by Barbara Ebel
As Danny sat on the front step, Julia walked around in circles on the grass. After several times going fast, she fell on the lawn.
“Are you making yourself dizzy?” Danny asked.
She giggled and got up as Rachel’s car pulled into the driveway; the door opened and she yelled for her daughter. Danny walked over with her little suitcase.
“I’ll take that,” Rachel said after giving Julia a kiss. “And don’t come any farther. God forbid you touch anything over here of mine or you’ll be suing me, too. You two are a sorry lot.”
“Sorry lot,” Julia mimicked.
“Just be back at a reasonable time with her on Saturday,” Danny said. Shaking his head, he turned and walked to the house. No wonder Julia was misbehaving.
When he got back in the house, Sara and Nancy were both finishing more pizza.
“If you both are finished,” he said, “I’ll put the box in the refrigerator and have another slice later when I get home.”
He gave them both a kiss and left for the hospital. The last rays of the sun disappeared to the west as he put his headlights on and wondered if Julia would be more pleasant when she got a little older. In a few years, he hoped her conduct would change for the better and she’d become a sweet and smart five-year-old.
-----
Danny scanned the print-out of his and his partner’s patients as he stopped in the hallway. A nurse took the last chart from him and stood it upright on the rolling cart that had accompanied him. All their patients had been seen except for the two remaining in the ICU. He thanked the nurse who had been conscientious coming on the evening shift; she had helped him out a few minutes before she even needed to clock in.
When the automatic doors of the ICU shut behind him, the isolation and coldness of the unit made him shudder. A fluorescent light fixture had burned out, the central area grayer than normal, and a nervous quietude hung in the air. How many times had he walked into this large arena and yet, on each occasion, it took on a life of its own? He looked to the right at David’s open door. The young man was now sequestered from society as if quarantined from his peers and the normalcy of life; whatever that may be.
Danny stepped into the room where the light was also subdued as if David had been tucked in bed for the night. An RN was alongside his bed taping the tubing from a small infusion bag into a heplock on his hand. Across the room, Annabel sat on a chair in the corner, her face puffy and her hands clasped on her lap; she had been crying.
“Dr. Tilson,” the nurse said. “I knew you’d be making rounds this evening. David had a seizure an hour ago. We spoke with Dr. Banks and she switched one of his anti-seizure medications again.”
“Thank you,” he said and nodded to Annabel.
Danny first examined David, who looked spent and deeply tired and didn’t stir when Danny jostled his shoulder. He listened to his heart and lungs with his stethoscope, flickered his penlight into his eyes, and checked his reflexes. After scanning his vital signs again on the monitor, he stepped to the counter and leaned against it.
Annabel glanced at him with moist eyes. He realized how far she’d come from being a tomboy with a crooked tooth and a baseball cap to being a more feminine young woman with a straight, white smile and a shiny curl to her hair.
But within a few seconds, she practically gave him a scowl. “All the muscles in his body contracted,” she said, as if accusing him. “I watched him convulse and distort. And then he lost consciousness.”
“A generalized motor seizure is a frightening experience when seen for the first time,” Danny said. “Especially if it’s someone you care about.”
“I mean, he ended up looking rigid and he could hardly breathe and saliva drooled from his mouth …” She whimpered and put her head in her hands. “They had to escort me out of here,” she mumbled. “How am I going to get that image out of my head?”
Danny put his hand on her shoulder. “Come on. Let’s find a private place to talk.”
She shrugged his hand off but got up, grabbing her satchel from the floor. Walking past him, she exited the unit while making sure she kept a distance from her father.
Outside the door, he pointed to the elevators. “We’ll go to the doctor’s lounge.”
“I’m not exactly a candidate,” she said.
“It’s after hours and there won’t be many people there, plus it’s fine. You are going to be there someday yourself, aren’t you? Is med school still on your agenda or has that changed?”
“I plan on applying,” she said and didn’t offer any more information. They rode down in silence as the elevator creaked and groaned more than usual and then went straight into the lounge. There were only a handful of doctors; Danny nodded at those who looked over.
“I had dinner at the house,” he said. “Why don’t you make yourself a sandwich?”
Annabel shook her head but stopped at the counter nevertheless. She took a scoop of chicken salad and a package of crackers, then poured an ice tea. Danny deliberated at the coffeepot; it looked fresh enough, so he poured a cup.
He pointed to the couch where Annabel kept the plate in her lap and put her drink on the side table. Danny sat in the separate leather chair and took a swig of lukewarm coffee.
“Before we talk about David, I need to know about you,” Danny said. “How is school going? Are you getting your work done while still managing these visits?”
“I had some exams earlier in the week so I’m kind of caught up. That’s why I decided to come tonight.” She tore the cellophane off the packet and crumpled it on the table.
“I never tell you this but, if there’s anything I can help you with as far as schoolwork, just holler.”
“I’m not a little kid, Dad.”
He let the remark slide and took another sip of his weak coffee.
