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Monday, November 25, 2013

Now.

(April 27, 2013)


I had a dream.

I'm walking down the pavement of a familiar park.  It's sunny out, and I notice a man on the path ahead of me.

This man turns to wave, smiling.  He is carrying a mail sack.  White.

I yell to him but he does not hear me.  He turns and continues to walk away.  I begin to run after him, and it is then that I realize what's in the bag.

He's holding my memories.  All of them.  My entire childhood, every book I've ever read.  All of my secrets, my fears.  A lifetime's worth of connections and recognition over his shoulder.  Like Santa Claus. 

I'm sprinting now, running as fast as I can.  The sun is setting, and I see him reach a hill.  He slows briefly before going over, out of sight.  Never breaking stride.

______________________________________________________________

People tell me how great I'm doing, how strong we are to get through something like this.  If it were them, they wouldn't be at work.  They couldn't get out of bed.  Little do they know that I'm really not that strong at all.  It's all that I have not to completely shut down.

Last night I found myself in the bathroom, screaming into a towel at 3am.  All of these thoughts...these thoughts that you might not be the same, that you might not remember us.  At times  they are too much for me to handle.  In the beginning, everything was happening so fast. It was difficult to think about time from one minute to the next.  I just took it every second, one at a time.  We all did.  But now?  Now we can see a bit farther.  My back aches from these chairs.  I long to go home straight from work, to kiss my son goodnight.  Now, this isn't some tragedy you are involved with.  Now this is life.

I can't figure out which is worse.  Is it better to know nothing about brain injury at all?  In some ways, I think so.  Then I might find it easier to be optimistic;  however I have this basis of knowledge.  The brain has always fascinated me.   I have taken classes, taught lessons.  I know what these injuries entail.  We discuss people with neurological disorders, their struggles.  In my mind they are always some stranger in a distant place.  They are never you.

It is becoming increasingly hard to focus on the positive.  I am grateful that you are alive, but I am terrified of what is to come.  Before, I could place my thoughts on the small victories but now they aren't enough.  I want you back, completely and in your entirety.  Yes it's selfish, but I can't help it.  I don't want you back in any capacity.  I want you back, same as before. 

Lately I wake up not wanting to.  I can't be happy for anyone else, and I can't seem to grasp how to function normally in this prognosis.  This unknown space.  How do you make dinner?  How do you engage in small talk with this ominous cloud over your every move?

Frank asked about you today.  As we left the grocery store, out of nowhere he asked if you were better.  I told him no. 

He looked up at me.  And in the middle of the parking lot on a Saturday afternoon, there it was.  "Almost, mommy."






Saturday, November 23, 2013

4.11.13



You looked almost normal lying there.  I was far from normal, in complete shock actually. 

Your hair was wet, as were your clothes, but aside from some dried blood here and there and a bad gash on your arm you looked like you had just fallen asleep after a long day at work, watching reruns of SNL.

Your chest was heaving a bit, which was strange to see.  I assumed, correctly, that this was from the lung.  I knew it was serious, but not necessarily fatal.  Just hard to watch.

It still didn’t hit me, though.  They said you had grasped the paramedics hand when asked.  They said you never stopped breathing.  I hung my thoughts there as I watched you silently.  No tears.  No emotion.  Mom kept stroking your arm.  “We will get that cut cleaned up,” the doctor said.  “Probably a few stitches.  We will clean him up,” he assured us.  It didn’t hit me until someone asked.

“So when he wakes up…?”

The doctor didn’t pause.  I wonder if that’s a tactic you have to learn in med school.  Just give it to them all at once.  One motion.  Rip off the band aid.

“When he wakes up, then we will know the extent of the brain damage.”

Brain damage?  It hadn’t crossed my mind.  I knew you had broken every rib, I knew your pelvis had been fractured (or so they thought at the time), I knew your lung had collapsed and your jaw was broken, but brain damage?  And he hadn’t said 'if ' but 'extent' as if he were confident there were some amount, just a little fuzzy on the details.  I thought of one of those clear jars full of M&Ms.  Guess how much to win the prize…

My mind could not grasp this as I watched you.  In that moment I could not process that two hours ago you had been a normal 22 year old on your way to dinner.  You would have responded to a text from me regarding some band, and  now as you lay there, you were forever changed.  That no matter what the doctors did from this point on, there was that.

The doctor elaborated, but I couldn’t concentrate.  He explained to Mom and Dad and Stashe, that the CT scan would show if surgery was necessary to remove a portion of your skull to allow for swelling.

