He tried to turn again, but she couldn’t tell if his movements were purposeful.
The EMTs charged into the room, took Arnie’s vital signs, slid him on a gurney, and rushed him out the door. In less than two minutes, they were on their way to Brier only blocks away. Lois knelt beside Arnie as the ambulance sped away, sirens blaring.
Moments later, the EMTs whisked Arnie into the ER and rolled him to Trauma I, where Jack Byrnes and the ER physician stood waiting.
They transferred Arnie to the hospital gurney then Jack examined him and the nurse again took his vital signs. Arnie responded to voice and to painful stimuli, but still not in a purposeful way.
Jack continued his examination. “What happened, Lois?”
“He thought he had a cold…a runny nose, sneezing, and headache. Moments before he went out, he told Beverly his eyes were light sensitive and that he thought he had encephalitis.”
“So much for diagnosis. We’ll do blood tests, a CT scan, and a spinal tap.”
Lois turned to Jack. “What’s going to happen?”
“I don’t know, but Arnie’s healthy. I can’t see any reason why he won’t be able to fight this off. We’ll treat him with everything in our arsenal.”
Lois stared at Jack. “Samantha Goldstein was young and healthy too, and look what happened to her.”
“I know.”
Lois collapsed into the corner chair and wept. “Jack, help me. I’m so frightened. I can’t stand to see him this way.”
Jack sighed. “I won’t lie to you. This scares me, too.”
The blood tests showed nonspecific signs of infection, the CT scan was normal, and the spinal tap revealed white blood cells of the number and type consistent with viral encephalitis. Jack treated Arnie with antiviral agents, and cortisone to reduce brain swelling.
Lois called her sister Sally to remain with the kids. Lois stayed by Arnie’s bed, gowned, gloved, and masked. She tried repeatedly to awaken her husband, but he didn’t respond.
By the next morning, Arnie remained asleep, however, when Lois shook him for the fifth time, screaming his name, he sat in bed and said in a slow and matter-of-fact way, “Lois…Lois.” He paused, looking around. “This is ICU, isn’t it?”
“Of course it is. What do you remember?”
Arnie spoke in a monotone. “I remember the headache and the pain in my eyes with light. I was sure that I had encephalitis.”
Lois ran to Beth’s office to tell her that Arnie had awakened, but when they returned, he was asleep again. They tried, but could not awaken him.
This cyclical pattern continued for a week, hours sleeping followed by lucid minutes.
Jack sat with Lois. “That’s why we call encephalitis, sleeping sickness.”
Each time Arnie awakened, Lois felt relief, only to have it evaporate when he fell back to sleep.
Jack studied Arnie’s chart. “This is more difficult than if he remained unconscious. I know it’s hard, the ups and the downs, but each awakening encourages me that the virus has caused no permanent damage to his brain. I’m looking for a change that will indicate sustained improvement.”
Lois winced at the icy term permanent damage. It was doc talk, Lois understood, so she said nothing. She wiped her reddened eyes. “Each time, I want to believe that it’s finally over, that Arnie’s finally back with us.”
Lois dipped the washcloth in cool water and wiped the perspiration from Arnie’s forehead. Maybe it was a reaction to her touch, but the right corner of his lip quivered. She removed her hand, and the twitching stopped. As she was about to touch him again, the spasm at the corner of his mouth returned and spread to his right cheek, and then to the entire right side of his face.
Lois gasped and reached for the nurse call button screaming, “Get the nurse in here now, he’s having a seizure!”
The steel bedsprings squeaked and the frame rattled. Suddenly, the bed shook violently as Arnie’s head reared backward and his trunk arched in a whole body spasm. Then, his body convulsed rhythmically. Pink, blood-tinged foamy fluid oozed from Arnie’s mouth and nose as the nurse entered, grabbed a padded tongue depressor, and rammed it between Arnie’s teeth.
Jack rushed to the bedside with a Valium-filled syringe in his hand. He grasped the thrashing arm, shoved the needle into the IV port, and injected. In twenty seconds, the seizure ended abruptly.
