by Adam Hughes
CHAPTER FIVE
Slow Motion
The Hodges made the 10-mile ride to the hospital in silence, except for the screeching siren of the ambulance in front of them and Clara’s gentle sobs from the passenger seat.
When they arrived, David angled their sedan into the visitors parking lot, and then the couple hurried toward the ER entry way where the paramedics were already unloading Dan and speaking with doctors. Clara started to call out to them, but David pulled her back and said softly, “Let’s let them do their jobs for a minute. We can follow them when they take him in, OK?”
Tears were still falling from her eyes, but Clara managed to nod. Once the medics had handed off Dan to the physicians and moved the ambulance out of the unloading zone, David led Clara across the driveway and caught up with the doctors. As they approached, one of the physicians nodded toward them and went back into the hospital. The other turned to face them.
“Dr. Parks!” Clara exclaimed. She had not recognized him from the back and through her emotion, but she was relieved to find their family physician on the scene to take care of her son.
“Hello, Clara,” Parks said, then, nodding toward David, “David.”
Parks grabbed hold of the sides of Dan’s gurney and wheeled it toward the hospital , where the other doctor and a nurse were holding open the front doors. “Come, walk with me,” Parks told the Hodges.
David walked along on Parks’ left side, while Clara scrambled around to the right side of the gurney and grabbed Dan’s hand. She looked across her unconscious son and pleaded with her eyes. “Is he going to be OK, Dr. Parks?”
“Clara, it’s just too early to know that with any certainty,” Parks told her. “What I can say is, he is breathing on his own, and his pulse is fairly steady, even though it’s slow.”
“Why is it slow? And why does he have that mask on if he’s breathing on his own?” she demanded.
“I don’t know why his heart is beating slowly, Clara,” Parks said. “That’s what we have to find out. And that mask just helps to make sure he’s getting enough oxygen. Even though he’s breathing on his own, his respiration is slow, too, which could lead to hypoxia — low oxygen levels.”
David could see Clara was on the verge of coming undone, so he interjected. “So what do we do now, Doc? What’s the next step?”
“Well, first we need to get an x-ray of his head,” Parks said, and he leaned toward Dan as they walked to get a better look at the right side of the boy’s face. “Looks like he got whacked pretty hard out there this evening, and we need to see what kind of damage he sustained. He could have brain swelling, and we have to find that out.”
“Oh no!” Clara exclaimed. “What happens if he does have brain swelling?”
Parks looked first to David and back to Clara. “Let’s not worry about that unless we have to, OK, Clara? For now, the important thing to keep in mind is, he appears to be stable.”
Clara nodded, and the Hodges walked along with Parks into the first available exam room, where he gave Dan a more thorough inspection before accompanying him to radiology.
The next several hours were a blur of tests and discovery, partial answers and new questions. By midnight, Parks had moved Dan to intensive care and was sitting in the waiting room down the hall, telling the Hodges what the hospital staff had found.
Mostly, the news was good, Parks said. Despite the fact Dan had been knocked unconscious by a pitch to the face, he hadn’t sustained any broken bones.The x-rays did show deep bone bruising in both his cheek and his temple, and he would be sore for many days, maybe weeks. Depending on his pain level when he woke up, they may have to consider wiring his jaw shut for a time, which would mean a liquid diet administered through a straw.
The force had twisted Dan’s neck around at the end of a swing, which surely strained it — he probably had whiplash — but there did not appear to be any real structural damage to his neck, either.
The final piece of news, Parks told David and Clara, and really it was great news, was there was no swelling in Dan’s brain. There did not appear to be any bleeding inside his head, either, but Hodges warned them that sometimes these symptoms were latent — they only developed hours or even days after an accident, so Dan was not necessarily out of the woods yet.
And then there was the bad news, which was why Dan was in the ICU and not curled up on the couch at home with an ice pack on his head, maybe sucking on a bowl of ice cream. The fact was, despite a lack of any sign of real, permanent damage, Dan was still unconscious. For now, Parks said, he was calling it a concussion because he could see a quarter-sized dark spot, a bruise, on Dan’s brain near the front right side, where the ball had crashed into his skull. It a was fairly common occurrence, and Parks suspected many athletes’ concussions which were never diagnosed at all.
What was particularly worrisome in Dan’s case was, not only had the young man been out cold for hours, but his breathing rate and pulse remained depressed. In fact, they had actually slowed down since Dan arrived at the ER earlier in the night. Some of that may have been because the heart of the crisis was past, and Dan’s body was calming down, but it hadn’t needed to calm down. Not with a starting heart rate of 40 and not when he had been breathing only five times per minute. As he lay in his room down the hall, Parks told the Hodges, Dan was down to about four breaths per minute, and his heart rate stood at 35 beats per minute.
