Regaining his composure, Vinny turned toward the amputee and gave him a thumbs-up. When he turned back to the bed, Peter’s eyes were open.
Vinny got in his brother’s face. “Peter, Peter, it’s me, Vinny. You’re gonna be all right, man.”
Vinny stared into Peter’s unfocused eyes. Then his brother’s head lolled and his eyes closed.
“Come on, man. Wake up, buddy.”
After repeated pleas went unanswered, Vinny pried open his brother’s left then right eye. Emptiness stared back, and Vinny slumped into his chair.
***
“Wake up and make yourself useful.”
“Uh, must’ve dozed off.”
Angela handed him a cup and lollipop-like swab “His lips are getting dried out. Swab ’em every now and then, but don’t get any in his mouth. He could aspirate.”
“His eyes were open for a second.”
“Good. You see how clear this fluid is?”
He leapt up. “Wow, it really cleared up!”
“That’s because the bleeding’s done, and it’s stable. I’ll inform the doctor. He’ll run scans tomorrow.”
As she turned to leave, Vinny said, “Wait, look, his eyes are open! Peter, how you doing, man?”
“Hello, Peter. You’re gonna be fine.” Angela patted his forearm.
Peter’s eyes shut.
***
Peter had been up periodically before being taken for the scans. When Angela rolled him back in, he was out cold.
“How soon will we get the results?”
“Immediately, it’s digital. Maggie told me the doctor and the head neuro guy were going over them now and will have an assessment for you.”
Vinny frowned.
“Stay positive. I’ve got a good feeling about it.”
“I—I just, you know; oh, forget it.”
“Forget nothing. What’s going on?”
“You mean besides my brother laying here like a vegetable in Germany?”
“I mean with you.”
“I don’t know what to do. I live down in Texas, and if he’s going to need, I don’t know, like a ton of care . . .” He shook his head. “We ain’t got nobody. Parents dead. No brothers, sisters, nobody to help out.”
“Whoa, take it one step at a time. First, let’s get a handle on his condition and then take it from there. Okay?”
“Guess so, no other choice.”
Angela smiled. “Oh, by the way, that girl Mary Rourke called again. Said you never called her back.”
“Okay, I’ll call her. And just so you know, she’s a friend of Pete’s, not mine.”
“Here comes Dr. Molanari.”
He turned and saw the doctor beckoning. Vinny flashed crossed fingers to Angela and followed the doctor out. Vinny and the doctor huddled in the busy corridor.
“Look, we were able to capture some really high-quality scans today. The resolution was outstanding. Now, we’ve got some good news and some not so good.”
Chapter 3
The doctor leaned into the wall as nurses streamed by.
“Peter’s taken a bit of a beating. It’s early in the game, but it could’ve been worse. That said, you should be prepared for the possibility of long-term or permanent impairment in his cognitive ability and memory.”
Vinny shook his head, “What d’ya mean? Is he going be slow or something?”
The doctor slipped a foot out of his clog.
“We really don’t know at this stage. Let’s concentrate on the positives. He’s lost most of his motor skills from the shock to the cranium, but it appears temporary and recoverable.”
“Okay.”
The physician waved at a passing colleague.
“Look, in a day or so, he’ll be awake, most times, and though communication will be challenging, it’s best to get him into intensive rehab as fast as possible. If we don’t have any setbacks, we’re looking at flying him to Walter Reed in five, six days, max.”
“Walter Reed in America?”
“Yes, DC.”
Peter felt a surge of hope and nodded.
“I’m sorry, but I’ve got to run.” The doctor put his hand on Vinny’s shoulder. “You hang in there, and take care of yourself. He’s going to need your support.”
***
Peter’s brown eyes moved from a spaced-out look that couldn’t follow your finger, to one evidencing focus. On the third day, he was able to follow movements, and a day later, to follow instructions: blinking once for yes, twice for no. Vinny was pleased but frustrated with the glacial pace. He estimated it would take two or three years before his brother would have any independence. At that pace, how was he ever going to get back to Texas and his life?
