though, as weak as the

proverbial newborn kitten and couldn't lift his head off the pillow. When she came in, however,

he smiled and turned his head toward her, even opening his eyes for her benefit.

"A barf-free night!" he said, hoping it sounded bright enough. He knew she was worried

about him and didn't want her to be worried sick.

"I'm really glad, darling. That's got to be a good sign."

There was a rap on the door and a very tall, very slender man, with dark hair winged at his

temples with silver, entered the room. "Good morning. I'm Doctor Knauer." He smiled at

Marshall. "I knew your father, Jonothan, Marshall. I met you once when you were a great

deal younger."

"Thank you for coming," Marshall said. "I know there wasn't much notice but..."

"When Mr. Malone called I recognized your name and, surprisingly enough, I had a large

opening free this morning." He didn't say that he'd been scheduled to do a liver transplant

but the patient had died first.

He listened to Marshall's heart, looked carefully at his eyes, read his chart. "Seems like

you've been vomiting a lot lately, right?"

"For several days now, yes. And tired. I don't seem to have any energy at all."

"He's not been eating either, Doctor Knauer," Eden added. "He's lost a lot of weight."

"You've been through a great deal in the last few months. I remember shortly before

Christmas the newspapers were full of accounts of the professor who'd voluntarily taken

a young woman's place in a hostage situation." He looked at Eden. "That would be you,

I presume?"

"She's my wife now," Marshall said before she could answer.

"And more recently there was that business in the Yucatan," Knauer added. "Mr. Malone

said that may be the possible cause of whatever's going on with you."

Eden fished in her purse. Connie had given her the tape before they left last night. She held

it out toward Doctor Knauer. "You may want to see this, Doctor. I was told it could be of

help in your diagnosis."

"Unusual," he said, but slipped it into a pocket. "I'm going to be sending you down for a

series of tests, Marshall, and I'll look at it right afterwards." He pulled the covers down

lower and lifted Marshall's gown. "Let me know if this hurts, all right?"

He pressed several places around Marshall's abdomen with no reaction, but when he got

to the area below his right rib cage, Marshall let out a gasp. Knauer made no comment,

just entered something in the chart. He pulled out a chair and sat down, looking from

Marshall to Eden. "What we're going to do is a needle biopsy of your liver. You'll have

a sonogram first so we know the best place to go in for that. You've already had a fairly

extensive set of bloodwork but we'll need a urine sample, too. I'll send someone in to get

that before they take you down for the sonogram."

"Do...do they put him to sleep for the biopsy?" Eden asked.

"No, that's not necessary. We'll numb the area first. It's not too bad a procedure."

The thought of a needle being stuck in Marshall's liver, however, did not particularly

appeal to her, not at all.

"May I ask what all those small red marks are, Marshall, on the back of your neck and

your arms and hands?"

"Olives."

"Olives?"

"Yes. I was, um, caught in a downdraft in an olive grove in Tuscany. The olives weren't ripe

yet, very hard."

"I would imagine," Knauer nodded. "Indeed. I must say I've never had a patient present

with olive marks before."

"I'm unique," Marshall smiled.

"In many ways," Knauer chuckled. He actually remembered quite a lot that Jonothan

Sinclair had told him years ago about his remarkable son. When he read about what he'd

done in the December forest, it had all simply been confirmed. "I'll send someone in right

away for the urine sample."

The needle was long and thin and Dr. Knauer was doing the biopsy himself. Marshall lay

quietly on the table, his teeth clamped, waiting, not sure what to expect. Truly, after all he'd

been through in the last several months, the taking of the sample turned out to be no big

deal for him and it was quickly over and sent off to the lab.

Marshall was taken back to his room where Eden waited anxiously for him. She'd called

Connie and Ryan, called Edith and Sylvie, called Terry to let them know what was being

done. "I'm fi...all right," Marshall said as he was put back in his bed. "There was nothing

to it."

Brett Knauer sat in his office, leaning back in his chair. He'd had a VCR brought in so

he could watch the tape. It was like something out of a movie, cruel, vicious, but this was    utterly real. This had happened to Marshall. This and more, from what he understood. How

did people do things like this to other people? He thought of Jonothan, how horrified he

would have been that this happened to his son. He, right from the beginning of his examination

of Marshall, had no doubt but that his liver was inflamed. Now he had to wait for the test

results to find out just how badly.

He watched the tape a second time, even more carefully observing the amount of liquid poured

onto the cloth, the length of time it was held there, the pressure applied. He was amazed, actually, that Marshall had survived that first onslaught. The third one, there when he was

tied to the bed, had been over the top in its lack of necessity. He could tell from Marshall's

face he was already profoundly sedated and yet the kidnapper had been absolutely brutal

in what he'd done. And hour after hour more of this? Days? The human body, especially the human liver, was never made for such treatment.

Marshall was tired just from the round trip by wheelchair to have the biopsy and closed his

eyes. "Sleep a while, darling. I'm going down to the cafeteria and get a quick bite. No-name

is hungry."

"Mmmmm," he murmured, and she kissed his cheek and left the room.

He dozed a few moments but woke, his mind filled with too many things to think about. He'd

made his will earlier, so that was all taken care of. It was the thought of leaving Eden, of not

being there to help raise his child, that was hard to deal with. His own father had been such

an integral part of his growing up. He didn't want his child not to have a father. Waiting for

the biopsy results was making him tense. So much was at stake. Dr. Knauer had put a rush

on the sample so the lab would get right on it. He'd know today. He'd know...something...

today.