Lois looked expectantly into Jack’s eyes.
“It’s the encephalitis. I’ve controlled the seizures with Valium and will begin medications so it won’t happen again.”
“What does it mean, Jack?”
“Nothing good, Lois. Nothing good.”
The seizures broke the pattern of sleep and awakening and Arnie slipped into a deep coma.
Friends, relatives, and patients, had managed to fill most of the available wall and counter space in Arnie’s room with get-well cards, flowers, and plants. In the center, Lois placed Amy and Rebecca’s Get Well Daddy drawings.
After two weeks, they moved Arnie to a private room adjacent to the ICU. Lois spent hours each day at his bedside, clutching his hands as if he’d disappear if she released them.
Arnie and Lois’s lives were so intertwined, that they had found it difficult to determine where one ended and the other began. It wasn’t the romantic fantasy of fulfillment by the blending of personalities or of one soul completing the other. Lois found it difficult to explain herself to others, but each time she looked at Arnie, she had to smile.
How can I go on without his love, without his touch, without his laughter, and without sharing my life with this incredible man? With so much at stake, she fought the intrusive, distressing thoughts—evolving truths rejected by her soul.
While he remained in a coma, the physical therapist splinted Arnie’s hands in a normal position to prevent contractions. Twice daily, the therapist came to put Arnie’s extremities through a full range of movements. They attached muscle-stimulating electrodes to force contractions and preserve muscle tone and strength. Jack placed a thin clear feeding tube through Arnie’s nose and into his stomach. Thick cream-colored liquid tube feeding dripped into Arnie on a regular schedule that simulated mealtimes.
Each day was like the last. Their words read like a script. “Any change, Jack?—No, I’m sorry, Lois.”
The staff of Brier Hospital, physicians, nurses, and others, Arnie’s fans, continued to express concern and then disappointment. Soon, Lois noticed that life for others, in spite of their real concern and their love for Arnie, had drifted back to normal.
Having a choice, nobody could live this way. Like an unending war, you could forget about it until the evening news reported twenty of our troops killed. The people would have their transient moments of angst, and then they’d return to blissful oblivion. Lois understood but resented the loneliness and isolation of her mission. Only Jack, Beth, and Beverly remained steadfast beside her, saving her from the added pain of going it alone.
Lois sat with Beth. “I don’t think I could do this without you. I can’t thank you or Jack enough.”
“It’s what you guys would do for us. It sounds trite, but that’s what friends are for.”
Jack Byrnes felt the pressure. Although he was doing everything possible, Jack, an activist physician at heart, found passive waiting difficult to impossible.
I’ll never get used to it, he thought.
Since most of his patients were in ICU, the sickest of the sick, death hovered nearby. It was the merciless specter, indifferent to the tragedy of their deaths. Irrational as it was, Jack’s struggle against death remained personal.
One evening, Jack led Lois into the nurse’s lounge. “I’m getting another EEG. Arnie’s brain waves looked okay. They show only the slow waves we expect in coma. Maybe he’s developed seizures that interfere with his level of consciousness. It’s a long shot, but I’m playing all the odds.”
“How long can he go on this way?”
“I don’t know what you mean,” Jack said with
consternation.
“No, Jack, it’s only a question. We’ll go on for as long as it takes. For as long as Arnie has any chance of recovery.”
Chapter Thirteen
The UC Medical Center was a crowded gray and tan high-rise complex that sat atop Parnassus Heights south of Golden Gate Park. Debbie and Matt Wallace arrived as bone-chilling fog rolled over the hills and into the city.
Once they diagnosed Debbie’s breast cancer, events moved so fast that she and Matt could barely keep up with the logistical demands much less the emotional ones. Julie Kramer, Debbie’s surgeon, had her scheduled for surgery the following week.
Today, they were seeing Dr. Stanley Becker, chairman of the department of oncology, and one of the nation’s leading cancer specialists. They sat in his sterile waiting room and flipped through outdated Time, Newsweek, Sunset, and a variety of car enthusiasts’ magazines.