The day Peter was going to be moved, he kept mouthing the name Mary, sending a chill down Vinny’s back. Peter’s face strained from the effort, and Vinny told his brother to save his strength for the flight to the States. Reacting to the news he was headed to America, Peter’s head moved, and his eyes lit up. Peter continued to struggle to speak Mary’s name. Vinny squeezed his hand and tried to calm him down. Finally, Pete had another coughing fit and collapsed into a deep sleep.
Vinny unhooked his hand as Angie tended to the patient in the next bed.
“Hey Ang, guess what? Petey reacted like crazy when I told him he was going home.”
“I don’t know, Vin, it’s doubtful he knows where he is.”
Vinny got up.
“Nah, I swear he moved his head, and his eyes lit up.”
“Well, you never know.”
“I’ll wake him, okay?”
She came to the bedside. “Leave him be. Hmm, his heart rate’s elevated.”
“I thought it was his excitement.”
“Not when he’s sleeping.”
Peter coughed, and Angie asked, “He been coughing regularly?”
“Yeah, every ten to fifteen minutes or so.”
“Anything come up? Like blood?”
“No.”
She opened his mouth, swabbed inside, and came up with what looked like a dab of blood. “Damn.”
“What’s wrong?”
She hit the call button and rushed out.
Vinny watched his brother’s heart rate fluctuate around 120, and he coughed twice in the five minutes it took for an X-ray machine to be rolled in and three pictures taken.
A few minutes later, Dr. Molanari came into the room, trailed by Angela.
“Your brother has a pulmonary embolism.”
Angela explained, “A blood clot in his right lung.”
“That serious?”
“Can be deadly.”
“You fucking kidding me?”
“The doctor is going to give him something to help with this.”
The doctor handed a syringe to Angie. “Here’s the TPA. In the left arm while I administer the coumadin.”
Vinny questioned, “How the heck did he get this?”
They said, “Combo of trauma to the leg and immobilization.”
Vinny wagged his head. “Now what?”
“Well, he’ll be on blood thinners. It’s complicated by the TBI. I hate to break it to you, but he isn’t going anywhere.”
Vinny shook his head and headed for the elevators.
A nurse at the station called out, “Vinny! Call for you, from New Jersey.”
Vinny pointed and headed to the lounge.
“Hi Vinny, how’s Peter?”
“Well, right now, not so good.”
Mary gasped. “What’s going on?”
“Look, he’s hooked up to a bunch of machines, and a new problem just cropped up.”
“Oh my God, I feel terrible.”
“Look, save your tears. You got your life to live, and Pete’s—”
“How dare you!”
“How dare me? No, it’s how the fuck dare you!” Vinny slammed the phone down.
***
Peter was the recipient of even more leg massages and was getting stuck with needles to chec
k how thin his blood was. It was a delicate balance. The doctors were fearful that if his blood was too thin it could ignite bleeding in the brain.
Antsy, Vinny went to call his boss with the news about his delayed return.
Vinny hung up and pinched the bridge of his nose with a thumb and forefinger. The call unsettled him as it didn’t jibe with the sympathetic accommodation he’d received to date. Vinny now got the vibe his boss was losing patience with his prolonged absence.
Chapter 4
It took five days for the threatening clot to dissipate. Peter was now ready to be moved out. The extra time revealed improvement in Peter’s alertness that was measurable. He even began to speak at times, though the words were muddled and disconnected. Welcomed, the speech progress was tempered by his repeated pleas for Mary.
Vinny despised making the journey to Walter Reed Hospital on a military flight, but with Peter clearly frightened, he relented. The presence of thirty or so maimed warriors aboard made the six-hour flight seem endless.
Walter Reed Military Medical Center was the size of a small city, with a staff of ten thousand, and six thousand rooms. It had been tending to America’s fighting forces for over a hundred years.
