Jack pulled back the sheet to examine Mike’s swollen abdomen. He checked the incisions, and the multiple drains, and again noted the extensive black and blue marking of blood that had seeped into his tissue. “It looks about the same to me.”
Lisa scanned Mike’s body, and then shook her head. “I don’t think so, Jack. Look at the space between the upper part of the incision, and the drain below his right ribs. Last night it wasn’t more than an inch and a half, now it more than two inches.”
Jack looked at Carla. “Did anyone measure his girth last night?”
Carla flipped through the nursing notes. “Here it is. Just above his navel, they measured thirty-eight inches.”
Jack took the tape measure, and passed it under Mike’s back. He drew the end of the tape across the black marking, and said, “I’d better do this again.” When the repeat measurement showed forty-one inches, he said, “Shit—something’s going on in there. We’d better get Julie Kramer up here, ASAP.”
“What is it?” Lisa cried.
“I don’t know. It could be fluid accumulation from all the injuries, or he could be bleeding internally. I’d like to put a needle in there to see, but it’s too dangerous.”
Suddenly, the cardiac monitor beeps increased as Mike’s heart rate reached 160 beats per minute.
“His blood pressure’s down to 90/50, Jack,” Carla said. “There’s fresh blood at his incision line.”
Jack checked Mike’s monitor reading. “He’s got to be bleeding. Get me two units of fresh blood, Carla, and make sure the blood bank has six units available at all times.”
Julie Kramer arrived as they completed the infusion of the second unit. Mike’s pressure had increased to 109/60. When Julie placed her hand on his abdomen, she said, “I’m calling surgery. We must go back in.”
Julie studied Lisa’s ashen face. “I’m sorry, but I can’t say this is unexpected. It could be anything from his damaged liver to bleeders that we missed.”
“How much of this can he take?” Lisa asked.
“Let’s hope it’s something simple, Lisa, so we can get in and out quickly.”
“Is he ready?” Julie asked.
“Go ahead,” said Mickey Katz, the anesthesiologist.
When Julie cut the abdominal sutures, the midline incision burst open, expelling dark clots, and a mixture of dark and bright red blood. She handed two large retractors to her assistant, and then cleared the large amount of blood with a large vacuum suction and surgical pads.
After she removed the blood-soaked pads, Julie peered into Mike’s abdominal cavity. “It’s part of the left lobe of his liver. Shit—I should have removed it yesterday.”
“Sure,” Mickey said, “we’re all geniuses in retrospect.”
“How’s he doing?” Julie asked.
“So far, okay. If we can keep up with his blood loss, and we don’t run into blood clotting problems, he should do okay. Are you going to remove that part of his liver?”
“Don’t have a choice.”
Julie began the delicate process of removing the damaged lobe of the liver, tying off numerous blood vessels and bile ducts. The electrocautery sizzled against the bleeding points with billows of smoke rising and filling the room with the smell of burning meat. After two hours, she placed clean white towels into the abdomen, waited for several minutes, and then removed them. They showed only mild blood staining and no sign of active bleeding.
“Let’s finish,” she said, repositioning the drains, and beginning to close using thick, stainless retention sutures.
Lisa and Phoebe were sitting and holding hands in the surgery waiting room when Julie entered.
Lisa tried to rise, but Julie sat her back down.
“How is…?” Lisa asked.
“He’s okay. I had to remove part of the left lobe of his liver. That’s where he was bleeding. I should have removed it yesterday and spared him a second operation.”
“Can we see him?”
“Of course.”
As they stood by the surgical gurney, Lisa said, “What will it mean for Mike to lose part of his liver?”
“The problem isn’t the resection,” Julie said. “He’ll grow new liver over time. It’s the amount of injury caused by the accident, and now a second surgery.” Julie removed the green surgical cap and used it to wipe her sweat-soaked forehead. She stared at Lisa, and said, “I think he’ll get through this. His EEG shows the characteristics of a patient in a coma. It’s his brain injury that worries me the most. Thinking about it keeps me awake at night.”
