Trapped (26 page)

Chapter Forty-Nine (Week 27)

Harvey Russo agreed to see Lisa at his office at seven-thirty the next morning, so she could get to Mike’s side early.

“How is he
?”

“Not good. They’re going to remove his colon tomorrow if he’s no
t better.”

“I work with Julie Kramer. She’s the best. I trust her with my life. Don’t despair. If removal of his colon saves his life, it’s a small price to pay.”

Harvey hugged Lisa. “Now let’s get back to you. I can’t find a way around it. The separation in the placenta hasn’t changed, but I can’t be certain that it won’t eventually.”

“Where does that leave me?”

“It means that we’re going to have to play it by ear. I called Harold Wexler, the chief of Obstetrics at Stanford, and he was as certain as we are about what to do.”

“What did he recommend?”

“What do you think? He doesn’t know you, or about what’s happening in your life. He has nothing to lose by taking the most conservative approach—bed rest.”

“As much as I want this baby, I don’t see how I can spend
all my time in bed, now.”

“What can I say? I’m not going to tell you what’s best
, and then go merrily on my way.”

“I can’t go to bed.”

“Look, Lisa, we don’t enjoy the usual doctor-patient relationship. We’re both professionals. I love Mike, and you know I’ll do anything to help you have his baby. Moreover, I trust you enough to allow you the latitude that I wouldn’t give to others.”

Lisa smiled. “Harvey, you’re such a dear man. If you weren’t happily married, I’d make a play for you.”

Harvey reddened. “I’ve worked with women my entire professional career, Lisa. You’re the first one to make me blush.”

“So, let’s have it.”

“We’ll hold off on bed rest for the moment, but I have some rules: no impact sports, no heavy lifting, no caffeine, no aspirin or anti-inflammatory drugs, and no vitamins or supplements that can possibly interfere with clotting.”

“What about Yoga?”

“I’m no expert on Yoga, but if it’s low impact, or, better yet, no impact, and it doesn’t stretch your belly too much, then I guess it’s okay.”

“Thanks, Harvey.”

“Please, Lisa, the only way you can trouble me is if you don’t call with any sign of bleeding or anything you feel unusual going on with the baby. Screw up once, and it’s your mother and leather restraints.”

“Got it,” Lisa said
, smiling. “Leather restraints, Harvey—very kinky.”

Harvey laughed. “I was born fifty years too early
.” He paused, and asked, “Do you have a second?”

“For you, anytime.”

“Have you met with Roberta recently?”

“A few times, but there’s so much going on that it's getting difficult for me.”

“If I’m not out of line, how does she seem to you?”

“We’re friends; she knows we talk about her, so I don’t see any problem. I can’t give you a simple answer to your question, Harvey. I really like Roberta, but her addiction makes the situation impos
sible. Like you, I sit between being a sympathetic ear and an enabler. You’ve been there, so you know what I mean.”

“I know exactly what you mean—love, even tough love isn’t enough. Maybe we need to wait until she hits bottom.”

“No Harvey, the price may be too high. Her drug use and her drug culture makes therapy, of any kind, impossible. To my mind, extensive inpatient rehabilitation is her only hope.”

When Lisa got to the ICU, Phoebe was still fussing over Mike’s bedding.

“Let me help you,” Lisa
said.

“Don’t you dare strain
yourself. I’ll do the muscle work. You adjust the linen.”

It’s voices—clear human voices—It’s Lisa, I’m sure, and maybe Phoebe.

I try to raise my head
—nothing.

I try to move my hand, wiggle my toes
—anything—and again, nothing.

My abdomen feels full
, like I just ate too much at Thanksgiving dinner.

Phoebe picked up the clipboard, and then squeezed Lisa’s hand. “It’s the permit for a total resection of Mike’s colon. They’re taking him tonight.”

Lisa stared at the forms. “I can’t
—not now—I’ll sign them later.”

Phoebe stared at Lisa
, but remained silent.

“Let me check his pupils
, and put in some more artificial tears,” Phoebe said.

When she pulled off the tape holding the lids closed, she gasped as Mike’s eyes, bright and brown, tracked her movements. Phoebe gasped, and then staggered backward.

Bright light
—something’s there. A blurry figure, no two figures, no, one—I’m seeing double.

