by Aqua Allsopp
“There is an injury to the spine, and we will not know the extent of the injury until he wakes up, and we can do further testing.
“His immediate family will be able to see him, it is fine to talk with him to reassure him that he is safe, that he will be okay, that you, the people that he loves are here with him. Please, if you must be upset, or cry, leave the patient’s room. It is important that you pray for him, but also that you also have faith in his recovery so that he will have faith also, so please bring your positive energy only, into the patient’s room. Now do you have any questions?”
Everyone looked to be in shock and shook their heads no, too overwhelmed to ask questions. Nathaniel's father stepped forward, shook Dr. Gautama’s hand and thanked him for saving Nathaniel’s life. Then he took the hand of Rebecca and Jergen, who then took another’s hand until the entire family, as well as Doctors Hedulund and Richardson, were all holding hands in prayer. They stood there praying for over an hour before Sarah and her mother went in to visit Nathaniel first.
One after the other, Nathaniel’s family came in to sit and talk with him.
“Brother, if you wanted me to finish the roof you only needed to ask, you didn't have to fall on your hard head to get me to do it for you. Father always said you had a hard head and a soft bottom, I bet he’s glad that you do now.” Jergen laughed, as he held his brother’s hand as he held back his tears.
Continuing on, Jergen said, “do you remember when you kept feeding father’s horse Nanny the wormy apples and every time she would spit them at you then give you a little kiss? I bet you never told Rebecca that Nanny was the first woman that you loved.”
Jergen laughed for his brother as his father held Nathaniel’s other hand and laughed with his boys. His face was red and soaked with tears, but nonetheless, he nodded to Jergen, smiling, silently telling him to continue to giving his brother happy thoughts.
Day after day, Sarah and Rebecca sat vigil over Nathaniel. The nurses and doctors were only able to tell them apart by a single trait. Everyone remarked that Sarah was the girl who asked a million questions about the patient’s care. When should a test be administered and how? Where does this line go and why? And she had a desire to do simple tasks herself. So the medical team began teaching Sarah about vital sign readings, teaching her new procedures and concepts, and even bringing Sarah medical books to read.
Dr. Richardson took a keen interest in Sarah’s medical education. “With everything that you’ve learned, Sarah, you will be a huge help to the health and welfare of your community.”
From time to time, someone would say, “You know, you really should consider going to medical school.” Dr. Richardson even offered to help Sarah get into undergraduate school and to find the money to pay for it.
Slowly, the doctors began to bring Nathaniel out of the coma until there were no more drugs being administered. Then they waited for Nathaniel to open his eyes or to move. Days turned into weeks, weeks into months.
“Sister, I do think this hospital food disagrees with you because you’re putting on a bit of weight. If you continue, Nathaniel may not recognize his wife when he wakes up,” Sara joked. Rebecca smiled at Sarah and motioned to her to walk out of the room with her.
“Sister, I am gaining weight, but it’s because I am pregnant by three months I feel. I am waiting to tell Nathaniel when he wakes up,” Rebecca beamed.
“Praise the Lord, sister!” Sarah said, “but are you certain?”
“I think so,”
“Rebecca, you should get tested to be sure, this news will make everyone so happy but you need to be sure, especially at a time like this. No one needs another disappointment right now.”
“You’re right. tomorrow when I go home to change clothes, I will go to the clinic for a pregnancy test,” Rebecca replied. “But I know that I have been with child since the first night Nathaniel and I spent in our home. I woke up the next day feeling different and throwing up every time that I went in the hen house.” The two girls laughed.
“Rebecca you should tell Nathaniel. The doctor says that he needs to fight to live and knowing you’re with child would make any man fight for his life, especially Nathaniel.”
“Maybe you’re right, Sister.”
“I know I am! Why wait another day when we're in a hospital? I’ll get a nurse to help us!” Without waiting for Rebecca’s agreement, Sarah quickly walked off in search of a nurse to administer a pregnancy test, leaving her sister alone to contemplate her future.
