Between Heaven and Earth

by Michele Paige Holmes

  “I understand,” Cassie said. She did now. She’d spent the past two months trying to make up for the previous five when her heart hadn’t been in the right place and, emotionally at least, she had been less than faithful to Devon. With renewed purpose she’d poured over the latest data and research, spoken with families of other PVS patients, gathered statistics, and come up with a treatment plan. She’d also come back to reality, which after so long in denial, had been extremely difficult.

  Her dream of Devon ever joining her again for date night at Ikeda’s or anywhere else was gone. He’d never live in their apartment again because he’d likely be wheelchair bound for life. He wouldn’t be the man he’d once been, but there was still a chance that he would be someone, a part of the person she’d loved.

  “Four of the eight patients from the last trial are now able to communicate verbally.” A real conversation with Devon would be such a gift. “And that possibility as well as the improvements that a small portion of patients taking both Amantidine and Zolpidem have seen are reason enough to try.”

  “Not to an insurance company which has to be fiscally responsible and accountable to all its customers,” Dr. Hammond argued. “It’s fifty thousand dollars just to have the device implanted. By the time you add on a year of therapy, you’ve spent a million or more.”

  “But in a clinical trial—”

  “It’s all free.” Dr. Hammond leaned forward, elbows on the desk, fingertips touching. “Because patients most likely to respond to the treatment are selected. I know the trial you’re referring to, Mrs. Webb. The clinicians are looking for patients who have been unresponsive for six months, not six years. In addition to that qualification, you’d need to have had a series of MRI’s tracking your husband’s progress, or lack thereof, since his accident.”

  “So you aren’t going to help me,” Cassie said, grateful for the moment that her feelings of anger were winning out over tears.

  “I am trying to help you,” Dr. Hammond insisted, “by telling you the truth. You lost your husband six and a half years ago just as surely as his partner’s wife lost her husband. You see, I do remember you and your husband. My best advice to you is to move on with your life. Quit hoping for the impossible and wasting years waiting for it.”

  “I’m not.” Cassie stood and grabbed the folder. “So long as my husband is breathing, I’ll never stop hoping. Nothing is impossible. Miracles happen every day, and there’s no reason Devon can’t be one of them. Good day, Dr. Hammond.”

  “Rough week?” Lynn asked as she peeked in on Cassie.

  Cassie beckoned her to enter Devon’s room. “I struck out at UC Davis. Dr. Hammond refused to write a letter recommending an MRI or that Devon be a patient for the trial.”

  “Are you sure?” Lynn asked.

  “Very.” Cassie moved Devon’s fingers carefully, one by one, wondering if the exercises were as futile as her appointment had been. Would he really never use his hands again, never talk to her again, never even look at her again? Sometimes she thought she’d take that. She’d settle for just one more chance to look into his eyes and have him look back. To have him know that she was here and that she still loved him.

  “Hmm.” Lynn came to the side of the bed where Cassie could see her. “That is interesting, especially in light of the information I have right here.”

  Cassie looked up to see a smile playing at the corners of Lynn’s mouth as she opened a chart and withdrew a printout. “Orders for Devon Webb to be transferred to the hospital for his upcoming MRI. Oh, and he’s had a couple of promising meds added to his list.”

  “Are you serious?” Cassie reached for the paper as Lynn handed it to her.

  “I’d never joke about this,” Lynn said. “I hope this is the miracle you’ve been searching for.”

  “It is.” Cassie clutched the paper to her heart. “It has to be.”

  Cassie hung up the phone, then placed her head face down on the table. Could nothing ever go her way? Devon’s scheduled MRI had at first been approved three weeks ago and then, just hours before it was to be done today, denied. Somehow his paperwork had been allowed to slip through the cracks, the not-so-nice lady at the insurance agency had explained, but unfortunately, they could not authorize a patient of his status to have unnecessary tests.

  He’s not dead, Cassie had wanted to scream at her but had instead hung up the phone before she said something that would make things worse. Could they get any worse?

