"Will he be in pain when he wakes up?" Viki asked. "He will probably have a headache and he may experience some muscle soreness. Some Tylenol should help with either of those two." "If Thomas wakes up, will he remember having the seizure?" Viki asked. "No, he may remember how he felt just before it, but once the actual seizure was in progress, he became unconscious." "So, the seizure itself wasn't painful to him?" Sam wanted to know. "No, not in this case. There are other kinds of seizures that patients can feel, but not one that immediately goes into tonicoclonic."

*********************************************************

Marcia was doing vitals on Todd when Susannah got back to his room.

"How's he doing?" Susannah asked.

"BP's good. One ten over seventy, as usual," Marcia answered. "His heart rate and respiration are normal," Marcia added.

Susannah checked his eyes. "Equal and reactive," she commented to Marcia. "Has he been waking up at all?" Susannah asked.

"No, he's been postictal for nearly ninety minutes now," Connie responded, shaking her head.

"Todd," Susannah called out softly. She stroked his head. "Todd!" She called a little louder, gently tapping his cheek. There was no response. Susannah wanted to pull up Todd's old medical records. "I'm heading to my office for a while. I'll be back in about thirty minutes. Call me immediately, if there is any change at all," Susannah instructed and then told Marcia to do vitals on him every fifteen minutes for the next hour.

**********************************************************

Blair came back into Todd's room a few minutes after Susannah left. She noticed the side rails had been padded with sheets. She smiled at Marcia. "Is it all right if I sit with him for while?"

"Sure, why don't you try talking to him. See if you can wake him up," Marcia suggested. Marcia checked the drip on his IV and went to get another bag of normal saline.

Blair was left alone in the room with Todd. She stroked his head and kissed him on the lips. "Come on baby, it's time to wake up." Blair continued to speak softly to him. She stroked his uninjured cheek as she spoke. "Todd, Starr is so much like you. She holds everything inside and imagines the worst, instead of talking to someone about it. She's also becoming a good little artist. She gets that from you, too. When you come home maybe you will realize how talented you are, and teach Starr a few things."

Blair thought for a minute, then quietly said, "Tom, Timmy, Andy, Thomas, all of you in there. If you are listening, I would love all of you to be able to come home to Starr and me. Starr loves all of you, and she loves to play with you and draw with you. She's always talking about those tea parties you used to have. She wants to come see you so much, but I told her they didn't allow children in here and that you didn't want her to see you when you weren't well. She understands so much. Todd, you would be so proud of our little girl. She is so smart and so beautiful, and she's grown a couple of inches since you've been in the hospital," Blair told all of them.

Blair bent down and whispered. "I told her that maybe there was a chance you could come home to us to finish your therapy. Don't worry, I explained that most likely it wouldn't be possible, but just the thought of it made her so happy. Oh Todd, Starr would be in heaven, if you could come home to us." Then Blair spoke directly into Todd's left ear, "And, so would I, baby, so would I."

Marcia came back into the room and hung the fresh bag of IV solution. "Did he seem to hear you?" She asked Blair.

"No, he didn't respond at all," Blair answered sadly as she continued to stroke Todd's head. Blair stayed for a little while longer and then kissed Todd again and left.

************************************************************

"Well, you look happy. So, what did Blair want to tell you about Starr?" Kevin observed, as soon as T�a joined him and Sam and Viki in the cafeteria.

"It's good news for once. I can't believe it. Blair is going to let me see Starr." T�a answered exuberantly.

"What's the catch?" Kevin asked. Sam and Viki quietly wondered the same thing.

"None that I can see. Blair said Starr thought I stopped coming to see her because I was angry with her and that I didn't love her any more."

"Oh, poor little Starr. T�a, did Blair set her straight?" Viki asked, upset that Starr was left to think that. Viki realized that she had been lax about seeing Starr. It wasn't just that she hated leaving the hospital, but seeing Starr just broke her heart. Every time Viki looked at the little girl who reminded her so much of Todd; and every time she saw Starr, Viki was reminded of how Todd longed to see his child, but couldn't allow himself to, and it just tore Viki to pieces. So, she hadn't seen the child much lately. She wondered if Starr felt that her aunt Viki also stopped loving her.

"T�a, that's wonderful. I know how desperately you wanted to see Starr," Sam stated, very happy for T�a and Starr.

