“Getting back to Mike’s decision,” Jack said, “how do you know it was rational? Can a person so sick, so depressed, and so disabled, make a rational decision, especially one that may cost him his life? You don’t want to make this mistake, Lisa.”
“Don’t bully her, Jack,” Phoebe said. “You may think it’s for a good reason, but it’s coercive.”
“I say it’s persuasion,” Julie said. “We’re giving you our best judgment about how to proceed.”
Lisa looked into their eyes. “I know you care about Mike, and that you want only what’s best for him, but this isn’t your decision. It’s Mike’s, and I will honor it.”
“Even if his decision is a mistake?” Jack said.
Lisa looked into Jack’s eyes. “Either way, it’s Mike who will live or die with this decision, not you, or me.”
“What about his mother and sisters?” Julie asked. “How do they feel about this?”
“Nora’s all over the place,” Lisa said. “First she wants to stop treatment. Who knows what she wants to do, now?”
“I know,” Julie said. “She wants me to operate.”
Lisa reddened. “How typical. I only hope, Julie, that you didn’t go behind my back to solicit her opinion. I call that permission shopping. It's beneath you.”
“Do you think I’d do that to you?” Julie asked.
“I’m not sure what anyone will do, given enough stress and frustration,” Lisa said. She stood, grasped Phoebe’s hands, and said, “Find the source of infection, or just treat it with antibiotics. If you discover some minor procedure that will cure the infection, I’ll go for it. Otherwise, I’m following Mike’s wishes, and, one way or another, so will you.”
Julie looked at Jack, shook her head, and then said, “I still want that EEG. Take a look at Mike’s eye movement. It’s more like REM sleep, and not coma.”
Chapter Fifty-Seven
As Lisa sat by Mike’s side throughout the day, she watched the staff pass by. Some smiled, but others stared, showing their disapproval of her decision.
Don’t do this to yourself, she thought.
They kept the tape off Mike’s lids so that they could watch his eye movements, but even when the REM stopped and he should have been awake, he did not respond.
Am I dreaming, or am I awake? Thought Mike. I can’t tell.
The EEG technician came at the right time so that she was able to record his brain waves during REM, as well as when his eyes were at rest. “I can’t give you a formal interpretation,” she said, “but to me, it looks like normal sleeping and waking patterns.”
After the three p.m. nursing report, Lisa said to Phoebe, “Isn’t it about time for you to get back to your own family?”
Phoebe embraced Lisa. “I have them covered. I’m staying as long as you are.”
Lisa could feel the chill in the air when Nora and Mike’s sisters arrived in the evening. The girls embraced Lisa, while Nora stood at the doorway with her arms folded across her chest.
That’s great body language, thought Lisa. There’s no way to please this woman—every choice I make is wrong.
After embracing Mike, they sat around the room—the silent vigil of a deathwatch. For Lisa, the tension was almost more than she could bear.
After Phoebe gave them a rundown of the situation, Emma turned to Lisa. “What right do you have to ignore Mike’s doctors?”
“You’re out of line,” Phoebe said. “How dare you question Lisa? Do you know how difficult this is for her?”
Lisa felt a cramp forming in her abdomen as she tried to stand.
“What’s the matter with you people? I’m honoring Mike’s decision, and so should you.”
“I won’t do it,” Nora said. “If he has any chance, we want it for him.”
“Excuse me, Nora,” Lisa said, “but weren’t you the one who was ready to pull the plug not so long ago?”
“I was wrong, then, and you’re wrong, now.”
“It’s not a matter of right or wrong,” Lisa said. “The doctors are not certain that his infection is coming from his colon. Mike had—no, he has the right to decide if he wants his colon removed and if he wants to go on in what he calls a living death. You’d take that right away from him?”
“If it allowed him to survive,” Nora said, “you bet I would.”
“That’s the difference between us, Nora. I love him enough to respect his wishes, while you can only selfishly obsess about your loss.”
