Victim

by Gary Kinder

  I had been in hospitals a million times and seen people suffer, but to watch Cort suffer like that was tough. I was familiar with the chest tubes because I had been working in the open-heart room, and I knew what they were pulling out. It depressed me to go in there. He was never feeling good, never comfortable, always in pain and messed up and plugged in and unplugged, and I really felt bad for him. I was always interested in the charts to see what I could dig out of those, almost like he was a patient, not my brother, because if I looked at him like he was my brother, if every time I walked in there I dwelled on that part, I would have gone crazy. I always treated him like Cort. I always came in and gave him a hug and a kiss and that sort of thing, held his hand for a while and sat there, but in my mind I had to almost look at everything clinically. It was just hard to see little brother laying there all shot to pieces and hurt.

  He’d been through ten weeks of stuff that would’ve killed the majority of people. Yet he was making this progress, and we were really getting enthusiastic. And then all of a sudden, everything turned around again. You felt like, The poor little bugger just can’t make it anymore. Something is going to snap, and his whole system’s going to collapse and he’s going to die. He was always flirting with death, and that was hard to cope with.

  We tried to continue our lives, but it was always there. You go to a show, before you go in, you call the hospital. You come out, you call the hospital. When you’re working, something will pop up and remind you, and the thoughts come back. I wonder what’s happened? I wonder if his temperature finally dropped or if they finally got his lung clear, if they finally got it reinflated again? Just all the time, thoughts.

  I was busy with the family and the baby growing up, and I’m sure I put in the least amount of time at the hospital. But even when I’d get up there, I’d feel myself kind of drifting back into it and really worrying about things, getting all these emotions built up, and it’d screw me up for the whole day, trying to get all that sorted out and put back in my mind, so I could go on with other things. That’s what made it hard for me to see Cort. I think Gary spent a fair amount of time over there, and Claire was with him an awful lot. Dad was back in the grind, but he spent all his time at the hospital. I think he got a little bit down about this time, because it got really critical again, and the question he had to ask himself was, How much more can Cort take before he just gives up?

  While Cortney lay feverish and breathing off a respirator, Claire hung posters around his room, bright cheerful posters, some of them with pictures of airplanes. She brought him funny get-well cards and read them to him and held them up before his eyes so he could see. She talked to him about flying and tried to make him comfortable and did little things for him that the nurses couldn’t do. She held his hand and whispered encouragment. With a hole in Cortney’s esophagus, his lung collapsed, and infection building in his chest, Claire was doing the only thing she could think of to do: try to give Cortney something to live for, so he wouldn’t give up.

  “That was the hardest part,” she remembered later, “when he got better and brought hope. And then suddenly got worse.”

  Claire had her lows and her doubts, said Gary, but she was supportive during that time to try to help Dad. Her thing was, Don’t bug me with the details, tell me he’s getting better if he is, and if he’s going to relapse a bit, fine, I’ll try to keep hanging on. Claire really doesn’t want to know what all the possible complications might be. She wants to know that he’s okay and that he’s going to get better. If you leave it at that, she’ll go with the peaks and the valleys. She’s strong that way.

  I was getting impatient for Cort to pull through, but I didn’t feel the emotional intensity that I had when he was at St. Benedict’s. Whether I had grown accustomed to that intensity level or what, I don’t know. You don’t go through something like that without becoming emotionally exhausted, but as the level raises, you get used to it, almost callous. Back at St. Benedict’s we kind of got our hopes up, and then all of a sudden we’re right back where we started from with this setback. I was already worn down, but Cort was still with us, so I was encouraged. I had some doubts, I had some worries, I vacillated back and forth, but still I’d come back to the old feeling I had gotten long ago, that he’d make it. And that’s what I kept trying to tell the rest of the family.

  Dad was always very optimistic. I’m sure inside he was just ripped apart, but when Cort was making a recovery there for a while, he was very optimistic. Then when Cort had this relapse, Dad got a bit depressed. I think it was more emotional exhaustion than anything. He was just getting worn out. I was low before but I kind of gained momentum, so I was hitting a peak through that time, even with the setbacks. A couple of times I actually stepped in and sort of switched roles with Dad, my hope taking over and his waning for a while. He was getting kind of desperate. He had the bishop come in and give Cort another blessing. He was groping, he was reaching out, looking for anything he could get, any kind of help. I remember one night in the hall outside the ICU, he said to the bishop, “I think I’m going to lose my son.”