As soon as they arrived, Peter was whisked away by a small army of medical personnel. A talkative volunteer showed Vinny to the family housing complex and asked too many questions. Vinny closed the door quickly and surveyed the surprising suite he’d bunk in for who knew how long. It was so nice that he started to question how much tax money was being spent on it. He unpacked and tried to go to sleep but kept himself up by fuming over the tax money spent to buy silence from the families of those hurt.
Vinny went to a meeting to go over Peter’s case in a rehab room filled with equipment in use. The huge, sunny room was filled with patients and their therapists, who provided motivation, encouragement, and praise.
Vinny was directed to a stocky man with horn-rimmed glasses standing beside a set of cubicles. He held a clipboard in one hand and offered the other.
“John Clalia. I’m Peter’s lead physiatrist. You got to be Peter’s brother Vinny, right?”
Vinny said, “Psychiatrist?”
“No, close, but its physiatrist. We’re trained in physical medicine and rehabilitation. I’m overseeing Peter’s case.”
The interior of the tiny cubicle was covered with photos of wounded soldiers in various stages of recovery. There were a lot of smiling faces on the torn-up bodies in the pictures, but they didn’t raise Vinny’s spirit.
“I don’t know how you guys do all this, day in, day out.”
“It’s extremely rewarding.”
“Frigging depressing is what it is.”
“Your brother sustained a traumatic brain injury. What we don’t know is how much function he’ll be able to recover. A significant amount of progress in these types of cases comes from the hard work that helps, or more correctly, forces the brain to learn again.” Clalia pushed his glasses up. “On a scale of one to ten, how would you rate Peter’s drive, his focus? What happens when the going gets tough?”
“He’s not easily dissuaded. He’s going to do what he wants to do, no matter what. I remember as kids he was tormented by one of my friends on a football team, but he didn’t give up.”
“Good. You mentioned he’ll do what he wants to do. What do you suggest we do to motivate him?”
“What more motivation does a guy need to get better?”
“Well, you’d be surprised. Many of the people we treat, they get down.”
“You mean depressed?”
“Yeah, it’s a typical phase most go through. Expect it to happen, and if it doesn’t, it’s a giant plus.”
Vinny shifted in his seat.
“The treatment your brother will receive here is comprehensive.”
“Like physical therapy?”
“That’s one component. We practice a holistic approach. He’ll also work with a speech pathologist, a neuropsychologist, an occupational therapist, a recreational therapist, and a social worker. There’ll even be someone for you to help you deal with all this.”
“I’m okay. I don’t need any help.”
“Well, we find most families need help with things like how to modify the house to prevent falls, or recognizing the early signs that the patient may be engaging in risky behavior.”
Vinny pulled his chin in.
“Risky, like drinking alcohol or an activity that heightens the risk of a concussion.”
Vinny sighed. “In other words, he needs a babysitter.”
Clalia took his glasses off and pinched the bridge of his nose. “The reality is your brother suffered a serious brain injury, and the facts are that people in his condition are ten times more likely to suffer a concussion after they recover.”
“Ten times?”
“Unfortunately, even if he recovers most of his physical abilities, a real danger exists. You see, a brain injury is an invisible disability. If he doesn’t modify his behavior, changing his lifestyle in some ways, he’s likely to suffer what could be a devastating concussion.”
“I thought he was here to get better, you know, not to be—”
Clalia held a hand up. “Part of the process is to be informed of the risks going forward, a way to ensure that the progress we make here is kept in the bank, so to speak.”
The physiatrist and Vinny talked for a half hour longer with the focus returning to the importance of Peter’s emotional stability. Clalia stressing that the highest degrees of recovery were inexorably linked to avoiding depression.
Chapter 5
The rehab room smelled of Pine-Sol. A couple of therapists were with his brother. Vinny liked the way they took his brother’s limp hand and shook it as if there were nothing wrong.