  Her phone rang again, and Cassie let it go to voicemail without picking up. Only when the chime sounded, letting her know there was a message, did she listen.

  “Hi, Cassie, this is Lynn. Just wanted to let you know that we need to take Devon over to the hospital soon. I’ve got some paperwork I need you to sign before his MRI, if you still want him to have one. You just have to sign for financial responsibility, and they’ll do it. They tried to call and cancel, but I told them to hold the spot, that it had just been changed to independent uninsured. You’ll need to give them a credit card today as well.”

  Cassie jumped up, grabbed her keys, and practically flew down the stairs to her car. Since when did Devon’s insurance not have to approve? She wasn’t sure exactly what loophole Lynn had found to get around that glitch, but she wasn’t going to miss this opportunity when it wasn’t likely to come again. Of course she’d take financial responsibility. She’d max out her credit card or do whatever she needed to for Devon to have this test.

  To have a chance.

  “Tell me what you see.” Dr. Hammond stepped aside so that Cassie could see the two images clipped in front of the light boxes on the wall in his office.

  “Isn’t that your job?” Cassie asked with a nervous laugh. “I don’t know one part of the brain from another.” Not entirely true. She’d actually learned quite a bit about the brain since Devon’s injury.

  “Do the images look the same or different?” Dr. Hammond asked quietly.

  Cassie stepped closer, straining her eyes as they moved carefully over each picture, searching for some difference, any minute change that would offer hope, but the two scans appeared identical, lacking significant color and showing clearly the lack of brain activity. ”They’re the same,” she said finally, waiting for the inevitable, “I told you so.”

  Dr. Hammond said nothing. He only switched off the light boxes, removed the images, and placed them on his desk. “I’d show you a scan of what we’d hoped to see, but I’m guessing you’re familiar enough with that already.”

  “Yes. Unfortunately.”

  “How is the new drug regimen going?”

  “It isn’t.” Cassie looked down as she admitted that failure, too. How hopeful she’d been at the first few doses of the drugs, particularly the Zolpidem, which had shown miraculous results in waking PVS patients, some who’d been in that state longer than Devon.

  “I’m sorry,” Dr. Hammond said, sounding genuinely so. “When you left my office last time, your conviction that your husband could and should be helped was so strong that I allowed myself to be swayed against my medical knowledge and understanding. I’m sorry if it’s given you false hope.”

  “You needn’t be,” Cassie said, finding it strange she almost seemed to be comforting him. She summoned an appreciative smile, though she was finding precious little to feel grateful for at the moment. “I’ve always had hope. I suppose that’s what comes of having experience with miracles. Devon and I were told we wouldn’t be able to have children of our own, on our own, and then we had our son without any help at all. We had one miracle, so of course I expected another. I thank you for helping us try.”

  “What now?” Dr. Hammond asked as she turned to go.

  Cassie drew in a deep breath and clutched at the thin, worn slip of paper in her pocket. “Now I do my best to build a life I can love without Devon.” There. She’d said it, even if she didn’t quite believe it yet. She had to, and she’d start by taking his car out of storage and selling it to pay for the MRI.
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  “Good luck to you, Mrs. Webb.” Dr. Hammond walked her through the waiting room to the door.

  “Thank you,” Cassie said, knowing she was going to need it.

  I can do this. Do or do not, there is no try. Remembering Matt’s disgruntled expression as he’d read that fortune gave her a boost of courage. She pulled the door to Dr. Hammond’s office closed behind her and stepped out into the sunshine.

  “I may need some help from the force today, Yoda.”

  Cassie removed the padlock from the storage unit, grabbed the handle, and heaved the door upward. It creaked and groaned but rolled to the top, revealing the large, cloth-draped shape within.

  For a long moment, she stood staring at it, hands on hips as she summoned courage. It’s just a car. Why is this so hard? She stepped forward and began gathering the fabric and pulling it over the top of the still-shiny black finish. How she’d hated this car when she first saw it. Who wanted to drive a black car? And the Audi’s price tag had delayed her grad school plans for a whole semester. What a fight we had. Cassie actually smiled at the memory. It was easier to remember the making up afterward now.

