Life Support: Escape to the Country

by Nicki Edwards

  “I’ll call her after we’ve been to the hospital and I have something to tell her.”

  Emma shook her head. “Call her now.”

  Tom sighed heavily and picked up the phone. Emma stood beside him as he punched in the number for his sister on the other side of the world.

  Sophie answered on the first ring as though she had been waiting for the call – the call where the voice on the other end would tell her the bad news. This wasn’t that call, but it might as well have been. Emma breathed in the sadness that misted around Tom. Though he and Sophie were on opposite sides of the world, they were connected by their love for their mum.

  Through tears Tom spoke, barely managing to get her name out. “Soph,” he whispered. “You have to come home.”

  Emma pictured his sister’s shock and her heart splintered for a woman she didn’t know.

  “Mum says it’s time,” Tom said.

  As Tom listened to his sister, a cloud crossed his features. He ran his fingers through his hair. “Christmas may be too late. I think you need to come now,” he repeated.

  Emma placed a hand on his arm and squeezed gently, hoping the tiny touch would give him the comfort he needed.

  Tom listened again. “I’m sorry Soph, I know it’s not easy for you being so far away. I wish I had a crystal ball, but I don’t. If only any of us knew how long she’s got, but the doctors won’t say. All I know is she’s asking for you. She said it’s time.” He paused and dragged in a deep breath. “I’m really sorry sis.”

  Hot tears streamed down Emma’s cheeks, one after the other, falling so hard and fast she could have caught them and formed a lake in her lap.

  Tom disconnected the call and stared at Emma. “That was the hardest thing I’ve ever had to do.”

  Chapter 21

  On Judy’s second day in ICU, Emma walked into the hospital room and found Tom sitting as still as a marble statue in a chair beside his mum’s bed. The only sign he was awake and aware of his surroundings was the occasional movement as he picked and worked at a piece of fingernail or changed position in the chair. Had he gone home at all?

  After the first long night, where she’d sat with Tom, waiting for a change in Judy’s condition, a sign of improvement, a glimmer of hope, Emma had gone back to her parents’ house as the sun threw banners of yellow and gold across the horizon. She’d showered, grabbed breakfast and taken a nap. Five hours later she’d woken and returned to the hospital to find Tom missing and Judy intubated and on a ventilator. Her pneumonia was so bad and her condition so deteriorated that without invasive ventilator support, she was struggling with each breath. The ventilator was buying time until Sophie arrived.

  Sarah, the bubbly nurse caring for Judy, told Emma she’d finally convinced Tom to go home and get changed. Sarah said he’d barely eaten or spoken, surviving on a mix of guilt and grief.

  He arrived back with wet hair, mismatched socks and red-rimmed eyes.

  “She’d be so mad with me,” he said softly as he walked in and greeted Emma with a tired hug.

  “Why?”

  “I’ve betrayed her. This is everything she didn’t want,” he said.

  “What do you mean?”

  He pointed. “This. ICU. The tube.”

  Judy lay on her back, eyes closed. The stiffly starched white bedsheet was perfectly folded in half and it lay draped over her body. Her arms were extended on pillows at her side on top of the sheet. They were already edematous and bruised, her fingers swollen beyond recognition. Judging by the multiple bruises and taped gauze on her skin, she’d been difficult to cannulate or someone had used her as a practice pincushion.

  Every orifice held a tube. Sticking from Judy’s mouth was the clear plastic endo-tracheal tube that went down into her stomach. A nasogastric tube protruded from one nostril. A central venous catheter had been threaded into her jugular vein, an arterial line in her arm, a urinary catheter in her bladder.

  She was heavily sedated on a cocktail of propofol and fentanyl. White tracheostomy tape wound tightly around the tube, holding it in place, and it snaked its way behind Judy’s head, knotted to one side against her gaunt, gray cheek. Every four seconds the ventilator, breathing on her behalf, rhythmically pushed air into her lungs with a soothing psht, psht sound.

  “Didn’t she want to be ventilated?” Emma asked softly.

  Tom shook his head and scratched at his beard. “But what choice did I have? Without it, she wouldn’t be here, the pneumonia is that bad. This at least might give her a chance.”