  One afternoon Gary visited Cortney at the hospital, then returned home to find his father standing alone in the backyard. He was hosing off the porch, absentmindedly spraying leaves and twigs across the concrete. To Gary he looked tired and depressed.

  Gary walked onto the patio, cracking a standard joke between the two of them.

  “I keep telling you, you can’t make this stuff grow.”

  His father looked up. “How’s Cortney?” he asked.

  Gary reported what the nurses had told him and what he had read on the chart: Cortney seemed slightly more aware of his surroundings, but the massive infection in his chest kept him feverish and gasping for air. His heart pounded as if it would break through his ribs. With little change, the story was the same they had been hearing for a week now.

  Byron listened quietly, nodding as Gary spoke. Then for the first time since the murders, Gary thought he saw his father’s mask of composure drop away. It was in his face and his voice and his words: he did not understand how anyone could survive even the complications Cortney had experienced at St. Benedict’s. For Cortney now to get a perforated esophagus, massive chest infections, a collapsed lung, high fevers …

  “You just can’t take that kind of punishment that long,” he said. “I have hope and I feel he’s going to make it, but I just don’t see how.”

  On July 4, Rees had placed the new tube in Cortney’s chest, slightly lower than the first, and for the next ten days the fluid had drained. But for all the fluid that was being pulled from the cavity, the X rays of Cortney’s left chest remained essentially unchanged. Without the oxygen mask over his face Cortney could hardly breathe.

  As Cortney lay in his bed, feverish and sweating, the tube in his chest dripped a thick, dark-colored serum filled with small clots of blood. From the gastrostomy tube in his stomach drained a viscous substance in varying shades of yellow-green. He cried for pain shots, and whined when the nurses tried to move him. He could not stand to be touched.

  “Cortney was using all his energy just to survive,” said one nurse. “I remember he didn’t have any fat, and you looked at that thin chest and that heart was just going just like this, and it looked like it was going to come right out of his chest.”

  With his esophagus punctured, Cortney’s only form of nourishment was the formula being fed into his gastrostomy and his jugular IV. But these highly concentrated mixtures were creating a rich sugar environment in Cortney’s body, a ripe medium for further infection. They also made Cortney’s stools liquid, and he was incontinent in bed four or five times a day. The liquid stools caused him to chafe and develop sores on his buttocks and groin, openings in the skin for bacteria that once inside would spread rapidly despite the high doses of antibiotics Cortney was receiving.

  Besides his buttocks and groin, open sores were developing across his collarbones and ribs, his shoulder blades, elbows and knees, po
ints where the skin had stretched thin and was beginning to tear. Cortney had become so emaciated that there was no fatty, protective tissue over these bony prominences, and the skin breaking down was creating even more avenues for infection to enter.

  With every system in his body already stretched beyond its limits, Cortney did not have the defenses left to fight off another infection. He was so close to death already that the nurses were surprised when they returned for their shifts each day and found him still alive.

  “They’d take him into surgery to drain an abscess or something,” one of them remembered, “and he’d have a big fever and come back from surgery blue, not breathing very well, and we’d keep thinking, Cortney won’t be here in the morning.”

  It gets intense, you know. It gets really intense and you have to realize that you may not end up with a son. Cortney was sick as a dog all the time down there. Rapid pulse, tremendous infections, and high fever. He was just sick unto death all the time. And so I just had to realize that he may not make it. And if he didn’t, then every day was a gift. Every day that he was alive and getting better or at least holding his own, or was just alive even, was a gift. Just an absolute gift. And these feelings don’t change. Every day you look at your son and you hope, Well, today he’s going to get better. And you walk in there and my Lord, his temp’s off the chart and his pulse is off the chart. And he’s laying there gasping and he’s got all these tubes and junk in him. I mean it’s a hell of a feeling. Just a feeling you can’t describe. And you’re helpless. There’s not a thing you can do about it. You know that the people taking care of him are doing everything in their power. And you know very well that if any more could be done for Cortney, you could call on somebody with more expertise and they’d do it. But we had everybody with all the expertise around already working on him. So you have to just rely on their judgment and their professionalism to get your son through his crisis. That’s all there is to it. And the feelings that go along with that are indescribable. They just are indescribable.