“What is it?” Lisa cried. She moved closer to look into Mike’s eyes. She saw them drift, fix on her, and then track her movement.

“Mike
—Mike—can you hear me?”

I try to speak…

To move…

To do anything, but I can only blink my eyes. I blink once—wait—then blink twice.

“If you understand me, blink once for ‘yes’.”

Mike’s lids blinked once.

Lisa tightened her grip on Phoebe’s hand.

“Are you in pain?”

Two blinks.

“Can you see me?”

Mike blinked once, then twice.

“What does that mean?”

“Maybe he’s not seeing that well,” Phoebe said.

Mike blinked once.

Phoebe embraced Lisa. “I think we have an alphabet board in the back. We had a patient last year, who had…”

“What?” Lisa
asked.

“I’m not sure.”

“Phoebe…?”

“I don’t know for sure…”

“Phoebe?”

“She had the
locked-in syndrome.”

“No
—No,” Lisa screamed. “No!”

Oh my God. I can’t believe it. Locked in—unable to move a muscle, except my eyes.

I’m a prisoner in my own body.

I know it’s coming.

Paralyzed and breathing by a machine, I still feel the panic of breathlessness.

My heart pounds…

A heavy weight sits on my chest…

My head spins and I begin to sweat…

I feel the tunnel surrounding
me and the suffocating cloak of claustrophobia compressing me with the iron grip of a straightjacket.

I struggle to free myself
—nothing moves.

I try to hold my breath
. Maybe I can end it this way. I can’t even do that, as the machine fills and empties my lungs.

Only two options
remain: the serenity of sleep or madness, the ultimate freedom.

Lisa stared into Mike’s eyes as they wandered without purpose, and welled with tears that streamed down the side of his cheeks. “I love you, Mike.”

I close my eyes, and keep them closed in denial.

Let me out of here, my mind shrieks. Let me out of here!

Death, once my greatest fear, suddenly beguiles me. It draws me forward to the final escape from a life unworthy of the name.

Chapter Fifty

An air of expectant excitement spread through Brier Hospital with the remarkable, yet curious awakening of Michael Cooper.

Medical personnel identify with a group of specific illnesses through their education or experience.
One of the ones they feared the most was the locked-in syndrome—a living death, a life more akin to death.

Carter Reynolds manifested the callous indifference of some neurosurgeons and neurologists more enchanted with ‘an interesting case’ and too often forgetting what it meant to
the patient and his family. “This illness was first described by Emile Zola in
Thérèse Raquin
in 1868. The character of that name had a stroke leaving her with ‘only the language of her eyes’. A century later, Plum and Posner coined the term ‘locked-in syndrome’ for patients paralyzed, except for blinking, and vertical eye movement, yet maintaining sentient consciousness.”

“That’s all fine,” Lisa
said, “but…”

“It all fits,” said Reynolds
, turning to his colleagues. He’d come into the ICU with a group of neurologists and medical students. “It’s damage to a specific area at the base of the brain. That’s why his EEG has been normal all this time.”

“What part of his brain is damaged?”
A medical student asked.

“If you recall your neuroanatomy,” Reynolds
said, “you remember the pons. It’s the knob-like process 2 centimeters long that’s located on the front part of the brainstem. That area, plus the corticobulbar…”

“I’m standing here,
Doctor,” Lisa shouted. “Control your excitement, and answer a few questions, please.”

Phoebe put her arm around Lisa.

Reynolds turned red, embarrassed. “I’m so sorry. I just…” he hesitated, “no, there’s no excuse. Please accept my apology.”

Lisa nodded.

“Let’s move into the nurse’s lounge,” Reynolds said.

After the group seated themselves around the table, Reynolds asked, “Is it okay to have these doctors sit in?”

“It’s fine,” Lisa said.

“The damaged part of Dr. Cooper’s brain contains the nerve fibers that carry the impulses
which control body movement,” Reynolds said. “In addition, there’s injury to cranial nerves that control the face, speech, and swallowing. Some nearby parts of the brain are preserved, such as hearing, vision to some degree, lid and vertical eye movement.”

“But what does it all mean?” Lisa
cried. “He’s trapped inside his own body. What’s going to happen?”

Reynolds studied his feet,
and then said, “I can quote statistics, but that’s not what you need. Patients like Dr. Cooper…”

“His name is Mike.”

