October 29, Saturday
“THANK YOU, Dr. Oscar, for joining us in this case review. Dr. Jarvis and I really appreciate it.”
Drs. Tyson and Jarvis are talking over my bed, and beaming Dr. Oscar in via Skype.
“Happy to help a soldier’s sister, Dr. Tyson. Is this the patient?”
“Yes, this is Marigold Kemp.”
“Hello, Marigold. I’m Dr. Oscar.”
I wish I could respond. I hope the doctors have good news for me.
“I’ve reviewed Ms. Kemp’s scans and MRI and I have to say I agree—you need to operate again and remove the dried blood and other debris from the first surgery. The pressure is too much, it’s leaning on vital areas of her brain waiting to come back to life. And you’re definitely in danger of killing the optic nerves.”
I’m no physician, but I know what that means—blindness. I wonder if that’s what Audrey was going to tell me that the doctors were keeping from me?
“The first surgery was tricky,” Dr. Tyson said.
“This one will be twice as complicated,” Dr. Oscar said. “If you like, I can scope in.”
“It would be an honor, sir.”
“The honor would be mine,” the man said. “For the chance to save this young girl and her baby. You don’t get many opportunities like that. When are you planning to do it?”
“We want to do it as soon as possible, so we’d like to schedule it for Wednesday.”
“November 2?”
“Yes.”
“Looking forward to it,” Dr. Oscar said. “Let talk on the first to go over a game plan.”
The Skype call was disconnected with a bleep and Dr. Tyson exhaled audibly. “We need to make sure the family knows how risky this surgery is. If her brain starts to swell and we can’t control it, we’ll lose her and the baby.”
“But if you don’t do the surgery,” Dr. Jarvis said.
“We’ll probably lose them both anyway.”
What was it ADA Spence had said? We have a lot to gain, and nothing to lose.
“But let’s hold off telling the family until we confer with Dr. Oscar on the first,” Tyson said.
“That late?”
“I don’t want to get their hopes up in case we find something unexpected. And I want to tell them exactly what we’re planning to do so they can make an informed decision. We took two big risks by administering the experimental drug. I want this surgery to be completely by the book. If we decide we can do it, and they need a couple more days to make up their mind, we’ll push the surgery out.”
“Okay, November first it is.”
October 30, Sunday
“HI, MARIGOLD, IT’S Jack Terry. I understand you’re not doing so well.”
Ah… ADA Spence must’ve him brought him up to speed on my marked decline. But Jack nor the ADA, not even my family knows yet about the Hail Mary the doctors are planning to throw up next week. I am buoyed by their optimism, wish they could perform the surgery tomorrow, but I understand the need for planning and tests, especially considering the shortcuts they took earlier on my behalf.
“Hey, I’m planning for you to be around to meet my first child when he or she is born.”
His voice is cracking and I realize he thinks I’m a goner. I’m touched this big alpha guy could be moved by my situation. I’m sure he’s seen every sadsack predicament under the sun.
“I just want to say that coming here on Sundays has meant a lot to me. It might sound silly, but it’s been nice to get away from work and other situations that were pulling on me and clear my mind enough to make some grown-up decisions. Watching what you’ve gone through has given me perspective.”
Wow… I had no idea anyone was analyzing my situation with such scrutiny.
“And I think it’s fair to come clean about the situation I’ve been wrestling with. Some of it you already know. The mother of my child didn’t plan to get pregnant.”
Let’s see, that would be Liz.
“It was carelessness on both our parts. What makes the situation especially difficult is I’m in love with someone else.”
That would be Carlotta.
“But there are some extra complications that would make it impossible to be with the woman I love while raising the child with its mother. Not that she would have me anyway.”
Carlotta again.
“In fact, she’s probably going to marry someone else.”
Gee, Detective, and I thought my situation was bleak.
