by Nat Burns
I tried to think about why I would be in a hospital but nothing would come to me. I had spent many years sleeping in hospitals, but this felt different. Residency. Yes, I was a physician. I shifted tentatively and then had to grit my teeth as pain rocketed through my entire body. I’d been hurt somehow.
Abrupt, acute nausea washed across me. Despite the pain caused by the movement, I leaned to one side and retched repeatedly. Sudden alarms shrieked all around me, and I screamed out as the sounds attacked my ears. My less encumbered hand lifted to cover my ears.
Bright light blinded me as someone switched it on, and I felt my body begin to seize up, I was bending backward against my will, my muscles contracting severely.
People surrounded me. My body was relaxed again, but there was still some nausea and I felt like the room was spinning. I cracked the lids of my good eye and saw dim figures standing next to my bed. Some were scurrying around very busily; others stood sentinel. There was something in my mouth and throat. I realized with some alarm that I was intubated. This meant I needed help to breathe. Tears welled again and spilled down my cheeks. My nose felt like a huge apple sitting in the middle of my face, and that damned headache was back. My hearing was hypersensitive, and each squeak of a nurse’s shoes made me quake inside. Luckily, those caring for me knew to speak softly.
I calmed and tried to take stock of my situation, trying desperately to remember what had happened to me. What incident had brought me to this place? Maybe I had been in a car accident. If so, I didn’t remember it at all. It was like I was in a box. My memory could go so far one way, so far another. Beyond those walls, there was nothing.
I schooled myself to take one moment at a time. I felt as though I had studied Zen Buddhism at some point, and it seemed to fit. Seemed to be what I needed most at this point.
I felt drugged suddenly, dopey. I looked at the faces around me and saw that they were all strangers. That made me sad, very sad. I needed to be with people who cared for me, not all these strangers.
“Go away!” I cried, sweeping one arm out to banish all of them. I paused in midsweep. “Go away,” I said again, much softer. Horror filled me. I could not understand the words I was saying. They sounded all wrong.
Chapter Thirty-Four
Ella
Dr Stephen Dorsey came into Maddie’s room carrying a lightweight plastic folding chair and Maddie’s chart. He unfolded the chair with some aplomb and placed it next to the two chairs already at the foot of Maddie’s bed. He motioned for us to sit in them as he took a seat on the plastic chair and crossed his legs. After Maddie’s Aunt Florida and I were seated, he opened up Maddie’s chart and took in a deep breath.
“Well. Dr Salas was in a terrible accident. She was lucky in a lot of ways. Many gas explosions lead to fires and horrible burns when the gas ignites. She experienced none of that. She was, however, thrown away from the car with some force and sustained a few broken bones.”
He flipped a page and studied it. I studied his intelligent thirty-something face. He was handsome but seemed studious.
“Broken bones will heal, of course. What we are concerned with the most is an area of edema, or swelling, on the right side of Dr Salas’s brain. Though it’s significant, we opted not to do surgery. Instead, we have increased her oxygen and lowered her body temperature to allow her body to process this fluid. Her neurologist, Amelia Penn, seems to think this is the best course of treatment in this particular case. Well, that and certain medications that she has prescribed.”
He paused to study each of us as he adjusted his glasses. “So, now let’s talk about the future.”
He looked directly at me. “Mrs. Salas here has said that I can talk freely in front of you. Is this all right with you?”
I nodded, and he continued.
“Whenever you have this kind of injury, which is a closed brain injury, one also sees a contrecoup injury. This means the brain bounced around in her head, which injured it in a specific way, from the contusion on both sides of her brain. We don’t think there’s a lot of axonal twisting, which often does happen in these kinds of accidents, but there is certainly concussion, and this may lead us to something called postconcussive disorder.”
He uncrossed his legs and leaned closer to us. “This disorder could manifest in a myriad of different ways. There could be minor changes, but in this situation, I think they may be significant and go on for some time—”
A tiny gasp escaped me, and I felt a sob welling in my throat. “Will she recover, Dr Dorsey?”
