by Brian Boyle
I look at my dad, feeling embarrassed. But he continues.
“One surgeon by the name of Dr. Nafisy explained to us that when you were first brought into surgery and Dr. Daee cut open your chest, he had to lift up your heart and move it across your chest. Usually, Dr. Nafisy said, most hearts would have stopped, but yours kept beating.”
These details sweep over me like a tidal wave. I ask him how much blood I lost.
He tells me that by the time I arrived at the trauma unit by helicopter forty-five minutes after the accident, I had already lost about 60 percent of my total blood. I needed thirty-six blood transfusions and thirteen plasma treatments in Intensive Care.
I never knew I was that close to death. But there’s one more thing I want to find out—at least now. “Dad, did my heart ever give out in surgery or any other time?”
He doesn’t say anything for several minutes. I know it must be hard for him. Finally, he says, “To this day, your mom and I still don’t know all the specifics. Some of the nurses told us that your heart stopped seven or eight times during those two months in ICU. We never asked for more details, because frankly we just didn’t want to find out.”
CHAPTER 17
THERAPY SESSIONS
I have settled into a regular routine at Kernan. Every morning, a nurse wakes me up at six o’clock to take some blood. I eat breakfast at eight, and my first bout of physical therapy with Karen starts at noon.
Her stern, drill-sergeant approach starts with a random selection of arm and leg raises. If my blood pressure and pulse are high, we switch to something easier. On the third day, she isn’t available, so I work with Derrick, an older man who’s even more aggressive and direct than Karen. He makes me stand on each leg for several seconds to improve my balance. But with my weak muscles, I wobble briefly on my left foot, then nearly fall flat on my face. Luckily, he catches me in time.
As I continue the balancing exercise while holding onto a wall for support, Derrick asks about my sports background. I mention I was on my high school swim team and that I’ve been thinking about getting back in the pool—especially since I found out that the center has an indoor pool. He shakes his head and tells me swimming is unlikely due to all my injuries. “I’m sure you have a lot of fight in you, kid,” he says. “You’re definitely a survivor, but this is reality we’re talking about. I have looked over your medical file, and it says that you were on life support for two months. Hell, man, you’re an animal and there’s no doubt about it. But getting back in the pool with the way your body is now, I just don’t think it’s likely. You’re living, you’re walking—you’ve got a future ahead of you. You’ll find something else besides swimming, I can promise you that.”
I complete the therapy session in silence, keeping my anger over his remarks in check. I have a strong inkling that there will be plenty more naysayers like Derrick in my new life, telling me what I can’t do rather than what I can do.
I look forward to my 3:00 p.m. occupational therapy session with the beautiful Jamie. If she only knew what a hopeless schoolboy crush I have on her. She’s hot, several years older, and look at me—I’m just a pathetic bag of skin of bones. What attractive girl would want to spend time with a banged-up guy like me? Yet Jamie is sensitive, tender, caring; she makes me feel like a normal person. I wonder if she’s always this nice and sweet with her patients. She is a saint.
Jamie’s job is to teach me how to do simple everyday chores. We start with tying shoelaces. She places a black Nike running shoe on the table in front of me. I stare at it. Nothing really intimidating, right? But looks are deceiving, because my left hand refuses to cooperate with my right. I flop my left hand upon the shoe for support as I ready my right hand to do all the work. You would think that I’m a diamond cutter by the intensity I direct toward this simple act. I take a break after the first loop. Several minutes later, I have the next loop established. My fingers fumble trying to interweave the loops for a knot. After fifteen minutes, I finish tying my first shoelace.
When Jamie shows me how to take a sponge bath in the middle of the therapy room without water, soap, or sponge, I’m self-conscious and red-faced. My pulse is quickened, but it’s not from panic or fear; I’m sure of that. As she guides my hands through the motions of what it will require to take a bath, my imagination is running wild. I see us in a bathtub together. My scars have healed. I have gained back all my weight and muscles. She rubs shampoo into my scalp. I feel her soft breasts against my broad back. She leans forward and places a dollop of soapy foam on my nose and lets out a sexy laugh. I splash water at her in response. She hugs me tight—so tight I want to burst with passion.
Oh well. A guy can have his fantasies; no harm with fun make-believe, especially in a place like this. That’s the cruel joke about rehab: almost everyone initially thinks that things will eventually return to the way they used to be. But that’s misguided and wrong; there’s a distinctive before and after. Some things will never be the same again.
I look around this room and see people just like me struggling to perform the most basic, minimal tasks in front of their therapists. Fullgrown men cry out in pain as they try to bench-press a broomstick. A young boy struggles to learn how to walk after a drunk driver ran him over. A young girl hides her tears behind sunglasses. She lost her arms and legs to a flesh-eating disease. She can’t be more than twelve years old. She has brown hair that falls to her shoulders and is neatly tied in the back with a yellow ribbon. She wears a tank top. All four limbs are now stubs, so she must learn how to sit up in a chair without falling over.
It’s all here, the breathtaking sadness, the human misery. But when you take away the catastrophic injuries, you find regular people who once lived normal everyday lives.