  They sat in silence, both deep in thought.

  Another nurse arrived and Sarah quietly introduced her to Tom and Emma before starting the handover.

  “I’ve done another set of ABGs. Her potassium is only two-point-seven so it will need replacing. And her urine output is off, so when they do the afternoon round you might ask them to consider some Lasix.”

  “What’s her CVP?”

  “Fifteen.”

  “What does her chest sound like?”

  “Wet.”

  Judy’s breathing sounded like a coffee maker percolating. Did Tom have any idea how sick his mum was or that it was unlikely she’d be able to breathe on her own when – if – they took the tube out?

  Thankfully, Sophie, Alex and baby Lily were on their way. They were somewhere across the Indian Ocean at the tail end of a torturous twenty-something-hour flight back to Australia.

  Hopefully they wouldn’t be too late.

  *

  The large clock on the wall showed five thirty. Tom and Emma were waiting for the doctor to come and speak to them. Simon Barclay, one of the intensive care consultants, was a handsome man in his early forties with an amazing bedside manner. He looked too young to be a consultant but had a reputation for being excellent at his job. His dignified treatment of Judy and his genuine concern for Tom made it easy to see why. Everyone from students to patients loved him and the other doctors spoke highly of him. In the brief time Tom and Emma had been sitting with Judy it had also become apparent that a number of nurses were secretly infatuated with him.

  Simon had been cautiously optimistic when Judy had first arrived, hoping to treat the pneumonia with antibiotics, but as each one of her body systems shut down, hopes for her recovery, or more time, faded.

  A pale rectangle of light from the fluorescent lights in the hallway spilled across the bed, making Tom’s usually tanned face seem gray, and emphasizing the tiredness in the shallow creases around his eyes. Emma stood at the table positioned at the foot of the bed, looking from Tom to Judy. Judy’s skin was the color of concrete, her eyes closed, her mouth turned down in a frightening grimace. A small blood blister had formed in the corners of her mouth where the plastic tube had pulled and dragged at her lower lip. Her tongue was swollen and dry. Emma wanted to reach in and adjust the position of the tube, but it wasn’t her place to do so and at the moment, preventing a pressure area on the side of Judy’s mouth was the least of Emma’s concerns. Tears welled behind closed eyelids and her heart ached for Tom – she knew how much he loved his mum.

  She flicked her eyes from Judy to the monitor, to the ventilator, to the infusions and back to the charts on the desk in front of her. She was usually calm in this hospital environment, but Judy’s illness had rocked her, triggering an anxious response within her. This could have been her mum.

  The lines on the chart in front of her danced as if black ants were marching across the page. She rubbed her eyes.

  “Does this remind you of Lleyton?”

  Tom’s voice startled her. She shook her head. No. She hadn’t given Lleyton a thought.

  What are her chances?” The words were so soft Emma wondered if she’d imagined them.

  Trying to meet Tom’s gaze steadily, she replied, “It’s too early to tell.”

  His shoulders slumped as though her lie had confirmed his worst fears. The truth was, without a miracle, Judy wouldn’t recover. Emma sensed Tom knew that. A painful lump formed in the back
of her throat and she attempted to swallow. Her heart was breaking for this family. There was silence except for the ticking of the clock as they waited for Sophie to arrive.

  Tom stood and paced around the small room like a trapped animal. The ventilator huffed and puffed in the background like a dragon, the only sound in the room other than the ticking of the clock.

  “Why her?” Tom asked.

  “I don’t know. I don’t know,” Emma replied.

  Simon arrived after six, acknowledging them with a brief smile. Emma sensed he wasn’t going to be the bearer of good news.

  He gave them a sad smile as he perched on the edge of Judy’s bed. “She’s struggling.” The words he offered were simple and heartfelt. They also lanced through Emma’s already wounded heart.

  Tom cleared his throat. “What’s the plan?”

  “We keep her sedated and ventilated, let her rest, and hope and pray her body responds to the antibiotics. But the issue is even if we get her breathing without the ventilator, with the tumor and the bony mets …”

  “She won’t survive.” Tom finished Simon’s sentence. “I know. Mum was aware of that.”

  “How long has she had the cancer?”

