"Yes that's, that's correct," Barb answers.
"We’re all so sorry for your family’s loss, but Amanda is quite an amazing patient. We did a lot of imaging when she first arrived here. Since she wasn’t conscious when she entered, we did MRIs of her brain and CT and MRI scans of her spine. We have learned some troubling things.
“The MRIs showed that she has bleeding in the frontal area of her brain lobes. Then, in the series of CT scans and MRIs of her spine we found that there is a fracture of the vertebrae at C2, which is in her neck. We stabilized her and reduced the swelling in her brain.”
Dr. Wrightson walks around the conference table and points to the scans that are clipped to a white board. Obviously, the doctors had been talking about these films before Barbara and Andy entered.
“With this type of fracture we have to be absolutely sure that there is no movement in her neck area. To do this we surgically attached what is called a halo. It encircles the skull and is attached with pins inserted into her head. Then we attach metal vertical rods to the halo and custom-fit a plastic jacket around her upper torso. Between the plastic jacket and the rods connected to the halo, any neck movement is prevented. We see a success rate of anywhere between 15 to 85 percent in halo patients. Success meaning that the cervical fracture heals itself and the bone fuses back together. I know I just covered a lot, do you have any questions?"
"Not yet…" Andy says.
“I had an infectious disease specialist at the surgery because Amanda had so many lacerations and contusions. We took some cultures and will follow up.
“Despite having multiple traumas, she had surprisingly little blood loss. I will need to reconfirm those figures. She did suffer a brain injury, which I'll have Dr. Lucent discuss."
"I'm Peter Lucent. We can tell you Amanda has suffered a mild to moderate brain injury, but not much else because she has not regained consciousness yet. The problem with Amanda’s type of injury is that the front lobe of the brain controls many executive functions. It controls our impulses, and it plays a significant part in our general cognitive reasoning. Frankly, we will need to carefully reduce her medications and hope for the best. Although we are currently assisting her breathing and providing her nutrition, she'll hopefully be breathing on her own soon and will come out of the coma. But with the type of impact that she suffered it's just going to be a wait-and-see situation."
"When can we see her?" Andy asks.
"Once she's and we get her into a room, we will allow immediate family to see her. But she will be in intensive care for some time."
"Does this mean she's going to have permanent brain damage?" Barb bluntly asks.
"We can't tell at this point," says Dr. Lucent.
"With the halo, does she need a wheelchair? And how long does she need the halo?" Barb asks.
Dr. Lucent looks a bit uncertain and turns to Dr. Wrightson for an answer.
"She’s definitely going to be in a wheelchair, at least—I’ll just say for a while. Until she's up and responsive we won’t know if she will have any paralysis. As for the halo, it could be 90 days or longer. We will conduct progress imaging to monitor the bone growth at the fracture site.
"The media is pressuring us for information on your niece, which is understandable given that she is the only known survivor of the crash. Do we have your permission to at least give general information about your positive identification, our surgery techniques, and her stable condition?"
Andy and Barb look at each other and ponder the question. Then, Andy answers.
"I see no problem with that."
"Do either of you want to attend the news briefing?"
"I don't think so," Barbara says, looking to Andy for his agreement. He nods affirmatively.
An administrative assistant, who had not spoken yet, produces a piece of paper with a short paragraph permitting the disclosure, which Andy signs. With that, the doctors rise from their chairs and one by one shake the hands of Andy and Barb before leaving.
"We want to thank you so much for everything you’re doing for her." Andy says sincerely.
"Sure. Again, we are sorry for your loss," Dr. Wrightson offers.
Barb and Andy then walk back to the family room to pass the news along to those anxiously waiting for an update.
Chapter 9
First View
“Mr. Michaels, the doctors say it’s okay for the immediate family to come up to ICU now.”
Andy and Barbara take the elevator up to the third floor and follow the nurse down the hall to a partially opened door. Amanda lays propped up slightly on the bed surrounded by medical equipment, and IV lines run everywhere. Her shoulder-length brown hair has been shaved away from her forehead in various places, and the metal halo has been affixed to her skull. Andy finally realizes that they actually screwed the thing into her skull to attach it. Yikes! Her face looks grotesquely bloated with random abrasions along her cheeks as well as along both of her arms. The blue hospital gown hangs loosely on her body, far too large for her petite frame. There’s also a clear breathing mask over her nose and mouth. Her eyes are closed.
“The doctors have a breathing tube on her even though it’s not clear she needs it. And she is being fed intravenously,” the ICU nurse explains. Her eyes move back and forth from Amanda to the various monitors. One of them is beeping every several seconds so she reaches over and touches a button, observes another set of displayed figures, satisfies herself that they are okay and looks back at Andy and Barb. Her look is one of expectancy. As in what questions do you have?
Amanda’s arms lie limply beside her motionless torso.
“Can I touch her?” Andy asks the nurse.
“Sure, just very gently.”
Andy walks to Amanda’s side and gently strokes her arm looking for a reaction. There is none. She remains motionless. Along the other side of the bed Barb also touches Amanda’s arm.
“Can you hear me Amanda? It’s your Aunt Barbara. Can you move or smile or do anything to let me know you hear me?” There’s no movement from Amanda.
