by Nancy Adams
Kathy frowned. “Not yet, I'm afraid, other than a few sounds that may be just gases moving out through her throat. That's perfectly normal, in comatose patients. Try talking to her, and see if you get any response. Sometimes, people in comas will respond to voices that are familiar.”
Kylie was standing next to her sister's bed, and reached down to take her hand. “Katie,” she said, “it's me, Kylie. Can you hear me?”
She stood there for a long moment, just holding Katie Lou's hand. When there was no response, she looked up at her parents and tears began to fall from her eyes. “Oh, Mom,” she said.
Judy smiled sadly. “I know, Baby,” she said, “I know. But we can't give up. She's in there, I know she is. We just have to have faith, and trust in God.”
Kathy nodded. “Faith is critical,” she said. “I've seen miracles here that medical science can't explain at all, so don't give up, and do keep praying. Will you all be staying with her?”
“If that's okay, yes,” Judy said. “This is her younger sister, Kylie.”
“It's fine,” Kathy said. “Dr. Meeks said there would be family staying in the room. I'll have a bed brought in, and that chair over there folds out flat, so one of you can sleep there. Give me just a few minutes.” She left them alone with Katie Lou.
Allen leaned down and kissed Katie's cheek. “Hey, Baby girl,” he said. “We're all here, and Darren said he'll be up tomorrow to see you. He got hurt, too, but not as badly as you did...” His voice trailed off.
The nurse came back a few moments later with an orderly who was pushing a bed. He set it up close to Katie's, then smiled and left. Kathy showed them how to operate the bed and how to use the TV control so that they could put on a program if they wished.
Kylie sat down in the chair while her parents stood beside the bed and talked to Katie. She watched them, wondering what life would be like if Katie Lou were not to come back to them.
This wasn't fair. Katie Lou had her whole life ahead of her; how could something like this happen? She was getting married in just a couple more weeks, for crying out loud. How could something like this happen, and why now? It just wasn't fair.
After a while, Judy and Allen came to sit on the bed that had been brought in, and the three of them talked about Katie Lou. They talked about her childhood, and how she'd always been the one to try all the daredevil stunts, while Kylie was more cautious and wouldn't take risks. Lately, it seemed, those roles had somewhat reversed themselves, as Kylie was the wild one who liked to go out and party, sometimes getting so drunk that she couldn't even find her way home, while Katie was more conservative, preferring to avoid drinking much at all. While Kylie might go to a rock concert, Katie would prefer an evening at a movie theater. Things had changed a lot over the past couple of years.
This was a change that none of them could have anticipated, that no one could have prepared for. This was a change that could devastate a family, and all three of them wondered how they would cope with it if it happened that Katie Lou could not come back, or couldn't come all the way back to them. What if she were brain damaged, and no longer the Katie Lou they knew? What if the trauma to her spine didn't heal properly, and she were paralyzed?
Still, she was their daughter and sister, and family looks after family. They'd do what they had to do to take care of her, and that was all they knew at that moment.
* * * * *
Katie Lou was aware that they were there, but no matter what she tried, she couldn't get her mouth to work, couldn't move a muscle. She no longer felt like she didn't have a body, though, because she had one and it hurt! In fact, it hurt quite a lot at the moment, especially in her head!
She heard Kylie speak to her, and knew who she was, just as she heard her parents and knew them. Some part of her wondered why Kylie was there, because she was sure Kylie wasn't anywhere nearby. She'd gone somewhere, but Katie couldn't recall where.
The pain overwhelmed her and she let herself succumb to it. She'd learned already that this was one way to escape it for short periods, by letting it drive her back into that darkness that had no sensation at all.