"Do you know how much Blair has told her about Todd?" Viki inquired, concerned T�a might say too much or the wrong thing.

"Blair said Starr was afraid . . ." T�a was hesitant to say it in front of Viki, but since she already began, she finished her sentence. "Starr was afraid Todd had died and everyone was keeping it from her."

Tears immediately fell from Viki's eyes. She thought of her precious Starr thinking the daddy she loved so much was dead and she also thought about how close that came to being true on several occasions. Viki put her hand to her mouth to try to hold back even more tears. Sam and Kevin both became choked up.

"Blair, did set her straight?" Sam asked in a broken voice.

"Yes, actually, from the things Blair told me she said to Starr I think she handled it well. Blair was as truthful with Starr as she could be. She said she thought Starr understood."

Viki was happy for T�a. She knew how much she loved Starr, and how much Starr loved her. She prayed for the day that Todd and T�a and Starr could be a family again.

Kevin was a little leery. "T�a, are you sure Blair's not up to something? I mean this change of heart is kind of sudden."

T�a was annoyed with Kevin. She finally had something to be happy over and she didn't like him spoiling it. "If there is one good thing about Blair, it is how much she loves Starr. Starr was upset. She thought the reason I wasn't coming around was because I didn't love her anymore or that I was angry with her. Hurting Starr that way was not Blair's intent. Once she realized keeping Starr and me apart was hurting her little girl, she put Starr's feelings above her own and asked me to come see her."

"I know that couldn't have been easy for Blair and I admire her for it," Sam commented.

"No, I'm sure it wasn't. Unlike Dorian, Blair does have a good heart, but her attitude and her own fears get in the way of it, sometimes," Viki added.

After a few more minutes, they all headed back to Todd's room. Blair was gone by the time they got there. Susannah was just walking down the hall on her way back to Todd's room. She waved them over to the lounge area. She wanted to tell them about something she had just read in Todd's old medical records. She also wanted to see if anyone had anymore questions.

Just as they reached the lounge area, they heard Marcia call for assistance. Todd was having another seizure.

"Call neurology, tell them to get here stat! Get Peterson and Altman!" Susannah called to Mary, who was manning the nurses station, as she ran into Todd's room. She wanted the medical residents in Todd's room as quickly as possible. Viki and Sam and T�a rushed to follow Susannah.

"Please wait in the lounge," Susannah called to them, over her shoulder.

Sam and T�a stopped in their tracks, but Viki continued to head toward Todd's room. "Honey, no! Come on. Let them do their job," Sam said and put his arm around Viki's waist.

"No! Sam, I want to be in there with him. Please! Susannah must think it's very serious or she wouldn't have called in all that additional staff. She wouldn't have told us to wait outside. Sam, we're his family. He needs to know we're here," Viki pleaded.

"He knows. He knows," Sam whispered. He took Viki in his arms and held her tightly. T�a stood by, quietly weeping. Kevin put his arm around her. He held back his own tears.

Viki, Kevin, T�a and Sam watched as Doctor Wells, the neurologist on duty, as well as, some doctors and nurses from other units rushed to Todd's room.

Todd had seized for three minutes and fifty-six seconds. His body was still for only a few seconds when another seizure immediately started. Todd was having life threatening status epilepticus seizures.

"We're going to status protocol," Doctor Wells called out loudly. "Two milligrams lorazepam IV," he ordered. He then told them to call the ER and tell them they were bringing Todd down. "Okay, there we go," Doctor Wells said, as Todd stopped seizing. He checked his eyes. "Dilated and sluggishly reactive to light," he commented. They knew that was as likely due to the lorazepam as the seizure. "Let's start the O2, hundred percent fifteen liters per minute," he ordered.

"BP one hundred over sixty, pulse sixty-two and regular, respiration twenty-two," Connie called out.

"Okay, let's transport him," Doctor Wells ordered.

Viki, Sam, Kevin and T�a stood like statues, as they watched medical personnel going in and out of Todd's room. When they saw Carl wheel a gurney into the room, they realized Todd was in a bad way and needed to be moved out of the psychiatric unit.

When Susannah came out of Todd's room, they all rushed to her. "Todd went into status epilepticus. He's been medicated with lorazepam and the seizures have stopped, but we're taking him to the ER where he'll be given an intravenous anticonvulsant. He'll be monitored in the ER for a while and then he'll probably be sent for a CT scan and then moved to ICU for a day or two. He'll be kept on seizure precautions until we're sure he's stabilized," Susannah explained.