Nora took a deep breath, and then turned to Lilly. “Maybe Lisa’s not able to do what’s right for Michael.”
“I’m standing right here, Nora,” Lisa said. “Talk to me, not about me.” She hesitated. “And who would be the best person to decide?”
“Michael wanted me to have a copy of his durable power of attorney. You know the language, Lisa.”
“I don’t know what you’re talking about.”
“Mike wrote that, if his first choice to execute this document wasn’t available, or capable of serving, he designated me, his mother.”
“And I’m not able to serve?”
“Please, Lisa. I’m trying to do what’s best for my son.”
“And I’m not?”
“Look what you’ve been through; what you’re going through. It has to affect your judgment.”
It surprised Lisa that her anger was ebbing away, and a clarity of mind had replaced it. “I feel sorry for you, Nora. I’m not sure you know what you’re doing. I know you love your son and, out of respect for that, I’ll let you continue to see him. Please, don’t say another word to me.”
As they left, Lilly turned back to Lisa, embraced her, and said, “We love Nora, but it was always about her. She’ll never understand. We love you, Lisa. Don’t ever forget that.”
During Lisa’s drive home, she relived her deepest depression and the overwhelming sense of hopelessness.
When she entered the house, Daisy’s enthusiastic greeting made her smile.
This is why we’re crazy about dogs—they love us no matter what.
Lisa opened the dishwasher to remove the clean dishes she’d accumulated over the last few days. As she bent over to remove a heavy ceramic casserole bowl, she felt a sharp, tearing sensation in her back. She placed her hands on her knees, and pushed, trying to stand erect. The pain increased.
What’s happening?
She held onto the counter top as she moved to the table, and sat. The pain eased a bit, and then increased. With the onset of pain came the strong urge to pee. She walked to the bathroom, urinated, and then looked down into the white porcelain bowl, filled with bright red blood and clots.
When Lisa stood, she suddenly felt faint, as she barely made it back to her bed and the telephone.
“Phoebe, I’m bleeding again—it’s bad this time.”
“I’m on my way, sweetie. I’ll call Harvey with my cell.”
“Bring her into Brier Emergency,” Harvey said.
Fortunately, the trip east through the Caldecott tunnel was quick at that time of night, so Phoebe arrived at Lisa’s in twenty minutes.
“How’s the pain? Are you still bleeding? How’s the baby?”
“The pain has eased off some, but I’m still passing clots. The baby’s restless.”
“Maybe we should call an ambulance.”
“No, I’m feeling better. Help me up.”
Daisy paced, whining and sniffing, ears back.
“You’ll come back for her, Phoebe, if I have to stay in the hospital?”
“Of course. Daisy’s practically a member of our family.”
Lisa put on a super absorbent pad, and brought two towels for Phoebe’s front seat.
“I’m dizzy,” Lisa said as they raced west on highway 24 toward Berkeley.
“Put the seat back, and stretch out. We’ll be there in ten minutes,” Phoebe said as she stared at the road ahead, gripping the steering wheel.
Phoebe weaved in and out, accelerating quickly, willing them to the ER.
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“Your driving is going to put me in labor, Phoebe. Take it easy. I’m fine.”
Phoebe glanced over to Lisa’s pallor. Her pallor had increased. Dammit, she thought as she stepped on the accelerator.
Eight minutes later, she pulled up the ramp in front of Brier’s Emergency Room, and blasted the horn.
A nurse and an orderly pushed a gurney through the sliding doors. The orderly, who looked like a football tackle, lifted Lisa onto the gurney and rushed her into Trauma I.
Like a coordinated ballet, they had Lisa in a hospital gown, drew blood, and inserted an intravenous line. They placed a strap across Lisa’s abdomen, holding an ultrasound probe to monitor the baby’s heart rate.
Harvey and the portable ultrasound machine arrived simultaneously.
“How are you feeling, Lisa?” Harvey asked.
“Nervous. I’m still bleeding a lot, I think, but the pain is gone. What’s wrong?”