Stacks of brochures spanning the broad breadth of cancer were scattered about the room. The bulletin board had postings on patient oriented seminars, professional meetings, newspaper clippings about the university, and a directory of cancer support groups.
What am I doing here? Debbie thought. I don’t want any part of this world.
The receptionist rose from her desk. “Doctor Becker will see you now.”
The large office had a sitting area with easy chairs, a couch, and a small conference table.
How many tears had been shed here? Debbie wondered.
The twelfth floor window immediately behind Dr. Becker’s desk revealed the brick wall of the adjacent nursing school.
Dr. Becker unfolded his sixty-year-old lanky body from the chair behind his desk and approached them with his hand extended. “Stan Becker.”
“I’m Matt Wallace and this is my wife Deborah.”
“Call me Debbie, please.”
Becker smiled. “Let’s move over to the conference table. We’ll be more comfortable.”
He’s friendly, Debbie thought, but so restrained that I can’t read the man. He lives in cancer’s black shadow. What should I expect?
Becker wore an Armani suit; the work of an expert tailor who’d fashioned the garment to fit his long arms and legs.
“How’s Arnie doing these days? He’s a special guy.”
“Haven’t you heard?”
“Heard what?”
“Arnie has encephalitis.”
“How bad?”
Debbie shook her head. “Bad.”
“I hadn’t heard a thing. I’ll give Brier a call.” Becker paused for a moment then faced Debbie. “How are you dealing with this so far?”
Debbie didn’t know how to respond. She sat with her head down in thought, and then looked into his eyes. “I’m not dealing with it. I’m living through it.”
“I’ve been at this for a while,” he said smiling, a genuine smile this time. “I’ve seen it all. Take my word for it, as dark as it looks now, you’ll get through it. Brier has wonderful support groups with women like you who will understand.
“Arnie’s office sent your complete chart including the surgical report, the pathologic examination and the slides, and your complete diagnostic evaluation. I’m presenting your case to the Tumor Board today, but I’ve been through this so often that I’ll tell you in advance, what they’ll recommend.
“First, you’ll have a mastectomy. Julie Kramer will discuss technical details with you regarding immediate reconstruction. She did her surgical residency here. Don’t tell her this, but she’s one of the best surgeons we’ve trained at the university. We tried to get her to stay on the teaching faculty, but she had her heart set on private practice. If technical considerations allow it, she’ll reconstruct your breast at once. Second,” he hesitated before delivering the grim news, “you’ll need to undergo a full course of chemotherapy.”
Becker stood and walked to the credenza next to his desk and grabbed a thick bound notebook. “Much of this will sound like a foreign language to you, but the information packet, more like a book, will tell you more than you ever want to know about chemotherapy. I’m going to recommend a full course of two powerful anticancer drugs, Adriamycin and Cytoxan. We call it the AC protocol. Therapy with the drug Taxol will follow.”
“Chemotherapy scares the hell out of me. How bad is it really?”
“Anyone who tells you that it’s a stroll in the park is lying. These are powerful drugs designed to kill cancer cells, but since these drugs affect all the cells in your body, they’ll make you sick…very sick. We’ve gotten much better controlling side effects, but still, it will be unpleasant for a time.”
Debbie looked into the doctor’s eyes, her voice cracking and barely under control. “What are my…”
“What are the chances of surviving your breast cancer?” he interrupted. “Considering the type of tumor, your age, and my expectation for your response to chemotherapy, your chance of surviving five years is close to 90 percent.”
“I’d prefer 100 percent, but that’s not bad, is it?”
“I’m not big on pep talks, they don’t endure, and so let me simply say that a life-affirming attitude is a potent force for success. Spend your time with the optimists and ignore the gloom and doomers. You’ll sail in a sea of opinion, part of it will be on course, much of it can send you adrift, and, if you’re not careful, you can sink in it. Hail me any time you need help in navigating these unchartered waters.”
They talked for another thirty minutes then Matt stood and extended his hand to Dr. Becker. “I appreciate the time you’ve spent with us today. You may be sorry you made yourself so available to us.”