"Is his life in danger?" T�a asked.

"No, not now, but the kind of seizures he had are very serious and he needs close monitoring. I know I'm asking for the impossible, but please try to stay calm. He'll be all right. They'll start him on a fosphenytoin drip. That requires he stay on a cardiac monitor and have his vitals checked every fifteen minutes."

As they wheeled Todd out, everyone had expected the worst. They thought he'd be on a respirator or look like he was in pain, but he just looked as if he were sleeping soundly.

Susannah rode with Todd and Doctor Wells in the patient transport elevator. Viki, Sam, Kevin and T�a waited impatiently for the next one and headed for the first floor. Todd was already in a cubicle when they rushed into the ER.

They heard Doctor Wells' voice. "Fosphenytoin, IV twelve hundred milligrams PE infused at one hundred and fifty milligrams PE per minute."

They were about to go into the cubicle Todd was in, when Susannah came out. "Just give them a few minutes to get him settled and then you can see him. He's doing okay. His blood pressure and heart rate are a little low, more from the medication than the seizure. We're watching him. Doctor Anderson has been paged and I will ask him to come to the ER as soon as he calls in," Susannah said, comfortingly.

A young doctor exited the cubicle. "Hello, are you the parents?" he asked, Sam and Viki, without introducing himself.

"I'm his sister and guardian, and Sam is like a father to Todd. We both consider Todd to be our child," Viki let him know and then pointed to T�a and Kevin. "This is his wife, Tea, and Kevin, my son." Doctor Ascherr nodded in their direction.

Again, they approached the cubicle Todd was in, but Doctor Ascherr stopped them. "I need to ask you some questions. Let's sit over here, please," the young doctor directed. His manner seemed cold and matter-of-fact. Viki and Sam, both, had a problem with that. They headed for some chairs in a waiting area.

"Doctor Hanen filled Doctor Wells in on Todd's history," Sam informed Doctor Ascherr. He was eager to get in to see Todd.

"Yes, I know but we like to speak to the family and make sure no pieces of information gets missed. This will only take a little while and then you can go see your boy."

Kevin stood behind Viki and T�a behind Susannah. "Doctor Wells filled us in on some of the history. I just want to make sure we cover everything," Doctor Ascherr reiterated. "Has Todd ever had a seizure before?"

"No, he . . ."

Susannah cut in as Viki began, "He had a seizure in late 1993 after he sustained a brain injury." They were all shocked. None of them had ever heard this before.

"I-I . . . I didn't know," Viki stammered.

"It happened after he was hit with a pipe," Susannah informed both Doctor Ascherr and Todd's family.

"Has he had any seizures since then?"

Viki held off and allowed Susannah to answer. She thought Susannah might have seen something else in Todd's old records that she didn't know about.

"Not that we know of," Susannah replied.

"Now, right before the first seizure he had today, did he seem more tired or upset than usual?" Doctor Ascherr inquired.

"Yes," Sam answered. Then asked the doctor, "Do you know that he has DID and many alters?"

"Yes, I saw it on the chart. I have to tell you that I'm not very familiar with DID, but I understand a child alter was out at the time of the seizure."

Viki spoke up, "Yes, Thomas. He's eight years old, and he did look very tired right before the first seizure." Viki asked if the akathisia or the constant motion Thomas had been in contributed or caused the seizure.

"Not that we know of." Susannah could see the young intern's answers were too vague to give Todd's family peace of mind about that. "No, there has been no evidence of akathisia leading to seizures," Susannah answered firmly. The questions continued.

"Was he thirsty?"

"No."

"Was he upset?"

"Yes."

"Did he sense or feel anything unusual right before the seizures?"

They informed him of the aura Thomas had. "Did his face change color during the seizure?" They described Todd's face to him.

"Is there a family history of seizures?"

"Not that I know of," Viki answered. Many of the questions had to be put on hold until Todd was alert enough to respond.

"Do you think the medications he's on could have caused this?" Sam asked.