Parks was concerned they may need to give him some help before the night was through.
“What do you mean by ‘help,’ doctor?” David asked, worry creasing his face.
“We’re going to bring a ventilator into his room, and I have a pulmonary specialist on standby,” Parks responded. “If he drops to three breaths per minute and stays there for more than half an hour, we’ll have to intubate him. Do you know what that means?”
David nodded, and Clara began to cry again. Her mother had died of lung cancer 10 years before and had spent the last several years of her life in and out of hospitals, almost always attached to one machine or another. The thought of her son suffering through the same sort of ordeal devastated Clara.
“OK,” Parks said, and his face turned even more solemn than it had been. “We also need to monitor his heart closely, because if his pulse rate drops much lower, he could develop an arrhythmia and go into cardiac arrest.”
“He could die?” Clara burst out.
Parks raised a hand and waved it back and forth. “No, Clara, I won’t let that happen,” he told her. “But it IS possible his heart will stop, and if that happens, then we’ll need to shock him to get it started again.” The doctor paused and took in a deep breath. “And,” he continued, “I want you to brace for the possibility we’ll need to use a pacemaker to make his heart pump fast enough to keep him alive.”
Clara whimpered but nodded, and David pulled her close to him and kissed the top of her head.
—
Doctors monitored Dan throughout the night but decided to hold off on hooking him up to any machines. By morning, they were feeding him through an IV, and he still had his oxygen mask on, but Parks reported to the Hodges that their son seemed to have stabilized. His heart rate had leveled off at a very slow but steady 20 beats per minute, and his breathing was hovering between three and four inhalations every 60 seconds. Not surprisingly, his blood pressure had also tanked, but it, too, was holding on at 60 over 20.
In short, Parks told David and Clara, Dan was in a coma, and they didn’t have any good answers as to why. The doctor left the hospital at eight that morning to check in on his practice and to try and grab a few minutes of sleep but promised he would return in the afternoon. He suggested they do the same, but Clara insisted she wasn’t leaving Dan’s side, so David volunteered to swing by their house and pick up some personal items so he and his wife could be more comfortable.
While David was out, Clara camped out in a stiff, straight chair next to Dan’s bed and, when her husband returned just before Noon, he found her sleep
ing with her head lolled off to one side. He didn’t want to wake her but was afraid she would hurt her neck and was relieved when a nurse burst into the room five minutes later. Clara jolted awake and jerked in her chair, then found David in the blazing overhead lights and smiled at him.
When the nurse had checked on Dan and gone on her way, David persuaded Clara to go with him to the hospital cafeteria. Neither one had much of an appetite, he conceded, but they had to eat so they didn’t get sick. Dan needed them, after all, even if they didn’t know what was wrong with him. They were gone for less than half an hour, but when they stepped through the door to Dan’s room, Dr. Parks was already tending his patient, flipping through a chart and making little grunting noises.
The doctor lifted his head when the Hodges walked in and nodded at them.
“David, Clara,” he said, and they returned the greeting.
Parks made a final mark on the chart and hung it back on the foot of the bed. He turned toward Dan’s parents with a serious expression on his face.
“Look,” he continued. “This is a small hospital with limited resources. I’m confident we can keep Dan alive, but that’s about as much as I can promise.”
Clara looked to David, concerned, and he squeezed her arm.
Parks sighed and finished his thought. “What I’m saying is, I think it’s time we transfer Dan to another hospital, one with more equipment and more specialists.”
“We’ll do whatever we need to do to help Dan, doctor,” David said.
“Yes,” Clara agreed. “We just want to know what’s going on so we can fix it.”
“Well,” Parks began, hesitation in his voice. He was clearly weighing his words, and finally decided to continue. “I’ve done a bit of research in the last couple of hours and I do have a theory … but as I said, it’s going to take more resources than I have available here to know for sure. And time. It’s going to take time.”
The Hodges just nodded.
“I’ve already contacted Methodist Hospital in Indianapolis,” Parks said, “and we’re set to take Dan there by ambulance this afternoon. I would suggest you follow behind in your car, though you’ll probably want to go home to grab some clothes and toiletries first.”
David pointed to the two duffel bags in the corner of the room, the ones he had carried in just before lunch.
“We’re ready to go, Doctor.”
