by Nancy Adams
Judy stopped in the doorway and stared, but Allen went to stand beside the bed, so she followed him a moment later. He had looked down among the wires and lines and tubes that almost obscured Katie from view and found her right hand, and was holding it in both of his. He moved it slightly toward his wife, and took one of his own hands away so she could touch it as well, then wrapped his hand around both of theirs.
“She's strong,” he said, and if Judy didn't know him so well, she'd have missed the soft sob that was in the back of his throat. “She's strong, and she'll come through this. Remember the time she tried to play Supergirl and fly off the roof of the garage, when she was eight? Knocked herself out cold and broke her left arm, but she was up a tree the day after they put the cast on, remember that?”
Judy looked at her daughter's face. There were tubes down her throat, through both her mouth and her nose, and other tubes were running into the side and back of her head, which was turned to the left. Those tubes were clear, and Judy could see that what was slowly running through them was red, like blood. She sucked in a breath, but managed to hold herself together and not start crying.
A couple of doctors came into the room, and Judy saw that their scrubs still had blood on them. “Are you her parents?” the taller one asked softly, and they only nodded. “Good, good. I'm Dr. Capshaw. I'm the neurosurgeon that's been called in to work with her. I'm going to be her primary while she's here, and Doctor Meeks will be working with me as her general care doctor. We just got her stabilized about twenty minutes ago, and brought her back to this room. Do you know what happened?”
“All we know is she went through a windshield,” Allen said.
The doctor nodded. “Yes, that's true. She suffered some pretty serious head injuries, I'm afraid, and we've had to actually drill some holes in her skull to relieve pressure on her brain, because she's bleeding inside. If the blood builds up too much pressure, it can cause serious brain damage or even death, so we took the steps necessary to let it off. The rest of the tubes are to make sure she gets plenty of oxygen and fluids. She's been completely unresponsive, and right now we're not sure whether she's going to regain response. She's in a pretty deep coma right now, and to be perfectly honest, most of the time when we see one this deep, they don't come back.” He stood and looked at them for a moment, and then added, “I'm sorry. I know that isn't the kind of news you want to hear...”
Allen looked up at him from across Katie's bed. “Dr. Capshaw, you're right. That's not what we want to hear. What we want to hear is that you're not going to stand there and tell us that there probably isn't any hope, because a doctor who will tell us that is a doctor who has already given up on our daughter, and if you've already given up, then you're already thinking about when to pull the plug. That isn't the kind of doctor we want working with our daughter, so we'll just dismiss you right now and ask to see someone who isn't a quitter.” He turned his face back to his daughter, as his wife stared at him in surprise.
Dr. Meeks, who had been silent so far, said, “Mr. Brennan, that was uncalled for; Dr. Capshaw is one of the best neurosurgeons you'll find anywhere, and there isn't anyone better to take care of your daughter...”
Dr. Capshaw let a flash of anger cross his face, and then composed himself and interrupted his colleague. “Mr. Brennan, I'm not even close to giving up on her,” he said, and Allen looked up at him again. “However, Sir, it's my unfortunate duty to explain to grieving parents and children and wives and husbands just how things can go, and even to explain what usually happens in this circumstance or that one; but the one thing I never do with any patient is give up on them, and I'm not about to give up on this one. Now, if you want to relieve me, that's fine; there are other fine doctors here that can take over. But I doubt you'll find anyone, here or anywhere, who will work as hard as I will to bring her back to you. Your call.”
Allen smiled. “Well, that's better. Now you're talking like a real doctor!”
Capshaw stood there and stared at him for a moment, and then smiled back. “Okay, then,” he said. “Here's what we're going to do...”
The doctor outlined a plan that involved getting Katie Lou admitted to the facility and started on a regimen of medications and physical therapies that had shown promise in aiding coma recovery. He would put them all into use, including some that were still considered experimental.
“We've done a basic MRI scan,” he said, “and what we've found is that, besides the subdural bleeding, there is significant bruising and swelling in her spinal cord, so she's at least partially paralyzed at this point. The damaged nerves can't carry messages to the muscles, so she can't move. Now, as the swelling goes down and the bruising fades, some of the normal function should return, and it's even possible she'll make a full recovery—if we can bring her back from wherever she's at. Now that she's physically stable, we're going to try to determine her mental state, and the way we're going to do that is with what's called a functional MRI.”
“Like a CAT scan?” Allen asked.
“Well, no,” the doctor said, “not really. A CT scan uses x-rays to take a lot of images of a body, then puts them all together in a computer to make a 3D image. An MRI, on the other hand, uses magnetic fields that line up all the protons in the body, then picks up a reflected radio signal from them that gives a more complete image. With a functional MRI, we're able to watch the blood-flow patterns inside a brain, which means we can tell when a patient is responding to certain stimuli—like the sound of her parents' voices. If she shows a response, then it's possible that she's not in an actual coma at all, but rather that she's in what we call a 'locked-in' state. She's at least partially conscious in there, but not able to communicate with us out here.”
“Oh, dear God,” Judy said. “How horrible!”