“Never. One more thing, you won’t offend me if you ask for another opinion. If you want one, let me help you. I know the best oncologists in California and around the world. I’ll arrange for you to see as many as you like.” He paused again. “I don’t want regret over ‘what ifs’ to be part of your care, now or anytime in the future.”
Chapter Fourteen
Little remained of the life that Lois and Arnie Roth shared. Her daily hospital trips were exercises in futility. Arnie simply looked as if he were asleep. For the first few weeks, Lois remained frantic. She knew that nobody could maintain this level of fear and anxiety indefinitely, yet any degree of relaxation, any moment of pleasure with the kids or with the hospital staff, felt like betrayal. If she only could maintain her focus, her determination, then Arnie would get better.
She watched as the physical therapist lubricated Arnie’s skin and joints with peppermint oil. Afterward, he put those joints through the full range of exercise movements to prevent contractures.
When the therapist worked hard to move Arnie’s joints, he remained motionless, serene. That must be painful, she thought.
Jack and Beth Byrnes shared Lois’s despair, but tried not to show it. Beth was okay with long periods of handholding and silence. Jack maintained the facade that somehow, he had things in hand. He needed to be in control, and tried to remain upbeat.
“I’m not ready for any of this,” Lois said. “I live each day in fear that we’ll lose him, yet I dread even more that he won’t be the same Arnie when he awakens. That would be…”
Jack squeezed her hand. “I can’t help myself. I’m an optimist. The last thing I want is to give you false hope, but when I put it together, look at Arnie physically and especially neurologically, I think that optimism is justified.” He paused. “How are the girls doing?”
“Amy is too young to understand. She just wants her Daddy. Rebecca understands all too well, and she’s devastated. The pain of Arnie’s illness has brought us closer.”
Four weeks passed. Arnie remained unresponsive. Jack came every day and the exchanges with Lois became strained. Each sensed what the other felt: disappointment and despair. For Lois, anger came as an extra burden. While she knew nobody would blame her, she felt guilty.
At Jack’s instructions, the nurses placed headphones on Arnie and they played his favorite music for hours each day. Lois re
ad books and magazine articles aloud.
Jack placed Arnie’s chart in the rack. “Lois, don’t be upset, but maybe it’s time to send Arnie to a coma care facility.”
“Don’t tell me Wellcare’s pushing you to transfer him. He’d love that.”
“They are pushing, but I don’t give a shit what they say. I believe that everything we’re doing at Brier can be done better in a place designed for patients like Arnie.”
“Patients like Arnie,” Lois exploded. “Don’t think or talk about him in that way. That’s Arnie Roth lying in that bed. He’s your best friend. He’s my life. He’s my…”
Lois burst into tears, but slowly regained control. “I know, Jack, but it’s like giving up…accepting that he’ll remain this way. I can’t stand it. I won’t do it.”
“I’ll ask around. Remember,” he said without conviction, “this type of facility may be the best thing for Arnie in his present condition. We’ll discuss it again when I have more information.”
One morning, a week later, Lois was sitting at Arnie’s bedside, gazing through the ICU window at the east bay and the distant city.
Beth carried fresh bagels from Saul’s kosher deli in downtown Berkeley. “Jack brought these in for the staff. He won’t be happy until we’re all in Weight Watchers. I grabbed some cream cheese, and you’ll find lox and smoked whitefish in the lounge.”
Lois tore an onion bagel in half, took a bite, and smiled. “Arnie loved…I mean he loves bagels and lox.”
What is that aroma? Fresh bagels, like Nana made. Then later, no, it’s smoke…a fire somewhere. I roll out of bed, walk to the door, and look down the shadowed hallway. It’s like a painting with symmetrically contracting walls creating the illusion of distance. Gray-yellow clouds revolve in a slow-motion cyclonic pattern obscuring the hall’s end. From time to time, the clouds part long enough to reveal a large steel door.
When I enter the mist, my face feels cool and I smell peppermint. I grasp the knob and the door trembles in anticipation.
The Sixth Sense (Brier Hospital Series Book 3) Page 6