The thought of Luke at Christmas at the inn came to his mind, the questions the little boy

had asked him about how he felt while he was alone in the forest. He remembered telling

Luke about Psalm 139, how God was in both the light and the darkness because there was

no place He was not. The Psalms, he knew, were made to be sung and so very softly he

sang to himself, alone in his hospital room, "O Lord Thou hast searched me and known me,

and art acquainted with all of my ways; Thou hast beset me behind and before, and laid

Thy hand upon me."

He felt the tension leaving him and he sang the verse again. Eden had just started to open

the door as he began it the second time and she paused there, holding the door partially open,

watching him, moved to her uttermost being by how much she loved him. He finished it then,

his voice firmer, louder, he sang once again, "Thou hast beset me behind and before, and laid Thy hand upon me."  He sang it with conviction, as affirmation. And the fullness of her heart overflowed and ran down her cheeks.

Still standing in the doorway, her voice breaking, she said, "I love you, Marshall Sinclair."

He smiled in her direction. "I could use a kiss right about now." 

She wanted to kiss him well but her belly against the bars didn't really permit it, not in the

way she wanted, so she lowered them on one side, away from his IV line, and kissed him for

a long, long time.

The wetness of her cheeks brushed off on his. "You've been crying?"

"Not sad tears. I was listening to you sing and they, they just came out because I love you so

much."

She kept the bar down all afternoon so she could be closer to him. He slept from time to

time but she thought his color looked better since he'd stopped the vomiting. She didn't

let go of his hand, not even when he was asleep. The need was constantly there, to touch

him, to hold whatever part of him she could, to feel the living warmth of his skin next to

hers. Once as he slept, she put her fingers on the pulse in his wrist, murmuring, "Please,

please, God, please," over and over.

In mid-afternoon she felt very tired and laid her head on the bed while he stroked his fingers

through her hair again and again. His touch was so soothing that she slept a while. They were

like that when Dr. Knauer came back and he watched them a moment before clearing his

throat to announce his presence.

He closed the door behind himself and approached the bed. "There are a lot of big words I

could use," he began, "like increased sulfobromophthalein retention, but I'm not going to

waste your time with those. Let's just put it this way. What those kidnappers gave you was

hepatoxic. That simply means it was bad stuff and what the liver does is filter that sort of

bad stuff. They gave you enough that it overwhelmed your liver's ability to process it. Your

liver is not happy about the fact of that and has somewhat enlarged and become inflamed.

That in turn causes the nausea and other symptoms you've been having, which build atop

each other until the body is debilitated. You do not have liver cancer nor are you in liver

failure. You do have some centrilobular granular degeneration but there's no overt necrosis." He smiled. "We doctors have to slip a little of the lingo in there just to earn our paychecks,

you understand."

"What...what is that he does have, then?"

"He has toxic hepatitis, Eden."

"Hepatitis? Isn't that contagious?" Marshall asked, suddenly afraid for Eden.

"Toxic hepatitis isn't viral, Marshall, it's not contagious, you can't give it to anyone. You

get it as the result of a toxic overload in your liver."

"What can be done about it?" Eden wasn't sure yet whether the news was good or bad.

"Not much more than we're doing. There's no specific treatment other than stopping the

inflow of the causative toxin and that's already been done. If he were here immediately

after his kidnapping, we might try to flush his liver, but too much time has passed for that.

It can take a while for symptoms to manifest but now that they have, what you need is a

lot of rest, a lot, and you need complete rehydration, which is what you're getting through

that IV, that and meds that keep you from feeling nauseated."

"Will...will...are you saying he's going to be all right?"

"Eden, the liver is the most forgiving and regenerative organ in the body. When I was a kid

I loved the old Greek legends but for some reason the one that grabbed me the most was about

Prometheus."

"I know it," Marshall nodded. "He stole fire from Zeus and gave it to mortals so Zeus had

him chained to a boulder in the Caucasus and every day an eagle would come and eat his

liver, but every night it would grow back, and the eagle would come again the next day,

on and on."

"That's the one. It's actually based in the fact that as little as 25% of a liver can regenerate

into a whole one. It fascinated me so much I became a hepatologist. Bottom line, you do not

require surgery, you do not need a new liver or part of the one you've got removed. You need

rest, rehydration, and confessing to an interest in the effect of herbs on the liver, I'm going

to start you on milk thistle. A lot of what is said about herbs is crap, but milk thistle has

black seeds whose active ingredient is silybum marianum, which actually does promote

regeneration and repair of liver cells and reduces inflammation. I'm going to get you the

purest milk thistle product on the market. I also want you to take soy lecithin. You rest a lot,

be good to yourself, eat a good quality protein diet, and you'll be dancing at your grandchildren's weddings."

"Oh, my God! Oh, my God!" Eden began to cry in the rush of the relief that swept over her.

"I'm going to keep you here a few more days, though. I want to continue your IV until I'm

certain you're past the stage that generates the nausea and weakness. Even after you're

home, however, I want you to be very careful about what you put into your body. No alcohol,

very few pain medications. Everything is filtered through the liver and you must let it rest,

not make it work more than it needs to in its daily chores."

Marshall was trying to process everything the doctor had just said but was interrupted by

a need to hold his wife, to feel his child kick. The rail on one side was still down and he

extended a hand toward her. She came to him and he enfolded her with himself as best he

could with the IV. No-name kicked and he felt it against his body. "I'm going to be there,"

he said into her hair. "I'm going to be there!"

Knauer backed quietly out of the room, closing the door. There were days like this that

made hepatology a glorious thing.

CONTINUED AS SONRISE

BACK TO PART SIXTEEN

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