Trapped

by Lawrence Gold

  “Where is who?” Asked the ward clerk.

  “Mike—where’s Mike?”

  “Mike?”

  “Dr. Cooper—I’m Lisa Cooper, his wife.”

  “He’s in room II, but you can’t go in.”

  “Like hell, I can’t. I’m a nurse, and his wife!”

  Lisa was about to push her way in when the door swung open, and Julie Kramer, a general surgeon, exited. She put both hands on Lisa’s shoulders, and pushed her backward. “Don’t go in, yet. Give me a minute.”

  “How bad is he?” Lisa asked.

  “Some drunk hit him broadside at thirty miles per hour. I didn’t know that the Honda had side airbags. If it hadn’t, he’d be dead, for sure.”

  “Mike had them installed after he bought the car. I want to see him.”

  “Wait a sec. Let me finish.”

  Lisa placed her arms across her chest.

  “His injuries are massive.”

  Lisa felt her legs weaken as she sank into the chair across from the door of his room.

  “We completed a CT scan of his head. He has a large subdural hematoma with blood pressing on his brain. We got to get it out before it does more damage. This is a mean head injury.”

  “What else?” Phoebe asked.

  “He fractured his left femur, and three ribs on the left. He’s bleeding into his abdomen—likely a ruptured spleen. We’re doing everything possible.”

  “I’ve got to see him before it’s too late.”

  “He’s in a coma, and we’re about to take him to surgery. He’ll be there for hours, if we’re lucky.”

  “Can we transfer him to the trauma center at the University of California Medical Center?”

  “He’d never survive the trip. We have great surgeons here, and, more than that, Mike is one of us. We’ll go all the way with him. He can’t get better care then we’ll give him. I promise.”

  Warren Davidson, the chief of medicine, opened the door and allowed Lisa into the treatment room. In the right corner stood a hospital gurney surrounded by doctors, nurses and technicians.

  Lisa couldn’t see Mike. She forced herself to the head of the gurney and elbowed her way through.

  Lisa could never have prepared herself for the sight. She scanned his enormous body. Mike’s long legs hung off the gurney. His head was wrapped in blood-stained gauze bandages, and his face was so swollen and purple-red that she couldn’t recognize the man she loved. They’d inserted a large chest tube between two of the lower ribs on the left, and she watched as his blood cycled back and forth within the clear tube with each of his respirator-assisted breaths. His abdomen was distended with blood, she knew. She looked up, seeking a familiar face.

  “Lisa,” Julie Kramer said, “We have no time. He’s needs surgery right now, before it’s too late.”

  Without warning, Mike’s monitor alarmed, and Mickey Katz, the anesthesiologist, yelled, “He’s going out!”

  Jack Byrnes, the chief of intensive care studied the monitor. “Damn it, it’s ventricular fibrillation.”

  He began external cardiac compressions, which were made more difficult because of Mike’s fractured ribs. “Shit,” he said, “get the defibrillator ready.”

  Lisa turned away, listening to Jack’s words. “Ready. All clear.” The electrical discharge had Mike’s body contracting. The gurney shook.

  After the third shock, the monitor beeped with each heartbeat, and Jack said, “He’s back. Can anyone get a pressure?”

  “It’s sixty over nothing,” the nurse said.

  Lisa shuddered, grasping at the faint trace of hope emitted by these electronically simulated heart beats.

  “Good enough,” Mickey said. “Let’s get him to surgery.”

  Lisa turned back to Mike’s bed long enough to grasp his lifeless fingers as the bed raced down the hall to the awaiting elevator.

  Phoebe watched Lisa moaning and holding herself with both arms. As she compulsively rocked at the waist, her image seemed to shrink, as if her soul was retreating to its primordial resting place. Phoebe wanted to help Lisa deal with the terror, but she couldn’t. Worse, she was about to make things more difficult for her friend.

  “I’ll call Nora and Mike’s sisters. They must hear from us before Mike’s accident goes public.”

  The horror of Phoebe’s words shocked Lisa back to reality as she renewed her sobbing. After a few minutes, she said, “This is going to destroy them. Mike is everything to them—their boy, in spite of his age. How can I do that to them?”