Static.  Everything was still.  What are you thinking about right now?  Can you hear us?  Do you know what is happening to you?  I wanted to rush the side of your bed and start talking to you about something.  Anything.  We could prove them wrong together, they would see.  You would open your eyes and yawn and the doctors would be baffled.  You would make a joke about how even with a head injury you were smarter than me.  You would get up and complain that your arm hurt, ask for some good drugs and we would all be on our way home.  All you needed was someone to believe it, someone on your side.

But I didn’t.  I just stood there. 

I noticed the stained cloth in the trash can.  Was that from you?  How often were these cans emptied?   I looked to the doctor as he spoke, hearing nothing.  What had this doctor eaten for dinner?  And when exactly does one take their breaks, on the midnight shift?  I took some mental guesses as to his favorite TV shows, clothing stores.  It seems crazy now.  As this man stood there, outlining your fate for us, my mind went somewhere else.  I simply refused to accept that this had happened to the smartest, funniest, most loving person I knew.

I was angry.  And I would be for a very long time.

Thursday, November 21, 2013

4.26.13

They walk among us.

Mortals, capable of immortal acts.  Sometimes I recognize them as they pass me in the hall.  Sometimes they are next to me on the elevator, seemingly normal human beings wearing white coats with novels in their eyes.

I watch them adjust their glasses, check their notes.  I notice the mechanical movements of their invaluable fingers.  Is it you?  Are you the one who plates the rib, that prevents the puncture?  Are you the reason my brother breathes again?  The sculptor of my mother's smile, can you restore my faith in life?

I thought we had moved past this, that day.  My kids had just finished the EOC.  You were not awake yet, but life was beginning to resemble some state of normalcy for the moment.  It was Friday, 2:20 pm when my phone rang.  We were in the library, waiting for the bell to ring.  I had gotten my kids jolly ranchers for the test, and had just placed one in my mouth.  Sour apple, which forever tastes rotten to me now.

Molly calls.  By now I've learned that no news is good news.  I hardly want to answer, so I don't.  Then I call right back.

They are not sure what happened, but you started bleeding heavily from the tracheostomy tube in your neck a short while ago.  You are currently being prepped.  I need to come quickly. 

I know I sound agitated to my sister.  A defense mechanism to hide the fear, the adrenaline that was now surging through my body.  As I quickly walk through the crowded halls back to my classroom, I want to scream.  Instead I grab my things quietly, and I make my way to the car.  I make my way to you. 

For the first time since you were hurt, I allow myself to feel the anger I have been repressing.  I'm gripping the steering wheel so hard that my knuckles are white.  It's completely illogical, but I'm angry at everything, and everyone I've ever met.  I'm angry at the person who asked if I was okay as I ran out the door.  I'm angry at the strangers in the next lane.  I'm angry at you.

By the time I reach the hospital, you are in surgery.  Mom and Dad and Molly are pacing outside the ICU waiting room.  I take a mental note as to the normalcy of this sight to my eyes now.  No one knows what happened.  You were doing so well, and then the sudden bleeding.

So here you are again, fighting for your life.  And here we were, clinging to a doctor's nod and a few baffled stares.  Bobby's plane will be landing soon, and he will come straight here.  One of your nurses informs us that the surgery is underway.  I call Mike and inform him that I won't be picking Frankie up from DayCare. 

This operation doesn't take as long as the others, and soon your surgeon is explaining to Mom and Dad that everything went well.    He has repaired the tiny tear in your jugular vein that caused the bleeding.  He referred to it as a "pin prick".  The doctor went on to say that he has never seen anything like this three days after a surgery.  He says that he is unsure of how it happened but assures us that it is fixed, and that he has eliminated the possibility of any further tears. 



It was later that mom told me.  She had been near your room when the bleeding began.  When she was alerted, she entered to find a doctor with his finger in your vein to stop the bleeding.  As the nurses cleaned your blood-soaked sheets, he stood next to you, explaining to mom that he was gently "pulling" the vein tissue upward.  He had seen this procedure done before, read about it somewhere.  While they were prepping your operating room and contacting your surgeon, he was saving your life, calmly and methodically in front of your mother.  Two days later you opened your eyes. 

Mortals, capable of immortal acts.