Clalia, glasses dangled from his neck, issued instructions, and the group moved Peter to a pair of parallel bars. They maneuvered Peter into a contraption between the handrails. Encircled by therapists, they lowered Peter, putting his hands on the rubberized rails and his feet on the ground.
A beefy kid knelt, straightening Peter’s feet, “Okay, Peter, let’s go for a stroll. Darlene, take a few photos for posterity’s sake.”
Slowly, the hoist inched the grimacing patient forward. Two therapists inched Pete’s hands forward while another kept pace with his feet.
“Come on, Pete. Take a step. Help us out here. You’re not going to make us do all the work, are you?”
“He’s moving his hands! Way to go, man!”
Excited by the declaration, Vinny studied his brother’s hands. There was no voluntary movement.
***
The exercise session lasted fifteen minutes before I ran out of steam. I was a prisoner of my body. It had to be depressing for Vinny as well, and I caught a glimpse of him cursing as they wheeled me out. I was beat and drifted to sleep.
I don’t remember getting put back in bed, but they told me I’d napped for two hours. They got me up, fed me a snack, and then helped me brush my teeth. When a mirror was propped up on the tray, I was glad to see that my hair had grown enough to cover the gap between my head and ears. Refreshed, I felt ready for a series of tests to determine my cognitive state—doctor speak for memory, language, executive function, and visuospatial capabilities.
They wheeled me to another wing of the hospital. A sedate suite of rooms with classical music playing softly in the background. I immediately thought of a funeral parlor and began to get worked up, but a neuropsychologist named James and his smiling female assistant noted my anxiety.
“Peter, we’re here to get an idea of what areas need attention. We’ll administer tests, but don’t worry. Your injury is still healing.”
I nodded.
“Most of all, please don’t get frustrated. Things that you may not be able to do today will come back quicker than you think, okay?”
I didn’t like the way this sounded, but not knowing what to do, nodded anyway.
“Let’s begin over h
ere.”
The doctor held up a red square. “What color do you see?”
“Uh, uh, rrr, red.”
“Excellent.”
The doctor went through six colors, and I nailed them. My spirits skyrocketed, but a problem arose when the doctor would show a color, hide it, and ask what color it was. When he did that, my success rate went down by half. I got irritable. The doctor moved on to another test.
The doctor showed me a picture of three animals and pointed at them. “Is this a cat? Dog?” Most of the identities I picked out. I mean, geez, they’re animals. But, when the doctor asked whether a certain animal was left, right, or in the middle of the picture, I got confused and failed miserably. How the hell could I be screwing this up?
I was getting tired of all the bullshit when they moved on to a test identifying shapes.
Surprisingly, I was able to identify each one correctly and was even able to recall most of them within ten seconds of seeing it. However, when the doctor lengthened the time to twenty seconds between seeing the images, I faltered, unable to recall even one shape.
The roller coaster continued. I did well in the language area, at times jumbling the order of words, but the doctor seemed pleased.
The last testing zone was visuospatial, to gauge how I interpreted what I saw. The doctor pulled out two props: a clock where he changed times, and two glasses of water with different amounts of water. It seemed simple but was a total disaster, exposing an area where loss screamed out.
I tried to pound the table as I spit out a stream of curses. The doctor tried to talk me down. He thought he was sly, concluding the series of tests with something I’d pass, ending on a high note. I saw right through him.
***
Walter Reed had a rigid schedule, almost Nazi-like. They wouldn’t let any grass grow when it concerned Peter’s care and rehab. Breakfast was at seven, followed by speech therapy, then a light muscle massage. Then it was physical therapy, focusing on the lower body, before lunch. After a nap, Peter would meet with Clalia before a session of emotional and psychological management with a neuropsychologist. Then it was back to PT, emphasizing the upper body, before dinner.
Most days, Peter was so fatigued he'd sleep when not in rehab. Vinny voiced his concerns, but the staff promised the regime would yield results.
Luca Mystery Series Box Set Page 3