  She took the keys from her pocket, unlocked the door, and climbed in the driver’s seat. She’d never driven the Audi except to move it here when she’d decided to put it in storage. She’d wanted Devon to find his beloved car just as it was before.

  He’ll never drive again. There was no point leaving it in storage forever, and as much as she didn’t care for her beat up Nissan, she preferred that over the Audi.

  Closing her eyes, she leaned her head back against the seat and drifted into the past. It wasn’t hard. The car still smelled like Devon, of aftershave and ammo. Beneath the seat she knew she’d find the box he locked his gun in on those few occasions he went somewhere that he couldn’t carry it. A wrapper from his last piece of candy lay in the cup holder. She’d even left his favorite retro ’80s CD, cued to his favorite song, in the player. She used to tease him about his music choices and tell him he’d been born in the wrong decade. What would he think of this last one that he’d missed over half of?

  Tilting her head back, Cassie looked up at the sunroof, remembering those magical moments driving across the Golden Gate. Best day of my life. She’d had a few days since that competed for that spot. Only a few when there should have been more.

  There will be.

  “You cannot love life until you live the life you love,” she repeated. Matt had mailed her the slip of paper a few days after their trip to San Francisco. Of all the fortunes they’d read together, he’d chosen to send this one and had written a long letter encouraging her to follow her dreams for her career and to do everything possible with and for Noah. Legoland is calling, he’d said at the end of his letter.

  Maybe it was. Maybe there would be enough money left over from selling the Audi. She understood Matt’s message and appreciated that he’d accepted what had to be. She couldn’t have him, couldn’t have love in her life like she used to, but there was still plenty about life to love. She just had to go after those things and make them happen.

  She’d gone after the most important, pulling out all the stops for Devon. That hadn’t gone as she’d hoped it would, but at least now she knew, and she could move on with a life that was best for her and Noah without the same belief that Devon would ever return to them. Adjusting her expectations and hope was going to take some getting used to and some time, but this was a start.

  She turned the key in the ignition, and the engine roared to life. Thank you, she thought, grateful for that small miracle. She backed out of the unit, then locked it and returned to the car. She opened the sunroof, letting in the warm spring air, and as she pulled onto the highway Devon’s favorite song blared from the speakers. Don’t you forget about me.

  “I won’t,” Cassie promised.

  A few minutes before nine, Cassie left Devon’s room for the night, leaving the door partly open behind her. She knew the staff checked on him regularly. Between rounds if there was any change in his monitor, it would trigger an alarm at the nurses’ station, but she always felt better leaving the door open, just in case. For so long she’d imagined him waking, then calling out to her in a panic. If that happened when she wasn’t here, she at least wanted to make sure someone else would hear him.

  Now that she was trying to face the reality that he was never going to wake, never going to call out to her in a panic or any other way, she still left his door open. It felt like he was less alone that way.

  “He would be less alone if you would allow him to go, to join the others who have gone before him.”

  Pearl. Cassie’s head snapped up and she looked around sharply, certain she’d just heard the woman, as certain as she was that Pearl was real and had appeared to her on more than one occasion.

  Appeared? As if she’s some angel or fairy or something. Maybe she was. A chill worked its way up Cassie’s spine, and she hugged her arms to herself, trying to ward off the strange sensation.

  Where are you? Show yourself. Instead of continuing toward the exit, Cassie backtracked to peer around the corner to the next hall of rooms. No one. She waited for the voice again, but it didn’t come. As with both the incident in Chinatown and at the Kings’ game, Pearl had simply vanished.

  Maybe I am losing my mind. Imagining voices and seeing people definitely wasn’t good. Cassie retraced her steps and made her way toward the front desk. She passed Devon’s room again and glanced in to find nothing changed. No Pearl there.

  She wasn’t usually given to superstition, but that day last fall, it had felt almost as if Pearl was some sort of mystic, what with all her talk of letting Devon move on. So why have I wanted to see her again? Why had she chased a woman down the street in Chinatown and later that night stared down the people seated behind them at the Kings’ game?