Monday, November 18, 2013

April 10,2013

I find it strange that this is a day of celebration for someone out there.  This is someone's birthday, someone's anniversary.  This is the day that forever changed me.  The person I was before then no longer exists.  In some ways this is a good thing.  I no longer have heart palpitations when my son runs a fever.  My road rage has lessened.  I forgive the rude lady in the line at the grocery store with ease.  Her brother is probably recovering from a traumatic brain injury.


4.10.13 


The wind was loud that night.  Howling is a term often used.  To most this is an unsettling sound, an eerie foreshadowing as it rattles their windows.  But since that day, I am no longer afraid of it.   Since that day I can hear its message much more clearly.


“Tell them you love them…” it whispers.  “Forget the laundry...have you told them today?” 


I distinctly remember feeling defeated, all day actually.   I remember minor things, like wearing a dress to work.  I remember being exhausted.  I kept wondering, “What’s wrong with me?”  There was absolutely nothing to be sad about, looking back.  The universe is funny that way, always trying to tell you.  Always watching. 


I came home from work at a normal enough time.  Frankie was napping and my mother left.  Little did I know this would be the very last time she would watch my son while I worked.  For three years it had been the two of them together.  April 10, 2013…the very last time. Mike arrived home and told me I looked tired.  I told him I was.  It is difficult to explain, how I felt that day.  It was not a premonition, but a feeling of immense dread.  Impending doom perhaps?  I went to bed at 7:30, which is highly abnormal.  Something about the day had worn me out physically, mentally.  I had to start over.  I remember hearing the sirens around then.  I remember the windows were open. 


I got out of bed about forty minutes later and listened to the news.  There had been a tornado in Hazelwood…near school.  I thought of my students, and of my family and called my mother.  “Everyone’s okay,” she assured me.  Bobby’s plane had landed and he was en route home, Mary and the kids had gotten into the basement.  Their house had sustained some damage but all were okay.  Everyone was home except for you.  You had left about ten minutes before I called…right after the sirens had stopped.  Mom assured me you were sitting in traffic on 170 due to some downed power lines.  Everyone was okay.  I went back to bed.  Impending doom. 


At 11:19 I heard Mike’s phone on the desk, a whisper of a ring.  Half asleep I wondered what time it was, but nothing registered yet.  I picked up my phone from the nightstand, still on silent from work.  Two missed calls.  Bobby. I shot up, noting the time and realizing something must be wrong.  I yelled for Mike to answer his phone, which was now ringing again. He got up to answer, and I could tell from his voice that it was not good news.


I don’t remember the following moments with much clarity.  I began to get dressed as Mike asked my brother what hospital.  As I found my gray sweatpants in the dark, I asked him to tell me what had happened.  It was then that I started to hyperventilate.   I asked Mike not to say anything yet.  I thought, in my panicked state, that this delay would buy me some time.  Time for someone to take this back, whatever this horrible thing was looming in our bedroom.  I knew something was about to change our lives forever.   Mike hung up the phone, and after a few seconds I said I was ready.   I remember hearing your name, and the words “critical condition”.  Mom called me as I was putting on my boots.  She was on her way to the hospital, and explained that you had been found underneath an overpass.  I immediately pictured you getting out of your car and being hit.  She told me you had fallen.  I asked if you were found breathing, and she said yes.  You never had to be resuscitated...the only piece of good news I would cling to for weeks.


I told Mike to stay with Frank, as I stumbled into his room to search for my sweatshirt.  My sweet baby boy was asleep in his bed, oblivious to his mommy’s world unraveling before her.  I bent down to kiss his forehead and began to weep, only for a brief second.  Then I hurried out the door. 


The car ride was something surreal.  The skies seemed so calm, almost taunting me as I drove to you.  I followed the speed limit, stopping only to vomit as I turned off our street.  I cannot explain the calmness that came over me after that.  I pictured you driving just hours before.  I wondered what time you had been hurt, and what I had been dreaming about at that moment.


I didn’t think about much on my drive, but could only imagine that your fall had made you unrecognizable to us.   I mentally prepared myself for that.  I didn’t anticipate how unrecognizable my entire world was about to become.