Rebecca remembered the doctor saying that Nathaniel would have a long way to recover his health, cognitive abilities, and mobility. It frightened her to think that she and Nathaniel would be so far away from medical care, from others in her community, and without a way to communicate immediately. But then, just as quickly, she remembered that her community was so full of love and support that she wouldn’t be alone in this, and knew that she could always count on her sister’s love and help. Rebecca knew that her sister would always be by her side.
Rebecca, surprised by how her sister took charge, and recognizing how much she had matured, couldn’t help but smile and think to herself, “We have all grown up rather quickly, Mrs. Mueller would be proud.”
A nurse returned with Sarah, collected her samples, and within the hour returned to confirm that Sarah was, in fact, pregnant.
That afternoon, when Dr. Richardson came to check on Nathaniel, Rebecca and Sarah were both bursting to give her the news. She immediately whisked Rebecca away for an ultrasound, telling her that she’s been through a lot of stress during the baby’s first trimester and wanted to rule out an ectopic pregnancy. Everything looked normal on the ultrasound, but that was common with babies affected by GA-1. Dr. Richardson felt it was the right time to tell Rebecca the news.
“Rebecca, I’m very happy for you and for Nathaniel, I think it will be great for you to tell him that he’s going to be a father, and you should tell him right away. Make plans for preparing the baby’s room and names for the baby, all of the things that you would talk to him about if he were able to speak to you.
“Nathaniel is with you; he’s just trapped inside his body right now. He will wake up, in his own time. Have faith,” Dr. Richardson said as she gently held Rebecca’s hand.
“I understand Doctor, thank you for the advice but I had already decided, with the help of my dear sister,” Rebecca said as she threw a loving glance at Sarah, “to tell him today.”
“That’s great!” Dr. Richardson said. “But I have something more to tell you. You and Nathaniel are both carriers for GA-1,” Sarah and Rebecca gasped collectively and immediately grabbed the other’s hand. Dr. Richardson continued, “That does not mean your baby will be affected with any of the disorders associated with GA-1, but we won’t know until after the baby is born. Then we can run some tests. So for now, focus your thoughts and prayers on having a happy and healthy baby to raise with your husband.”
As the tears streamed down Rebecca’s reddened face, Dr. Richardson dropped her hand and held the girl tenderly, rocking her as a mother would a daughter, whispering, “It will all be alright Rebecca, you are not alone, we are with you, you will get through this! You are stronger than you think. Cry if you need to, it’s okay.”
Moved by seeing her sister cry, Sarah moved in for a hug. The three women remained in a triad embrace for what seemed like hours. Rebecca breathed in deeply, withdrew from the hug, and exhaled slowly with a new determination to pray her way through to a healthy husband and a healthy child.
Knowing how close the sisters were, Dr. Richardson asked Sarah if she would like to know her test results.
“Yes, Doctor please tell me,” Sarah responded.
“You are also a carrier of GA-1.”
Sarah’s breath caught in her throat, as her sister squeezed her hand praying that her sister would have been spared this burden of worry.
Sarah quickly recovered herself after a moment then asked, “And Jergen, is he a carrier?
/> “I’m sorry Sarah, I cannot tell you another person’s medical information, you will have to ask Jergen,” Dr. Richardson replied.
Having spent so many months in hospital with Rebecca and Nathaniel, Sarah understood patient privacy and responded that she understood.
Later, when Jergen came to visit his brother, Sarah met him in the hallway.
“Good evening Jergen,” Sarah said.
“Good evening Sarah, how is my brother today?”
“No change I fear,” Sarah responded as had become the norm. “Jergen, please forgive me for being forward but I received my GA-1 test results today. If you have received yours can you tell me, do you carry the gene?”
“I have received my results and yes I do carry the gene, and you, are you a carrier of the GA-1 gene as well?” He asked the question with stoicism but could see the answer in her glazed and reddened eyes already.