He sighed. “Yes, to some extent, but no, not completely.”
I covered my mouth with one hand. I had to stuff down that sob, that scream that wanted to get loose.
“She’s relatively young, and her natural high level of intelligence will help her brain create new neural pathways, allowing her to do just about everything she did before, just slightly differently. Well, almost everything. But there’s also the issue of her tolerance and energy level. This kind of injury can manifest in anger and intolerance to even the smallest irritant, so don’t be surprised by her anger and frustration. It’s a given that there will be some of that. The brain is an intricate organ, and injuries to it can cause all manner of emotional and intellectual misfiring.”
He paused and fingered his clean-shaven chin. “Life will be very different for her, and she will need long-term continued care and therapy. In injuries like this, the motion inside the skull can cause microtears of the brain matter. This will, no doubt, cause scarring in the brain which might lead to an ataxic, or drunken-like gait, or even aphasia, which are problems with speech, depending on where the scarring is. That’s something that medicine just can’t fix.”
Silence fell in the room, the only sound the mild beeping and whooshing of the various machines connected to Maddie.
“So, any questions?” he asked.
“Why is she hooked up to the breathing machine?” Florida asked. “Is she not able to breathe on her own?”
“She had a bad spell a while back, and we decided that getting as much oxygen in her as we could would help her,” he explained. “She kept pulling out the cannula, that tubing that was giving her extra oxygen. She’ll come off the machine soon, we hope. We have her sedated until that happens.”
Florida nodded and shifted restlessly in her chair.
I was thinking how important being a doctor was to Maddie. “She won’t be able to practice medicine anymore, will she?” I asked sadly. “She’ll hate that.”
He sighed and thoughtfully patted Maddie’s chart against his knee. “Let’s not get that far ahead. I don’t want any of us to be too negative. Although the scans show that the swelling and bruising is pretty severe, she may rebound better than any of us believe after therapy. We’re in a wait-and-see mode. Dr Penn says that she has seen eventual complete recoveries after an injury like this. Sometimes people only have mild stammers or gait issues, but all their cognition comes back. Some are physically fine, but they lose all short-term memory. So, as you can see, I really can’t answer that question just yet. Anything else?”
We both shook our heads, and he stood and folded his chair. “You can ask for me at the nurses’ station if you think of anything else. My advice is just to be here for her and be very, very grateful that she is alive.”
We sat, lost in thought, after Dr Dorsey left the room. I watched the slow rise and fall of Maddie’s chest as the machine hissed. I felt oddly empty inside. It was as though I had no emotion left—for anything.
Florida patted my hand as she stood. I really had come to like Maddie’s aunt. She was a comfortable, down-to-earth woman and had been unusually consoling to me. I found myself wondering if she knew about Maddie and me. How could that be, though, unless Maddie had called her?
“I guess we’d better get to the church. We only have about twenty minutes to get there,” she said. She moved to the bed and pressed a kiss to Maddie’s forehead. “Fight your way back, little Corinthia,” she whispered.
“I’ll wait for you in the hall,” she told me as she passed by toward the door.
I was grateful for the time alone with Maddie. I took her hand and caressed it as I leaned to press my cheek to the less wounded side of her face. “I love you, Maddie, darling. I promise I’ll be back soon.”
There was, of course, no response.
The funeral was beautiful, if such an event could be called that. The saddest part was the tiny white coffin for the baby who’d never been officially born before dying. The Horten and Collins families had decided to combine Lizzie, Darwin and the baby boy’s funeral into one service. I thought that was a good idea.
Sandy, of course, was devastated, sobbing uncontrollably and barely able to stand. She had known Lizzie longer than I had and had followed her pregnancy closely. She also knew Lizzie’s husband, Darwin, who I’d never met before.
The firefighter’s funeral had been two days ago. Florida, Sandy and I had attended that one as well. I felt as though I attended all these for Maddie. She would have been there if she could have been, and she would want to know all about them as soon as she got better.
