After the Fall (5 page)

Concussion? Hahnemann? Penn? MRI?
Despite the throbbing sensation, Laura forced her eyes open. She couldn't see much more than a white ceiling. Yes, she was in a hospital.
The beeping sound was a monitor. The smell, antiseptics. The pain, real and severe. A sensation that her whole right side was suspended.

She was about to try to make a sound, try to communicate, when Natalie said, “Tim's calling in the best hand surgeon in the country for the reconstruction.”

“If only I'd insisted on picking her up this morning,” Mike said, “none of this would have happened.”

“Stop, Mike,” Nicole's voice, “she fell on the ice. That's nobody's fault. Let's just concentrate on cheering her up when she wakes up. Okay?”

I fell? I have a concussion?
That accounted for the intolerable pounding. Laura tried to focus on her kids' conversation but failed, drifting into a cocooned half sleep, grateful that when she stopped concentrating on the voices, the pressure in her head subsided.

Laura awoke to the sounds of her children disagreeing, but could only catch snippets, didn't know if she was dreaming. Then memory returned, unwelcome, ominous.

An attempt to speak resulted in a pathetic muffled sound. How long had she been out? Sunlight streamed in the lone window…

“Mom, you're awake.” Her daughters spoke over each other.

Laura tried to sit up, but with a massive spike of pain on her right side, collapsed back against the pillows. She squeezed her eyes shut. Something was very wrong.
Try to isolate the pain
. Her training was starting to kick in, only this was not a patient, this was her body, and this was more pain than she ever could have imagined.

Immediately, Laura felt hands on her, so many hands reaching out to her that she couldn't muster the concentration to count. Her kids' and Tim's, all easing her back against the pillow.

Tim's voice came through. “Laura, you've had a fall. You hit your head pretty hard. On the ice.”

She looked from worried face to worried face. Even moving her eyes made her feel dizzy, disoriented. She did realize she had an intravenous line in her left arm, taped to a padded board. But something horrible was wrong with her right arm. The pain on her right side was excruciating. Worse than the raging thunderbolts in her head. She had to find the source, but moving her head sent shock waves through her brain.

“Mom, you're going to be okay,” Natalie said. “Just lean back, okay?” Her med student daughter practicing bedside manner.

Laura ignored the increased throbbing in her head to twist as far to the right as she could. That's when she saw the contraption that suspended her arm, as well as the bulky dressing that enveloped her arm from just below the shoulder to her hand. She was not an orthopedic surgeon, but she'd seen enough trauma to recognize that she must have fractured her hand or her wrist or both.

“What's wrong with my hand?” Laura gasped, her voice raspy. She tried to raise her head. Couldn't. Her head stayed on the pillow.

A gaunt, blond doctor in a white coat had walked into the room. He stood for a moment with no facial expression, observing, before addressing them. “Mom's awake, I see. Now if you'll let me inside your inner circle, I'll do a quick neuro assessment.”

Laura hated when doctors talked about their patients in the third person, and antipathy brought with it sharper consciousness. She wanted to say: “How about starting like this. ‘Laura,' or ‘Doctor Nelson, I see you are awake. I'd like to examine you.'” Stepping toward her, he did announce that he was Dr. So and So, a neurosurgeon. Not a neurosurgeon she'd want operating on her.

Tim and the kids stood back as the doctor brushed aside her bangs and inspected her head. Then he put her through a series
of tests to check her mental status, her cranial nerves, her motor skills, and her reflexes. Laura tried to comply, just wanting him out of there so she could insist that her family tell her what was wrong with her hand.

“Mom has a hairline skull fracture, a brain contusion with minimal swelling, no localizing lesions,” the neurosurgeon reported. “She should be okay, but we'll do a repeat CAT scan tomorrow.” Then he nodded toward Laura's bandaged appendage. “How we doing here?”

I don't know about you, but I'm doing poorly
.

“Thank you, Doctor.” Tim terminated the consultation, guiding the man by his elbow to the door.

The kids had surrounded her again when Tim pushed his way into the middle of the pack.

“Okay,” Laura said, looking from one stricken face to another. “Who's going to tell me?”

“Laura, you've just regained consciousness. You were out for almost thirty hours. Your head must hurt terribly. We can get you pain medication—”

“I have an awful headache. But, tell me. What is wrong with my
hand?”

“You fell on the ice. Just outside my apartment,” Tim said. “Next to the limo. You went down hard, hit your head. You must have tried to break the fall with your right hand.”

Laura could feel her face twist into a grimace, and she must have let out a groan because Patrick moved in closer and said, “Mom, let's go over this later. Okay?”

“Now,” Laura said. “Please.”

Tim continued. “Your hand took the brunt as well as your wrist. Several bones are fractured. There's some nerve injury.”

Laura knew the damage must be severe. Why else would all the faces around her look so terrified? A fractured hand, a wrist, no big deal.
Unless you are a surgeon
.

“You've already had stabilizing surgery, but you're going to need a top-notch hand surgeon. We have one flying in from
Denver. We all assume Philly's the mecca of medical care, and turns out the best guy is in Denver.”

“Lots of ski accidents,” Kevin said.

“The specialist will be in this afternoon,” Mike said. “Then we'll know more, but right now you should get some rest.”

“We all waited for you to wake up, Mom,” said Nicole, “and now we all want you back to sleep.”

A gray-haired woman in a blue-patterned uniform came through the door with a prefilled syringe on a tray. “Your pain meds,” she said, glancing up at Laura's elevated right arm. “You're going to need this, honey.”

Laura—chief of surgery at Tampa City—relegated to “honey.” And yes, the pain was excruciating, and she did welcome the offer of relief.