“But hey, I’m the one who messed up everything. And it’ll probably all work out for the best because this girl makes me absolutely crazy and that’s not sustainable in a relationship. And now she can be with a guy who can make her happy in a way I never could.”
Sounds like he had it all figured out.
“Right,” he said, as if to bolster his own argument to himself.
“Anyway, I’ll be here next Sunday, Marigold… and I expect you to be here, too.” The door opened and closed with a bang.
October 31, Monday
THE HOSPITAL is doing what it can to make Halloween fun for the kids who are stuck here. Spooky music is playing over the intercom in between announcements. The staff are wearing costumes and passing out candy, and there’s a general sense of fun in the air.
Roberta dropped by earlier to describe her zombie outfit, and to bring me a scarf covered with sugar skulls and spider webs. She proclaimed me gloriously spooky before she bounced out of here to go to a party.
I’m tired, and fatigue is pulling at the corners of my mind, but I’m excited about tomorrow and the possibilities that surgery offers to me and my baby. I might not get much sleep tonight.
The door opened and closed. I don’t recognize the shoes or the footsteps, but I assume it’s a nurse wearing a costume.
So I’m surprised to hear the rosary beads on my bedrail clink together.
“I’m sorry, Marigold.”
The voice sounds slurred, but familiar. Recognition shoots through me. Sidney!
But before I can register the pleasure of her surprise visit, my brain starts going haywire, misfiring and fogging. I am falling headlong, tumbling over and over into a deeper, darker place. I’m not getting enough oxygen.
And it dawns on me that my sister is smothering me.
*****
Don’t miss a single day of COMA GIRL!
You can follow along for free on www.stephaniebond.com,
or if you prefer to read the segments early or all at once,
click here to pre-order COMA GIRL, part 5!
Bonus! Interview with an estate planning attorney:
What will happen if YOU wind up in a coma?
I’ve heard from so many readers who’ve said reading about Marigold has made them shudder over the possibility of winding up in a coma and not being able to communicate their wishes regarding their own care. So I posed a few questions about planning ahead for a health crisis to Atlanta attorney Jessi L. Patton, of Patton Law, LLC, who specializes in advising technical firms and entrepreneurs on business law and estate planning. I believe you’ll find Jessi’s responses eye-opening! (Pardon the pun, Marigold.)
SB: In COMA GIRL, Marigold Kemp is a single, 28-year-old woman who lies in a coma, the victim of a tragic accident. Marigold’s parents are living, married, and they also live in Atlanta. She has a single older brother in the US Army who’s stationed in Afghanistan, and a younger sister who goes to school in Boston. Marigold never had a conversation with her family members about her wishes in the wake of a traumatic medical event. She filled out an advance healthcare directive, but she never showed it to anyone. So in this situation, who has the responsibility of making medical decisions on her behalf?
JP: In Marigold’s situation, her parents would be named as her healthcare agents. This means they are legally empowered to make health and personal care decisions on behalf of Marigold. This would include medical treatment decisions including whether artificial means would be used to preserve Mari
gold’s life. If Marigold were to wake up (fingers crossed!) but is still unable to communicate, her parents may also be called upon to choose where Marigold lives or how she would be cared for. If the worst happens, her parents may also be asked to decide upon the disposition of Marigold’s body after death, approving organ donation, or authorizing an autopsy.
SB: Would it matter if Marigold were estranged from her family and/or if they lived out of state or in another country?
JP: Although this would not affect their legal standing as Marigold’s agents, doctors or a court may be forced to seek out the next of kin if her parents and siblings are unable to be located. It is also possible that her doctor may proceed with care without the guidance of her family if they could not be found. In addition, if Dr. Tyson had Marigold’s advance healthcare directive on file and knew of her (once recorded) preference to reject life-sustaining measures, she would not need to obtain consensus from her family.
SB: What if there is dissent among family members, i.e., between parents and siblings, as to her care?