Doctor Ascherr looked down at the chart. "Mmmm, olanzapine, paroxetine, lorazepam, epoetin," he read out loud. "Well, we use lorazepam to treat seizures, so there's no problem there. Paroxetine doesn't usually trigger seizures either. There is a very slight chance that olanzapine and epoetin can trigger seizures, but with his history of brain injury, I would say it is much more likely that he has developed epilepsy, but for the time being his medications have been discontinued."

"The epoetin, that's the Procrit, isn't it?" Sam asked.

"Yes," doctor Ascherr answered.

"But he's so anemic, now. If you stop that, won't it get worse?" Viki asked.

"We will reintroduce medications one by one and see if they trigger seizures," Susannah explained.

"What are you doing for Todd, right now, to prevent any more seizures?" Kevin asked. He was afraid for Todd, and afraid for what this was doing to his mother.

"Todd has been started on a fosphenytoin drip. Then he'll be put on a standing dose of Dilantin. He needs to be carefully monitored. We'll be keeping him here for about ninety minutes, until the loading dose of fosphenytoin finishes and we've had a chance to evaluate him again. Then we'll take him for a CT scan," Ascherr informed them.

"Todd is terrified of confinement. He can't tolerate tests like that. Will you put him to sleep before the CT scan?" Viki was panicking.

"Yes, that's right, and what if he has another seizure while he's in the machine?" Sam added, frantically.

"Todd is already sedated with lorazepam, he will probably be given more sedation before he goes for the CT scan. The fosphenytoin will also keep him a little sedated. Just in case, Doctor Wells or I or Doctor Anderson, if he gets here, will be with him when he has the CT scan. If he becomes agitated or starts to seize we will be ready with the appropriate medication. After the CT scan, he'll be moved to ICU. Tomorrow he'll be started on oral doses of Dilantin." Doctor Ascherr informed them.

"Yes, Doctor Hanen explained that to us. Is Dilantin dangerous? Are there serious side effects?" Sam asked.

"All anticonvulsants have the potential for some serious side effects, however, they are necessary to prevent further seizures, but there can be problems. Most of the serious side effects are rare. The fosphenytoin is only being used as an emergency treatment to treat the status epilepticus. IV phenytoin, Dilantin, could have been used, but the fosphenytoin, you may be familiar with the brand name, Cerebyx, causes less cardiac irritability and less irritability to the IV site. Also, it can be given more rapidly. It may make Todd nauseous and dizzy. His speech may be slurred. He may have some intense itching, especially in the groin area. But, those symptoms will all pass in about an hour or so."

Viki was just becoming more frightened by the minute. "What about the Dilantin. He'll be getting that long term, won't he?" She pressed.

"Unfortunately, as I said, there can be some side effects that range from unpleasant to extremely serious. It can worsen his depression, and confusion. It can also cause aggression. Paradoxically, anticonvulsants, or the seizures themselves, can sometimes be beneficial to mental problems. We can't predict how . . . " Doctor Ascherr looked at the chart, apparently forgetting his patient's name.

"Todd!" Sam said through clenched teeth. He did not like this young doctor.

"Yes, we cannot predict how Todd will react at this time. The fosphenytoin and the lorazepam have caused his pressure to drop a little, we are keeping an eye on that."

"Is he in any danger from the medication or the seizures?" Viki wanted clarity.

Doctor Ascherr could hear the fear in her voice. He hated to have to fill the family in on dangerous side effects of medications, that were not likely to occur; because it worried them needlessly and caused them to ask questions about things that would probably never happen, but he also knew it was their right to be informed.

"Right now, because of the fosphenytoin, Todd will need to be watched for V-Fib, which is a dangerous heart arrhythmia. There is a very slim possibility of Dilantin also causing some cardiac disturbances and causing some problems lowering his red and, or white blood cells, and the possibility of nephritis, which is an inflammation of the kidneys. But those things don't concern me, what . . ."

"THOSE THINGS DON'T CONCERN YOU!" Sam shouted and stood up and grabbed the young doctor by the lapels of his lab coat. "YOU ARROGANT SON OF A BITCH! IF THAT WAS YOUR KID IN THERE, MAYBE YOU'D BE CONCERNED!"

"Sam!" Viki cried out. Susannah and Kevin rushed to tear Sam off of Doctor Ascherr.