Friday, November 15, 2013

ICU 101

(May 1, 2013) 




Things I've learned in the ICU waiting room:

1.  There is absolutely no way to turn off the lights, even overnight.

2.  Chairs can make excellent beds, floors excellent chairs, and walls excellent therapists.
3.  You might die.
4.  Waking from a coma is nothing like the movies.  It starts with an eye flicker or a leg twitch, and takes multiple days to happen completely.
5.  My entire life has been a phone call away from completely falling apart.  Everyone's is.
6.  You can have multiple chest tubes placed into one lung.
7.  What "clonus" is.
8.  People will assume that snacks/bottled water/magazines are public domain in places like these.
9.  Mom and Dad won't turn anyone down, even when it comes to a co-worker's delicious baked goods...they will share.
10.  I am strangely forgiving these days.  
11.  You might live.
12.  I am not above begging.
13.  You have a lot of friends.  A lot.
14.  Complete strangers can feel like family.
15.  My childhood dream of becoming a neurosurgeon hasn't faded.
16.  I don't like your absence from us.  I'm not sure I can live with it.
17.  My son can be quite easily convinced that there is a blue monkey living on this floor.
18.  I can still laugh.  
19.  You are a fighter.  Such...a fighter.
20.  Heroes wear blue scrubs and go by names like "Elise" and "Dani". 
21.  Google is my best friend, and also my worst enemy.
22.  How to wait for something that might never come.
23.  It is possible to lose nine pounds in seventeen days.
24.  You have to recover, because you have to recover, because you have to.






Wednesday, November 13, 2013

Beep.


April 14, 2013

I hear it in my nightmares.

High-pitched machine sounds.  Incessant, robotic beeping.  Sometimes I’m on the outside of the curtain and I can’t see what’s happening.  Sometimes I’m right next to you and I can’t help because I don’t understand.

The nurses run by, avoiding eye contact.  And I know why.  I’ve heard the things they have to say.  I shared a couch with a woman once.  Later I saw her receive the news, watched her collapse in the hall.

So many machines in your room right now.  One is breathing for you, it beeps when your respiratory rate drops too low, or gets too high.  Then there’s the machine that dispenses your medication…well, most of it.  Reminder beeping.

You have an ICP monitor for intracranial pressure.  This tells us if the swelling in your brain has elevated.  There’s one for body temperature too, and for tube feedings, blood pressure…There’s another monitor for your oxygen saturation level.  That’s the scary one.  Whenever we enter your room, that’s the first number we look for since that Sunday.  The day we almost lost you.

I had taken a walk with a visiting friend.  Sometimes, when the weather is nice and you head outside you can catch a glimpse of your old life.  The one before this place.  We had only just begun to accept that you might make it out of here, you know.

We were walking back inside when we spotted your friends near the exit door, stopping to say hello.  I like to talk to them.  It feels like I’m talking to you.


Mike comes running from the other hallway.   He tells me that something is going on with you, and that I need to come quickly.  I try to play it cool, but I can feel my heart start to race.  “Okay,”  I smile, only increasing my pace a tiny bit.  “I’m sure it’ll be okay,”  I try to reassure myself. “I’ll make sure to update you guys.”  My legs are taking over now, and I’m already ten paces ahead of my husband and dear friend.

I walk into the waiting room and my stomach drops.  Dad is cradling Mom, and she won’t look at me.  Bobby fills me in.  Your ever-unsteady oxygen levels have dropped into the 30’s, and they can’t get them back up.  You know when people on medical TV shows speak of “crashing”?

You were crashing.


They told us not to come back.  I try to imagine them pounding on your chest, cursing in English accents and perfectly applied lip liner.  The one nurse was just caught sleeping with the new doctor in the on-call room.  Incredibly dramatic.

But I know what’s really happening.  Right now.  At this moment.  They have lost control, officially.  It isn’t up to their machines anymore.  Isn’t being kept in check by Mom’s prayers, or my OCD-like counting of the tiles on the way in from the parking garage.   It’s up to you now.  Would you dare give up?

Glancing at my family just then, it is all too clear what hangs in the balance.  Stasia enters…she had been at the Laundromat down the street, washing your clothes when she received this call.  Someone brings her up to speed, and she begins to cry.  I look around.  Nearly everyone is crying now.  Was this it?  Are you tapping out?

Dad begins to lead everyone in prayer, The Rosary I believe.  I remember mouthing the words to The Hail Mary.  Many times.  I'm not sure I was producing any sound.   Everyone was monotone.  Words that were said across the dinner table from you hundreds of times, forever etched into the most horrific moments of my life.  

Suddenly, I want to be very far away.  I’m not sure if this is normal, but I remain there in the corner chair, fixated on the soda machine in the hallway.  I see the woman falling.  Her back slides down the wall as her knees buckle.  There is nothing pulling her back up.