“I’m sorry. Patients like Mike with traumatic brain injury do best. They may show healing after prolonged periods of disability. Overall, however, most patients don’t recover. The ones who do, are often left with severe brain damage.”

Lisa held her face with both hands
, and wept.

“Please,” Reynolds
said, acting as if he were human, after all, “there’s a chance. Some patients have recovered. Many universities are working on this problem, and there’s been some success with experimental protocols. I need to review all of this for you, so we can make plans.”

“What do we do
, now?” Phoebe asked.

“I expect that Mike’s attention span may be limited at first
, but, over time, it should improve. We need to work with the alphabet board, so he can reach us. It’s important for him, and for us to communicate since we need to understand the quality of his thoughts. Later, we can look at all kinds of computer-assisted communication devices. This is only the beginning.”

“The beginning?” Lisa asked.

“When I went to medical school, they taught us that once the brain was damaged, the changes were irreversible. Today, we know that concept is completely false, and that the brain has plasticity, a fancy word that means that the brain can heal itself and grow new brain tissue. We’re depending on time, and Mike’s healing powers.”

When Lisa and Phoebe returned to Mike’s bedside, his eyes remained open. Lisa moved to position herself before his face. “Mike
, can you hear me?”

Nothing.

Lisa shook his shoulder, and then, in a louder voice said, “Mike, it’s Lisa. I’m here.”

Nothing.

“Reynolds said that his attention span was likely to be limited, at first,” Phoebe said. “Try again.”

Lisa place
d both hands on Mike’s face, bent over, and kissed him on the lips.

Her hands—they’re warm…

Her lips
—they’re soft…

Her love
—I feel it like the sun’s warmth.

Tears streamed from
Mike’s and Lisa’s eyes as she bent over her husband and embraced him. In an instant, their two souls united in love and loss.

Chapter Fifty-One (Week 28)

Mike’s condition remained stable into the next week. His colon remained distended, but hadn’t dilated further. The surgeons had their scalpels at the ready.

Lisa twisted and turned. Unable to sleep, her mind raced with unanswered questions. Finally, sometime after
3, she fell asleep and dreamed…

I take the last step into the deep sand. My foot sinks to the ankle—that’s unusual, I think.

I begin walking over the tall dunes
, struggling on the upward slope, sliding down on the other side. My balance with this big pregnant belly in front isn’t good, so I’m especially careful to not fall.

T
he sound of the ocean is just ahead, I but cannot see it.

I feel the soft salty breeze
, and smell the ocean, but each time I turn, all I see is more dunes.

I turn back
.

W
hich way is home?

It’s getting darker by the
minute.

I’m tired.

My head is down as I start up the slope again.

Suddenly, the sand under my feet gives way
, and I’m falling backward into a darkened pit. Sand from above covers me to the waist—I can’t move my legs. More sand pours in. I can’t see my belly. I struggle to move, but soon sand covers my arms and hands. As it reaches my mouth, I begin to scream.

Something hot and wet—dog spit, Mike used to say, from a gleaming pink tongue laps at my face.

“It’s okay
, girl,” Lisa said. “It was only a dream.”

Daisy took her last lick
, and then snuggled up next to Lisa’s belly. Lisa scratched behind the dog’s ears as her tail thumped against the bedding.

“Okay
, okay, Daisy. I’m glad to see you, too.”

After Mike and Lisa fell in love with Daisy, the depth of their affection for the animal astounded them. She remembered when Mike first told his favorite joke to her
: “Do you know the difference between a bride and a puppy?”

“No,
” she smiled.

He smiled back at her. Mike enjoyed telling her his favorite jokes. “After a year, the dog is still glad to see you.”

Lisa had to admit that she had a special bond with Daisy, who sensed her moods, knew when she needed an emotional lift, and, yes, gave her unconditional love.

“Get your toy,” Lisa said, as she rolled out of bed and led Daisy to the sliding patio door
, which admitted the intense streams of morning sunlight. Lisa slid open the door, and tossed a red rubber dog bone into the backyard.

While Daisy remained outside, Lisa performed a physical assessment on herself. She stretched, massaged her back, shoulders and neck,
and then placed both hands on her belly, and said, “Good morning, sweetie. Mommy’s here. I love you.”