  So the feelings, sure they get bad, but then you get hope that the next day’s going to be better. And then the hope makes you feel better and so you get to feeling like you can go another day, and he’ll go another day. And if he goes another day, with his problems, we sure to hell ought to be able to go another day with what little piddly problems we have. We didn’t have any problems. Cortney had all the problems. We just had to wait.

  Feverish and irrational, Cortney often talked nonsense, sometimes at night in his sleep, but mostly during the day when he was awake. With his eyes open and a confused frown on his face, he would tilt his head and say things like, “The gas cap is off,” or “This is a nice seven forty-seven.” Frightened and sobbing, he once screamed that the finnan haddies were coming to get him, and when the nurse promised she wouldn’t allow anyone suspicious into his room, Cortney said to her, “But you don’t know, they’re masters of disguise.”

  There was a difference between Cortney talking nonsense and Cortney having nightmares—actual dreams in which he relived the scene at the Hi-Fi Shop. On July 9, early in the morning when it was still dark, Cortney became restless in his sleep, jerking his arms and legs about the bed. The nurse thought he appeared frightened. Then Cortney started talking as though there were someone else in the room besides the nurse.

  “Those two men,” he whispered, “don’t let them take me downstairs.” Then he yelled, “Don’t put me on the floor!”

  He thrashed in his bed, twisting his arms and legs in the sheets. Then he stopped and looked at the nurse.

  “When they put me on the floor, something exploded!”

  Cortney often had nightmares where he groaned and turned in his bed but said nothing. Only occasionally did he speak out. Ladora Davidson took care of Cortney frequendy and remembered only once hearing him talk in his sleep.

  “It was in the middle of the day,” she said, “and he woke up screaming: They’re coming down the steps! They’re going to get me!’ And then the next thing he said was ‘Oh, my God! My mother, my mother!’ He’d wake up many times, very sweaty, and I’d say, ‘Cortney, what were you dreaming?’ And he’d say: ‘I don’t know. I’ve been running.’”

  The perforation had not sealed, and the tissues inflamed by the infection still leaking into Cortney’s chest continued to manufacture the thick fluid that was pressing against his lung. He complained constantly of pain in his left chest, and the gastrostomy feedings nauseated him so badly he gagged and vomited nearly every shift. He cursed the nurses, screamed for pain shots, and fought being moved for anything. Then on the twenty-fourth of July the nurses heard a new complaint from Cortney, one that only the nurses at St. Benedict’s had heard before: he had suddenly developed a sharp pain down in his belly. An abdominal infection that had flared briefly and mysteriously at St. Benedict’s weeks before seemed to be coming back, and Dr. O. E. Grua, an abdominal surgeon, was called in immediately to examine Cortney.

  This time Cortney was able to localize the pain: abdominal cramping on the lower right. The symptoms seemed to be the same as the ones he had exhibited before, when his abdomen eventually had grown distended and firm and the bowel sounds had stopped. X rays were taken, but the site at the lower end of Cortney’s stomach, where Dr. Grua suspected a possible leak, seemed to be intact. The day following the X rays Cortney continued his usual complaints of nausea and pain in his left chest, but the pain in his abdomen that had suddenly flared again just as suddenly seemed to go away.

  For the next two weeks Cortney slowly improved. Scar tissue was finally beginning to seal the perforation in his esophagus, and the fluid stopped forming in his chest, allowing his lung to begin the slow process of reinflating. A physical therapist began working with his limbs. Cortney was gradually becoming more alert, talking more, and once even attempted to smile for a nurse.