JP: Unfortunately, there is often disagreement over treatment and end-of-life care when a patient is left in a persistent vegetative state. The legal struggle over Terri Schiavo’s prolonged life support is a very sad example of this conflict, which included a 15-year legal battle between Terri’s family and her husband.
This is one of the primary reasons everyone should have an advance healthcare directive and a trustworthy agent, especially if your wishes differ from your family members or spouse. In thinking about who to name as your healthcare agent, choose someone who respects your wishes, even if he or she has different opinions. For example, your agent might choose life-sustaining measures for himself but if you do not want those same actions, he should be able to respect and communicate your wishes to your physician and family. Your healthcare agent should also be able to handle a disagreement and express your wishes to the people who disagree.
SB: What if one of Marigold’s friends came forward and said she’d told them she wanted them to make decisions on her behalf, but the friend had nothing in writing?
JP: Unfortunately, the friend would have no legal standing but depending on her relationship with the family, she may be able to convince Marigold’s parents to align their decisions with her own given Marigold’s wishes. If this were not the case, the friend may contest Marigold’s healthcare agents in court and apply to be an appointed guardian. However, a judge would most likely not rule in her favor unless she was able to show that members of Marigold’s family were unfit to be her agents.
SB: What if Marigold had communicated to a non-relative in casual communication (i.e., email) that if something ever happened to her, she would want them to make decisions for her?
JP: Although a witnessed document authenticates a proper advance healthcare directive in each state, emails may be used to prove Marigold’s wishes in court if her friend decided to contest the standing of Marigold’s existing agents.
SB: Okay, so what should Marigold have done to make sure her medical wishes were followed in a situation where she is incapacitated to make those decisions?
JP: Hindsight is 20/20 but Marigold should have notified her family of her advance healthcare directive, discussed her wishes with doctors and family members, and appointed a strong healthcare agent. (On the flip side, forgetting to notify her family of her wishes might work in her favor since she now realizes she wants life preservation measures after all!)
SB: So it’s not enough to have an advance healthcare directive—someone actually has to know about it, right?
JP: Absolutely. The most important part of the advance healthcare directive is that you have a conversation with your physicians, family, friends, and agents about your wishes. Advance planning is an ongoing process. You should always double-check to be sure your healthcare providers are aware of your advance healthcare directive, especially before surgeries or major medical procedures.
SB: At the end of COMA GIRL, part 2, we find out Marigold is pregnant. Who has the responsibility of making medical decisions on behalf of her unborn child?
JP: In Marigold’s case, it would most likely be her parents. A pregnancy may also cancel a woman’s existing advance healthcare directive and many states (including Georgia where Marigold resides) have passed laws saying the option to reject life-sustaining measures doesn’t apply to pregnant women. Therefore, if you live in a state with such a restriction, medical providers may refuse to remove life support if you are pregnant. However, if you’re pregnant or might be in the future, it’s a good idea to state in your advance healthcare directive whether you want your documents to take effect because these laws are legally suspect under US Supreme Court rulings that protect a woman’s right to choose whether or not to bear children.
(Note for unmarried couples: It’s crucial that unmarried couples who are having a baby have an advance healthcare directive prepared because in most states, unless the partner is named in a written directive, healthcare decisions will belong to the mother’s relatives.)
SB: Do the laws/guidelines governing advance healthcare directives differ from state to state?
JP: Absolutely. The laws governing advance healthcare directives can vary so it is important to complete and sign advance healthcare directives that comply with your state’s law. Some states honor advance healthcare directives from another state while others will honor out-of-state advance healthcare directives as long as they are similar to the state’s own law. The best solution is to complete advance healthcare directives for all states you spend a significant amount of time in.
SB: Many people think they don’t need an advance healthcare directive, but it really is a gift to your family and friends, isn’t it?