  “You don’t have to. I’ll do it.”

  “No, Phoebe. It’s got to come from me.”

  Lisa sat by the phone, picking it up, and putting it down. When she finally dialed Nora’s number, she hung up as the phone started to ring. The second time she dialed, the phone rang six times, and, as Lisa was about to hang up, the phone clicked. “Hi, Nora speaking.”

  Lisa opened her mouth to speak, but nothing came out.

  “Hello, who’s calling?”

  “It’s Lisa,” she said in a near whisper.

  “Lisa, sweetheart. How’s my favorite daughter-in-law?”

  Suddenly, Lisa felt nauseated. She couldn’t breathe.

  Nora knew in an instant that something was wrong. “Lisa, what is it?” She asked, her voice faltering.

  “It’s Mike—there’s been an accident…”

  “Where is he?

  “How is he?

  “I’ll get ready and come down to see him. I’ll call the girls. Just tell me he’s okay…”

  Silence.

  “Lisa!” She screamed—“Oh my God—Lisa—talk to me!”

  In a monotone, Lisa said, “It was our anniversary—I’d planned a great dinner—he bought me a…”

  “Lisa!”

  “He never knew what hit him, Nora,” Lisa said sobbing. “The drunk driver ran the light and crashed into Mike’s car. It was instantaneous. He didn’t know what happened.”

  “He’s not…”

  “No! God no. They just took him to surgery. It’s bad, but he’s still alive.”

  Separated by the phone line, Lisa could see and feel Nora’s devastation as both wept in silence.

  Lisa listened. What can I say?

  Nora took a deep breath. “Have you called any of the girls?”

  “No, I wanted to tell you first. I’ll call them when I hang up.”

  Lisa heard Nora blow her nose, then Nora said, “No, I’ll do it. It’s better if it comes from me.”

  “No, I can’t let you do this. It’s my responsibility.”

  “We love you, Lisa. We’ve been so happy for you and Mike. I know you feel that you must do this, but trust me, I know my daughters. I know how to tell them. We’ll be down to Brier as fast as we can.”

  Chapter Thirty-Two

  Lisa sat in the surgical waiting room with Phoebe by her side.

  This must be a nightmare, she thought, waiting for it all to end, waiting to roll over and find Mike by her side.

  One by one, the family arrived Nora came first followed by Mike’s sisters. Sheriff Herman Manning drove Sandy and arrived an hour later from Grass Valley.

  Phoebe paraphrased Mike’s physicians as each asked about his condition.

  Lisa sat in silence, staring at the door.

  After ninety minutes, Phoebe rose, and headed for the phone. “I’ll find out what’s happening.”

  As she dialed, the circulating nurse, in green scrubs, opened the door and entered. “Dr. Kramer sent me here to give you an update. The good news is that he’s alive. The bad news,” she paused, “is that his injuries are worse than we thought. Carter Reynolds, the neurosurgeon, removed the large clot without difficulty, but his brain was badly compressed. He says we can’t know right now what that will mean, although getting the clot out in the first few hours is encouraging. When Julie got into Mike’s abdomen, she found that the spleen was ruptured. She had to remove it. She also found his liver to be lacerated. She’s trying to repair it,
but much of it may have to go—it’s too soon to tell.”

  “How are his vital signs?” Lisa asked.

  “They’re pretty much stable, another Mickey Katz miracle—the guy’s simply the best.”

  “How much longer?” Phoebe asked.

  “Hours. Many hours.”

  They sat as the hours passed. Everyone wanted to say something, but they had retreated into their own silent spheres. Nurses, techs, physicians, and even a few hospital administrators stuck their heads in to express their concern and their best wishes.

  Lisa had the image of solitude, of sitting in the center of a silent auditorium, waiting for the curtains to go up. Her tears ran dry, as did her saliva. The wait was unbearable.

  Phoebe’s whispers of hope came from afar—hollow—meaningless.

  By the tenth hour, half the people in the room were asleep. When Julie Kramer entered the room, everyone stood.