* * * * *
Morning came, but Allen, Judy and Kylie hadn't slept much. The only thing that told them it was actually morning was the change of shift among the nurses, and a few moments later an orderly came in and changed the bag of fluid that kept Katie from becoming dehydrated. Allen asked the orderly how to get to the cafeteria, then led Judy and Kylie down to get some breakfast and coffee. It was only a little after seven, and Dr. Capshaw had said the tests would begin around nine, so he wanted to get eating out of the way. The ladies agreed, and they found that the cafeteria's food wasn't nearly as bad as they'd feared.
They lingered a bit over their breakfast, talking more about Katie. Each of them was worried about the test that would be performed that morning, and whether it would show any real response, but they bowed their heads together and prayed for a miracle that would bring their beloved Katie back. As they prayed, each of them felt a peace come over them, and it was Kylie who spoke first.
“I know I haven't been real good about going to church, and all,” she said, “but I think God is trying to let me know that she's gonna be alright. I can't explain it—it's like I just felt Him telling me not to worry, to relax and trust Him...”
“I know,” Judy said, “I felt it too.”
“Yeah, me too,” Allen added. “I think He's trying to tell us to just have faith, and He'll take care of her. Let's go on back upstairs, it's after eight. I'd hate it if they decided to start early and we weren't there.”
The ladies agreed, and they made their way back up through the elevator to Katie's room. She was still there, and there was no apparent change, but even she wore a more peaceful look on her face. Her parents stood on either side of the bed. Kylie moved to stand beside their father, and they joined their hands with hers to pray again for her recovery.
Dr. Capshaw came in at just before nine, and was introduced to Kylie.
“Great,” he said, “the more familiar voices, the better! Now, I told your folks Saturday night, what we're going to do is watch for blood flow to certain areas of the brain after certain stimuli; for example, we stick a needle in her foot, and watch for blood flow to the brain's pain center, the dorsal posterior insula. What we've found is that whenever someone feels pain, that's the part of the brain that has activity that we can measure.” He moved to stand closer to the bed and look down at Katie. “We'll also have each of you talking to her, touching her. What we're looking for is activity in the parts of the brain that respond to sound and recognition, and also to touch. If she responds to any of it, then we'll start working on measuring the strength of her responses. If we can get a steady response, we might be able to make a way for her to communicate with us, at least in a limited sense, like yes or no.”
Kylie smiled. “That would be cool, if she can tell us, like, when she needs something, or if she's hungry or whatever.”
He grinned at her. “Of course, it takes the MRI to do it, so that means we can't do it often. Radiology gets annoyed when I take over their lab all the time. What we'd try to do is help her to find other ways to communicate, like flexing a finger or toe, or even an eyelid. If we can use this method to help her learn one that doesn't need thousands of dollars a day in expense, then we've got a start toward helping her to recover.”
Judy spoke up. “Doctor, you sound a little more hopeful than you did the other night. Has there been something new that caused that?”
“Or are you just trying to keep our spirits up?” Allen added, and both his wife and his daughter gave him dirty looks.
Dr. Capshaw wasn't offended, though. “Actually, I had a couple of EEGs run since last night, and I got to look at them this morning when I got here. There is some significant brain activity showing on them, more than I'd expect to see in a case like this. We’d put her on life support when she came in, because she wasn't breathing steadily on her own, but she is now, so w
e took her off of it early yesterday morning. All of this together makes me think your daughter isn't waiting for us; she's trying to come out on her own. If I'm right, then maybe we can give her the encouragement she needs, and help her along. I've got everything set up, and a couple of orderlies will be here any second to take her down. We're going to radiology, down on the second floor.”
The orderlies came in then, and began making sure that all of the machines were disconnected properly and the IV poles were mounted on the bed, so there would be no interruption of her fluid intake. They'd have to be removed when they got to radiology.
“In order to do this properly,” Dr. Capshaw said, “what we'll need you to do is change into scrubs, and make certain there is no magnetic metal anywhere on your body, because no metal can be allowed anywhere near the MRI unit; the machine can literally draw anything magnetic into itself at extremely high speeds, and bits of metal inside the body have been known to come out violently, tearing right through skin and muscle to do so. If you've got any metal implants, or shrapnel, for instance...”