As the technician adjusted the machine, Harvey picked up the probe, covered the tip with clear jelly, and moved it over Lisa’s abdomen.
“What is it?” Lisa asked, trying to control her panic.
“Give me a sec,” Harvey said, moving the probe more slowly over her lower abdomen. He held the probe in one area for several minutes, while he reached for the dials and switches of the complicated machine.
“Harvey?” Lisa screamed, “it’s coming back—a strong cramp. I’m not sure I can take it. My back is killing me!”
“It’s a partial abruption. Most of the placenta is intact, except the inferior edge. That’s where you’re bleeding.”
“The baby’s heart rate,” cried the nurse. “It’s slowing. The baby’s in trouble.”
“My baby! My baby,” cried Lisa. “What have I done? Don’t let anything happen to him—please, Harvey…”
What’s the matter with me? Lisa thought. What did I ever do to deserve this? What did our baby do to deserve this?
Chapter Fifty-Eight (Week 31)
By the time Lisa reached the obstetrical ward, the contractions stopped, and the baby’s heart rate returned to normal. Phoebe remained at her side.
“What’s going to happen, Harvey?”
He held Lisa’s hand, and said, “You and your passenger will be visiting with us for a while, maybe until delivery.”
Lisa turned away, and then sobbed. “It’s all my fault—it’s all my fault.”
“Don’t be ridiculous, Lisa. This is just bad luck. We’re going to get through this.”
“You don’t understand.”
“Understand what?”
“The second trimester left me feeling horny, but that eased off. Last night, however, I had an erotic dream…”
“You mean you had an orgasm? Big deal. Many women find the increased blood flow into the pelvic area increases their libido. It’s normal, Lisa.”
“But last night, before all this happened,” she blushed, “I had a pretty spectacular one. I must have injured myself.”
Harvey smiled, and then said, “No way that you caused this. I know many patients try to blame themselves for everything, but do me a big favor—don’t do it on my watch.”
“I’m about thirty or thirty-one weeks. I can’t stand the thought of being here for a couple of months. I’ll go stir crazy. And.” She paused, “what about Mike? He needs me.”
“I don’t think you’ll go the whole way, Lisa. Abruptions frequently lead to early labor and premature births. Mike’s right upstairs. I’m sure we can get you two together.”
Lisa gave Harvey a kiss. “I’ll see you later.”
“Count on it,” he said as he left the room.
“Don’t worry,” Phoebe said. “Max and I will be here to keep you entertained.”
“What about Daisy?”
“A couple of steaks, and she’ll be perfectly happy with us.”
Phoebe pulled her chair closer to Lisa’s bed, and held her hand. “This may not be the right time to talk about it, sweetie…”
“Talk about what?”
“It’s bad karma,” she paused. “Maybe I should wait.”
“Then you shouldn’t have started in the first place.”
“I have a big mouth, Lisa. I open it, and things come out. Sometimes it even surprises me.”
“Phoebe?”
“If something happens with this pregnancy, I just remembered that you have two fertilized ova in storage…you know, the two you never used.”
“I remember,” Lisa said, looking toward the floor. “I’ve been thinking about them since Mike’s accident. This pregnancy was a miracle. I failed at IVF and implantation twice. It’s asking too much to think that one or the other embryo might survive.”
“Do me a favor, sweetie.”
“Anything.”
“Let’s carry this one to term. We’ll worry about the others later.”
“Thirty-one weeks and counting,” Phoebe said, as she placed Lisa’s books, tapes, and her laptop computer on the bed. “We’re settled in for the long haul.”
When Harvey arrived for rounds the next morning, Lisa said, “I’m still bleeding.”
“I know,” Harvey said.
He repeated the ultrasound and her lab tests. They hadn’t changed. “The bleeding may continue until we deliver this baby.”
“Okay,” Lisa said, “but I want to see Mike.”
“I’ll let you go, but only in the gurney chair. You and that device will become attached at the hip. Understand?”