“Yes,” Sarah said in a whisper. Sarah was unsure about her feelings on the news. On one hand, she feared that if she and Jergen both carried the gene for GA-1 he would not want to marry her, but upon hearing that he also carried the gene, she felt that he was somehow changed from being a previously “perfect man,” to an imperfect carrier of a flaw which could cause their children to have a lifetime of health challenges.
Seeing the tears in her eyes, Jergen wanted to hold her, but instead he stood a respectable distance away.
“It’s okay Sarah, it does not mean that our children will be affected, and if it is God’s will to bless us with the challenge of children with a health disorder, we will be okay. We are strong and young and have the faith and courage to face anything.” Jergen was speaking to his own fears of not being wanted by any Amish woman, let alone Sarah, because he was a carrier.
Sarah took no comfort in Jergen’s words, she dutifully responded, “Yes Jergen, thank you for your encouraging words,” then turned and quickly walked away and into a bathroom stall for a good cry.
She didn’t even know what she was crying about. She only knew that somehow, for the second time in three months, her life had been turned upside down and the impending choices she had to make were about to change her life forever.
Jergen entered his brother’s hospital room full of sadness and confusion over not being able to read what might be going on in Sarah’s head. When he saw Rebecca’s face smiling and happy, his own face brightened.
“Is there some good news, sister?” he asked.
“Yes Jergen, you are going to be an uncle,” she said, holding the bump in her petite belly that was previously invisible in her traditional, loose-fitting dress. “I am three months with child, I think we conceived the first night in our home. I was waiting for Nathaniel to awaken before I told him, but now that I am beginning to show I wanted to tell him before other people started to notice.”
Jergen grabbed his sister-in-law’s hand. “That is wonderful news Sister. I know my brother is happy. So, Brother, you are going to have a child very soon. I shall set straight away at making a crib for the baby, and a rocking chair for Rebecca. You rest as for as much time as you need and don’t worry about anything when you are ready to wake up your family will be here.” Jergen said as he held back tears and wondered if his brother and Sarah also carried the GA-1 gene.
“Rebecca, I learned a few months ago that I am a carrier of the GA-1 gene, I just told Sarah today, but I do not know how she feels about this news. Have you and Nathaniel received your test results?”
“Yes and we are the same, but our baby will be fine. I am praying fervently, and I have faith that everything will be fine,” Rebecca said resolutely.
“I know it will sister, you and Nathaniel already have one cross to bear, you will not have another one. I shall pray that this is so, also.”
“Thank you, brother,” she said. Rebecca felt suddenly drained and decided to ride home in Jergen’s buggy. She saw Sarah on her way out of the room, and she agreed to stay the night with Nathaniel, but avoided eye contact with Jergen as he departed with her sister.
As Sarah sat chatting away to her brother-in-law, she also thought about her future until she was interrupted by Dr. Hedulund, who stopped by to check on Nathaniel. Sarah took the opportunity to talk with the doctor about what could happen if two people who carry the GA-1 gene should marry and procreate.
Hour after hour passed as they talked on into the night. Sarah cried a lot, Dr. Hedulund consoled her, listened, and even held her hand a few times as she wept. Sarah was too heart-sick to notice. In the early morning hours, Sarah was alone and deep in thought when she heard someone calling for her sister.
“Re-a, Re-a,” the garbled voice cried. Sarah jumped out of her chair and nearly screamed when she realized it was Nathaniel trying to say, “Rebecca.”
“Nathaniel, Nathaniel, it’s me, Sarah, how are you? Wait, let me get the doctor,” Sarah said as she frantically pressed the nurse’s call button again and again.
“Mr. Brewer, Nathaniel, I’m Jenny, you’re at Penn State Hospital in Lancaster, Pennsylvania. You fell off your roof, and you have been in a coma for some time now. Do you understand?” Nathaniel nodded and tried to say the word yes.
“Good, Nathaniel, you are okay, your sister-in-law Sarah is here with you, and we will get your wife here as fast as we can, okay?” Nathaniel nodded yes. “I will get your doctor and come right back okay?” Nathaniel nodded again.
A nervous Sarah began talking rapidly, kissing her brother-in-law’s face, smiling, crying, and nearly bursting with joy.