JP: I couldn’t have said it better myself. If the time comes that an advance healthcare directive is needed, it will most likely be one of the worst days of your family members’ lives. Having to make medical decisions that could possibly end your life puts an incredible amount of stress on someone during an already tragic time, especially if they have to guess to what you would want. Taking the time to complete an advance healthcare directive and explaining your wishes to family members may one day relieve an incredible burden for your loved ones’ shoulders.
SB: What should a person do if they’re concerned about what will happen to them if they’re in a situation similar to our beloved heroine, Marigold?
JP: I’m so glad you asked! It’s important to know that an advance healthcare directive includes two important components:
1. Designating a healthcare agent, which we know identifies the person you select to be your voice for your healthcare decisions if you cannot speak for yourself; and
2. A “living will” which documents what medical treatments you would or would not want at the end of your life.
You should complete an advance healthcare directive as well as a financial power of attorney designation because your loved ones may also need access to your bank accounts to keep your bills and rent up to date if you were unable to do so. Be sure to name more than one healthcare agent and power of attorney in case your first choice is unavailable. I always recommend clients name two contingents for each, in addition to your first choice.
Make several copies of the completed documents and give them to each of your agents and power of attorneys. Make sure your healthcare providers have copies of your advance healthcare directive as well. Your local hospital might be willing to file your advance healthcare directive in case you are admitted in the future. Keep the original documents in a safe but easily accessible place, and tell others where you put them (hello, Marigold!). (Note: You do not want to keep your advance healthcare directive and power of attorney documents in a safe deposit box because other people may need access to them.)
Last but not least, the most important step is to speak with anyone who might be involved in your healthcare decision-making. This includes family members, loved ones, and your healthcare providers. Yo
u want to make sure they understand how you feel about medical treatment if you were in a situation like Marigold’s.
SB: My heartfelt thanks to Jessi L. Patton, of Patton Law, LLC, for taking the time to enlighten us about healthcare decision-making. You can learn more about Jessi and follow her informational blog at www.jessipatton.com.
___________
(Please note the information in this interview is intended for educational purposes only, and should not be construed as legal advice. Because laws differ from country to country and from state to state, you should consult a lawyer who is familiar with estate planning statutes in your area.)
A FREE Coma Girl Coloring Sheet!
Coloring is all the craze! Enthusiasts say it’s fun and even therapeutic—have you tried it yet? This is the fourth of 6 coloring sheets to celebrate the one bit of color in COMA GIRL’s limited world—the scarves Sidney brings to cover Marigold’s head bandages. This one is Halloween themed. Print the FREE coloring sheet at ComaGirlColoring4 (if you can’t print from your ebook reader, type the URL behind this link into a web browser from any computer) then add your own interpretation with colored pencils, crayons, markers, etc.
And if you’re a social creature, take a picture of your masterpiece and post it to social media with the #ComaGirl hashtag!
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Enjoy!
A note from the author
Thank you so very much for taking the time to read my story COMA GIRL (part 4). I hope you’re still having fun—I’m certainly having fun writing it. This project has been a labor of love for me. I’ve been toying with the idea of a daily serial for some time, and once I decided how to present it, I needed the right story, something that would sustain a daily narrative for an extended period of time.
When I was ten years old, one of my teachers revealed an accident had left her in a coma when she was young. She said she remembered all the conversations around her during that time and when she awoke, astounded doctors and family members by asking them about things they had said while she was “asleep.” At ten, my imagination was just starting to take flight, so I was fascinated by her tale and it stayed with me. Fast forward to when I began a fiction-writing career in the late 1990s. I pitched a romantic comedy about a woman in a coma to a publisher who liked the idea and, subsequently, bought it. But before I could finish writing it, the line closed and the contract was cancelled. (Please do not get me started about the unending wonkiness of the publishing industry.) I was so disappointed. I had written several chapters of the story and while I loved the concept, it didn’t fit any line I wrote for as my career progressed. So it sat on a shelf for 20 years.
Coma Girl: Part 4 (Kindle Single) Page 6