Lisa smiled. “Agreed.”
After lunch, Lisa’s nurse wheeled her into the ICU and squeezed the gurney, with the fetal monitor at Lisa’s feet, next to Mike’s bed.
Phoebe had volunteered again to care for Mike. She hugged Lisa, and said, “His fever is down to 100 degrees and his abdomen is less swollen. I still can’t get him to respond.”
Lisa twisted in the gurney, trying to find a position where she could meet Mike’s eyes.
“Don’t,” Phoebe said. “I don’t want you stretching that way. I’ll reposition him so he’s facing you.”
Lisa faced Mike. “Mike, it’s Lisa. Can you hear me?”
Mike’s eyelids were open. His eyes wandered vertically and slightly to the right and left, but they refused to meet Lisa’s eyes.
A voice in the distance—am I dreaming, or is it real? It’s dark with specks of red—flashes of light, and then vague shadows. The shadow moves, blurred or doubled. It’s a face.
I feel something in my hand—it’s Lisa. It’s her hand.
I command my hand to move…
Nothing.
I know I can do it. It’s a simple thing, to move your hand.
Nothing.
“He’s back,” Lisa said. “I see it in his eyes. He’s back.”
“Mike. It’s Lisa. Do you hear me?”
Yes.
“Phoebe, get the board.”
I should be angry. I’m still here, but there’s her face. Those eyes. Everything I ever wanted or needed is inches away, or miles…
“You’re not angry with me, are you? I couldn’t stand that.”
No.
“Should I tell you what’s been happening?”
Yes.
“You’re not going to shoot the messenger, are you?”
Tears formed in Mike’s eyes.
Lisa began crying. “I love you so much. We thought we’d lost you.”
She described his condition and her struggle with Jack Byrnes and Julie Kramer. Then she continued with Nora and Emma.
“I didn’t think they had the right to decide for you. Please tell me I did the right thing.”
“You did,” he said through the alphabet board. “What next?”
“We do everything to get you better. We have calls out to the best neurologists around the world who have expertise in your problem.”
“The locked-in syndrome.”
“Yes.”
“I knew the diagnosis. Now, I really understand it.”
Mike held
his eyes still for a moment, and then fixed them on Lisa, again.
“Why are you in bed?”
“I’m fine. I’m still bleeding. Harvey’s really conservative.”
“What’s wrong?”
Lisa hesitated.
“Tell me.”
“It’s an abruption, but Harvey says that the clot hasn’t increased. We both need to be in bed for a while.”
An abruption—what else can happen to us?
Chapter Fifty-Nine
With so much going on, Lisa’s mind filled with clichés: a waiting game, the other shoe to drop, and sweating it out.
Metaphors ensnare us, even overused ones, because metaphor may be how our minds work.
Lisa recalled a TV interview with a Vietnam veteran who characterized his war experience as long periods of boredom, punctuated by minutes of free-fall toward certain death.
How can all this be happening, and yet I’m bored? She thought.
Each day reflected the last: lying in bed, reading, TV and visiting Mike. The initial frantic efforts to get Mike to move had become rote. How long could they continue?
So much effort required some encouragement, some sign that what they were doing mattered.
Soon, Lisa added feeling neglected to being bored. People had lives of their own, and, in spite of their best intentions, this was her lonely vigil.
At the end of the week, Sunday, Lilly and Sally came to visit.
“Where are Nora and Emma?” Lisa asked.
“They don’t feel welcome,” Lilly said.
“Oh, please. Tell them I’d love a visit, if they’d just keep their mouths at home.” She paused. “No, I’m sorry, don’t say that.”
“We understand,” Sally said, “but nothing’s going to change Nora’s personality. We’ve lived with it long enough to know.”
“I don’t expect to change her, either. I’m only asking for common courtesy, and the possibility that her visits won’t leave me upset. I can’t tolerate stress now, and neither can my baby.”
“We’ll try to explain it to her,” Lilly said, “but you know Mom.”
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