A young, muscle-bound guy, probably in his late twenties, looks like he recently fought in Iraq or Afghanistan because he is wearing a U.S. Marines T-shirt and has a military haircut. A large white bandage is wrapped around his waist. He sits quietly in a chair, while his therapist continually checks his bandages for seepage.
Surprisingly, the older women in this room, most of them in wheelchairs—probably due to broken hips from falls—are the most active, often doing flexibility exercises with their arms.
Single-leg amputees learn how to use a cane or a crutch. The doubleleg amputees are usually on the soft blue mats spread out on the floor, their freshly amputated limbs covered in white gauze.
There is a limited degree of competition between everyone, but the real rivalry is not with one another. Instead, the challenge remains an internal battle, conducted entirely within our own private hell. Victory is measured in the smallest achievable increments. Like tying a shoelace.
CHAPTER 18
WITNESS
Strolling through the center’s sprawling grounds with my parents, I continue to press them for more details about Intensive Care. Because my memory is an incomplete, smudged blur, I believe that for my rehab to be ultimately successful, I need to know more about what happened to my body.
From what my dad has already said, my body was the site of a medical war fought minute-by-minute, hour-by-hour, day-by-day. The battlegrounds were my displaced and smashed up heart, lungs, kidneys, liver, bladder, spleen, gall bladder, bowels, intestines, stomach, brain, bones, and my blood loss.
“The complications were endless,” Dad emphasizes. “It seemed like we were signing authorization papers for surgeries every other day. Each time was more heartbreaking. You made it through the first week, which surprised everyone, even us. But things didn’t get better; they got worse. More surgeries, blood clots, blood transfusions. You needed a tracheotomy to continue breathing on life support. The breathing tube through your mouth could only be used for a short time because of the chance of infection.”
Dad tells me that the breathing tube was placed in my neck with a huge tubular cylinder, which looked like a vacuum hose and was attached to a big machine with a monitor. The tube had a plug with a slender plastic tube
feeding into a canister. This was done to suction out my lungs. He tells me the canister would fill up constantly with what looked like chunks of raw meat. This last detail is gross. But this was my daily reality, a constant clashing between infection setting in and medical technology hoping to curb it. But medicine was losing.
Pneumonia, infections, and fever set in on top of everything else. Then came the dreadful day came when the trache tube clogged up and I turned blue from lack of oxygen. My parents had seen me for the morning visit and were sitting out in the front lobby to wait until the two o’clock visit. About an hour later, a nurse asked them to come with her and see Dr. Catevenis. Once again they thought this was it, and they literally ran down the halls. When they got to my room, everyone looked disheveled; Dr. Catevenis was sweating, and nurses were everywhere. I looked like a body lying in a morgue. Dr. Catevenis said to them, “I think I got to him in time.”
“They weren’t sure how many minutes your brain had gone without oxygen,” says Dad. “Then Dr. Daee came in and Mom was crying. He hugged her and told us they were going to take you back into surgery to insert a new vacuum tube for your breathing.”
Then he tells me that the doctors were forced to chemically paralyze me to help heal my damaged insides. They came in to see me and I looked like death. My blue eyes looked almost black. No sign of life. “We were so numb at this point, but we couldn’t give up on you. There was something deep inside you fighting to live,” he says.
I was put into a bed that looked like something out of a science fiction movie. It had compartments to fit my torso, head, legs, and arms. Once I was secured with straps, the bed tilted to from side to side to keep my body in motion so my lungs wouldn’t fill up with fluids.
I learn that they kept me in this special bed contraption for five days because the paralysis medicine was so strong it could damage the brain. After I was returned to my regular bed, they started to wean me off the heavy medicine and placed me back in the chemical coma. Then, another kind of bed was brought in. “This one swayed you from side to side,” Dad says. “But your infections were getting worse, and the doctors were trying to pinpoint what they were and where they were coming from; they suspected either the gall bladder or liver. After more tests were conducted, Dr. Daee said that you needed an operation to remove the gall bladder. He informed us that he ‘doesn’t like to cut unless absolutely necessary,’ but we knew surgery was inevitable.”
As the weeks went by, things looked increasingly bleak. By August, it seemed hopeless, but I was still clinging to life. They were so tired, sad, broken, and lost in a world in which they had no control. My fever continued and infection lingered. The nurses wrapped me with big bags of ice and covered me with a silver ice blanket to try to lower my body temperature. I would shiver intensely from the cold. Then came a jolt of more bad news.
Dr. Saeed Koolaee, the cardiologist, saw that I had fluid around my heart, which was squeezing the organ and building rapidly. The next day, Dr. Daee and Dr. Nafisy, the cardiac surgeon, double-teamed the surgery. Dr. Daee removed my gall bladder and Dr. Nafisy installed a drainage tube to reduce the excess fluid around the heart.
