by Barbara Ebel
Garret’s horror-stricken face made Danny put his hand on his upper arm.
“This can’t be.” The fifty-one year old stared past Danny and his eyes grew big. “Operate inside my brain?”
Danny scooted the nearby chair right up to the railing so that, when he sat down he was eye level with Garret. “I know. This sounds scary and it is. At this moment, it is both dangerous for you to have this aneurysm and dangerous for you to have the surgery. You could die if the artery ruptures and causes massive bleeding inside your brain. Your best chance is for me to try and prevent that. I can only do this particular aneurysm with surgery.”
Danny squeezed his arm. “Would you like to think it over for a few minutes?”
Garret squeezed his eyes shut. When he opened them, he said, “Dr. Tilson, please.” A few seconds later, he continued. “Do the surgery.”
“I assure you - with positive energy, skillful hands and even a prayer or two - I will do my best.”
-----
The OR staff had done a fine job of expediting Danny’s case despite a full emergency schedule. A line-up of cases was typical for a Friday night but not necessarily so for neurosurgery as the trauma service took the bulk of weekend emergencies. At least, Danny thought, Garret wasn’t having the operation because of a motorcycle accident. He always secretly hated those cases. Motor vehicle head injuries were one thing but motorcycles were time bombs waiting for their next victim.
Danny glanced around the OR checking out the staff for his case while his favorite anesthesiologist, Dean, put his patient to sleep. The general anesthetic induction went well, Mr. Archer was intubated, and Dean worked on getting more IV access.
“Well, Mr. Archer saved us a step,” Danny said while the nurse scrubbed the antibacterial solution over the surgical site. “He must have shaved his head this morning.”
After he scrubbed his hands, gowned and gloved, Danny reviewed the films. He took a deep breath under his mask as he drilled into the frontal area.
When he removed a section of the skull, he peered over at Dean. “This is going to be a large aneurysm. Anyone want to spout off some small talk ahead of time?”
“Thanks for letting me know,” Dean said. “Let’s send for two units of blood then, just in case.”
“Dr. Tilson,” the circulator said, “we can forego the small talk right now until you get this patient’s problem resolved.”
“Hopefully, we get to small talk later. Right now this aneurysm has me worried.” He looked at the anesthesiologist and they both nodded. Danny moved the large portable microscope closer, but now he had to spread brain tissue apart with instruments and get as close to the defect as possible. Although he heard the bellows of the anesthesia machine and the tones and whistles reflecting signs of life on the monitors, his attention and concentration were on moist gray matter. Perhaps the tissue he now touched held the memories of Mr. Archer when he was twelve years old or perhaps when he turned forty and had gotten a job promotion. He could only guess. But he never wanted to somehow disturb a patient’s memory so he had to make sure the arterial deformity didn’t tear as he approached it.
When Danny had separated a fissure of two convolutions of the brain and clamped them open, he looked again at the arteriogram. He sat back down and teased the sulci apart a bit more. The anterior cerebral artery of the Circle of Willis was now in view.
The room remained quiet. Danny’s pulse ebbed slower as he took a small breath and said a small prayer. If there is a God or a guardian angel and you are shadowing me, then bless my hands and my talents to safely give Garret Archer a deserving chance. Let him get through this safely. My heart tells me he is a good man.
Danny dabbed a pledget in, then carefully isolated and exposed the aneurysm. From the scrub tech’s table, he selected the surgical clip and skillfully placed the clip around the aneurysm’s base. He took a deeper breath and relaxed his hand. Now blood was prevented from entering the saccular termination of the vessel.
When Danny glanced over, his attentive anesthesiologist was standing up, not only monitoring his patient’s progress but Danny’s as well.
“Nice job,” Dean said. “And Mr. Archer’s vital signs are doing super.”
“Thanks to you. I may be the technician but you’re the life support.”
“Appreciate that.”