Dr. Capshaw nodded gravely. “Yes, it's horrible,” he said, “but it's also an indicator that she may be capable of recovering from it. The more response we see, the greater the chance that we'll be able to help her come back from it, and you guys will play an important part in that chance. See, if she recognizes your voices, then we'll see increased blood flow in a certain part of her brain. In that case, we'll have you talk to her about things she likes to do, or people she cares about. When we find things that make a good, strong, obvious response, then we have a way to communicate with her; for instance, if she likes tennis, and responds when she thinks about it, we'll see an increase of blood flow to a certain part of her brain. If she likes scary movies, that will show up in a different part—so now we've got 'tennis' for yes, and 'scary movies' for no, and we can play twenty questions with her.”
Allen nodded. “Like when paralyzed people blink once for yes, twice for no—that sort of thing. And if she can do that, then she'll get better?”
“All I can say is that it improves her chance for recovery,” the doctor replied. “How great that recovery will be is not something that medical science has any control over. However, there are some encouraging examples where using this type of communication has actually led to a fairly complete recovery. The key is going to be how well she can respond to you and actually understand you. You can literally help to guide her back to us, by having her try different things to see if she's able to move a finger or toe, raise an eyebrow, that sort of thing.”
Allen tightened the arm he had around his wife, and looked down at Katie Lou. “Whatever we can do,” he said, and Judy echoed him.
Dr. Capshaw smiled. “That's the spirit! Now, we're just going to monitor her for the rest of today and tomorrow, let her body get used to all the indignities we've put it through, and we'll start with the FMRI on Monday morning. I can let you stay in her room with her, if you want; we've got beds that we can bring right in for you, so you won't have to worry about getting a motel or anything. Did you come prepared for a lengthy stay, or do you need to go home for work or other kids?”
Allen and Judy looked at each other. “I need to get the shop set up to run without me for a while,” Allen s
aid, and Judy nodded.
“I can let Monica run the beauty shop,” she said. “We can get all that set up tomorrow and be back here tomorrow night.”
Dr. Capshaw smiled. “I'll have her room all set up for you, then,” he said, “and we'll see you at nine o'clock Monday morning!” He shook both their hands, and both he and Dr. Meeks left the room. Allen and Judy were alone with their daughter.
They looked down at her, and Judy began to cry softly. “Allen, what if—what if there's no response? What if she never comes back to us?”
Allen pulled her close and kissed the top of her head. “She will, Honey, she will. She's listening to us right now, and wishing she could tell us so.” He reached out and caressed Katie's forehead. “Don't you worry, Sweetheart,” he said. “We know you're there, and we won't ever give up on you!”
* * * * *
Katie Lou had begun to realize that she was alive as she was being loaded into the helicopter, but nothing she could do would make her body respond to her commands. She had felt a flush of panic, but it wasn't like other times, when her heart would race and her breathing would speed up; this time, it was just a feeling of urgency in her mind, rather than any physiological responses in her body.
For just a moment, she had the fleeting thought that she'd been decapitated, that the reason she couldn't feel her body was because it was no longer attached to her head, but there was…she could only think of it as a 'heaviness' where her body should be, and it told her that it was there, even if it wasn't moving and doing what she wanted.
She couldn't quite feel anything. There was a very slight sense of movement as she was being carried to the helicopter—though she didn't actually know it was a helicopter she was put into—and occasionally, she felt a slight sloshing in her guts as the aircraft banked and turned, but other than that, she felt nothing that could be termed an actual physical sensation.
She had no sense of time, either. She didn't know how long she'd been this way, and the few senses of something touching her or being moved about did nothing to help. She could hear, though it was hard to make out what was being said sometimes; some words came through, but others didn't, and there was no pattern to it that she could find.
She didn't know how she'd gotten to be this way. She remembered being out on the lake, but that was it. She'd been lying in the sun, she thought, and then she was in this condition. Maybe it was only a dream? She didn't know.
There was a voice, and it took a moment to realize it was her father's, and there was her mother's voice, too. They were close, and they were talking about her with one of the other voices she'd been hearing, but she couldn't focus on what they were saying. She gathered that she'd been hurt, and that they thought she could hear them, but that was about all. She wondered what had happened to her, and if anyone else was hurt. She thought there should be someone else she ought to be thinking of, but she couldn't remember whom.
She waited for her parents to talk again, but they didn't. She waited and waited, but an eternity passed, and still they didn't speak again.
2
Judy called Kylie's number again as they left the medical center, and this time she got an answer.
“Mom?” she heard Kylie say over what sounded like loud partying in the background. “Hang on a minute, let me get outside!” She heard Kylie pushing through a crowd, with an occasional “excuse me,” or “comin' through!” A moment later, the noise subsided.
“Okay, that's better. I got your message, but I know it's kinda late, there, so I was gonna call you back in the morning. What's up?”
Judy closed her eyes and said a silent prayer that God would give her the right words to say. “Kylie—Katie Lou's been in an accident, and she's in a coma. They life-flighted her to Columbia Medical School, and your dad and I are just on the way home from there, right now.”