Chapter Thirty-Five
Maddie
I woke into grayness. Sudden terror filled me. I couldn’t swallow or move my head. A sort of claustrophobia washed over me, but I worked hard to calm myself, realizing that a machine was breathing for me. I held my breath until the machine caught up with the breaths I felt I should be taking. I exhaled with the machine and counted each uptake the machine made for me: sixteen, then sixteen again. I was getting enough air. Then I had a new fear—suppose the machine failed and I suffocated. Only an act of steel will kept me from thrashing about, and I forced the failure thought from my mind. Unreasonable, I told myself, remarkably unusual for the machines to fail.
“Dr Salas! You’re awake!” a young, small-statured nurse exclaimed as she entered the room. “I wondered what that strange reading out there was all about.”
She studied my face, and I guessed she read calm there. “Just nod or shake your head, okay? Are you in any pain?”
I shook my head to one side in the negative.
“Good.” She paused a long beat, still studying me. “Would you like the breathing tube out?”
Oh my God! I was ecstatic to discover that it didn’t have to be permanent. I nodded as well as I was able.
She smiled. “Okay. I’m going to go check with Dr Dorsey and see what he says about it. Be right back.”
When she left the room, I studied my surroundings. It was a typical hospital room. I recognized the dark ocean green used by the… Funny, I couldn’t remember the name of the hospital. I had to still be in… Maypearl. Yes, Maypearl, Alabama. I worked there, as a physician.
“Well, well, Dr Salas. How are you feeling?” asked the doctor as he and the nurse entered my room.
Stupid man, I thought, even as I studied him. Medium height, athletic build, but nerdy with glasses and an unkempt shock of black hair. How did he expect me to respond?
His apologetic smile, filled with perfectly straight teeth, was genuine. “Well. That was a dumb question, huh? Let’s get this tube out and we’ll talk then,” he said.
I gave him a weak thumbs-up with my less-injured hand, and he moved to the head of the bed. The process of the tube leaving my body, while welcome, was surely classified as one of the many torture devices of the Spanish Inquisition. It hurt but was completed quickly. I choked on the water the small nurse provided, and shards of pain resurfaced. I moaned and tried to curl on one side, but the pain in my legs and the many clear rubber tubes inserted into my body prevented it.
The doctor pulled a chair closer to the bed and sat in it. “Dr Salas, I’m Dr Dorsey. I doubt you remember what happened to you, but you were in a car that exploded several weeks ago. The explosion tossed you into the air and against a building. You have a concussion. You had some swelling, but that’s gone down now. We did not operate but let time work in your favor.”
The hospital was waking up around us. I could hear increased activity and voices out in the halls.
I shifted my position slightly, carefully, trying to avoid any more pain. “How long?” I asked.
I stopped in shock, puzzled. Was my hearing bad? No, my hearing was acutely aware. I looked at his face, which was frowning, and his eyes were concerned. Okay, something was wrong. I tried again.
“How long ago?” I asked, then pressed my lips together. I was aphasic. “No, no, no!” I cried out, and my words sounded like a crow cawing.
“Dr Salas,” Dr Dorsey said as he grasped my shoulders. I was unaware of it, but I’d sat upright in the bed, and my cast-bound right arm was wildly slinging about. My left arm was pulling painfully against the IV tubing.
“Give just one of halo,” Dorsey instructed the nurse.
Yes, calm me down, I thought. It was as though I was outside my body, tutting at myself for my improper antics. Within seconds, the drug had taken control, and I was able to stop spasming.
“Dr Salas,” Dr Dorsey said calmly, looking directly into my eyes. “You need to stay calm. We will determine what’s causing the aphasia. In the meantime, answer these questions for me by moving your head. Don’t try to talk.”
He released his hold on me and took a seat. “Now, in your opinion, how is your cognition? Do you understand everything I am saying?”
I nodded.