"GET OFF OF ME!" Sam yelled, and pulled away from Kevin and Susannah. Sam stood quietly for a moment. He shook his head to clear it. Then realizing what he had just done, he looked horrified. Tears formed in his eyes and spilled down his cheeks. "Oh man, I'm sorry. I'm . . . I'm so sorry." Sam didn't know what else to say. He had really lost it. Viki took him in her arms.

Doctor Ascherr straightened his lab coat. He looked at Susannah. Her look begged him not to make a big deal over this. "It's all right. I understand you are very upset. I didn't mean to suggest that I didn't care about what is happening to Todd. I merely meant that those problems were not likely to happen. You have taught me a lesson in how to relate to patients and their families," Doctor Ascherr graciously offered. They all walked away for a minute to give Sam and Viki some privacy.

"I can't believe I did that." Sam was distraught.

Viki held on to him and stated, "Sam listen to me. No one blames you. You have been under an inhumane amount of pressure. That young doctor understands. He'll become a better doctor for it. Honey?" Viki lifted Sam's face and wiped the tears from his cheeks, "He'll be okay. Our boy is a survivor."

"Like his big sister," Sam said and hugged Viki and then suggested, "Let's go find out if we can see him now."

Viki and Sam joined Susannah, Kevin, and T�a over by the nurses station. Doctor Ascherr had gone back in to check on Todd.

Sam patted Kevin on the back, and said, "Thanks, I'm sorry I lost control that way."

"Hey, he is an arrogant SOB. You just taught him not to be," Kevin commented. Sam nodded, and patted Kevin's back one more time.

"Sam, are you all right?" Susannah asked.

"Yeah, I'm fine. Or I will be once we know Todd's going to be all right."

"Would you like to go someplace private and talk with me for a while?" Susannah offered.

"No. Thank you, but I just want to see Todd." Sam's voice still had a little edge to it.

Viki suddenly remembered, "Blair, do you think we should notify Blair? Dear Lord, I don't want a repeat of what happened earlier." Sam and Viki looked at Susannah for guidance.

"I can't tell you what to do as far as Blair is concerned, but T�a and Kevin, I do need to say that when Blair comes back to see Todd, I think it would be best if you either went home or went to the cafeteria while she is here."

T�a cast her eyes downward for a moment. She then took a deep breath and nodded her head and replied, "I understand, just let me know when Blair is coming and I'll make sure not to be here."

"Now wait a damn minute. I don't think it's fair to ask T�a, Todd's wife, to leave so that Blair, Todd's ex-wife can visit him!" Kevin spoke up angrily.

"Kevin, please, it's all right. No one has the strength to go another round with Blair," T�a responded.

"Kevin, I'm sorry, but that is what is best for all concerned right now, especially Todd. I don't want the three of you around him at the same time," Susannah held her ground.

"Then tell Blair not to show up. T�a has a right to be here," Kevin's tone sounded even angrier.

"Sweetheart, please!" Viki pleaded, taking his arm.

"Yes, Kevin, I understand what you're saying and it's not fair, but let it go. For Christ's sake, we have more to worry about here than hurt feelings," Sam scolded. He was anxious to get in there to see Todd and he had no patience for this.

"Viki, Sam, it's all right, really. I will go to the cafeteria when Blair comes," T�a assured them.

"Thank you, honey. I'm sorry it has to be like this," Viki commented and hugged T�a.

"Same goes for me, T�a, thank you," Sam said and took T�a's hand.

"Yes, T�a, I appreciate your understanding." Susannah praised her.

"Kevin?" Viki asked her son.

"Yeah, okay, if Blair comes I will make sure not to be here," Kevin answered bitterly.

"T�a, why don't you go in first, just in case Blair comes and you have to leave," Viki offered generously.

Sam realized Viki was right, even though he wanted nothing more at that moment than to see Todd, he added, "She's right, T�a. You go ahead, we'll go in later."

T�a looked at them with tears in her eyes, and headed for the cubicle Todd was in. Kevin started to go in with her. "Uh Kev, why don't we give T�a some time alone with her husband," Sam suggested, putting his hand on Kevin's arm.

Kevin seemed surprised by Sam's remark. "I was going to offer moral support, and I want to see Todd."

"I think your mom here could use a little moral support right about now, too," Sam responded.

Kevin looked a little guilty for a moment. "Mom, I'm sorry, I . . ."

"Sweetheart, it's all right. I know you are concerned about T�a, but I do think she might want a few minutes alone with Todd." Viki hugged her son.