In the early morning, my vomit turned black. Dark and thick. I couldn’t even move my head to reach the bucket. I tried to keep going by forcing myself to answer Peter’s questions, but he couldn’t make any sense of what I was saying. Scared out of his wits, he called our surgery the moment it opened, to urge our GP to come immediately. Sensing the panic in Peter’s voice, the receptionist promised to get hold of our doctor as quickly as possible.
Later, we learned that our GP hesitated when that call came. Out with his family and some friends, he was enjoying a last morning of the New Year break. He thought about not picking up but, ever diligent, he took the call.
With a biological storm hammering its way through my last defenses, that was my lucky break.
“Rikke! Can you hear what I’m saying?” I could hear someone breathing heavily, words as if they were coming from far away. The voice got louder. “Peter. This is not good. Try to straighten her arm.”
My body seized up. The GP injected a dose of penicillin into my arm while Peter tried to hold it still. A syringe fell onto the ceramic tiles in the bedroom.
Within minutes two ambulances arrived. Paramedics ran through the house, shouting, pushing furniture aside, here to save a life.
I didn’t sense the paramedics moving me. I was leaving. Strapped to a stretcher, my heart slowed down. And then, it stopped.
I was clinically dead.
There was nothing. No light at the end of the tunnel, no angels, no harps. No Heaven’s Gate and no Hell. Nothing. Being dead means exactly that. You are gone. It’s as simple and frightening as that.
My heart may have stopped, but the paramedics were not going to give up that easily. While in the ambulance, they worked on me, urging me to stay with them. However, as they pumped my heart into beating, the rest of my organs began to surrender. You can only push nature so far. My body was beginning to come to the end of its life.
Turning to Peter, our GP said, “You can’t drive. You’re in shock. I’ll take you. Leave the children with your mother and she can bring them in her car.”
Peter’s mother had arrived shortly before the ambulances to help out. In a kind of dreamlike trance, Peter took the front seat in our GP’s car.
“I’m sorry, I can’t tell you exactly what’s going to happen,” said our GP. “It’s a matter of minutes. It might still be possible to save her, and that we got to her just in time.”
As I was being transferred from the ambulance to Intensive Care, doctors were ready with a defibrillator to send tiny electrical shocks into my heart in an attempt to restore its rhythm. I was put on a ventilator to get air into my lungs, and a dialysis machine to clean my blood. There was really nothing left now that I could do myself. I was pricked and pierced, but little did it matter. Not even my bodily reflexes worked. I had entered a passive, comatose state of peace. A deep state of unconsciousness, away from the turmoil.
From somewhere far away, the very bottom of the sea maybe, I could hear a nurse call my name: “Rikke, Rikke. Your children are here.”
“Hi, Mummy!” came a barely audible, tiny voice.
And then, miraculously, before my brain shut down completely, it reacted by allowing one last salty, watery signal as my children touched me, three different sized hands stroking my arm. What remained of my conscious mind said goodbye with a solitary tear to the tiny group of people I loved the most in the world.
And then I sank into the darkness.
Victoria’s small voice filled the room as she reached for her father’s hand. “What will happen to Mum?”
“I don’t know, sweetheart. I don’t know,” he said. Victoria flinched. Her father always had answers.
two
Surviving
It was a nurse in Intensive Care who told Peter, “Write down a few notes about what happens every day. If you write things down, it will help you remember.” What she meant, but what she couldn’t quite bring herself to say, was: Write everything down so that you will have something to remember your wife by when she is gone.
Peter is a university professor and an expert in human history, the very deep history that takes us back millions of years to our ape ancestry. Documenting is second nature to him, and he is never without a pen and notepad. An acute observer of everyday life, he lets no detail escape him, and so this advice resonated. He began to chart everything, meticulously documenting all the things that happened and the emotional responses of the children, of our extended family, and his own deepest, most private thoughts. And as the days darkened, Peter knew that I would want to know everything—and if not me, then the children, who would want to know in time, if the very worst happened.
Writing kept him sane.
His notes were what enabled me to piece this time together. Like much of this story of the days before I got sick and the weeks that followed, I’ve had to fit it all together, like writing a biography of another person. Doctor’s notes. Medical charts. Endless readings of my bodily functions. Doses of drugs. Photographs. X-rays. Scans. All the records I could get my hands on. Conversations with staff. Physicians. Nurses. Therapists. Family. Friends.
A nurse had taken Peter aside and told him that “in situations like this,” all close family members should be there. “What is a situation like this?” asked Peter. “Are those her parents?” replied the nurse, looking over at Peter’s parents, who had arrived earlier and brought the children to the hospital. When Peter shook his head, she advised him to call my parents and “any other close family” right now. Seeing Peter’s expression, she offered to make the call.
My parents divorced after I moved away from home to go to college. My younger sister now had her own family. My father had a new one. My mother married again, too, but was now living alone. But they all still lived close to each other; I was the odd one out, living away from everyone else.