“We’re going to have to sit and talk to her a lot and see what happens. I’ve heard amazing stories about relatives talking to someone in a coma and the person wakes up one day like nothing ever happened.”
Andy forms an odd smile, one that indicates a mixed bag of emotions.
The nurse hovers impatiently in the corner of the room. She finally speaks up. “We’re going to be monitoring her 24/7 and giving her the best possible care. You ought to try to go home and get some sleep, then come back in the morning.”
Andy and Barbara walk out of the room and back toward the family room to explain the circumstances to everyone else.
It’s a media circus on the first floor of the hospital and in the parking lot with all the press and TV reporters.
“I’m going to hire a security service to keep reporters out of Amanda's room. They’ll be here first thing tomorrow," Andy says. Barb agrees, then insists that Andy be the one to go home first. She will sleep overnight in the waiting room on a chair or whatever she can find.
Chapter 10
Andy Crashes
As he shuts and locks the door on his black Mini Cooper, Andy feels the exhaustion of the long day. Getting sleep is just about the only thing on Andy's mind, after the constant array of noises permeating the hospital waiting room, even though nobody else was there after midnight. Tossing his keys down on the kitchen counter he sees the blinking light on his answering machine and punches it to check messages. The first is from his father about traveling to the area to be with Amanda. Will dad behave himself, he wonders. It would be nice, for once. Then there is a message from Sarah, his ex-wife. He cringes but decides to listen.
“Andy, it’s Sarah. I don’t know what to say, this is such a horrible day for you. I’m so sorry about Ron and Rochelle. And then when I heard about Amanda I couldn’t believe it. What a miracle! I don’t know what else to say, but if there’s anything I can do please let me know.
I hope to hear from you.”
Andy divorced Sarah in the middle of handling the 9/11 cases after five years of marriage. Sarah and Andy had met at Georgetown law school and he thought their marriage was meaningful until one day she announced that Andy wasn’t paying enough attention to her and was too much in love with his job.
Sarah, being a lawyer herself, was the top Capitol Hill aide – commonly called an “AA” – to Republican Senator Mike Pierce of Indiana. She didn’t want to have kids, not right away anyway; she said she felt it would interfere with her job, and she was probably right. It was only later, through happenstance that Andy learned that Sarah was having an affair with Sen. Pierce, a fact that still had never been made public. Although there is no such thing as a good divorce, the fact that they had no children made it a smidge easier. Psychologically it took a heavy toll on Andy, but he kept himself immersed in his cases.
Andy punches the button on the machine and listens to the next message. How ironic he thinks, when the next caller is Rebecca, the woman he’s been dating for nearly two years. At least the messages are in chronological order with his life, he rationalizes.
“Andy, it’s Rebecca again. I wanted to know if there’s anything I can do to help. I’m definitely coming by the hospital tomorrow. When you get this message please get back to me. Love you.”
Just hearing her voice brings a smile to his weary face. Rebecca and Andy have a good thing going. She owns and manages her chic clothing store, Becca’s, right on Wisconsin. Amanda loves Becca’s shop, and seems to love Becca too. Andy hovers in her store sometimes after work, waiting for her to close up. He tries to be invisible and patient, sitting in one of the comfortable customer chairs wedged between the clothing racks, near the full length mirrors in the rear of the store. He casually flips through fashion magazines she subscribes to that he would never really look at otherwise, but it’s better than having nothing to read while he waits for her to free up.
After listening to his messages, Andy heads to his bedroom. He doesn’t even remember his body hitting the bed.
The warm light streams through the hospital window between the slats of the vertical blinds, creating linear patterns on the hospital room wall. Barbara sits in one of the chairs reading the morning paper.
The security guard peeks in the room and tells her there are two men here to see her “from the government.” Barb puts the newspaper down, and walks out the door to find two clean-cut official-looking guys in slacks and black shoes.
One of the men says, “Good morning, I understand you’re the aunt of Ms. Michaels?” At the same time, he lifts a small billfold from the inside pocket of his jacket and flashes a badge. Barb notices the words “Federal Bureau of Investigation.”
“I’m Charles Barnes, and this is Mr. Zelniak, from Homeland Security.” Zelniak also slides a badge out of his inside pocket and holds it up for Barbara to inspect.
“Well, this is unexpected,” Barbara says. “Are you here because…actually, why are you here?”
“This is really just routine due diligence. Because your niece is the only survivor of the jet crash, we’re hoping to interview her, that is, if and when she’s capable of talking with us.”
Barbara scratches her nose a moment and looks past the both of them. “Are you suggesting that something like terrorism caused the crash?”
Zelniak speaks up. “Whenever there is any type of domestic crash and the cause is not yet identified, it’s standard procedure to rule out any possibility of sabotage. Having said that, no ma’am, there is no evidence of any type of sabotage or terrorism here. Nonetheless, we would like to talk to your niece.”
“We understand that she’s in a coma now, but if she wakes up please give us a call. We’d like to ask her some routine questions so we can close this file.” With that Barnes hands his card to Barb, and Zelniak follows suit.