Chapter Thirty-Four
Lisa boarded the emotional roller coaster, moving from intolerable pain to lifeless lassitude, from flashes of hope to devastating despair, and from the warm communion of friends and loved ones to the arctic agony of her isolation. Her stony face reflected emotional exhaustion. She listened to the words of condolence, hope, support, and expressed memories of times shared by close friends and relatives, but absorbed little of it.
Lisa remained alone.
“Don’t go on this way,” Phoebe said.
Lisa looked up. “What way?”
“Please, don’t do this to yourself.”
“What are you talking about Phoebe? Look at me. Look at my life. I don’t understand any of this. What kind of a fucking world do we live in? What did I do to deserve this? Haven’t I suffered enough?”
Lisa reddened. What am I saying? She thought—It’s me—me—always me.
“Don’t expect metaphysical explanations from me, sweetie. I’m Miss pragmatic—I go with what works.”
“They say things happen for a reason—what a load of crap that is. This is a sick, meaningless, and cruel world. We’d better get used to it.”
“I know it looks that way, but we know better. I don’t know how to say this without sounding like a Hallmark card or regurgitating platitudes.” Phoebe caressed Lisa’s hair, and then continued, “Life, especially a quality life, says enjoy our world of love and kindness while you can; carpe diem. Someday, it’s going to end.”
“I can’t believe you’re talking this way. He’s not dead, you know. I’d like to believe we can live that way, but we don’t. The difference between the neurotic or the depressed and normal, is our ability to deny the disaster demons. Obviously,” Lisa said, pointing to Mike’s bed, “for me, that’s not possible.”
“As long as I’m alive, you’ll never be alone.”
“What’s going to happen to me? What am I going to do? I so wanted Mike’s baby—I couldn’t even get that one right.”
“Be kind to yourself. You’re stronger than you think. You need that strength now more than ever.”
When Jack Byrnes came in for morning rounds on the third day, Lisa said, “When I was at Chico nursing school, we had a presentation from the U.K. on coma arousal. It’s a program designed to stimulate the brain of comatose patients. They had some promising results. What do you think?”
“I know the studies and the theory behind the techniques,” Jack said. “We’ve done some of it informally by reading and playing music to patients, but these programs demand much more. I’m not sure if it’s worth it, especially; if it takes away resources we need for routine care and diverts our attention away from his medical problems.”
“I’d never let that happen, and I’ll provide the woman power. The only thing I request is that you ask the nurses to talk to him while they’re at the bedside, and that they be vigorous with Mike’s personal care, you know, washing and massaging. That, with physical therapy and range-of-motion exercises, should give him plenty of tactile stimulation.”
Daisy continued to mourn. When Lisa got home each day, Daisy was waiting sad-eyed on the sofa for Mike. After a few moments, Daisy would come to Lisa, placing her head in her lap. At first, the dog’s grief upset Lisa even more, but soon she came to see it as the purest and most honest expression of loss by one being for another. “It’s you and me, Daisy—for now.”
Daisy became more attenti
ve to Lisa. Each time Lisa returned from the hospital, she’d follow her around the house. At first, Lisa thought this was a sign of the dog’s anxiety, but Daisy was more relaxed, and happier than normal. As Lisa lay on the sofa watching television, Daisy would lie next to her, lift her head to look for Mike, and then return to Lisa’s lap.
Phoebe stood at Mike’s bedside the next morning. She fought with the ICU nursing care coordinator to be Mike’s nurse for the shift. She usually got what she wanted.
She studied Lisa, and shook her head. “You look exhausted.”
“I’m sleeping well, but I’m tired all the time. I’ve been going to bed early, and I wake up refreshed, but soon I’m beat. I’ve missed my period, but that’s stress.”
When Lisa became nauseated each morning and when she felt the increased sensitivity in her breasts, she rushed to the pharmacy.
“Phoebe,” Lisa said, getting her friend on the phone, “you won’t believe it.”
“Believe what?”
“I think I’m pregnant.”