“You need to come immediately,” the nurse told my mum. “You should be prepared to say goodbye.” My mother broke down, completely unable to take in what the nurse was telling her. Nothing made sense. At least Peter had witnessed my collapse. To my mother and then my sister and father, there was nothing wrong. They had all talked to me the day before. What did the nurse mean they had to say goodbye?
Meanwhile, a decision was made to scan my brain. It was a risk. I might have already been too fragile, and simply moving me to the scanner could have had fatal consequences. But there was no way around it at this stage. The doctors needed to see how severe the damage was, to check if I was brain dead. In a body that was now a biological battlefield, with armies of blood clots pounding away at any remaining healthy part, this would be a highly probable scenario. If that was the case and I had already mentally departed, never to return, swift action was required to harvest whatever useful organs were still left in my body to save others. Following the scan, doctors thought there was still a chance I might make it, but not at the local hospital. Instead, I needed to be taken to the university hospital, a leading research facility thirty miles south. Before the doctors had a chance to discuss this with Peter, I was on my way.
To prevent whatever it was that had hit me from spreading and sending the others down the same perilous road, Peter and the children had to take a powerful antidote against the most aggressive of bacterial infections. For Peter, Johan, and Victoria, this made total sense; but for Daniel, in his confusion and shock, taking pills was not something he was able to do. In his eight-year-old mind, all he could see were enemies—illness, the hospital, doctors, nurses—who had so suddenly taken his mother away from him, and he believed instinctively that in order to save me and himself, he needed to fight them with everything he had.
Peter tried to comfort Daniel, but was getting increasingly desperate. He knew that I was probably dying, and at the same time he was fighting for this not to happen to any other member of the family. He knew he had to get Daniel to take that medicine.
Two doctors, two nurses, two hours. Pills, sugar-coated and yogurt-enhanced, broken and crush
ed. Persuasion, cajoling, bribing. Nothing seemed to work. But in the end, Daniel caved in and, because time now was of the essence, had a double dose injected straight into his veins. He was safe.
As I was being transferred from the local hospital to the university hospital, the health authorities were following protocol and had already started damage control. Immediate family had been taken care of. The next step was to track down our houseguests from New Year’s Eve. They were already far away in the Netherlands and in Britain. To ensure their safety, they, too, needed shots.
While I was being settled into a bed in Intensive Care, isolated from all other patients, my father-in-law drove Peter, his mother, and the children to the university hospital, where they were joined by my parents and sister, who had by now driven the two and a half hours across the country. A doctor had come to tell them what she knew of my condition.
It was already dark outside. The night shift was in place. A workday like any other at Intensive Care.
My sister was the first to speak. “I just need to know one thing. Will she still be here tomorrow?”
“We can’t tell,” the doctor said.
Victoria froze. Fourteen—perceptive and sensitive—she made the connection between now and the next day when I might not be there. She kept her gaze fixed firmly on her father, hoping he could give her what the doctor did not. Her heart broke. Going to bed was all of a sudden dangerous, because waking up could bring the most terrifying news, and so, without saying a word, she made a decision not to sleep. Irrational as it was, in that moment, she believed her way of helping me to live was to fight her own need for sleep. And so began her own difficult internal battle.
My body was in septic shock and had started the process of killing itself. Multiple micro blood clots were exploding inside me like tiny fireworks, while small blood vessels started to leak everywhere. My body was bloated, already forty pounds heavier from the fluids being pumped into me; my hands, feet, and nose were turning black. My face and the rest of my body were purple, blue, and dark red, as a mosaic pattern grew from deep beneath my skin. I was in a deep coma.
My medication was controlled by what was literally called a space station, fitted with super-advanced devices constantly monitoring and administering high-precision, computer-controlled dosages. There was everything you know from the movies or your favorite medical drama series, only more of everything. All the lights, screens, tubes and wires feeding my carefully balanced intravenous medical cocktail, making sure I got just enough of everything and not too little. Even a small mistake could tip me over the edge.
I was being treated for an aggressive bacterial infection, but so far that was only the doctors’ best bet. I could have had an aggressive virus, or even a rare parasite or a malignant fungus. I was still in quarantine, and so to be in the same room, but not contaminated by me, visitors and medical staff had to go through a complex routine, disinfecting hands, putting on disposable medical coveralls and facemasks.
Involuntary actors in a science fiction movie, my children were reluctant to set foot in my room. They were terrified. I was barely recognizable and I was barely alive. Johan was the first to muster the courage. Standing next to his father, wearing strange protective clothing so as not to be condemned to a terrible fate by his mother, my son watched. He knew that I was being kept artificially alive, against all hope and odds.
On the first night, Victoria made it to the doorway. She didn’t want to come in. She peeked through the door to catch a glimpse of my bed. She hardly saw me. It was even more difficult for Daniel. He could scarcely manage to hear about how I was doing. He couldn’t even bear to see the door of the room I was in. On the third day, after Peter had taken them to the maternity unit in which they were born, and they had been able to forget the real world for a moment, they gained the strength to come in and stand by my bed, talking, crying, watching.