“What you should be helping with is getting David out of this predicament.” She tossed a glare at him then quickly averted her eyes and scooped chicken salad onto a cracker. What is it with girls, Danny thought. Is raising boys this difficult?
“Spare me the accusatory tone,” he said. “I don’t deserve that. Dr. Banks and I have tried to avoid it but it’s now inevitable. David is not responding to standard treatments. I’m going to arm you with more knowledge about what’s going to happen.”
She took a bite and held his glance.
“What we need to know,” Danny said, “is the region of David’s brain that is the source of the epilepsy so that I can remove it.”
“Oh my God. Really? Brain surgery?”
Danny loosened the top of his shirt and nodded. “But this is easier said than done. There is a very complex and highly invasive first step, a pre-surgical phase. I would have to perform a cranial operation to implant electrodes on the surface of his cortex.”
Annabel scrunched up her forehead. “A surgery before you do the surgery?”
“Yes. And after the wound is closed, David would have to remain in the intensive care unit. It gets worse. He would have to stay there for several weeks with wires passing through his cranium.”
“What on earth for?” she asked, putting the plate aside and wringing her hands.
“For that extended period, the electrodes are connected to a recording machine which will identify the source of the epilepsy during the seizures.”
“No! That is insane. We’re living in the twentieth century. We can turn up our house heat remotely and soon we’ll have smart cars that can parallel park by themselves. Our cell phones are remarkable and can tell us the price of gas in our vicinity. In the scheme of things, this sounds barbaric. It’s like something from the nineteenth century. You surgeons and researchers have gotten lazy and haven’t technically developed the process any further!”
She stopped her tirade but he’d never seen her so passionate about anything before.
“Annabel, I can’t change what already is and I have to do what is best for my patients.”
“But a college student being imprisoned
in an ICU for weeks on end? That’s torture. His health and his schoolwork and his whole life will be changed, maybe forever. He’ll lose his friends, he may never get to play basketball again, not to mention he’ll be bored to death.”
Danny winced. “I deal with the reality of the neurosurgical issue and what I have at hand. I cannot control those things.”
“Ha. Some neurosurgeon.”
“Excuse me, young lady?” Danny said, his blood starting to boil.
She blinked and turned aside. “I’m sorry. I know you’ve had outstanding accomplishments because of your work with that pandemic two years ago and then that issue with that potent drink last year. You’re apparently a big deal when it comes to neurosurgeons.”
Danny held his tongue; at least she apologized which was more than he expected.
“But still,” she said, “what you’re proposing as the current course of treatment, this pre-surgical phase as you’ve termed it, is archaic. I guess I just called you out as you are a better neurosurgeon than that.”
Annabel got up. “Are we finished here? If so, I’m going back to my dorm.”
Chapter 15
With ridiculous zest, Julia ran circles around the kitchen island in pursuit of Snoopy. The dog caught the gist of the game in no time flat and was more than accommodating to stay out of her arms reach. Julia plopped down around a corner but Snoopy kept going. When he looped back around, he plowed into her.
“I tricked you!” she squealed. But the dog loved it even more and showered her face with her wet tongue.
Rachel watched with a smile on her face. It was the perfect way for her daughter to start the morning before the appointment they had; one which was the main reason she needed Julia on this week day.
“You two get along like a butterfly and a wildflower,” Rachel said. “She is so attached to you.”
Julia put her arms around the dog and squeezed.
“Stand up, sweetheart. Let me brush your hair and put on this ribbon clip.”
Rachel finished and said, “It’s even the color of your shirt. You look so pretty.”
“You’re pretty,” Julia said.
“You’re prettier.” Rachel squatted and looked into her daughter’s wide-set eyes. “We’re going somewhere this morning. You can talk with a nice lady and she may help you out because you can tell her how much you want to live with your mommy. Okay?”
Julia wrapped her arms around Rachel and squeezed.
“That’s a good girl. Now I have to make a phone call and then we’ll be leaving. You can play with Snoopy again for a few minutes.”
Rachel stepped into the bedroom and called Beckett and Livingston in Knoxville.
“Phil, it’s Rachel.”
“Miss Hendersen. To what do I owe the honor? How is your pediatric hospital service coming along?”
“It’s lots of fun, Phil, except that I prefer time with my own daughter at home a lot better.”
“I’m glad she stirs that motherly instinct in you. Now, what can I do for you?”
“I’m putting legal paperwork in the mail to you today. It’s from Mark Cunningham but it does not involve Danny Tilson.”
“I’m not exactly following you.”
She rolled her eyes. “Danny must have referred his attorney to a buddy of his. This friend, Casey, wants to take a bite out of my purse strings because of a little mishap he had under the hood of my car.”
“Is this guy a mechanic?”
“No, but he thought he’d play superhero and get my car started.”
“Sounds like a Good Samaritan. You know that under that law he is legally protected if he was giving you assistance because you were ‘injured, ill, in peril, or otherwise incapacitated.’”
She took a deep sigh, rolled her eyes again, and mumbled “nitwit” under her breath.