Before Danny backed out and closed, however, he had to verify the more baffling aspect of the arteriogram; the lack of vasculature and blood flow distal to the aneurysm as well as other arterial branches. He evaluated the anterior cerebral artery and the anterior communicating artery. Normally there’d be small arteries branching off, like a healthy branch with twigs. But, in this case, a scarcity of vessels budded off.
His patient may have avoided dire consequences of a ruptured aneurysm because Danny had successfully clipped it but what on earth could he do about a lack of blood flow to this man’s frontal lobe? And since adequate oxygenated blood wasn’t flowing there, that area of brain looked less vibrant … almost like the atrophic changes of someone with dementia.
Danny slowly removed his instruments and made sure the spongy brain matter fell back into place. He swiveled the microscope further away and began closing.
-----
The bedroom ceiling fan was set on medium so Danny felt the cool air as it pushed down and he opened his eyes. Sara’s hair lay slightly on her left cheek and her lips were parted; after each shallow breath, her chest rose slightly. She couldn’t look more peaceful or beautiful.
Something moist pushed into Danny’s hand draped on the side of the bed. Dakota’s nose nuzzled again while his back end danced and his tail wagged. “Shhh,” Danny whispered as he planted his feet on the rug and ruffled Dakota’s head.
After taking a quick shower, he put on long pants and a nice Henley shirt; not his usual Sunday morning attire when he had off but his colleagues were covering call as well as his patient rounds. He went into the adjacent bedroom with Dakota at his heels.
“Da-Ka,” Julia said, wide awake and waving her hands.
Danny laughed. “Well, good morning to you, too. I guess Dakota does come first.”
She grabbed onto Dakota’s back and snuggled into him as Danny picked out a dress. When she finally turned her attention to her father, Danny took her to the bathroom and gave her verbal encouragement on the toilet.
“Daddy,” she said as he slipped on her purple dress. He picked her up and carried her down the stairs, his affection for his daughter so complete he never wanted the moment to fade. At the bottom of the steps, he held her hand as she toddled back to the kitchen with Dakota. They both took him out to the yard as a mockingbird mimicked two cowbirds at the feeder. Then the dog raced off the patio and over the hill chasing a squirrel.
Danny sat for a few minutes on the patio and watched as the sorrel retriever trotted back to them. He looked at his watch; it was 7:30. They went back inside and Danny made coffee. Later they had a planned trip for visitation with Rachel but, for now, he had his own agenda with his little girl.
Soon thereafter, he left the house, strapped Julia in her car seat, and drove a few miles away.
-----
“Are you sure you and Sara don’t want to hike with us in middle Tennessee?” Casey asked.
Mary stood next to him at their double bathroom sink. “I’m taking a sabbatical from hiking. I did so much of it in Alaska that I still have the forests and lakes and glaciers implanted on my brain, giving me the fodder I need for my canvases.” She squeezed toothpaste on her brush while he looked at her questioningly.
“No, really,” she said. “Sara and I are going out for a late lunch. If Rachel really loves her daughter and wants to see her, I’m sure she wouldn’t appreciate two other women there.”
Casey plugged in his electric shaver. “You are sweet to consider that.”
“Don’t get me wrong, though. I think that woman is as twisted as spiral pasta.”
With a few swipes of his shaver, Casey
trimmed his buzz cut, put on a short-sleeve crew shirt and Columbia shorts, and bounded down the steps with Mary to a hearty welcome by Dakota.
“I’ll crack the eggs,” Casey said sidling next to Mary where she’d started to fry bacon in the oversized pan. “I’m assuming everyone will have some and, if not, the extra will go to me.” He smiled and then got a plate for the bacon.
“Nancy and Sara are still upstairs getting ready, but where’s Danny and Julia?” he asked.
“He’s not outside,” Mary said. “I just checked.” She opened the house door to the garage. “That explains it. The Lexus is gone.”
“If he’s making a donut run, he’d better make it snappy.”
-----
Within fifteen minutes, Casey, Mary, Sara and Nancy were sitting across from each other chowing down bacon, eggs and bagels.
