Trapped

by Lawrence Gold

  Lisa flushed with affection for her friend. “I can never thank you enough—I’m going to cry.”

  “Don’t. You’ll make me cry, too.”

  “Can I help you?” The ward clerk responded to Lisa’s call button.

  “It’s Lisa. Can you ask my nurse to step in when she has a chance?”

  “Is everything okay?”

  “I’m fine.”

  “I’ll tell Betty. She’ll be with you in a minute.”

  Ten minutes later, Betty Howard entered Lisa’s room. “What’s up?”

  “Can you help get me up and into a wheelchair? I want to visit my baby in NICU, and then Mike in ICU.”

  “I can’t without getting Dr. Russo’s permission. If I didn’t, and something happened to you, you know…”

  “What time is it?”

  Betty looked at her watch, and said, “It’s almost six.”

  “Let’s give Harvey another half hour of sleep, and then call him.”

  Thirty minutes later, Lisa’s phone rang. “I’ll let you go,” Harvey said, “but if you overdo it, I’ve authorized them to restrain you, and take you back. I’m not going to have you screw up my incredible work.”

  Lisa smiled. He’s so easy. “Thank you, Harvey. I’ll behave. I promise.”

  Betty rolled in the wheelchair. She applied a pressure bandage to Lisa’s incision, and held her hand against her abdomen. Lisa groaned as she sat upright in preparation to stand, and then groaned again as she collapsed into the chair.

  Lisa grabbed the chair supports. “Let’s get going.”

  When they arrived in the NICU, the nurses hugged Lisa and wheeled her to her son’s incubator. Sharon kissed Lisa, and said, “You remember what a preemie looks like, but this is your son, so don’t get upset.”

  Lisa craned her neck to get a better view. At first, all she could see was the tubes and wires, but then, there he was; her tiny pink son slept fitfully as he struggled to breathe.

  Lisa turned her head away for a moment, took a deep breath, and then returned her attention to her son.

  Sharon placed her hand on Lisa’s shoulder. “It’s never easy to watch this. I don’t know if I could do it, if it were my own baby.”

  Lisa patted Sharon’s hand. “It’s either hormones or maternal instincts, but I don’t have a choice, and you wouldn’t, either.”

  Lisa sat watching Aaron. As she inserted her arm through one portal and caressed her baby, she felt fullness in her breasts.

  It’s too early for my milk to come in, she thought.

  “It’s time to get back,” Betty said.

  Lisa turned to Sharon, and said, “Thank you, again. Please ask the nurses to keep me posted.”

  Just as Lisa exited the NICU, she turned back for one more look at her son, when three nurses and the respiratory tech moved toward her baby’s incubator and the code blue alarm sounded.

  Chapter Seventy

  “Take me back,” Lisa shouted as she looked through the observation window into the NICU.

  “No way,” Betty said. “You’ll only get in their way.”

  Lisa tried to stand, but grunted with pain and collapsed back into the wheelchair. “I can’t sit here and do nothing.”

  After what seemed an eternity, Brad, who’d been sleeping nearby, rushed into the room.

  “What happened?”

  “I don’t know,” Sharon said. “He was stable. Lisa just visited. Moments after she left, the baby’s respirations increased, and his oxygen saturation plummeted. He looks bluer to me, and he’s struggling more to breathe.”

  “Get a chest x-ray, stat,” he shouted as he reached into the incubator to examine the baby.

  Lisa had both hands placed on the heavy glass as she stared into the NICU. She’d seen the image before, but from the other side of the glass as she cared for these babies. She wondered if the staff could see in her eyes, the fear of a mother eager to protect her baby, but powerless to do anything but watch.

  Brad quickly glanced up until his eyes met Lisa’s. He held them, and then he turned to the respiratory tech. “He has diminished breath sounds on the right, his neck veins are distended, and his belly is more swollen. How are his pressure readings?”

  “They’re up. The machine is working harder to ventilate the baby. I’ve increased the pressure and the concentration of oxygen.”

  Just then, the x-ray machine rolled in, and, in seconds, had snapped two views.

  “What is it?” Sharon cried.