Part II
Chapter Thirty-Five (Weeks 1-6)
Lisa had dipped the tip of the pregnancy test strip into her urine, and had stared at the device. In a dreamlike state, she watched as the little gray window read ‘pregnant’. When she repeated the test, and again the result insisted that she was pregnant, Lisa felt so weak that she needed to grasp the edge of the bathtub and ease herself down.
All that time, all that suffering and disappointment, and now with Mike near death, I’m pregnant.
Phoebe rushed over. When Lisa threw open the door, Phoebe embraced her so hard, she could barely breathe. When Lisa groaned, Phoebe said, “Oh, I’d better be careful.”
They walked into the kitchen, where Lisa brewed a pot of coffee.
As they sat across from each other, Phoebe said, “So, say something.”
“What do you want me to say?”
Phoebe stared at the friend she knew so well. “I’m trying to read your expressionless face.” She smiled at Lisa. “C’mon, it’s me, Lisa. Don’t hold back, now”.
When Phoebe cocked her head in a questioning gesture, Lisa burst out laughing. Phoebe joined her, and said, “You know perfectly well what I want you to say.”
“I feel like Alice in Wonderland. I don’t know how I got here, or where I’m going.” Lisa wrapped her arms around her abdomen. “We want this baby. It is to be a part of us, to share in the essence of our love. It’s supposed to be for us, not for me, alone.”
“You’re happy about this baby, right?”
“Happy? I’m overjoyed. It’s Mike. He’s part of me, and if I’m not to have him, above all else, I want his baby.”
By the end of Mike’s first week in ICU, Lisa and the staff had reached a point of equilibrium. Frenzied uneasiness had settled into watchful waiting. One agony replaced another.
Although Mike had minor problems with IVs, tubes, and maintaining nutritional support, they banked each day without a major complication like a lay away deposit—the payoff, if there was to be one, lay ahead in an uncertain future.
“You’re going to be a daddy,” Lisa said to Mike’s expressionless face. The nurses taping his eyelids closed for the protection of his corneas only made the situation feel more ominous. “This baby is the miracle we prayed for. Is it too much to ask for another?”
Lisa, Nora, Mike’s sisters, Phoebe, and several NICU nurses had implemented the full coma arousal program. Someone was usually at his bedside as they challenged Mike’s five senses. They used flashing lights, strong perfumes, drops of vinegar or mustard on his tongue, and vigorous massage. When they weren’t talking to Mike, earphones played his favorite music, and intermittently blasted the shocking sound of banging two saucepans together in an attempt to elicit the startle response.
Carter Reynolds assessed Mike’s condition each morning by shaking his head. He was so phlegmatic that Lisa wanted to punch him out. “We’re doing everything possible.” His expression of hopelessness said more than his words.
By contrast, Julie Kramer had something encouraging to say each day. She was like a mother who finds some way to magnify the smallest success of her child. Her approach wasn’t planned, Lisa recognized, it was the essence of Julie’s personality.
Phoebe and Lisa sat in Dr. Harvey Russo’s crowded waiting room.
This must be his obstetrical office hours, Lisa thought as she scanned the pregnant bellies that ranged from imperceptible to inescapable. Some abdomens were so enormous that the mother-to-be was merely an appendage.
Staring at one uncomfortable young woman who looked like she could almost place her chin on her abdomen, Lisa said, “I don’t think I’m ready for that.”
They’d painted the waiting room walls pale blue, and decorated it with baby and pregnancy photography. Newborn and first-year baby photographs in bright colors lent warmth to the space, while stark high-contrast black and white photographs elicited a sense of uneasiness.
Phoebe pointed to one black and white photograph of a naked woman at term. “I guess that’s what they call feminist art. To me, it's an angry version of Demi Moore’s cover of Vanity Fair. To tell you the truth, Lisa, I can do without the hostile imagery.”
Lisa noticed that the office chose oversize wooden arm chairs in the waiting room, a deliberate concession to women late in their pregnancies.