“You’re awfully quiet these days,” Casey said, rustling Nancy’s light brown hair. She frowned and took another piece of bacon. “Is it because you’ve become ‘sisterless’ or because you’re back in school?”
Nancy looked at her mother and then Casey. “Yeah, well, it is kind of different without her,” she said fidgeting with hair around her ears.
They heard the garage door open and Dakota jumped up, cocking his head at the door.
When Danny walked in, he placed Julia on the floor much to Dakota’s delight. “It smells great in here,” he said and headed straight for the remaining eggs in the pan.
“So where are the donuts and apple fritters?” Mary asked. “We’ve done our part for breakfast; what’s yours?”
“I’m sorry. I would have stopped but I knew I better get home.”
He sat down at the table while everyone stared at him waiting for an explanation.
“Julia and I went to church.”
Except for Julia and Dakota, silence deafened the kitchen and everyone exchanged glances.
“Dad, you’re not exactly a churchgoer. I can’t remember when you last did something in the Catholic church,” Nancy said.
“You’re right about that. Perhaps I haven’t been a good role model.”
“But you are. You’re a good person and father.”
“Actually, it didn’t matter. Julia and I would have gone to any denominational church but the Catholic church is so close.” He looked at his sister. “Mary, it’s different than what we were exposed to with Mom and Dad. Things have gotten more contemporary. Perhaps religion can play a positive role in my life at this stage.”
“What do you think their main philosophy is? Or their mission statement?” his sister asked.
Danny thought about it. “I’m not sure since this was my first time after a long absence. But the priest’s words grabbed me immediately. He said it’s fundamental to believe in ‘essential truth.’ The core and highest sense of human beings should be essential truth. Maybe it sounds nebulous, but not to me.”
“I don’t understand, Dad,” Nancy said.
“I think it’s like this, sweetheart. I’ve become a non-practicing atheist.”
-----
Casey planted a cooler on the floor and Danny waved good-bye. As they pulled out of the driveway, Sara and Mary chuckled to see the two men leave with Julia and Dakota. Danny had dressed his two-year old in a pink sunhat and top along with lightweight pants and toddler tennis shoes. Julia already craned her neck to see Dakota panting over the seat and giggled between her outbursts of “Da-Ka.”
It took almost two hours to travel to middle Tennessee and then they took back roads to the state park, passing tiny houses, trailer homes and small neat farms with cattle standing knee-deep in ponds. Some houses had peeling paint and front yards cluttered with rusted car parts and tossed furniture. They passed a sign for ‘fresh eggs’ by a mailbox and soon passed purple and yellow wildflowers that were pretty enough to cut and bring home. Finally, the curved roads brought them to an open red gate and a sign for “Burgess Falls State Park.”
“Someday, we should come back and make sure we see the garden growing behind the upper parking lot,” Casey said as they slowly passed it to the lower lot. “I read it’s planted to attract a huge variety of butterflies.”
Danny nodded as Dakota sensed the end of the ride and his excitement mounted to get out. Danny parked in the last aisle closest to the trail’s entrance and, when he opened the door, he heard the gurgling and rushing of water.
“Here she comes,” Casey said, getting out and spotting Rachel. “Did you know she was bringing someone along?”
“Apparently, her boyfriend,” Danny replied, glancing her way. He noted her trim figure in shorts and a tank top as well as her gorgeous face with those eyes. No wonder she always has a man close by, he thought. He strapped on a light backpack containing small water bottles and a plastic toddler’s cup. Ducking into the back seat, he unstrapped Julia while Casey wanted to voice his own thoughts about ‘a boyfriend’ but instead leashed Dakota.
Danny held Julia’s hand and Casey allowed Dakota to quickly lift his leg; then they proceeded a few steps towards Rachel and Evan.
Rachel rushed towards Julia with a wide smile, crouched down, and picked her up. “Julia! I am so happy to see you.” She kissed her cheek and squeezed her close. Although Julia smiled and puckered her lips back at her mother, she didn’t say anything.
“Julia, it’s Mommy. Can you say Mommy?”
There was a silence except for the sound of the water. When Rachel put her down, Julia sidled up to Dakota.