  “I think it’s a tension pneumothorax. He has too much pressure on one lung, and it’s pushing everything to the other side. It’s worse than losing half his lung capacity.”

  Five minutes later, Brad stared at the computer images, and pointed to a line on the screen, “There it is. See how the midline structures are pushed to the left?”

  Suddenly, the alarm on the cardiac monitor screamed, and Sharon shouted, “His heart rate is over 200 beats per minute, and I’m seeing all kinds of abnormal beats.”

  “What’s his blood pressure?”

  Her pause of seconds, felt like an eternity. “I can’t get any blood pressure—we’re losing him!”

  “Get me a needle, a catheter, and a chest tube tray,” Brad yelled. “I’m going to insert the tube into his chest.”

  Brad quickly donned sterile gloves, swiped the baby’s right chest with Betadyne solution, and, without hesitation, plunged the needle, syringe attached, into the tiny gap between the ribs. As the needle entered the space between the chest wall and the lung ( the pleural space ), the tremendous pressure inside the baby’s chest pushed the syringe plunger outward, making the diagnosis. Brad heard a distinct whooshing sound as air escaped from the plastic tube he had inserted through the needle. In an instant, the baby breathed more easily, and his oxygen saturation rose. Blue lips turned pink.

  “Unbelievable,” Brad said with relief. “A tension pneumothorax. Is the tray ready?”

  “Yes,” Sharon said as she wheeled the instrument tray in place beside the incubator.

  “Put on a pair of gloves, Sharon. You’re assisting.”

  After a small incision between the ribs, Brad grasped a small rubber catheter with small holes at the end. He used a tiny curved surgical clamp to force it into the space between the lungs and the chest wall. He immediately attached the catheter to a sealed floor drainage system with a one-way valve, which allowed air and blood out, but nothing back into the lung. He placed a small stitch to keep the catheter in place, and then added sterile dressing.

  Brad pulled off his bloodstained gloves, and removed his sweat-soaked surgical cap. He left the NICU to talk with Lisa.

  “He’s going to be fine.”

  “What happened?” Lisa asked.

  “It was a tension pneumothorax, but we got the air out, and the tube is in place. We’ll need to keep it there for a few days.”

  Lisa wept with relief. “What’s the next crisis, Brad?”

  “Don’t do that to yourself. Optimism doesn’t come easily to you, does it?”

  “How can I be an optimist with my history?”

  “I don’t think people choose their outlook on life. I think you have it at birth, and you’re stuck with it.”

  “If only Mike was here,” Lisa said.

  “In a sense, he was. I think I felt his presence as I stood over the baby with his voice in my mind. It was like the first days when I joined him in practice, and he demanded that I better myself as a physician.”

  “I’ll wheel you back to the ward,” Brad said. “I’m meeting Kenny in fifteen minutes. He’ll take over. I’m exhausted.”

  When they reached Lisa’s room, Phoebe was waiting.

  She helped Lisa back into bed, and then asked, “How’s the baby?”

  “He’s fine, now,” Lisa said, and then she told Phoebe the story.

  As Brad turned to leave, Phoebe hugged him. “Thanks for everything.”

  “We live for the good outcomes, and I know we’re going to have one her
e. I’ll ask Kenny to call you every few hours,” he said, staring at Phoebe, “I’ll deliver the ‘or else’ to him.”

  Chapter Seventy-One

  True to his promise, Kenny Dillard, Brad’s partner, called Lisa every two hours. “He’s doing great, Lisa. He’s breathing more easily, his lungs are becoming more compliant, and we’re using much less oxygen.”

  Lisa took a breath. “He’s going to be okay?”

  Kenny hesitated. “You know preemies, Lisa. Let’s not tempt the fates. Your son’s doing well, and that’s enough for now. It's late, why don’t you get some sleep. If anything—and I mean anything significant happens overnight, I’ll call.—I promise.”

  “Thanks, Kenny. I’m beat.”

  “Get some sleep,” Phoebe said. “I’m heading home to reintroduce myself to my son, my husband, and your dog.”

  Lisa pulled Phoebe toward her, and hugged her, refusing to let go. “I can’t tell you what our friendship means to me.—I couldn’t have survived this without you.”