“Nope,” Allen said. “Had a steel splinter, once, but we got it out.”
Capshaw smiled. “Let's hope so. I'd like for each of you to be in the room with her for a time, and if there's any steel inside your bodies at all, it can get pretty uncomfortable.” He showed them to changing rooms, and went to start getting Katie Lou set up for her ride through the Magnetron.
When they were in the ladies’ changing room, Kylie looked at her mother. “Mom,” she said, “I'm scared. I mean, scared that—well, what if Katie Lou doesn't come back? What if she's too—what if she can't?”
Judy put an arm around her and pulled her close. “Right now, Kylie, I'm going to hold onto the hope that she will recover, and trust God to see to it,” she said softly, “but if it should be His will that she doesn't—or if He decides that it's time for Him to take her from us—then all we can do is trust that He knows best, and that we'll see her again when we get to Heaven. For now, though, let's just keep praying, and do what the doctor says.”
Kylie nodded and wiped the tears from her eyes before they could be fully formed. She got dressed in the scrubs they'd been given, and followed her mom out again.
Allen was already there, dressed in his own scrubs and waiting. His face seemed drawn and tight. Judy went to him and hugged him, and Kylie did the same. Allen was the rock that they all leaned on, Judy knew, but sometimes even a rock needed a little support. She'd have to remember that through the things they were facing.
The technicians were busying themselves with getting everything ready. Katie Lou was on the sliding bed that would carry her through the big doughnut, and Allen asked why they were actually strapping her down.
“Well, sometimes,” the technician said, “the magnetic field can affect the inner ear, and throw off balance. If that happens, even in someone who isn't normally responsive, it can cause a sudden physical feeling like you're falling, so you might try to move to catch yourself. In a person who's awake, you can caution them not to move and they're usually okay, but when they're not, we have to make sure.”
Allen nodded, then pointed at a cage-like helmet that was over Katie's head. “And that?”
“What that does is hold the head perfectly still. When we're mapping specific areas of the brain for responsiveness, we need to be sure that the brain remains in the same precise position, so that the images aren't overlapping in different sections. Even a small overlap can cause a misreading, so once again, we take precautions.”
A few moments later, Dr. Capshaw said they were ready to begin, suggesting that Allen go first. A plastic chair had been placed near the machine, just to the right of where Katie would be laying, and Allen would be able to see her face inside the cage and doughnut as the test ran. The doctor got him situated just where he wanted him, then left the room again.
“Alright, Mr. Brennan, please don’t move, and don't touch your daughter during the test,” came the voice of the tech over the speaker. Allen nodded, but never took his eyes off of Katie's still-bruised face, where small cuts and gashes remained visible from the shattered glass of the windshield.
One of the problems with being an automotive mechanic was that Allen could visualize every part of the car that his daughter had been injured in, could actually see in his mind the entire sequence of events that had taken place, and as the MRI machine began to hum, he let his mind go over it.
The first part would happen as the front end of the car—you couldn't call it a bumper, not anymore—came into contact with the tree that it hit. While it would normally be hard to break the impact into frames, like slowing down a movie to examine each moment, his mind could do it easily. The plastic front edge would crinkle at first, and some of the impact would be transmitted along the brackets that supported it to the frame of the car. At that point, it would be little more than a vibration, but only scant milliseconds later, as the brackets were drawn together by the front edge wrapping itself around the tree, the leading tips of the frame would be pulled inward and shoved backward at the same instant. The front end of the car, containing the engine compartment, would begin to be forced backward, but the frame underneath was designed to crumple and absorb some of the shock, so that would be happening as well.
This was the point where the kinetic energy of the car's forward motion was finally interrupted, and the car would be decelerating so rapidly that it seemed almost instantly stopped. That energy was not so quickly removed from the passengers, though, because such a sudden stop would kill them instantly, so car manufacturers had come up with restraints that were designed to remove kinetic energy from human bodies inside a vehicle in as short a time as possible.