*****
Sarah, having witnessed many of the tests administered to Nathaniel, had some idea of how bad things were, and prepared herself for what she knew she must do.
By the time that Rebecca arrived at the hospital, Nathaniel had been poked, prodded, scanned, and analyzed to determine what his rehabilitation and long-term challenges were, to the extent that they could be determined at the time. The doctor waited to talk with Rebecca first; her sister Sarah at her side.
“Mrs. Brewer, I will tell you straight how things are for your husband at this time and where I think he can go in the future with a lot of hard work.”
The mere sound of the doctor’s ominous words made Rebecca’s blood run cold. Sarah could feel her sister shaking, so she placed a tender arm around her. Rebecca slumped into Sarah’s arm out of exhaustion and fear of what she was about to hear. Her small pregnant body felt quite frail to Sarah.
“Nathaniel has a very good chance of re-learning how to walk, talk, and care for himself,” the doctor said with a smile. “But, I’m afraid that you will be feeding, changing, carrying, and teaching both your husband and your child at the same time and for as many years.” “If he does the work, it will take three to five years before Nathaniel is strong enough to be independent. He will never be the man that he used to be; able to do manual labor for his work. He will have to also learn a new way to make a living, or at least perform fewer manual and fine dexterity tasks. But he will walk again, he will have a long and happy life—if he does the work and stays positive.
“But one thing more Rebecca,” Dr. Gautama said, moving to the edge of his seat and taking her hand. “Your husband will always need to live close to an advanced medical treatment facility because chronic pain, infection, and other potentially lethal and chronic health concerns will always loom over him.
“Also, for a time, he will need to live at a rehabilitation center and seeing you and other family members every day will be crucial in his recovery. With that said, living in an Amish community with limited access to basic medical care, and far away from rehabilitative services will be extremely risky for Nathaniel.
“As for you, you’re going to need a lot of help with a wheelchair-bound husband who is years away from being able to take care of himself. It’s imperative that you have access to modern conveniences like electricity for example, or I fear for your health trying to maintain a simple life in the country with two people so dependent on you.
“I kn
ow that your family will be there to help, but the majority of the work and worry will fall to you, so making your life as easy as possible, with the use of machines and technology means that you can focus more time and energy on raising your child and caring for your husband. I know this is a lot to think about, I’ll be available to you to talk again soon. In the meantime, celebrate that your husband has taken his first step toward recovery by waking up.”
“Thank you, Doctor,” was all that Rebecca could manage before turning to her sister and collapsing on her shoulder under the weight of the decisions that she must make.
“There, there Sister, I am here, I will never leave you. I will always be by your side Rebecca, whatever you decide. My life is with you.”
“Thank you, Sarah,” Rebecca said through her tears.
*****
After Nathaniel was released from the hospital and admitted to the rehabilitation center, Rebecca and Sarah took a one-bedroom apartment across the street. The two sisters settled into a routine of trading off day and afternoon shifts at the Rehab center with Nathaniel.
The nurses teased that he was either going to get better quickly or die trying because of his wife and sister-in-law’s zealousness at rebuilding his vocabulary, pronunciation, cognition, strength, and motor skills.
As Rebecca’s belly grew larger and larger, she spent fewer hours at rehab with Nathaniel, leaving the task to Sarah to pick up the slack. One day after returning from lunch, Sarah was surprised to see that Nathaniel had a visitor.
“Jergen, it is nice to see you. How are you?” Sarah said, her face flushed with excitement at seeing Jergen for the first time in months.
After that day in the hospital, he had been timing his visits with his brother while Rebecca was with Nathaniel, intentionally avoiding Sarah. At seeing his beautiful intended, Jergen rose to greet her warmly.
“Sarah, may we step into the hall to speak?”
“Yes Jergen,” Sarah replied.
“Sarah, when we spoke last, I felt as though you had changed your mind about wanting to be my wife. I have come today to ask for your hand in marriage. If you accept, I expect you to come back to the community and to build a life with me.”