  She walked up to Lisa and embraced her. “He’s in recovery.” She grasped Lisa’s hand, and pulled her along.

  When they entered the room, post-operative patients filled each available gurney. Patients were at different stages of the recovery process. Lisa walked past Mike’s gurney, not recognizing him until Julie pulled her arm and brought her to his side.

  The giant man was a mass of tubes; drains from his head, chest, and four from his abdomen. The endotracheal tube remained in his throat, attached to the ventilator. He had multiple IVs running fluids and blood into his tortured body. Lisa absorbed these sights in an instant, while her attention fixed on his bloated, purple-gray, and impassive face. Lisa recognized the face—she’d seen it many times before—the face of the dead.

  “Is he…?”

  “It’s a miracle, Lisa, at least so far,” Julie said. “After I removed the spleen, I was able to repair his damaged liver without removing any of it. I hope that’s not going to be a mistake. It’s strictly a judgment call on my part. I hope I made the right decision.”

  Lisa grasped Julie’s small hand, brought it to her lips, and kissed it. “I can’t thank you enough.”

  Julie reddened. “This was the easy part, I’m afraid. We’ve done everything we can. The rest is up to Mike, and to providence.”

  “Mike didn’t get this far without a reason. He’s not ready to go. I’m not ready to let him go.”

  After four hours, and with no alteration in Mike’s level of consciousness, they moved him to the intensive care unit. The ICU staff placed him directly across from the nursing station. Doctors, nurses, and their families received a different level of attention from the hospital staff, the ‘one-of-our-own’ kind of care.

  “It’s a two-edged sword,” said Jack Byrnes, the medical director of the ICU. “I’ll be directing Mike’s care, but I must constantly guard against doing too much or too little under the pressure of everyone’s concern, a daily live performance under the microscope.”

  Jack hugged Lisa and Phoebe at Mike’s bedside.

  “What do you think?” Lisa asked.

  Jack gestured for them to follow him into his small office. “I don’t think he can hear us, but I’ve been surprised before when ‘comatose’ patients survived, and recalled the details of our bedside conversations. I won’t make that mistake, again.

  “Have a seat,” Jack said, and hesitated to formulate his answer.

  “You’re both pros, so I’m talking with you in that way. While I’m concerned with every aspect of Mike’s injuries, the two elements that worry me the most are the overall amount of traumatic damage, and his head injury. If we manage to get him through this only to discover that his brain is….”

  Lisa gasped as tears ran from her eyes.

  “I’m sorry,” Jack said. “I’ve never found a good way to talk about these things, and it’s way too early, but did you guys ever talk about Mike’s desires for care under these circumstances?”

  “My God,” Lisa cried. “I can’t talk about that.”

  “Let’s hope it never becomes an issue,” Jack said.

  “I’d never—he’d never want to be kept alive in a vegetative state—never. I know that with certainty.”

  “I need to talk with you about something, Lisa,” Jack said.

  “What?”

  “The neurosurgeon, Carter Reynolds, is pushing me to put Mike on a barbiturate, the so-called Phenobarbital-induced coma.”

  “He doesn’t need a drug for that,” Phoebe said, “he’s already there.”

  “It’s a controversial technique,” Jack said. “The theory, and some data suggests, that the drug can reduce the high pressure in Mike’s brain by lowering its metabolism.”

  “If it helps,” Lisa said, “then why not?”

  “I’m not sure it helps, and it might do some harm. First, it could lower his blood pressure, and second, it might make it difficult for us to access his neurological status.”

  “There are lots of ways to lower brain pressure,” Phoebe said, “we use them all the time in ICU.”

  “Easy, girl,” Jack said. “I raised the subject because the neurosurgeon made the suggestion, although not forcefully, that we consider it. We want to play all the odds for Mike.”

  “Don’t ask me to make that decision,” Lisa said. “I trust you to do what’s best for Mike.”

  “I’m not asking,” Jack said, shaking his head. “I want you to know that we’ll do anything—everything, to get Mike through this.”

  “I know,” Lisa said. “I know.”

