by Barbara Ebel
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Danny and Vance sat huddled over a table in the doctor’s lounge as a group of medical students filtered in. Their wide eyes, youthful looks, and perky demeanors spoke volumes as to their inexperience. One of them stopped and glanced over. “Can you imagine shadowing or working with him?” he said, nodding towards Danny.
The others nodded while Danny couldn’t fathom how they all knew him. Perhaps they recognized him from the infrequent medical grand rounds he presented. He pushed his copy of the day’s surgery schedule in his pocket and looked at Vance.
“Don’t come over to see the family if you don’t want to,” he said. “Just meet me in the OR. I suspect Tara and Floyd are going to be nervous wrecks.” He got up slowly, taking his empty coffee cup with him.
“Thanks, Danny. And thanks for letting me come into surgery and follow this case through its entirety.”
As Danny suspected when he entered through the curtains, Tara and Floyd looked more unnerved than he’d ever seen them before and he totally understood why. This would be the most invasive procedure yet to do on their son. Implanting the electrodes didn’t compare to taking out brain tissue. However, Danny thought, the most potentially fatal experience David had encountered was still the secondary impact. He walked over to the empty side of the room alongside the stretcher.
“Dr. Tilson, I can’t wait to get this over with,” David said, staring at the IV in his hand. “I’m not scared one bit.”
“That’s because of what that doctor just put in your IV,” Danny said and smiled.
“Dr. Tilson, how long is this going to take?” Tara stuttered out every word. She gripped her son’s hand like that of a steering wheel in a storm.
“Now, Tara,” Floyd said, “we’ve been through all this before. Let’s not bother him. It’s going to take as long as it takes.” He took his hand off his wife and looked at Danny. “So … how long, Doc?”
“Let’s say between two and four hours. Honestly, I don’t expect any complications and I’ll send a nurse out to give you an update. My work will be tedious and that’s the reason why I’ll take my time.”
“Okay, thank you. Tara, let’s go now and leave David to everyone’s care.”
Tara stayed near her son. “I’m going to say a prayer the whole time you’re back there,” she said. “We love you.” She gave him a kiss on the cheek, finally let go of his hand, and stepped away.
“If it’s okay with you,” Danny said, “I’ll say a little prayer while I’m scrubbing. He’ll be in good hands no matter how you look at it.”
“That’s fine,” she said, her eyes moistening. “That’s very fine indeed.”
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Methodically, Danny scrubbed at the sink, said a few religious words like he’d promised Tara and pushed open the door with his back. David was asleep already and, as Vance stood against the wall, Danny gowned and gloved. All the same steps he had taken with David’s last surgery were repeated: a bactericidal scrub on a shaved and pin-fixated head, skin incision, removal of skull bone, and clamping back the area for exposure.
He stood up straight to pause and glanced at the instrument table as well as the scrub tech. He frowned under his mask at some of the tools of his profession: a scalpel, a scissors, a mess of hemostats, clamps and sponges. Outcomes have little to do with these instruments, he thought. They have to do with the person wielding them. No different than Mary’s art work; paintbrushes didn’t matter, but she and her talent did. He smiled under his mask, acknowledging the pride he felt for his sister.
Watching from the side, Vance had stepped a bit closer. After some time, Danny grinned to see that David’s brain tissue had a healthy, vibrant appearance. He worked on removing the former equipment he had placed – the electrodes, the antenna and the RF chip. A little bit of blood oozed from the site which made him intermittently use a small suction catheter.
“We agreed on approximately this much,” Danny finally said to Vance, reconfirming their previous discussions about the length and width of the area to now be removed. He motioned with his thumb and index finger an area about a centimeter square.
“That’s correct,” Vance said.
“And a depth of half a centimeter.”
“Correct again,” Vance said.
Even to hear this reassurance from another researcher’s opinion, Danny hesitated a moment then gave an order to himself. He must take out as few brain cells as possible so as to not disturb other mental facilities. But equally as important was to cut out the cells responsible for David’s seizures.
“Okay,” he said. He extended his hand to the scrub tech. “Scalpel, please.”
Chapter 29
Three days later, Danny made rounds with growing optimism for David who had sailed through surgery and recovery. And although it was still early, the young man showed no signs of seizure activity.
His last patient to see, Danny pushed open David’s door and also found his parents and Annabel inside. “Now I know where to find my daughter on this lovely morning,” he said.
“We all can’t wait to see if you discharge David,” she responded.
All eyes focused on him. David sat on the recliner and the other three, all in sneakers, were ready to spring out the door.
“Let me take a look at him while you all wait outside,” Danny said.
When they begrudgingly left, he examined the youth and then sat on the end of the bed.
David looked worried. “So what do you think, Dr. Tilson?”
“Right now, I couldn’t be more pleased. You’re going home.”
David rose and pumped his fist. “Yessss.”
“But here are my strict orders. The same conditions of no driving, no sports, and no extra physical activity apply. Walking is fine. If you have a seizure, come in before the appointment I’m giving you in a week. This is a wait and see game to find out if we have indeed cured your epilepsy from your secondary impact.”
When Danny opened the door, the rest of them practically fell in.