  Tom dropped his head. “This time? Six months. Before that, we thought she was in remission. She had breast cancer years ago, back when I was still at school.”

  “And she’s refused treatment this time, is that right?”

  Tom sighed heavily. “Yes, but I don’t know why.”

  “Would she want this?” Simon asked kindly, pointing to the ventilator.

  Tom hung his head further. “No,” he said softly. “It’s what I wanted. Until my sister gets here.”

  “I understand.”

  There was a long beat of silence and Emma remained quiet watching the two men. Tom worked on another fingernail.

  “What would you like to do when your sister gets here?” Simon asked gently.

  “Can we take the tube out so Mum can talk to us?”

  Simon licked his lips and changed position. “Even if we wean her from the ventilator, Tom, there’s every likelihood she won’t be able to breathe on her own. Maybe a few breaths and that’s all.”

  Emma nodded, her own throat feeling strangely restricted. She sucked in a lungful of air, grateful she was able to. Did Tom understand what Simon was saying?

  “She’s ready to go, but I’m not.” Tom’s words were soft.

  “That’s understandable.”

  “Sophie and her husband will be here soon.”

  Emma cleared her throat. “Simon, would you consider lightening up the sedation, and seeing if Judy is tolerant to the tube? She won’t be able to talk, but at least she’ll be able to respond.”

  Simon nodded. “I think that’s an excellent idea. How about we leave her well sedated tonight. You two go and get some sleep and come back tomorrow with your family. We’ll decrease the sedation and wake her up slowly, giving her plenty of ventilator support to help with the breathing.”

  Tom stood and moved around the room. He looked too big to be contained in such a small space but the way he paced told Emma he was too scared to stand still. He raked his fingers through his dark hair before jamming his hands in his jeans pockets.

  “I want her to be able to meet her granddaughter and I want the chance to say good-bye. Is that too much to ask?”

  Simon smiled sadly again as he placed one hand on Tom’s shoulders. “No, that’s not too much to ask.”

  “Thank you, Simon. I know you’re doing everything you can,” Emma said softly.

  “The worst part is knowing we’re doing everything and yet nothing is going to change the outcome.”

  Simon shook Tom by the hand and left the room, head bowed.

  *

  Emma woke slowly the next morning and stretched her tired limbs. She had no idea what time it was, but it felt like she was struggling through a heavy fog. It took her a few moments to register where she was and why her alarm was beeping. When she realized, she sat bolt upright.

  Tom. ICU. Judy.

  Emptiness overwhelmed her and she sagged back on Tom’s pillow. Her muscles were stiff and sore. She squinted at the clock. Seven thirty. She had stayed awake until after midnight, waiting for Sophie, her husband Alex and baby Lily to arrive. After brief introductions, she’d headed to bed at Tom’s place near the stables around one o’clock. She’d slept – alone – in his king-sized bed, tossing and turning all night, waking at every little sound. He’d spent the night on the couch at the cottage.

  At eight o’clock, with barely any sleep and on empty stomachs, everyone drove together into Birrangulla and went straight to the hospital. Emma’s sister-in-law, Kate, greeted them all at the door to ICU and ushered them into the waiting room. No one sat.

  “How is she?” Tom asked.

  Kate sighed softly. “Not good I’m afraid. She’s still going downhill fast. I’m very sorry.” Kate smiled kindly at Sophie and put an arm around her shoulders. “At least you made it in time.”

  Kate’s words were soft, but they seemed to land like bullets and penetrate straight through Sophie’s shield. Sophie handed a squirming Lily to Alex, collapsed into a chair and sobbed. Emma passed her a box of tissues and placed a supportive hand on her shoulder. She snuck a look at Tom’s sagging shoulders then at Kate. From the expression on Kate’s face, it was obvious Judy didn’t have long.

  “Why don’t you go in and see her first, Soph?” Tom suggested when Sophie’s tears eventually dried.

  Sophie clutched at her chest as though pained. “I don’t know if I can. I don’t want to see her all hooked up to those machines.”

  Alex held his wife’s elbow tenderly. “Those machines have been keeping your mum alive until you got here darling. You have to go in.”