About half the women had men accompanying them. Some men were comfortable, while others looked like caged animals.
Oh, how I want Mike here with me, Lisa thought.
A woman in her early twenties sat next to them. She looked fifty weeks pregnant. “I’m going to burst,” she said, “if I don’t have this baby soon. I can barely move.”
When they called her name, the woman struggled, but couldn’t get up. Lisa remembered her body mechanics class in nursing school and came to the rescue. They watched as she lumbered into Dr. Russo’s office.
Woman after woman waddled into the inner office, and, finally, the receptionist said, “Lisa Cooper, you’re next.”
The nurse weighed Lisa, took her blood pressure, pulse, and got a sample of urine for examination.
When Harvey Russo finally entered the examining room, he hugged Lisa, and smiled. “I’m so pleased. There’s only one thing that could make things better…”
Lisa looked down, her eyes filling.
“I’m so sorry. I don’t mean to upset you. This feels like a miracle to me. I thought you’d…”
“No, Harvey, it’s me, and you’re right, this is a miracle. I’m beside myself with joy.”
“How are you feeling?”
“Tired and nauseated, but otherwise fine.”
“Your blood pressure’s normal, as is your urinalysis. Everything’s routine. Let’s keep it that way.”
Harvey ordered some prenatal vitamins, and had Lisa make an appointment for one month.
The news of Lisa’s pregnancy thrilled Sandy, her mother. “I’m going to be a grandmother. I’m so happy for you. How are you feeling, and is there anything I can do?”
“I’m fine, Mother, just tired.”
“I want to be there for your delivery, if it’s okay with you.”
“Of course.”
“If you’d like, I’ll stay with you for a few weeks after the baby comes.”
“That would be great, too.”
This time, Lisa did not hesitate to make the call to Nora. “It’s Lisa.”
“Oh, I was thinking about you. I’m meeting the girls to celebrate my birthday Friday.” She lowered her voice, and said, “I thought a celebration was inappropriate with Mike so sick, but they insisted. Can you make it?”
“Of course,” Lisa said, and then she hesitated for a moment, and asked, “Are you sitting?”
Alarmed, Nora said, “Is everything okay?”
“Nora, it’s a miracle…”
“What are you talking about?”
“I’m pregnant!”
After a moment of silence, Nora wept
.
“Nora—Nora, are you okay?”
“I’m so happy. Ecstatic. This will blow the girls away. How far along are you?”
“Six or seven weeks. The obstetrician says everything looks good.”
The line remained silent for a moment, and then Nora said, “If only Mike…”
“I know,” Lisa said. “I know.”
Six months after the Edna-Sue Jones fiasco, as Harvey Russo entered his office, his secretary held up a thick envelope. “I hope I didn’t make a mistake by signing for it.”
Harvey looked at the registered letter and felt his stomach turn. The letter carried the return address for Richard Boardman, Attorney at Law.
No good deed goes unpunished, Harvey thought as he read the document. It was the typical notice of intention to enter into litigation against: Harvey Russo, Kirby Dornan, Mike Cooper, Ernie Paul, Brier Hospital, and one hundred unnamed individuals. The allegations: performance of an inappropriate and unnecessary hysterectomy, and multiple acts of negligence against Edna-Sue Jones and Baby Boy Jones. The plaintiff sought actual damages, punitive damages, and lifelong support for the disabilities of Baby Boy Jones.
The next step in litigation was equally unpleasant, as three agents for the plaintiff invaded Harvey’s office with a subpoena for Edna-Sue’s medical records.
Harvey and the staff watched in disbelief as they pulled her charts, x-rays, and laboratory records for the copy machine they had brought with them.
As they rummaged through the patient files, Harvey grasped the drawer, and shoved it closed. The agent barely missed a set of crushed fingers. “Don’t touch those records. That’s privileged information.”
“We have a right to all of Ms. Jones’ records, Doctor. It’s a crime to withhold any such information.”
“You’ve copied every record in our possession; now get the fuck out of here.”
Trapped Page 16