-----
“I’m coming with you two to court,” Casey said. “As a matter of fact, I can drive.” He stood in Danny and Sara’s big room as Sara packed a handbag and Danny straightened his tie in a mirror.
“That’s fine,” Sara said. “And thank you.”
“It’s alright,” Casey said, “And I still haven’t told Mary a thing so as to not upset her. I told her I’m just going with you to your attorney’s office.”
“Which is partially true,” Sara said, “And I agree she doesn’t need the stress. She loves Julia as much as the rest of us.”
Danny poked his head out the back door and said good-bye to Annabel, Nancy, Julia and Dakota; then they left in Casey’s car. He could think of more pleasant things to do besides going to a custody trial regarding his own daughter and he frowned with displeasure.
Sara sat in the front passenger seat and Casey intermittently watched his best friend in the rearview mirror. With nervous apprehension, Danny had remained silent and stared out the window looking at nothing in particular.
“You haven’t given us an update lately about David,” Casey said trying to take Danny’s mind off what would transpire at the courthouse.
“Danny,” Sara said, “Casey asked you something.”
“Oh, sorry,” he mumbled and Casey repeated the question.
A faint smile crossed Danny’s face. “I’ve seen him already for two follow-up visits. So far, not one seizure or even a suspicious twitch.”
“That’s remarkable,” Sara said, “but how is he otherwise? You said that by removing brain cells, a patient could lose important functions because each part of the brain serves a different purpose.”
“Yes,” Danny said as Casey peered again into the mirror. “Even though he tells me nothing has changed, I sent him for testing … like a before and after comparison. The epileptogenic cells I removed have not made a difference in his functioning. He’s had no motor deficits. Other functions such as
long term memory, language recognition and the formation of new memories are also the same.”
“We’re thrilled for him,” Casey said. “And this is a huge breakthrough.”
“I believe so,” Danny said. “I’m in the process of writing a paper with Vance. It will be submitted to the American Association of Neurological Surgeons, the American Neurological Association, and other major publications.”
Casey parked in a parking garage and they all piled out of the car. Now there was another important aspect of Danny’s life to take care of.
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“Perhaps the judge is eating lunch in his chambers,” Mark Cunningham said to Danny, trying to make a joke. Even though he’d spread paperwork at their table, his briefcase still bulged on the chair beside him. He squeezed his cell phone into a side pocket and nervously eyed his watch.
They’d all been waiting in the courtroom for fifteen minutes which gave Danny more time to regain his anxiety. He stretched his shirt collar off his neck and then tapped his shoe on the tile floor underneath the wooden table. Glancing behind him, he gave Sara and Casey a quick glance. They sat close together; Sara professionally dressed in a cream jacket over a blouse and Casey in a brown sports coat and white shirt. Their presence did more for slowing his heart rate than tapping his foot.
Phil Beckett and Rachel sat at their own table and kept up a running dialogue, their jovial demeanor worrying Danny even more.
Right after the court stenographer sat, the bailiff announced Judge Munoz. A husky older man, he gathered his robe in front, sat down and focused on the documents he’d brought in. “Rachel Hendersen vs. Daniel Tilson,” he said, glancing forward, “regarding custody of your child, Julia. Are we to commence or have the parties come to terms with a suitable arrangement for said minor child?”
“My client believes there are new concerns that warrant this trial, Your Honor,” said Phil. “And she believes Mr. Tilson would never agree to what’s in the best interest of Julia.”
Looking at their table, Danny scowled; Mark slid his hand a few inches and tapped his client’s forearm.
“Okay, then,” the judge said. “I have digested all the previous court documents and motions in this ongoing case and am aware of the perilous history of this child with your client, Mr. Beckett.”
“Your Honor, all ….”
“I’m not finished, Mr. Beckett. To Ms. Hendersen’s credit, she has righted the situation regarding her daughter’s abuse and it looks like visitation between both parties has proceeded along smoothly since that time. Additionally, there have been no more incidents.” He leaned back in his chair and breathed deeply.
“That is correct, but there’s a problem,” Phil responded and then paused for dramatic effect. “Julia does not want to be with her father at all.”
Danny felt his hands tremble. Was this as true? That one emphatic sentence cast him as some ogre or an unfit parent and he felt perspiration collect under his shirt. Looking over at the other table, Rachel appeared as relaxed as if she’d walked out of a massage parlor and her bespeaking eyes focused on the judge. Quite suddenly, Danny realized she’d probably been planning this trial for a long time.
“Mr. Beckett,” the judge said. “You can’t expect me to talk to this child in chambers about this matter. I won’t do it. She is too young and it could leave a lasting scar.”
Danny felt a bit relieved. At least this judge had common sense.
“I agree, Your Honor,” Phil said, “and we would never suggest that. If the court would allow, I have subpoenaed a therapist who has spent time with Julia. She is a professional in her field and can share her findings with the court.”
Danny’s pulse quickened; he inconspicuously picked up his pen and wrote a note to Mark. If Julia was seeing a therapist, I had no knowledge of it.
Mark read it and scribbled below. Exactly. That’s the way Rachel wanted it.