“Since you’re my attorney, you should know I’m not going after him for trying to help me; he’s suing me.”
“Well, that’s a switch.”
“Call it what you want. Why don’t you just read it when you get it and spare me explaining it to my own lawyer?”
“It’s your salary being put to good use,” he said. “I’ll look forward to receiving your envelope. In the meantime, have yourself a good weekend.”
-----
Rachel grasped Julia’s small hand in her own and guided her down the pleasant strip mall’s sidewalk; there were holly bushes and an occasional redbud tree in a patch of dirt. They passed a women’s salon and a local favorite lunch spot. She stopped at the next storefront with black and gold lettering on the glass door: The Family Therapy Group.
She entered into an inviting area with a matching black and gold rug; it had directional marks on the tufted fabric like it had just been vacuumed. She signed in, then sat on a chair next to a mat with books and toys. While she answered the questions on a form she was given, Julia watched a little boy talking in Spanish to his mother.
Soon the other client was called to the back and another woman in her 20s opened the door again. Rachel and Julia followed behind her slender figure and went into a small room with a large bookcase, a desk, and a chair and a couch. The curtains were half open to the rear parking lot.
“I’m Miriam Kelly,” the woman said, shaking Rachel’s hand. “And this must be Julia.” She squatted and smiled. “It’s nice to meet you, young lady.”
Rachel made herself comfortable while Julia giggled and jumped up on the couch next to her.
Miriam sat down on the chair. She wore three large rings on her right hand and, as she glanced over Rachel’s form, her straight black hair fell forward. “So you work in an OR?” she asked.
“I do. I am the one performing the necessary evil of keeping surgeons sane by handing them what they need under the tensest circumstances. But I also keep them sane with my chitchat,” she added and laughed. “Just like you must diffuse a lot of antsy family situations in this room.”
“That’s so true,” Miriam said. “So, when you’re not in the OR, what do you do for fun?”
“Besides my job, I gain a lot of fulfillment with the volunteer work I’m doing at a children’s hospital. Some of those kids with chronic conditions and a history of multiple surgeries need all the love and attention they can get from volunteer groups like the one I’m in. Other than that, the most pleasure in my life is from this pretty girl right here. Right, Julia?”
Julia shifted on the cushion, cuddling into Rachel’s lap.
“Excellent,” Miriam said. “Well, I’ve read your notes on the second page so the best thing now would be for me to talk to Julia alone. It sounds like there are some things troubling her or she would like addressed. She and I can have a nice chat and perhaps I can make her feel better about things.”
“I sure would appreciate it,” Rachael said. She gave Julia a kiss on the top of her head and got up.
“By the way,” Miriam said, “has Julia’s father done anything like bring her to a counselor or therapist?”
“Him? He doesn’t have time for that sort of thing, even if he did think of it.”
Miriam grinned with acknowledgement, Rachel left the room, and Julia and the counselor warmed up and began talking.
-----
Friday afternoon, Danny finished dictating his last patient’s visit just as Cheryl popped her head in the door. “Do you want to talk to David Bell’s basketball coach? He’s on line two.”
Danny nodded while he picked up. “Lester, what a pleasant surprise.”
“Dr. Tilson, I hope you don’t mind my calling to find out how David is. We just had practice and the team was talking about him. Some of them have visited David in the hospital but we don’t know or understand how he is from the neurology or medical standpoint. I know you must honor his privacy but maybe you could shed a little light so I can report back to the team. We all miss him.”
“No, I’m glad you called. What happened is an integral part of the team’s history and it could have happened to any one of th
e players. As you know, he surprised us by waking up and by doing it so soon. The players must have heard from the nurses that the main problem now is seizures.”
“That’s what they are telling me. Can we be optimistic they are going to go away? Will he ever play for the school again, even if it’s next year?”
“It’s not looking likely. He’s still in the ICU because we may need to do some drastic measures to get them under control.”
Lester sank into the chair in his small university office. “The injuries are one of the few thorns in this otherwise fun and rewarding job of being a coach.”
“I bet,” Danny said. “And by the way, have the return-to-play medical guidelines been restressed at any university meetings?”
“Yes. David’s situation has brought the subject back to the table.”
“Good. University sports programs have a duty to these young players. The first hit to the head is problematic but the second or third impact can cause permanent long-term brain injury. Cumulative sports concussions can increase this likelihood by almost forty percent.”
“Any other information I can bring to the next meeting?”
Danny considered and was grateful for the question. “A couple of points can be reiterated, such as the athletes must always have information readily available about the potential for serious head injury; the games must have a medical professional present to asses a head impact, which you’re doing; and we must keep up and review impact measurement data. The standards must be held high.”
“Appreciate that. And we all want you to have a season pass to our games. One is in the mail but I’ll put you on a list to receive one every year.”
“Thank you. And Lester, please feel free to call me any time. I can share overall information about David’s progress if it’s okay with the family and then the whole team can be updated.”
“Appreciate that.”
When Danny hung up, both Cheryl and Matthew Jacob walked in. Matthew planted himself on the couch.