“Hi,” Danny said to Evan. “I’m Danny Tilson and this is Casey Hamilton.”
“Evan Parks.” He extended his hand, giving them both a firm handshake. “I hope you don’t mind that I came along. I’ve admired Rachel for giving you so much time with Julia but I finally egged her on to arrange a visitation.”
“No. We’re glad you came,” Danny said. “And thanks for this park suggestion. It looks beautiful.”
Evan nodded towards the head of the trail. “It’s a one and a half-mile round-trip hike and the three waterfalls cascade down from over two-hundred and fifty feet in elevation. There are plenty of places to stop and view the upper, middle and lower falls. They get progressively larger so the best is at the end.”
“Rachel, we’re here for you and Julia,” Danny said. “Whenever you want to stop, just holler. And we can take turns carrying her.”
“It’s a very craggy course,” Evan said. “Be really careful as there are outcroppings of rocks, overhanging cliffs above your head, and tree roots jutting up throughout the trail. In several places, there are man-made steps and wooden hand rails.”
Danny glanced down to check if everyone had worn sneakers and also made sure his cell phone was in his pocket. “I’ll carry Julia to start,” he said, picking her up. She waved her hand at Dakota as she was hoisted into Danny’s arms.
Casey sighed with relief, thinking the group dynamics had started out better than he anticipated. He rustled Dakota’s top coat. “Why don’t we let him lead the way?” he asked and all of them nodded.
They walked fifty feet where the trail officially started and dipped down a rocky incline. In front of them, the Falling Water River rushed by.
Chapter 9
About halfway through the hike, Danny put Julia down so Rachel or Evan could take her hand and walk onto a natural-fenced platform overlooking the semi-circular middle falls which cascaded into a large pool. From there the river kept following its rugged course to the large waterfalls which then eventually ran into Center Hill Lake.
Danny, Casey and Dakota stayed slightly behind, sitting on a wooden bench, letting the other three have time together.
“I was anticipating your daughter’s father to be somewhat cantankerous,” Evan said, “because when you and I first met, you told me he had given you trouble; that he hadn’t shown up with your daughter when he was supposed to. I remember I had called the Nashville police about him.”
Rachel cringed. She had crouched down next to Julia and was pointing towa
rds the water through the wooden slots. Boyfriend or not, she didn’t like him wondering about her dealings with Danny. Boyfriends would come and go for her but, for better or worse, Danny would be like an umbilical cord to her for the foreseeable future and it had been to her advantage to make Evan suspect him as a shady character to keep the limelight off of her and the abuse Julia had received from Leo. So she certainly didn’t want Evan getting chummy with Danny now.
“All of that was legally taken care of, Evan. The situation actually required it. All this time probably made Danny figure out that he’d better be a more responsible father and it’s given me time to get back to regular hours at the hospital.” She got up and looked at him without smiling. “It shouldn’t be that much of a concern to you, anyway,” she added curtly.
Evan rubbed her shoulder. “I didn’t mean to make you upset. You both have a beautiful daughter and I can see the concern from both of you.”
A smile crept across her face. “I forgive you. Would you like to carry Julia the rest of the way?”
“I don’t have much experience with children but I’d be happy to.”
“First,” she said, reaching out to him, “would you take a picture of Julia and me?” She dug into the pocket and pulled out a digital camera.
“Sure.”
-----
At the end of the main hike, a steep, narrow trail led down to the top of the big falls where the rushing river built up all its energy to plunge off the cliffs. There they took several steps up a metal staircase to a platform and then descended down eighty rustic steps alongside the falls as it plunged one-hundred and thirty feet down into a gorge.
When they got to the bottom, Danny stood transfixed at the beauty; not only from the waterfall on the right but the archeological magnificence of the layers of rock on the other side. He took a deep breath as a mist of water blew towards them and he remembered hearing once that negative ions from water were uplifting. At this moment, he believed it. He also believed that this natural site gave testimony to the supreme magnificence of creation and a higher responsible power.