“What? What?” Kylie shouted. “Oh, god, Mom—I'll be home tomorrow, I can get a flight sometime in the morning, and I'll—I'll call you in the morning, as soon as I know when I'll be in. I left my car at the airport, so I won't need you to pick me up—can I go see her? I mean, will they let me in?”
“Yes, you can go see her, but she's not responding just yet, so just be prepared for that. She's hurt pretty badly, and they had to drill some holes in her head to let some bleeding out so it didn't do brain damage. She's got tubes stuck everywhere. Your father and I are going back up there tomorrow night; they said we can stay right in her room with her, and they're going to start doing some tests on Monday morning, so we want to be there for that. If you come home, you can just stay there with us, I'm sure.”
“I'll be there. I flew out of Columbia, so that's a good thing, I'll be right there as soon as I get off the plane. I'll go right to the medical center, and meet you there when you get back, okay?”
Judy nodded into the phone, ignoring the fact that Kylie couldn't see her. “That's fine, Honey, we'll see you then, and thank you. I was hoping you'd come...”
“Mom, of course I'm coming!” Kylie said. “This is my big Sissy we're talking about! I'll be there, for her and for you, don't worry! I'm going back to my room now, so I can start packing and get a flight set up. I'll call you in the morning to let you know the details. I love you, Mom!”
“I love you too, Sweetheart!”
She called Darren again, to tell him what they'd learned, and were told that he was out cold on pain meds. His father had answered his phone, and expressed his concern for Katie Lou, as well. The hospital had decided to keep Darren overnight for observation, but he was expected to be released in the morning and would undoubtedly be up to see Katie Lou as soon as he felt able to drive.
They got home late, but neither of them wanted to go right to bed, so they packed their bags for a week-long stay and got them in the car and ready. When that was done, Judy realized that they hadn't eaten dinner, so she heated them up a couple of frozen meals and they ate them together at the kitchen table. Halfway through eating, Allen reached over and took Judy's hand, and they finished eating that way, then went to bed. It took each of them a while to get to sleep.
When they got up the next morning, they began getting ready for church without even discussing it. They were regular church goers, and it didn't even occur to them not to go; besides, they wanted to let their church family know what had happened, and ask for prayers for Katie Lou to recover and come home soon.
Kylie called while they were in the car on the way to church. She'd gotten a flight that would take her to Chicago first, then to Columbia, putting her there about four that afternoon. Allen and Judy promised to be there by then, so they could all go and eat their dinner together, then get situated in Katie's room.
When church was over, they began making arrangements for their respective businesses. Allen put his automotive shop under the control of his top mechanic, Mike Bull, and Judy put her own top employee, Monica Stiles, in charge of her beauty salon. Both businesses could run for a while this way, and if things took longer than expected, then they'd figure something else out when the time came.
By three PM, everything was done that needed doing, they'd had a dozen visitors who promised to pray, and their neighbor, Pete, who was eighty-seven, had promised to feed their dog and watch over the house for them, so they got into their car and headed back to Columbia. Judy's phone rang as they were leaving the house; it was Kylie, telling them that she'd gotten to Chicago just in time to run like mad to get to the gate for her flight to Columbia, but she'd made it. She’d be boarding shortly, and she'd see them within an hour or two at the medical center.
It rang again a half hour later. Darren called to say he'd be up to see Katie Lou on Monday, though he'd have to get someone to drive him. He didn't want to chance driving on his pain meds, and even breathing felt like he was dying without them. Judy agreed that he shouldn't try driving just yet, and said she knew Katie would be glad to have him there.
They arrived at four on the dot, just about the time Kylie's plane should be
landing. They sat in the car for a bit, expecting the younger daughter to call and let them know she'd arrived, and sure enough, Judy's phone rang ten minutes later.
“Mom? Ask Daddy if he's got his jumper cables, my stupid car won't start!”
Allen grinned; it was nice to have something feel normal, and Kylie's car not starting was about as normal as it could get. She'd bought herself a vintage 1966 Buick Riviera and was determined to restore it herself, but never seemed to get around to doing any work to it. Between getting it started and making sure the headlights would work, Allen figured he spent about ten hours a month tinkering with it for her.
He drove to the airport, and they found Kylie with her car in the long-term parking lot. Allen had to explain to a security guard why he only wanted to go into the lot for a few minutes, but when the guard saw the old Riviera, he smiled and waved them in. Allen pulled up close and opened his hood, then hooked the cables to Kylie's battery and let his engine charge it for a few minutes. When he nodded, she turned her ignition key, and the big 455 engine fired right up. He unhooked the cables and closed both hoods, and they drove out of the lot. Kylie had to stop and pay, but the guard waved Allen and Judy on through.
Kylie wanted to see her sister as soon as possible, so they went straight back to the Medical Center, and Allen and Judy led the way to Katie's room. A few of the tubes had been removed, and she didn't look quite as much like an alien octopus as she had the evening before. As they stood at her bedside, a nurse came in and smiled at them.
“Hi,” she said, “I'm Kathy; I'm her main duty nurse. I'm about to go off for today, but I saw you come in and thought you might have some questions. Is there anything I can tell you or do before I go?”
“Has she shown any signs of responsiveness?” Kylie asked.