  In a rare moment of gravity, Phoebe said, “Of all the people, Lisa, you understand perfectly. All this is easy when you love someone. The lyric may be corny, but it’s apt: ‘that’s what friends are for’.”

  Lisa had vague memories of movement in the room, brief examinations by her nurse, and twinges of pain as she enjoyed her morphine-assisted sleep.

  When she opened her eyes, the sun shone through a crack in the drapes. She groaned with abdominal pain as she reached for the phone, and dialed the NICU.

  “He’s fine,” said the shift charge nurse. “Come on down to visit when you’re ready.”

  Lisa dialed ICU. Mike’s condition hadn’t changed.

  Harvey Russo entered her room a few minutes after seven. “Have you had enough excitement for a while, Lisa?”

  “Excitement, what excitement?”

  “Right,” he said, smiling.

  “You heard about the baby?”

  “Sure did. Just came from NICU. Talked with Kenny and had my first good look at your son. He’s scrawny for a linebacker.”

  “Just wait. With Phoebe, and Mike’s mother and sisters, he’s going to bulk up quickly.”

  “Let’s take a look at your belly,” he said as he pulled back her gown and removed the blood-stained dressings. He looked at the incision and then gently palpated her abdomen. “Nice and soft. Whoever did that stitching is an Oleg Cassini.”

  Lisa looked over her still-distended abdomen, saw the ugly black sutures, and smirked. “Yes, Harvey, it’s a thing of beauty.”

  “Your life of leisure is over. I want you up and about as much as possible. If all’s well, you’ll be out of here in two or three days.”

  “Is it okay if I spend some time visiting both the men in my life?”

  “No problem, and Lisa…”

  “Yes?”

  “Don’t overdo it.”

  Lisa couldn’t wait for Harvey to leave. As he exited, she pushed the nurse call button, and said, “I’m going to NICU to see my baby.”

  “Hold on a sec, Lisa. I’m sending your nurse,” the ward clerk said.

  A minute later, as Lisa slipped into her robe, Annie Kaplan, her nurse, came in. “I’ll wheel you down, but I can’t stay too long. I’ve got a few sickies today.”

  “Drop me off. I’ll have someone bring me to ICU. When I’m done, I’ll call the ward so you can send someone to get me.”

  The NICU was busy, but calm. Lisa strained to see her baby’s incubator as Annie wheeled her in. The room smelled of baby: meconium and Desitin.

  “It’s that one,” Lisa said, pointing to an incubator in the corner.

  Sharon Bridges had both arms extended through the incubator portals doing something to the baby. When she heard the wheelchair approach, she turned, and said, “Hi, Lisa. You’ll hardly recognize our big boy, today.”

  “Big boy?”

  “A figure of speech—a potential big boy.”

  When Sharon stepped back so Lisa could approach, Lisa looked through the plastic to the pink form of her baby sleeping soundly and at ease.

  “Brad’s going to try to get him off the ventilator, later. His oxygenation is excellent, and as you can see, he’s breathing like a normal baby.”

  “What about the chest tube?”

  “He’ll need that for a few more days.”

  Lisa extended her arms into the incubator, and caressed her son. She felt his warmth, and the heat of the lights in the incubator. She turned to Sharon. “I’m starting to pump my breasts. Can you use my milk to feed him?”

  “When it comes in, you bet. Nothing’s like the real thing.”

  Lisa reached back in, slipped her hand under the baby’s head, and lifted it slightly. Staring through the Plexiglas, she said, “He looks just like Mike, doesn’t he, Sharon?”

  “The spitting image,” Sharon said, smiling.

  When Lisa arrived at Mike’s bedside, she grasped the handles of her wheelchair, and grimaced as she pushed up to the standing position. She bent over her husband, placed a kiss on his lips, and said, “Wake up, sweetie. It’s your favorite wife.”

  Mike raised his lids. His eyes wandered for several seconds, and then, with more lateral movement than she noted before, he held her gaze.

  “Can you see me?”

  Yes.

  “Are you okay?”

  Mike closed his eyes.