Eventually, the doctors decided to slowly turn down the coma sedation, which was two hundred times stronger than morphine, to see the response. Even though I was chemically unconscious, I would get agitated. Then something happened—a day they never thought would arrive. “You opened your eyes halfway,” my dad says. “You stared at us for about ten minutes, and then your eyes closed. There was no movement in any other part of your body, but we would take anything we could get. The doctors continued to slowly wean you off the coma sedation medication. Yet the more awake you became, the more terrified you looked each time you opened your eyes. Just your eyeballs would move as if you were trying to look around the room. That was it. There was no other movement in your body. We couldn’t imagine what you were thinking. Mom would massage your face hoping it would trigger some response. Then a fever came back with a vengeance. After several days, you opened your eyes again and closed them about halfway. It seemed like you were trying to blink, letting us know that you were there.”
I recall that first blink. Then I began to have those seizures.
My father explained it was from withdrawing from medication. I was a health-conscious kid who never got into drugs, drinking, or smoking. The doctors even told my parents that my blood was spotless of any chemicals—that was rare to see nowadays. Taking me off all the medicine got rough. “You didn’t just have a monkey on your back,” says my dad. “You had a gorilla.” Drug withdrawal is devastating to watch.
My parents had to witness the misery on my face, while my body sweat profusely. I was vomiting all the time, which was scary because I was still on life support and there was the threat of the trache clogging. My body stayed in the fetal position with my knees touching my chin. I shook uncontrollably. “The drugs that saved your life,” he says, “now became the demons you had to fight. Then the high fevers struck again. Out came the ice and cooling blankets. Your eyes were open but staring straight out into space.”
Yeah, I must have looked like a zombie junkie in detox. But the truth is that the doctors rolled the dice with the heavy drugs, because without them I would have died.
“The first time we saw you strapped into the chair,” continues my dad, “we thought that you were brain-damaged. One of the nurses told us this is also called ‘death without a funeral.’ We were both shocked but couldn’t show it. We just stood there in silence asking ourselves, ‘When is he going to get better?’ You had lost so much weight—just skin and bones. You were slumped sideways, eyes dazed with a blind stare, and your mouth hung open with drool running down your chin. We were willing to deal with whatever it would take to get you back, brain-damaged or not. But the next day, your eyes were open and blinking on command. Later that day, you moved your lips trying to talk but nothing came out. We wanted to think you were saying, ‘I can’t talk.’ This meant a lot to us. It suggested you were aware even in your locked-in state. We had hope again.”
On subsequent visits, he says, I showed more positive signs of life. I would blink more. I even nodded slightly when the night nurse asked if I’d like to watch the 2004 Summer Olympics. But two days later, everything seemed to be going in reverse. They walked into my room in the morning to find me staring at the ceiling again. They tried to get a response from me but got nothing. I looked like I was giving up. “As we left your room, we walked through the big double doors of the ICU ward thinking, ‘We’ve come this far. What’s happening now?’ As Mom started to cry, I told her, ‘I think Brian is giving up. He’s leaving us now.’ She thought the same thing. So on the second visit that day, I started yelling and swearing at you. ‘Brian, we need you to fight now; you are the only thing we have in our lives.’ I could see fright, panic, terror, exhaustion, and confusion in your eyes.”
I can’t help but wonder why the fight went out of me then, especially after I had battled for so long. What’s remarkable is that my dad wouldn’t let me disappear into death’s void. His tough-love bedside sermon marked the true beginning of my recovery, because the next day I was able to smile, blink more, even wag a finger. While I had another bad spell for about a week with seizures and tremors, I had definitely turned the corner. But without my parents’ support and love, that route could just as easily have become a tragic dead end.
PART TWO
BODY
CHAPTER 19
COMING HOME
I have only been at Kernan five days, but I’m going home today. Our health insurance provider decided to cut short the length of my stay because it thought that my rehab could be done at much lower cost through twice-weekly outpatient treatment. I can’t wait to leave Kernan even though I’m still in bad shape. I can walk maybe ten to fifteen feet unaided, with someone on the other end of the restraint belt just in case I fall. I can bicep-curl two and a half pounds with my right arm and bench-press a broomstick. But apart from th
e lovely Jamie, the therapists and nurses are much less friendly than those at Prince George’s Hospital where I was treated like royalty. At Kernan, I feel like I’m just another anonymous patient in its body-mending factory about to be spat out into the world as a defective product. I feel sorry for those like Tony who have languished here for months.
My parents are excited as they pack my wheelchair, clothes, walker, and the rest of my belongings in Dad’s pickup truck for the two-hour trip. On the drive home, they tell me how they’ve set up the downstairs so I can get around. Though I’m no longer stuck in a hospital and getting poked with needles, I still have a very long road of recovery looming ahead. I have no idea what the future will be like. I can only focus on the present. I look out the window, watching the soft, cotton-white clouds float by in the bright blue sky. I feel the warmth of the sun on my face slightly magnified through the glass window. I roll down the window so the fresh air can penetrate the deepest spaces in my weakened lungs. The humid summer air is mixed with the car exhaust and diesel fumes from the other vehicles on the road. I inhale deeply, missing the smell of the real world that bypassed me this summer.