“Good. That’s a positive sign.” There was that nice smile again. “Do you remember the accident?”
I shook my head.
“That’s not uncommon. I didn’t really expect you to. This inability to talk may clear up after some more time has passed. We’ve kept you sedated for the past four weeks so that your brain could begin to heal.”
I grew agitated again, and he laid a calming hand on my forearm. “Your patients are being looked after. Don’t worry about that. Your only thoughts should be focused on your continued healing. It’s going to take some time, but I promise we’ll get you back home as quickly as we can, okay?”
I nodded but couldn’t help the tear that spilled onto my cheek. Four weeks! That was crazy!
The doctor rose and shoved the chair back. “By the way, you had a greenstick on that right arm, but it’s knitting very nicely. I think the cast can come off sometime this week, and we’ll get you out of that bed and into some therapy.” He grabbed my chart, studied me briefly and then hurried from the room.
The nurse approached and adjusted my tubing. She rearranged my arms on top of the sheet. “Are you warm enough, honey? We’ve been keeping the temp pretty low in here.” She adjusted the oxygen at the head of the bed and positioned a nasal cannula. “We’ll keep a little oxygen going for another day or two, okay?”
I realized suddenly that I was cold. “I’m cold,” I said and watched her study me blankly.
“Let’s not talk now, Dr Salas. Just indicate to me what you need. Is the oxygen okay?”
I nodded.
“But you’re cold?” she asked.
I nodded.
“Well, then. I’m gonna march right out to the nurses’ station and fetch you a cozy blanket from the warmer. I’ll be right back.”
After she left, I turned my head and looked past the monitoring machines and through the window to the growing daylight outside.
“Pretty,” I said. The word sounded like an exotic disease.
Chapter Thirty-Six
Ella
Abby Hamilton died, finally succumbing to the cancer that had taken over her small body. When Sandy told me the news, I felt as though I couldn’t breathe.
“How can we go to another funeral?” Sandy stated, her eyes red and rimmed with unshed tears. I pulled her close and hugged her as she allowed herself to weep.
We had grown close during the weeks that Maddie had been in the hospital. We often went together to see her after work, although I loved the late nights when I would sneak in alone and hold my dearest love’s hand until I was sleepy enough to drive home an
d go to bed. Florida was there some evenings, and I think she came every morning as well.
“We’ll do fine,” I told Sandy. “We loved her, and we have to say goodbye properly.”
Sandy nodded as Dr McLean came down the hall from Maddie’s office. Randy McLean was a very nice, friendly man and a competent doctor. It wasn’t his fault that he wasn’t Maddie. Still, every time I saw him come from her office, I grew angry.
He patted Sandy on the shoulder. “Here’s the death certificate. I called the funeral home before I left the house, but I didn’t wait around for them. Do you think you can get this copy to them?”
Sandy scrubbed at her eyes and blew her nose loudly. “Absolutely, Dr McLean. Right away.”
He went back into the office, and I lifted the next folder from the stack and stepped into the waiting room. “DunDun?” I called out.
DunDun Morris was a sweet, shy redhead being treated for recurring eczema. He nodded shyly as he passed me and stepped into the back hallway.
“Come this way, and we’ll get you situated,” I said as I led him along the hallway. “So the hydrocortisone cream didn’t work for you?”
“No, ma’am. I think it gets washed off when I do the drying after the wash, even though I try to be careful. I’ve tried just about everything now.” He was soft-spoken, and I had to listen closely to hear him. I knew he worked at Wheelie’s Car Wash most days after school.
“Well, I’m sure Dr McLean will come up with a new treatment plan that will work better.”
“Will Doctor Maddie be back soon?” he asked as I took his vitals. “I sure do miss her. We had a lot of fun just talking.”
My hands trembled as I replaced the ear thermometer into its holder. I sighed.
“I don’t really know, DunDun. The doctors over at the hospital are trying to wake her up, but she just doesn’t seem to want to come out of it. Believe me, we miss her too.”