While I was totally unaware of what was happening, it soon became clear to Peter that something was upsetting Daniel above and beyond the trauma of seeing me, and when he burst into uncontrollable tears, Peter took him outside. They walked into the quiet winter darkness, holding hands. There, his tiny body shaking, he told his father, “I’m scared of mobile phones.”
Nobody had noticed his silent pain. After a while, as his father held him tight, he calmed down. And then it came out: In the face of such mystification and shock, all he could do was to watch what was going on. To watch me, to watch the doctors and nurses, to watch the machines, to watch his father, his sister and brother, his grandparents, his aunt. From his eight-year-old perspective, he was literally looking up and observing and all he could see were grief-stricken faces. Adults crying. Seeing how they crumbled in the hall outside my room. Seeing how they were trying but ultimately failing to control themselves, how they fell apart. Seeing how they stopped noticing him, because all they saw was me.
Barely audible, his voice was but a tiny whisper.
“Every time a phone rings, I’m afraid someone will tell me Mum has died.”
Eight years old, he didn’t own a phone, but everyone around him did and they were using them. Constantly. They were talking about me. He heard adults crying on the phone. He heard them telling others that I probably wouldn’t survive. From the mobile phone conversations we all think go unheard, he picked up everything. People around me expected me to die. But no one told him this to his face, so he had to put the pieces together for himself. And he arrived at the inevitable conclusion. It was just a matter of when. The way the message would be delivered was already obvious. The sound of a mobile phone was the sound of the end.
At the university hospital, Peter was told not to be more than a few minutes away from me. I was never alone—there was a nurse with me twenty-four hours a day. The nights were often filled with insecurity and new medical examinations. Suddenly my blood pressure would rise or my temperature would drop. The saturation of my blood would fall, and my heart rate slow down. Nurses and doctors would rush in. In thirty seconds things could go from calm to nerve-wracking chaos. There would be new tests and waiting. Lots of waiting. Changing bags of blood and plasma, giving me a new run of saline, all of this, unnatural as it would have been only days before, became the new normal. Spending all of his waking hours by my side, in the same room with everything going on around me, Peter began to go with the routines.
The hospital had rooms for friends and relatives of severely or terminally ill patients. It was like a hotel—but then again, it was nothing like a hotel. Peter checked in. During the few broken moments of sleep he managed, he was never more than five minutes away. During the long days, he would sit by my bedside talking or reading to me, trying not to get in the way of all the tubes coming out of me. He read everything aloud. Letters, medical journals, scientific articles, work e-mails, books. The content didn’t matter. He had read and heard that the only thing that mattered for me to feel safe, and maybe even wake up, was the sound of his voice.
Peter was given the phone number of a psychologist. Talking to a faceless stranger about the impending death of the person closest to you is a difficult task, but Peter needed answers. Above anything else he heard from the psychologist was that he would need to prepare himself for my death. And in the course of another conversation, a nurse indicated that he should think about whether or not to turn off the ventilator that was keeping me alive. Even if my brain was no longer working, she told him, and there was no prospect of it ever getting going again, there was still a chance that I could save someone else’s life by donating my organs.
These were dark-blue times for Peter. There are many hours in a day and he had a lot of time to think and as he sat there next to me, in moments where he was unable to talk, he planned my funeral. We had never talked about what we wanted when the end came, and so he had to go on what he thought I would want.
There was, in fact, no doubt in Peter’s mind that my ashes should be scattered in Cambridge. Some of our happiest years had been spent there, whe
n the children were much younger and Peter and I were both working—he as a university researcher and me as a postdoc. We had spent three years immersing ourselves in the rhythm of this most traditional and historic of English towns. The children had all learned to speak English with a fluency they have to this day, and we had been drawn closer together as we explored the town and its surroundings. And so, Peter envisioned a beautiful ceremony by the River Cam, scattering my ashes on the gently flowing water, letting me be part of the place forever.
This was exactly what I would have wanted.
As the days went by and I remained in a coma, various causes for my sudden illness were eliminated. I was diagnosed with pneumococcal meningitis, a bacterial form of meningitis. Streptococcus pneumoniae is a special kind of sugar-coated bacteria that acts like a tiny armored vehicle destroying everything on its way through the human body. In most cases, it is caught by the spleen and the symptoms will be a mild cold. But in me, the bacteria seemed to have no barrier, sending toxins through my body. This ominous darkness spread everywhere, including into my brain, where multiple small blood clots exploded deep inside. It also caused a large hematoma, a swelling of blood that developed in the right side of my brain, which, if it continued to grow, would eventually extinguish the light in my mind. I would never again be myself.
My body had worked overtime to produce myoglobin, a protein that provides oxygen to keep us going for longer when performing. Too much myoglobin is not good. The muscles cannot handle it and release it in the body, where it produces a toxin compromising almost every organ. Usually the kidneys take care of the problem by flushing the extra myoglobin through the urine. But if there is too much, the kidneys give up. And if your kidneys give up, you stop producing urine, and all the bad things your body is perfectly adapted to get rid of start building up inside you.
The Blink of an Eye Page 2