  Cassie supposed it was to prove that Pearl really did exist, that she hadn’t imagined the entire incident. But what if she had? What if she’d fallen asleep, as she sometimes did, in Devon’s room and had dreamed the entire exchange? Except that she hadn’t imagined running into Matt and his boys at the hospital cafeteria just a few minutes later. Something had prompted her to abandon her usual schedule that night and leave Devon’s room early. It didn’t make sense.

  “On the contrary, I’ve hardly known a situation or two people who make more sense together.”

  Cassie paused mid step and stared at the petite woman standing just inside the lobby.

  “Hello, Cassandra. So good to see you again,” Pearl said. Today she wore a pair of navy slacks and a rose-colored blouse. A delicate pearl bracelet adorned her wrist, and the same antique pearl comb was tucked into the side of her hair, holding back a simple chignon. Aside from the lack of scrubs, she looked exactly as Cassie remembered her from that night so many months ago.

  “Who are you?” Cassie demanded instead of returning Pearl’s pleasant greeting. “Not a nurse like you pretended to be.”

  “Not a nurse,” Pearl said with a gentle smile, “though I don’t recall ever stating that I was.”

  “You were wearing scrubs,” Cassie pointed out.

  “Yes.” Pearl nodded. “Sometimes a certain uniform or outfit is required for a particular job. For instance, if we were in the 1800s, do you think I’d be wearing these pants?”

  The 1800s? Cassie didn’t bother trying to figure out what Pearl meant. The woman made no sense, unless— “Are you a patient here?” Why hadn't she thought of that before? Sierra wasn’t a mental facility, but many of the residents were old, and she’d met a few with varying degrees of dementia. Maybe Pearl was like that but was also here for some type of physical therapy or after-surgery care. Maybe she’d been here last fall as well, and she’d wandered from her room, though that didn’t explain the altered visiting hours sign or the security guard.

  “Sometimes it’s best not to try too hard to figure things out,” Pearl advised, as if she sensed the direction of Cassie’s thoughts. “I
am not a patient here or a nurse; however, I am here to help you, this time at your request. You wanted to see me again, did you not?”

  Cassie could only nod mutely.

  “Well, here I am, and I am real. Long ago I learned the importance of making that known. Not doing so caused a rather significant problem for a young woman once.” Pearl’s face was at first troubled then serene again. “It all worked out for her in the end. It always does, no matter what the difficulties.” She smiled brightly. “Even in your case, Cassandra.” Pearl gestured to the sofa. “Come. Sit with me a minute, and perhaps I can clear a few things up. I see that you’re troubled.”

  Numbly, Cassie followed her and sat beside Pearl on the couch farthest from the door and nearest the large fireplace, which she’d never seen in use once during the entire time Devon had lived here.

  “Now then.” Pearl angled herself toward Cassie. “Was there something you wished to ask me?”

  The confusion, hurt, and anger Cassie had been harboring for months tumbled out in a flurry of questions. “What you said about my husband when you came before— why did you say that? Why did you tell me to give up on him? What right did you have to say such a horrible thing? Why were you in his room that night? How come no one else here knew about you?”

  “My,” Pearl exclaimed, that same serene smile on her face. “Such a lot of questions. Let’s focus on the one that matters, shall we?” She continued without waiting for a response. “I did not tell you to give up on Devon. You are confusing giving up and letting go. They are not the same thing.”

  “They feel the same,” Cassie said, irritated at Pearl’s easy dismissal of her other questions. “They are the same, especially if what you say is true, if I’m what is holding Devon here on Earth, if without my faith in him, he’ll die.”

  “Death is not what most believe it to be,” Pearl said. “It is but the beginning of another, more glorious life. Letting your husband go on, as he should, is not the same as giving up on him, leaving him to suffer here alone.” She paused, brow furrowed and lips pressed together in contemplation. “Think of it this way. When you sent your son to kindergarten last September, it was the beginning of a new stage of life for him, and that required some definite letting go on your part, did it not?”