The first of these was the seat belt, and Allen knew Katie well enough to know she'd have been wearing one. Somehow it had failed, though, and allowed her body to be thrown violently forward. Her body was met by the inflating airbag, the secondary, passive restraint whose purpose was to prevent the body from making contact with the dashboard or windshield.
When it worked in concert with the seat belt, the airbag was an amazing device that had saved many, many lives. Unfortunately in this case, it was low and allowed Katie's unrestrained body to slide over it as it inflated, and as a result, she was thrown at sixty miles per hour into the windshield itself. The airbag, by a quirk of its design, actually broke the windshield just before she got to it, which may have saved her life, but even though it was shattered, the cellulose layer that kept it from becoming a thousand shards of razor-sharp glass also meant that her head had to crash through. The impact on her head and neck and spine was tremendous; her brain was slammed against the interior of her skull so hard that it ruptured the dura mater, the thick membrane that is the outermost of the three layers that encapsulate the brain. This caused the bleeding inside the skull that put pressure on her brain, and the doctors had had to drill holes in her skull to relieve it before it could do serious damage, or even kill her. In addition, every single one of the discs in her spinal column was compressed and battered, while the vertebrae themselves were rocked around, causing the spinal cord to become bruised and inflamed.
Once she had gone through the windshield, Katie Lou would have flown through the air. He'd heard that she was found on her back, so she probably landed that way, doing a complete somersault in the air before she struck the ground again. The impact would have added to the bruising of her spine, and when her head struck the ground, it would have only completed the damage done by penetrating the windshield.
All of this actually went through Allen's mind in a matter of seconds, as the big MRI machine got up to speed, but when he had thought it through, he found himself wondering how she had even lived through it. He looked at his daughter, lying there before him looking frail and tiny, and realized that she must have been a lot stronger than he had ever imagined. He didn't think he could have survived a crash like that, and he was twice her size.
The carriage on which Katie
lay began to slide into the humming machine, and Allen forced himself to pay attention. A moment later, he heard Dr. Capshaw's voice come through the speaker.
“Okay, Mr. Brennan, I'd like you to start speaking to your daughter. Just reassure her that you're here and that you love her, and let's see what results we get.”
Allen stared down at his baby girl, and tears began to fall from his eyes, unbidden but unrestrained. Strangely enough, even though he was crying, he felt a smile tugging at the corners of his mouth, and began to speak.
“Katie Lou,” he said, “I'm here. Baby girl, it looks like you've gotten yourself in a mess, this time, but you know Daddy's here for you, don't you? I was just thinking about the time you came home when you were sixteen saying you thought the cops might be coming after you, cause you went to the store and bought a bunch of stuff, but forgot to pay for one candy bar. Remember that? You were so scared, you just knew old man Davis at the store was gonna have you arrested, and you thought you were going to prison, like in Shawshank Redemption, you remember? But what did I tell you? I told you Daddy won't let anything bad happen, and we went back to the store and you showed him the candy bar you forgot about, and what happened? He didn't call the cops on you, did he? Nope; he up and asked you if you wanted a job, cause he liked the fact you were so honest that you had to own up, even if you thought you were gonna be in trouble for it.” Allen wiped his eyes with his scrub shirtsleeve. “Ah, Katie, I was so proud of you that day. I was so proud.”
He trailed off, and just sat there for a moment, trying to think of what to say next, and suddenly he heard Dr. Capshaw over the speaker.
“Mr. Brennan,” he said, “I can tell you that she knows you're there, and she hears you. We're getting significant responses, and it's pretty encouraging...”
Another voice suddenly cut in, and Allen had to force himself to focus. He heard a voice that sounded like Katie's, and then he realized that it was Katie's voice.
“Daddy,” she said, though it was slurred, “I wanna go home...”