M
ONDAY
, F
EBRUARY
17

When Laura awoke in the late afternoon, Tim and all five kids were there. Her family was strangely subdued, each looking to the other, no one having much to say. The pain in her head had abated, but her right hand and her whole forearm felt on fire.

A nurse came in, offered pain meds.

Laura refused. She had to know what was happening before she drifted off to la-la land.

“Dr. Nelson,” a booming male voice intruded. “Good. You're awake. I need you awake to explain what's going on.”

Laura blinked, her vision hazy. She was almost blind without her contacts or glasses, but the person was tall, had a lot of dark curly hair, and wore scrubs.

“I'm Dr. Matt Corey,” he explained, his voice still loud, yet kindly. “I'm here from Denver. I specialize in hand injuries like yours.”

Yes, she'd injured her hand in a fall. And she'd hit her head.

“I don't beat around the bush. The fall fractured the radial styloid; you have a proximal avulsion of the abductor pollicis longus and the extensor pollicis brevis.”

Laura felt tears spilling. She looked into Dr. Corey's eyes. She saw compassion and respect. He was giving it to her straight. She translated, mentally: wrist shattered; muscles and tendons connecting the bones in the hand to the forearm torn out of their insertions; small bones in the hand crushed.

But the hand specialist was not finished. “We could repair most of that, but…” He hesitated. Laura thought she could hear Tim and all the kids holding their breath.
But what?
“You're developing compartment syndrome. Around the thenar space. The specialists here took you to the operating room, did a fasciotomy, decompressed the space, tried a K-wire, but there was too much ischemic tissue damage—”

“Dr. Corey, you are telling me my hand will no longer be functional.” Not a question, a statement of fact.

Tim and her kids gathered in closer, and Laura felt every heartbeat exaggerate the drumming ache in her head and tear at the overwhelming pain in her hand.

“Dr. Corey, I thank you for your honesty,” she managed before the tears started overflowing, “and for coming so far on such short notice.” She couldn't hold back, couldn't remember when she'd cried in front of her kids. Maybe never. Maybe when their father died.

“I'm sorry, Laura,” Tim said, grabbing a handful of Kleenex.

“I'll be okay,” Laura choked out through the tears. “But could you ask that nurse to come back. I'd love some pain meds. My hand hurts like hell.”

T
UESDAY
, F
EBRUARY
18

Jake left the FDA early on Tuesday afternoon. He'd had a busy day strategizing, networking, planting problems for Immunone, the wonder drug. Keystone Pharma was well respected among FDA staffers, having few detractors, so he couldn't count on applause when he detonated his Immunone-bashing plan. Not a problem, because he was at the center of the data collection process and could arrange for data to disappear. Twenty-five years at the agency, you knew all the nooks and crannies, all the hiding places, physical and electronic. Today, he would set the stage. Tomorrow, he'd implement. But tonight, he'd enjoy.

After leaving the FDA, Jake stopped by his house to gather a few items of clothing. He planned to arrive at Addie's in time for them to have a nice dinner out before a night of sizzling sex. He was fifty-five years old but performing like an eighteen-year-old. Sexual prowess was not a problem. The anticipation of Karolee's return, the menace of Addie's Islamic family, the conflict of interest concerns in their jobs—despite three potential strikes against them, Jake and Addie were unstoppable.

As Jake pulled into a rare empty spot in front of Addie's building, he felt an overpowering sense of wonder. Yes, fifty-five years old and crazy in love with a thirty-four-year-old Arab beauty. And the most wonderful part was that she loved him too. They may have three or three hundred strikes against them, but Jake had been a Marine. Marines win.

Jake had arrived early. Addie wouldn't be home for another hour. So he lowered the car seat, leaned against the head rest, and drifted off to sleep.

He woke up to a pecking noise on the driver's side window. For a moment, Jake didn't know where he was. The sun had set, leaving him in a dark, moonless night. Then someone leaned over the windshield, gesturing to him. Addie. He'd been in a deep sleep. He tried to shake it off, reaching for the lever to adjust the seat upward, and motioned her to get in on the passenger side.

“What are you doing here? What if somebody sees you?” she asked, opening the door, tossing her briefcase on the floorboard, and climbing in.

“It's dark. Nobody's going to see me, Addie. You worry too much.”

“Did you hear the really bad news?” she asked, black eyes flashing in the dimly lit interior.

Jake shook his head. With Addie, bad news was usually about the deteriorating situation between the United States and Iraq, and the UN's hunt for weapons of mass destruction.

“Dr. Minn from Keystone Pharma died. He was hit by a car Sunday night in Philadelphia. My family thinks Washington is dangerous for me, but Philadelphia and Baltimore are worse.”

Jake refrained from saying,
What about Baghdad?

Addie didn't stop to take a breath. “What does that mean for Immunone? Dr. Minn was the key researcher. Will this slow down the approval? What if—”

“Addie, stop! I told you there were problems with the drug. I'm sorry about Dr. Minn, but it shouldn't matter.” By all means, Dr. Minn out of the picture must matter.

“It's too cold to talk in here,” Addie said, grabbing her briefcase, noticing Jake's overnight bag in the back seat. “Good. You brought your things. You're staying all night?”

“Yes, my darling, we have the whole night. Just the two of us. After a nice dinner, we'll—”

“We can't stay out here. People will see you. Like that old lady did last night. My father can't find out that a man stayed overnight with me, it's against Islamic law. You Westerners will never understand.”

“I can look out for myself, and I can take care of you. You worry too much. Now let's go upstairs, decide where to have dinner.”

Addie got out of the car and they walked together to the elevator, took it to her floor, and proceeded to her apartment. Jake noticed how she kept her head down, eyes averted. That would change once they were married. She'd hold her head high, proud to be with him.