  Then on August 6 he renewed his complaints of abdominal pain. He said he had a stomachache. Three days later a nurse noted that Cortney was experiencing “stomach distress.” In a series of barium X rays taken the afternoon of August 11, Cortney’s bowel was filmed and showed up even more obstructed than it had been at St. Benedict’s. The inflammation had come on so much faster than before, the symptoms so much more acute, that when he saw the results of the X rays, Dr. Grua scheduled an emergency exploratory for that night.

  Before he was taken to surgery, Cortney said to a nurse, “My stomach’s so bad.” A short while later his father accompanied him into the operating room and watched as Dr. Grua cut him open, probed his abdominal cavity with his fingers, then pulled out his intestines and examined them as he would a ticker tape.

  I don’t think anybody will ever know what torment my son had to go through, physically and mentally. I don’t think anybody’s ever going to know that. Lord, they talk about stress. When you’re all burned out inside, and your head is all shot up, and your body, every system has been damaged, I don’t know how in the hell anybody can figure that that’s not stressful.

  I had a feeling that very first night that Cortney was going to make it. I came home and I said a little prayer, and I had a feeling from that minute on. And I just went along with that right from scratch. I didn’t know how far he was going to go, but I knew within myself that he was going to be all right. And that he wasn’t going to die.

  Then they took him to surgery at the McKay that time to dilate his esophagus and they perforated it, went right through it, and from then on there was no more esophagus, it was all hyperalimentation. And with hyperalimentation, they were feeding him all this sugar. When Grua cut him open, they did a biopsy on his liver and it was fatty-degenerated, it couldn’t hack all the sugar. And his guts were inflamed and they got adherent and massed together. And they were taking quarts of stuff out of his chest just so he could breathe. He was one sick cracker. He had high fevers every day. Tachycardia off the chart. Short of breath. Sicker than hell. And getting all these damned medications in tremendous doses, and just sick. I mean si
ck! Hell, he was sick like that for six weeks.

  See, when you got your lung down and you’re just short of breath anyway, you can’t breathe, you’ve got infection all over hell, your heart’s doing about two or three times normal speed, and this goes on day in and day out, and your fever’s going up and up and down and up, where do you run out of reserve? I’m telling you, all his systems had been just all shot to hell, and I don’t understand. Any one of the things he had could have killed him. Any one of them. Anytime in there he could’ve gone any minute. It just was one thing after another, and I didn’t see how anybody could keep up under that kind of program for week after week, month after month. I thought he was going … if he was going to die, that’s when I thought he was going to die.

  Cortney’s intestines were red from inflammation, and his colon had stuck to his liver. The liver was enlarged and mushy. The appendix too was inflamed and twisted backward. The lower stomach valve that Grua had suspected as the source of a possible leak was intact but appeared weakened.

  Throughout the procedure the anesthetist had difficulty getting enough oxygen to Cortney, and then Cortney’s blood gases suddenly went out of balance. Byron rushed over to the anesthetist several times, checking the ventilator and the blood gases.

  “Is he pink?” he kept asking. “Is he pink?”

  When Dr. Grua completed the two-hour exploratory, pointing out his findings to Byron, he stuffed Cortney’s reddened intestines back through the incision. Then he oversewed the weakened area at the lower end of the stomach and prepared to close. There was nothing else he could do except rest the intestines, increase antibiotic coverage as he had done before, and wait. When Cortney left the operating room, he was still on high oxygen.

  For days after the exploratory Cortney lay motionless on his back, the deep abdominal incision held together by two large, white bone buttons sewn to the skin of his belly. Beneath the buttons his intestines remained silent day after day, paralyzed by the inflammation. His temperature rose again to over 103 degrees and he was put back on the cooling mattress, shivering and sweating at the same time, as the nurses tried to control his fever. His heart pounded 170 times a minute, and the doctors could not slow it down even with carotid massage. He couldn’t be fed orally because of his damaged esophagus. He could take nothing through his gastrostomy tube because of the inflammation in his intestines. The only way the doctors could feed him was to hyperaliment him intravenously, and even that had to be moderated to avoid the further degeneration of his liver. Since his arrival at McKay-Dee seven weeks earlier, his weight had increased to 132 pounds, but now it started dropping rapidly.