She felt the baby awaken and begin to move, gently twisting
as if trying to find a comfortable position.

Could any position in the uterus be uncomfortable?

Lisa went to the bathroom and checked her pad; it was clean. A good start for the day.

She washed her face, brushed her teeth
, and gargled with a cinnamon-flavored anti-cavity rinse, and then walked into the kitchen and pushed the button on the coffee maker.

“Oh, I would have made the coffee,” Sandy said as she staggered
, bleary-eyed into the kitchen.

“Good morning, Mother.”

“Is everything…”

“So far, so good. No bleeding this morning.”

“What can I make you for breakfast?”

“Remember those buttermilk pancakes you used to make at home? I’d love that
, with sausage.”

“Coming right up,” said Sandy smiling and setting to work.

Lisa picked up the phone, and then dialed directly into Brier ICU.

When Phoebe came to the phone, Lisa
asked, “How’s he doing?”

“I sense that he’s more with it
this morning. Lots of yes and no answers. He’s waiting for you to come in.”

Lisa felt her heart beating. “I’ll be right in after breakfast.”

Lisa heard Daisy scratching at the patio door, and started to get up.

“No, you rest. I’ll let the dog in.”

Sandy looked at Daisy through the heavy glass door. “Do you wipe her feet before you let her in? It’s dirty out there. We don’t want her bringing in germs.”

Germs?

“Please, Mother. Just let her in. Daisy’s no dirtier than the rest of us.”

Sandy sneered at that comment, gave a strong humph, and then opened the door.

Daisy forced her way in before the door was completely open, raced to Lisa’s side, and jumped into her lap.

“Easy, Daisy. Watch Mommy’s belly.”

As Lisa kissed Daisy’s snout, Sandy paled, and then turned away. “Boy, Daisy,” Lisa said, “you sure smell like an outside dog this morning.”

“How can you kiss that disgusting dog?”

“Please, Mother.”

Lisa grabbed the
Contra Costa Times
, placed Daisy in the seat next to her, and read.

Soon, the room filled with the aroma of pancakes and fried sausage.

When Sandy approached the table and saw Lisa and Daisy awaiting their breakfasts, she groaned. “You want me to serve the dog, and then eat at the same table with it?”

Lisa shook her head. “Let me give her a few bites
, and then I’ll put her down. She’s just used to this. Mike loved having Daisy at the table, and so did I.”

“It’s bad enough that you sleep with that dirty beast, but this is too much.”

“Maybe it’s time for you to go back to Grass Valley, Mother.”

Harvey had just delivered the fourth baby of the night.

I’m getting too old for this.

I’m beat,
he thought, as he headed for the Brier parking garage at seven-thirty a.m. One of his young partners had come in, so Harvey planned at trip home for breakfast and a shower.

As he entered the ‘Doctor’s
Only’ section, he heard the sound of feet approaching from behind.

He turned in time to see a tattooed, black-jacketed, husky man turn into the space between his car and the one next to it, blocking any hope of escape.

“You Russo?” Growled the man as he approached, holding something behind his back.

“I’m Dr. Russo. What can I do for you?”

“Ain’t you done enough, you son-of-a-bitch?” The man muttered as he came closer.

“I don’t know what you’re talking about. Now get out of my way before you get into trouble.”

“Me, in trouble,” he laughed, pulling an aluminum bat from behind his back. “That’s a laugh.”

“I still don’t know what
this is all about. You’re making a mistake.”

“Some mistake. You know Edna-Sue
—this is for her,” he shouted as he swung the bat.

Harvey stepped inside the arc of the swing
, and delivered a solid kick into his attacker’s groin. As the man bent over to hold his genitals, Harvey delivered a blow to his neck. The man fell to the floor and remained still.

Harvey rolled him over, felt his pulse
, and extended his neck to insure an adequate airway. He then pulled out his cell phone and dialed 911, and waited until the police arrived.

The man started to stir
, as Berkeley’s finest arrived.

“You’d better take him to ER,” Harvey
said, “before you lock him up.”

“We’ll need a statement from you,
Doc.”

“
I’ll be down to the station after I take a shower and have a bite.”

“And, Doc…
”

“Yes
?”

“Remind me to
not get into a fight with you.”