As Danny stared at those words, he realized Mark understood Rachel sometimes better than he did.
“Okay,” the judge said. “We are getting ahead of ourselves. But since I am the speed-reader that I am and have the dynamics of these parties understood, then let’s bring in the therapist. I take it from my papers, it’s a Miss Kelly?”
“Yes, Your Honor,” Phil said.
Several pews behind Danny, Sara grabbed Casey’s forearm and squeezed. Leaning into him, she whispered. “They are being railroaded.”
Casey nodded and turned around as a bailiff was escorting a young woman through the door. As her heels clicked up the aisle, Danny also turned and looked; the woman had a slender figure and walked with a feminine sway, her hair fell straight as a ruler onto the top of a chic pantsuit
After the lady settled into the chair next to the judge’s bench and was sworn in, Phil Beckett strode up to her. “Please state your name, occupation, and place of work for the record,” he said.
“Miriam Kelly. I am a family therapist who studied and trained at East Tennessee State University. I have been practicing for eight years at The Family Therapy Group here in Nashville.” She spoke distinctly and with only a trace of a southern accent. Danny figured she had testified more than once because of her work.
“Okay, excellent,” Phil said. “When did Ms. Hendersen bring Julia in?”
“It was months ago, sir. I’m not sure of the date. It should be on my record note which you asked for and I supplied.”
“And only Ms. Hendersen brought her daughter in? Mr. Tilson has never shown up with his daughter at The Family Therapy Group, correct?”
“That is correct.”
“And how much time did you spend with Rachel Hendersen?”
“Not much at all. We had the usual introductory remarks, she told me what she does and she explained her concern for her daughter and then left me alone with Julia. Almost the entire visit I spent getting to know and talking with Julia.”
“So you couldn’t have formed some kind of an attachment or empathy with my client? And you’re sure you had no other personal conversations?”
“She did mention she was doing volunteer work in a children’s hospital. Other than that, it was the briefest of encounters.”
“Okay, thank you for that. I probed just to make sure you didn’t become partial to the mother who is bringing this issue to court.”
“Actually, sir, I don’t know what the issue is. I only know of what transpired at that visit.”
“Then, unless I need to ask you a specific question, why don’t you tell the court what little Julia said to you behind closed doors that day?”
“Well … where to begin? She was very free with sharing her thoughts about her situation going back and forth between both parents and what occurred at both places. I learned that she spent lots of alone time with her mother but at the Tilson residence she described a more chaotic household. People coming and going and a large, rambunctious dog. Well, actually, the dog was supposed to really be her mother’s.”
She stopped briefly and licked her lips. “Go on,” Phil said.
“She said that her mother loved her more and that her father loved some lady more than her. I don’t know if she was referring to a wife. She also said she didn’t want to live with the father at all. What she wants is to be in her mother’s apartment or house or wherever she lives and that she loves her mother the most. I heard it over and over, ‘I want to live with Mommy.’”
“Wow,” Phil said. “How often do you see this kind of determination in a child this young?”
“I’ve never seen this kind of ‘determination,’ as you call it. This little girl is sure about what she wants and it’s apparent she’s not enjoying the present situation.”
Since the judge was hanging on every word, Mark tapped Danny to get his attention. When Danny looked at him, Mark shook his head and Danny’s horror at the testimony caused his heart to thunder in his chest.
Thinking that all the damage had been done and there was nothing that could make it worse, Mark decided to
ask Miriam Kelly a thing or two as well before she left the stand.
“Miss Kelly,” he said,” you commented yourself that, in all your years of being a therapist, you have not come across a young child as determined as Julia to live with one parent versus the other. And all evidence that we have is that Dr. Tilson is an outstanding family man and surgeon and his character is not up for debate. Didn’t you stop to consider that her strong, adamant desires are abnormal and wonder where do they come from?”
“Children can latch onto an idea from a pleasurable experience and make it like a fantasy that grows and grows. Somehow Julia loves and trusts her mother so much more.”
Danny wasn’t a therapist but he thought that Miriam Kelly needed to be on a couch herself to understand her profession better.
“You still aren’t answering my specific question,” Mark said.
Kelly gave a shrug of her shoulders and was dismissed from the room. After more reiteration of prior custody history, the judge made it clear their time in court was finished.
“Mr. Beckett and Mr. Cunningham, I will rule on this situation or change in a very prompt manner. I see the petitioner wants some monetary changes if she is given custody and she also wants Dr. Tilson to pay her legal bills. I will give you my answers soon.”
Rachel pushed her elbow into Phil. “Don’t forget that one last thing,” she whispered.
“Your Honor,” Phil said. “We would appreciate a timely ruling. My client will be leaving Nashville for a job relocation and it’s obviously in Julia’s best interest if she goes with her.”
“You didn’t tell me about that,” the judge said and looked carefully at Rachel. “Not that it changes anything,” he added.
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Danny tossed and turned for a long time. Eventually he halted rocking the bed like he was in a canoe but how could he sleep when his mind raced like a wound-up clock? The day’s events in the courtroom weighed on him too heavily and the therapist’s words played in his head like a stuck record, that Julia had said multiple times “I want to live with Mommy.”