  Sophie blew her nose and stood. “I can’t go on my own. Will you come in with me?”

  Tom and Alex nodded.

  Sophie looked at Emma. “You too, Emma. Please.”

  “I don’t want to intrude. This is a family time.”

  “I want you here for Tom.”

  Emma swallowed and gave a small nod. “Okay then.”

  Sophie squared her shoulders, inhaled deeply. “I can do this.”

  Time seemed to stop as Tom and Alex guided Sophie into the room.

  “Mummy.” Sophie’s cry tore straight through them. She fell across her mother’s chest and wept.

  Amanda, the nurse on duty, stepped back with moist eyes to give the family much needed space. Everyone ignored the two-visitors-at-a-time rule.

  “I don’t want you to die,” Sophie cried.

  Alex stroked his wife’s back and murmured softly in her ear.

  Tom shuffled from one foot to the other. Emma bounced Lily on her hip while the baby cooed and giggled and looked around her with delight and wonder and not a care in the world.

  Simon arrived and his presence filled the small space further. He pushed a chair close to the bed and indicated Sophie should sit. She dropped into the chair and clutched her mum’s puffy hands, stroking each finger slowly.

  Sorrow anchored Emma’s feet to the floor and she was unable to pull her eyes away from the unfolding scene. Tears welled up and she brushed them away with one hand. She glanced at Tom and watched tears glisten as they rolled, unabashed, down his own cheeks.

  “We’re going to decrease the sedation,” Amanda said. “She may wake up quickly, but she may not.”

  Sophie and Tom nodded in understanding.

  “I just want her to open her eyes and see Lily,” Sophie said with a sniff.

  Emma bit her lip and blinked rapidly to stop the tears. Every time she suggested she should give the family space and allow them the privacy they needed, Sophie and Tom made it clear they wanted her to stay, so she stayed.

  Tom sat on the other side of the bed and picked up his mum’s other hand. He ran his rough fingers over her smooth, soft skin.

  “What about Ruby? Should she be here?” Emma a
sked.

  “No.” Like the snapping shut of a book, Tom’s expression made it clear the subject was closed.

  It was an hour before Judy stirred. Sophie was in the corner feeding Lily, her daughter’s mouth covering her breast, Lily’s chubby hand reaching for the necklace around Sophie’s neck. Alex stood to the side, stroking the downy blonde fuzz on Lily’s tiny head, his love for his wife and baby evident on his face.

  “Mum?” Tom spoke, breaking the silence. Everyone shifted position to stare at Judy.

  Sophie disengaged her nipple from her daughter’s mouth and pulled her shirt down. Lily wailed her disgust. Emma held out her arms and Sophie wordlessly passed her over. Emma laid the baby across one shoulder and patted gently, hoping to elicit some wind. She was rewarded with a healthy burp.

  Emma glanced down at Judy’s hand, resting in Tom’s. Her fingers twitched and contracted. Emma’s gaze traveled up to Judy’s face. It was contorted, as though she was in pain or trying to speak.

  “It’s okay Mum,” Tom croaked.

  Judy moved her head slightly to one side and struggled to open her eyes.

  “Hi Mummy, I’m here,” Sophie whispered.

  “You’re in hospital, you’ve got a breathing tube in,” Tom said.

  Judy frowned.

  “I know you didn’t want one, but we didn’t have a choice,” Tom said. “You were really sick and we needed time for Sophie and Alex to get here.”

  Judy grimaced, biting down on the tube with her teeth. An alarm sounded. Amanda, Judy’s nurse, silenced the machine and spoke softly to Judy who closed her eyes and slowed her breathing.

  “I’ve brought Lily to meet you.” Tears rolled unchecked down Sophie’s cheeks.

  A lump grew in Emma’s own throat and tears pricked behind her eyelids.

  Judy’s eyes closed again. Emma found some lavender massage oil and passed it to Sophie. For the next half an hour Sophie massaged her mum’s hands and feet as Judy opened her eyes long enough to gaze steadfastly into their eyes before closing them again. The effort of breathing was clearly exhausting her.

  “I love you so much Mum,” Sophie said as she wiped at her bloodshot eyes. “You have been the best mum in the world.”