A New Cullen Sister

Chapter 3

The tour was interesting, and they were able to engage with a few patients before being unceremoniously kicked out by the nursing staff as visiting hours had begun. The group leader, Dr Sanders, then led them to a room that they had previously thought was unoccupied. In there was a young girl, no older than about 16, arguing quietly with her doctor. She was sitting up in bed. The group waited outside until she was done, her deep coughing a tell-tale indication of her disease.

"I just want to go outside for a few minutes. Five minutes tops. I need some fresh air. I'm going crazy in here," she pleaded.

"Amelia, you are too sick to go outside. You will get worse. You're one cough away from landing up in ICU," replied her doctor gently.

"Dr Anderson, I have not left this place in nearly four months. It's visiting hours now, no one will notice that I'm gone. I've had my physio for today. All I am asking is to go on the balcony for a little while. I'm not asking to go to the shop down the road, although I desperately need to get some things, I'm not even asking to sit in the hospital garden, I'm just asking for you to give me my balcony key so that I can open the door and breathe some fresh air, not stale hospital air."

"It is out of the question, Amelia. Your lungs are unhappy."

The young girl sighed deeply, coughed and hung her head sadly, furiously wiping her face when Dr Anderson's back was turned. Dr Sanders knocked and the group gathered in the room.

"Shall we come back when visiting hours are over?" queried Dr Sanders.

"That won't be necessary," said Dr Anderson, "She has no visitors."

Carlisle heard Esme's sharp intake of breath. He squeezed her hand reassuringly. Esme glanced around the room. She had a small bookcase in her room, chock-full of books. A few textbooks lay on top of her bedside table, a glass of water next to that. There was a cupboard in her room as well that was slightly ajar and Esme spied a few clothes in there. A teddy bear lay at the foot of her bed, well-worn and obviously well-loved.

"This is Amelia Theodore, aged 15. She was flown in from Seattle just over four months ago. She presented with severe haemoptysis as a result of a Pseudomonas infection due to underlying Cystic Fibrosis. We embolised the bleeding and treated her with an aggressive IV antibiotic protocol of garamycin, vancomycin and flucoxacillin, as well as inhalational garamycin and pulmicort but we are still struggling with the bleeding problem. She has received three blood transfusions. She was in ICU for five weeks and has been in this ward ever since. Initial response to antibiotics was good, but the infection remains present. She has CFR-Diabetes, malabsorption of nutrients and is underweight. She is currently receiving chest physiotherapy twice per day, receiving IV antibiotics and takes multiple medications, including insulin and digestive aids, and is receiving enteral nutrition via a PEG to supplement her diet. As you can see, she requires an oxygen line and her lung function is down to 32%. She is in right heart failure and has been placed on the list for a bilateral lung transplant and a heart transplant."

After discussing the patient a little more, the group left Amelia in peace. Esme took her in. She was surprisingly tall for her illness and painfully thin. Her dark hair was thin and needed a wash. She had eyes that were almost green in colour and was incredibly pale, paler than Esme was, almost grey in colour. She was beautiful, although unkempt. At 15, this stunning young girl was dying and she knew it – it lurked in the heaviness of her eyes, the dark circles under her eyes, the shallow breaths she took that were obviously so very painful and tiring.

"What did you mean when you said that she had no one?" Carlisle asked of Dr Anderson, knowing that his wife was desperate to know, but was too shy to ask herself. He was aware that although Esme was enjoying herself, she felt rather out of her league.

"She is in the foster care system. I don't know the details – Amelia does not speak of it - but I understand that both of her parents are deceased."

Carlisle nodded and thanked the doctor.

"What did all of that medical talk mean?" asked Esme softly.

"Young Amelia has Cystic Fibrosis. She got a really bad lung infection which caused her to cough up blood. They managed to stop the bleeding but because they are struggling to get rid of the infection, the blood vessels in her lungs keep rupturing as the coughing is very bad. Dr Anderson listed the medication that they were giving her. The nature of CF is such that patients suffer from digestive problems and many develop Type 1 Diabetes. The pancreas has two chief functions, one endocrine and one exocrine. The exocrine part is responsible for releasing enzymes to aid in digestion. All exocrine glands in the body are affected by CF. As the exocrine part of the pancreas is affected, eventually the endocrine function is impaired as well, in other words, the part of her pancreas that produces insulin, hence so many CF patients develop Diabetes.

"As she is so underweight and probably throws up a lot with all the coughing, they are tube feeding her to help her pick up weight. As soon as she reaches a goal weight, they will probably let her go home. It's usually 50 kilograms, or 110 pounds. She is not doing well at all. Without a lung transplant, she will die, but right now, she is too sick to have one. It won't be long before her kidneys and liver start shutting down," Carlisle explained.

Esme sighed sadly and glanced at Amelia's room. "I wish there was something that we could do to help her."

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Amelia gathered her toiletries and walked slowly to her bathroom. She ran a bath and soaked for a little while, trying to wrap her head around things. She was dying, she knew it. All she wanted was to go outside for a little while. But even so, she knew that she had a lot to be grateful for. The hospital had a library service so at least she got some new books to read every few days or so. Her school back in Seattle had online classes so she was able to do her homework assignments and not fall behind. She was desperate to get to a local supermarket and buy a few necessities, like shampoo and soap and toothpaste – those supplies were dwindling and she was forced to stretch it for as long as possible. Even if the kiosk at the hospital sold such items, she was not allowed out of the ward in any case. She had been in hospital when her parents had passed away in a tragic accident when she was only three. She barely remembered them. From there, she was bounced from foster home to foster home – no one wanted a sick child. She understood, sort of. And yet, she still yearned for a family, even although she had long since accepted that she was probably never going to get that wish.

Eventually at the ages of ten, and after more than two dozen homes, she was put in a group home. It was there that she met her best friend, Bree Tanner. Bree had been hurt, and afterwards, she had snuck into the hospital and explained what had happened, red eyes and all. She told her of vampires, of their ways. She had not wanted to harm humans, but had been forced into some battle. She went in the hopes of meeting the animal-drinkers that they were supposed to harm and planned to hide and surrender and learn their ways. Bree promised Amelia that she would come back for her, but she never had. Amelia knew in her heart that her best friend had died out there and missed her terribly. Fastforward a few months and here she was, dying alone.

Amelia sighed and got out of the bathtub. After eating dinner, she hunted for her shopping list. She could not find it and decided to look for it in the morning. Sleepily, she grabbed a piece of scrap paper and wrote "black ballpoint pens" on it. She put it to the side, filled up her glass of water and climbed into bed armed with the last unread book in her stack. She fell asleep halfway through the chapter.