  Chapter Thirty-Three

  Lisa jerked awake as the first rays of the rising sun streamed through the windows of the ICU waiting room. Phoebe’s head lay on the sofa’s armrest, her legs curled to her chest. Nora and Mike’s sisters had left shortly after two a.m.

  When Lisa pushed open the door to the ICU, the clicks and the raspy movement of air through Mike’s respirator sent chills down her spine. She moved to his bedside, looked him over, and then checked the cardiac, blood pressure, and intracerebral pressure monitors. She lifted the sheet, and looked at the multiple drains from Mike’s chest and abdomen. She checked the drains from his head, and then collapsed in physical and emotional exhaustion into the easy chair the night nurse had placed by his bed.

  Carla Watts, Mike’s day nurse, had received report from the night shift, and came to the bedside to do her assessment. “Have you been here all night?”

  “Yes,” Lisa said. “I must have nodded off somewhere after three. How’s he doing?”

  “His pressures are stable, although we had to increase his ventilation when his brain pressure rose last night. We gave more Mannitol to bring it down. The lab drew this morning’s blood, x-ray is on its way, and in the next ninety minutes we’ll have a deluge of docs.”

  “Is it all right if I watch?”

  “Of course.”

  Carla started at his head, checking the drains, the dressings, and the pressure monitor. Although it was early in his course, she leaned over to smell the bandages for signs of infection. “Just dried blood and Betadyne antiseptic,” she said.

  She moved downward to check the IV lines, cardiac monitoring, and pressure lines, and the chest tube, squeezing it to insure its patency. She moved to the abdomen, and then down to his lower extremities where she checked the adjustment on the traction device that immobilized his left thigh, the site of his fractured femur.

  “It’s overwhelming,” Lisa said.

  “Tell me about it,” Carla said with a subtle smile. “I know how bad it looks. It always looks this way at the beginning, but I’ve been at this long enough now to see the recovery ahead.”

  Carla recorded her findings, made her nurse’s notes, and then stood with her hands on her hips. “Look at this guy—he’s a huge and powerful man. That’s really going to help.”

  “I’d like to wait until the docs come through this morning, then I’d better get home for the dog, and to get some sleep.”

  “Can I give you a small piece of advice, Lisa?”

  “Sure.”
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  “We’re in for a long haul, here. These are devastating injuries, and it’s going to take some time before we know how he’s doing. If you want to help Mike, you must protect yourself first. It won’t do either of you any good for you to wind up sick, too.”

  “I know. We see it all the time in the NICU. Parents exhaust themselves trying to be with their babies 24/7. I understand it more now than ever. It’s visceral—almost as if stepping away puts Mike in jeopardy. I know it’s ridiculous, but that’s how I feel.”

  “Be smart, Lisa. This will be a marathon, not a sprint.”

  When Lisa arrived home after Mike’s first full ICU day, she was exhausted. Daisy went through her greeting ritual of tail-wagging and wet kisses, but she kept returning to the front door, looking for Mike. Lisa fed the dog, and then they walked for an hour, but instead of pushing ahead as usual, Daisy stopped often, looking back expectantly.

  Lisa made her final call on Mike’s condition, and then crawled into bed with Daisy by her side.

  She slept fitfully, waking every hour or so, finally catching three or four hours in the late morning.

  Lisa drove in commuter traffic toward Berkeley in bright sunshine. She exited the Caldecott Tunnel into heavy fog, and continued to Brier and parked in the garage.

  When she reached Mike’s bedside, Carla had completed changing the scalp dressings.

  Lisa bent over Mike, grasped his hand, and placed a kiss on his flaccid lips; lips so unlike the ones she remembered. “How’s he doing?”

  “No change. I’m still waiting for his morning lab results.”

  Jack Byrnes came over to join them, squeezed Lisa’s hand, and said, “So far, so good.”

  “What does the neurosurgeon say?”

  “Carter says it’s too early to know much. Mike has some abnormal reflexes, but we expect that with the severity of his brain injury. He did an electroencephalogram (EEG) to get a grasp on his brain wave activity.”

  “You don’t think…” cried Lisa.

  “No,” Jack said. “We need one for a point of reference, a baseline reading for future tracings.”