  “I’ll get the alphabet board.”

  Mike’s nurse propped it up before his face.

  You must let me know what’s happening. I hear a lot—more than people think, but not enough. How are you? How’s our baby?

  “I’m so sorry,” she said, “I had a difficult labor with all the bleeding. They nearly had to do a hysterectomy. I’m okay, now. Aaron, our son, has IRDS, and had a tension pneumothorax, but he’s doing better, now.”

  Life goes on while I lie here on my ass…one hell of a man…one hell of a father, he thought.

  You’re lucky…

  “No, we’re lucky.”

  “What?” She asked when he stopped spelling. “What’s wrong?”

  I can’t go on this way. I can’t find a way to describe how awful this is for me. We had an understanding, and you must help me, now.

  “Help you?”

  Please, don’t make me, pardon the expression, spell it out.

  Lisa laughed. “If you can find humor here, you can find it anywhere.”

  Her laughter warms me, Mike thought. I love making Lisa laugh. Laughter had been a large part of our lives.

  “Have you tried to move?”

  I can’t move. I’ve tried it a thousand times.

  “People recover. They’ve just started treatment. We can’t stop now, not when there’s hope that you’ll come out of this.”

  You don’t understand.

  “What don’t I understand?”

  Tears ran over Mike’s cheeks.

  After five minutes, he opened his eyes.

  If I go on this way much longer, I’m going to lose my mind. I can’t take the pain, the isolation, and the fear—the panic reactions. I’m entrapped within all of it. My only escape is through the effects of morphine. If you really love me, you won’t ask me to live this way.

  “You have so much to live for. Please, for my sake, and for your son, let’s give this some more time.”

  Mike’s lids closed.

  Chapter Seventy-Two

  Baby Aaron improved each day.

  When Harvey discharged Lisa on the morning of day five post op, she returned home long enough to change clothes and rush back to Brier.

  Except for sleeping at home, Lisa remained at the baby’s side through each step of his recovery. He progressed from ventilator to high oxygen support, to normal oxygen, and to room air. He moved from the cave of the incubator with heat and blue light to a normal crib, and he passed from gourmet formula to breast milk via feeding tube, and then to Lisa’s breasts.

  While Lisa had her own preconceptions about breastfeed
ing, she was unprepared for its reality. She’d been pumping regularly for tube feedings, so her breasts were engorged. She held him to her chest, but, at first, while so small and so frail, he showed no interest. Today, for the first time, he showed enthusiasm.

  “Try to time his open mouth so that he gets more than the nipple,” Sharon said. “It’ll be more comfortable that way.”

  Lisa held him in her arms, exposed her breast, and, as the nipple passed by his mouth, he turned and opened his mouth to feed. She leaned forward just at the right time as he latched onto the nipple, as well as a good amount of surrounding breast.

  Lisa gasped as he sucked forcefully. Moments of slight discomfort faded almost immediately, and she enjoyed one of nature’s surprises, the intense pleasure of feeding her son.

  Phoebe was visiting on break from ICU, when Nora came into the NICU. “He’s a beautiful boy. He looks just like Michael. Can I feed him?”

  “Only if your breasts are full, Mother.”

  Nora sat upright, shocked.

  “I’m kidding, Mother. He may be hungry, now. Ask the nurse for a bottle of my milk. It’s in the refrigerator. Warm it, and see if he’ll feed.”

  When Nora held and fed the baby, she smiled, and looked completely at ease for the first time in a long while.

  “You look good, Mom. Feeding the baby looks natural for you.”

  “I did it four times, and loved it.”

  After the baby finished, he lay asleep in Nora’s arms.

  “Can I talk with you about Michael?” Nora asked.

  “Of course.”

  “It’s never been an easy subject for us, has it?”

  “No, but go ahead.”

  “These are questions, not suggestions, or criticisms.”

  “Nora, please.”

  “Tell me how he’s doing.”

  “Most of his medical problems have subsided. We’re left with the physical and emotional problems of this locked-in syndrome. I know I’m not the most objective observer, but I think there’s been subtle improvement. I’m pretty sure he moved his index finger one afternoon.”