Barb shuffles them in between her thumb and forefinger a moment.
“Right now the most important thing to us is that Amanda wakes up. But we’ll definitely let you know if and when she can speak to you.”
I wonder what that was really about, Barb thinks, as she watches them walk down the hall.
Chapter 11
Awakened
Three full days have passed since Andy and Barb first saw Amanda in ICU. She is no longer in ICU because she is breathing on her own, but she’s still on nutritional IVs and requires constant monitoring. Dr. Lucent and Dr. Wrightson have made their daily rounds. Lucent, the more upbeat of the two, has reinforced the idea that Amanda could regain consciousness at any time.
"Sure, go on in."
The security guard has gotten to know the young volunteer in the last few days and casually waves him into Amanda's small hospital room. He goes about his routine, changing the used towels and tidying the bathroom. Out of the corner of his eye he looks at the pitiful young girl in the blue hospital gown and metal halo. Hmm…kind of cute, he thinks to himself, admiring her hair with its uneven cuts around the halo and the fixation pins. He would have to be living under a rock to not realize how much the media has been covering her story in the last few days.
"Who are those guys on your shirt?"
Her eyes stare into his but she hasn’t moved.
He can only stammer. "Uh…what? Uh…I need to go tell someone."
“Hey, wait!” she says as he darts out of the room, looking for the first family member or nurse he can find.
"Nurse, Nurse! The halo girl just opened her eyes and talked! Where’s the doctor?"
The nurse dashes down toward the nurses' station with the volunteer trotting behind her. She quickly scans the nurse’s notes relating to the patient and pages the neurosurgeon and Dr. Lucent. After they have a brief discussion, the nurse dashes down the hall to convey the news to Barbara Simon.
"Dr. Lucent asks that you please not enter her room until he and the other doctors evaluate her. You can go in as soon as they’re done."
Barb hurriedly texts Andy: “Amanda out of coma! Get here ASAP!”
Andy responds seconds later that he’s on his way.
Within minutes the doctors and nurses have assembled in Amanda's room. Dr. Lucent, the neurologist, is the first to speak as Amanda looks around the room in silence.
"Ms. Michaels, my name is Dr. Lucent. I'm one of the doctors treating you. I'd like to ask you a few questions in order to evaluate you."
"I want to know what I'm doing here and why my head is locked in place," Amanda says in an aggravated tone. “What’s the thing on my head for? Can someone get me a mirror please?”
Lucent decides to ignore the mirror request. "You are a patient in Loudoun Memorial Hospital, and you were in an accident. Do you remember anything about that?"
"What are you talking about?"
“Please wrap your hand around my index finger. I want to check your strength." Amanda complies.
Next Dr. Lucent asks her to follow his pen as he moves it left and right, checking her vision. He completes several other quick bedside tests.
"I need to ask you a couple of questions. Do you know what kind of accident you were in?"
"I already told you no. I don’t know what you’re talking about."
"Tell me your name."
"Uh …I’m not sure. What’s my name?"
"It's Amanda Michaels. Do you know where you go to school?"
"No…tell me where."
"According to our notes it's called Middleburg Academy. Can you tell me what grade you're in?"
"No, I really can't."
"Amanda, do you know your parents' names and whether you have any brothers or sisters?"
"Umm…do I have any brothers or sisters? Do I?” Something shoots through her synapses. “Yes, I have a little brother named Justin. I can’t recall my parents’ names."
"Do you know who the president of the United States is?"
“No.”
"Can you tell me how many states there are in the United States?"
"Fifty,
and that’s a really ugly jacket you have on. Same for the other guys hovering around behind you. Why are all these people here?" Amanda asks.
Dr. Lucent motions with his finger to the other doctors and nurses and they huddle at the corner of the room, whispering.
"I don't like when people tell secrets, stop it!" Amanda says.
Dr. Lucent walks back over to her bedside and places both hands on top of the white linens.
"Do you play any sports in school?” he asks, trying to trigger her memory.
"I like swimming. I like riding bikes."
"Do you know your address?"
"Nope. Where is the guy with the T-shirt I was talking to?"
The doctor holds up his pen. "What is this?"
"It's a pen, duh. Where’s that kid that I was talking to?" Amanda again asks.
"I'm not sure who you’re talking about," Dr. Lucent says, turning to the nurses with a quizzical look.
One of the nurses pipes up. "I think she's referring to Kent Perless, one of our hospital volunteers."
"Oh," Dr. Lucent says. "I can send him back in here later. Do you know him from before your stay here with us?"
"I just like his T-shirt," Amanda replies, not really answering the question. “And my little brother Justin — why isn’t he here? How long have I been here, anyway?”
"It was great talking with you, and we'll talk again real soon," Lucent says, eyeing the door.
“How soon? I’m hungry.”
“I’ll get you some food right away, and I’ll be back in just a few minutes.” Lucent tells one of the nurses to give Amanda some soft foods as everyone files out of the room.
In the hall, Andy rushes at them from the other direction.
“Hey you guys, what’s the deal? Is she talking? When can we see her?”
“We are just figuring that out now, your timing is great.”
Taming the Telomeres, a Thriller Page 4