Here comes the nurse…maybe thirty minutes later?  I still don’t know how long it was.  It might last my entire lifetime.  She asks for Mom and Dad only, and they quickly leave.  Out the window, Mom suddenly stops, shaking her head.  I watch as Dad gently coaxes her the rest of the way, following your nurse out of sight.

We all sit in silence.  After a few minutes, Mike says something about how if you had passed, it wouldn’t be taking them this long.  I love my husband.

I will never forget my parents’ expressions upon re-entry that day.  The tears…thumbs up…all smiles.  You had pulled through!  From that moment on, we would all enter the waiting room like that.  Every time.


Everyone begins to cry, embracing.  I’m not sure that I understood true happiness before that moment, or fear for that matter.  I listen as they rejoice.  I watch the color return to their faces once again.  I notice that my fingernails are gone.

I begin to laugh.  Uncontrollable, belly-laughter.  I’m laughing so hard that I’m shaking and my abs start to hurt.  Like a crazy person.  I can’t stop.  Nothing about this situation comes close to being funny, but I can’t stop.  I’m so terrified, elated, confused.  I can feel the tears now, and I’m cackling.  The loudest sound in the room.

I hear my mother then.  “Someone come over here with Nora, please.”

Thursday, November 7, 2013


April 17, 2013

 

Have you ever felt hysterical in front of a room of teenagers while discussing the symbiotic relationship of the clownfish and the sea anemone?

I have.

Back to work.  I gave myself a pep talk on the drive that morning.  Strange how just a week before, I had made this drive with all of the usual thoughts that accompany my morning rush…would I have time to run by my mailbox to pick up copies before second hour?  Had I remembered my lunch?  Was Frankie’s favorite sweatshirt clean in case my mother took him to the park?

Today was different.  This drive felt foreign to me now.  It’s amazing, the tricks your mind can play on you when you are most vulnerable.  It was like I was driving to work for the first time.  I was nervous, scared…what would my kids say?  Had anyone told them?  What would I say to them?  And these new thoughts, these questions that no one seemed to have the answers to…How was your oxygen saturation at this moment?  Were you still running a fever since I left you last night?  Had they figured out a way to rotate you that would not potentially kill you?  I found myself counting each overpass on my route to school.  Nineteen.

Walking through the halls was something of a nightmare.  I wanted to be in my room, in hiding.  I could tell that people weren’t sure what to say to me…and I didn’t blame them.  After all, I didn’t even know what to say to myself.  I could barely stand to be conscious because of all of the thoughts that were entering my realm at that time.   My laptop bag had been partially unzipped.  It fell open halfway to my classroom in the middle of the hallway, papers spilling everywhere.  I didn’t lose it then. 

My first class went okay.  We were prepping for the EOC.  This would happen to you a week before my kids took their most significant assessment of the year.  It all seemed so irrelevant now.  I heard someone ask how my brother was doing mid-lecture.  “He’s okay,” I lied.  I found myself staring at the doorway.  I could see you walking through over a year ago, carrying the Teddy Grahams I had forgotten to grab that morning for our activity about natural selection.  I recalled my students’ reactions after you had left.  They said you looked just like me.  They could tell you were my brother before I told them.  I thought of that day…the text I sent you in thanks.  Would you remember that?  Would you wake up?  Would you be able to make those awful jokes with me again?  I wished I could travel back to that moment…follow you out the door and hug you.  I would forget whatever important function I had after work.  I would stop by Taco Bell and we would watch cheesy movies together.  I thought of all the times you had been just a few blocks away, perfectly healthy. 

The bell rings and a new class enters.  Different questions now.  Some of the students are more tactful than others.  “Is your brother the one that jumped off that bridge?”  Like a dagger.  Is that what people think about you?  I didn’t lose it then.

My sixth hour.  My rambunctious, inquisitive, blood pressure- elevating sixth hour.  I had been dreading them all day.  As they pass me in the hall to enter class, I feel a sudden urge to run far away.  They could find a sub, right?  I can’t bear to answer any more questions about you.

I walk in and they are all seated.  Mentally I congratulate myself as this has never happened before.  Their eyes follow me as I take attendance, collect the homework.  I’m at the projector now, going over symbiosis.  A hand is raised.  “Mrs. LaFata, are you okay?”  I can feel it in my throat.  I fight it again…for the millionth time today.  “Yes, thank you.  So the clownfish…you guys have seen Nemo, right?”  Their gazes are unaltered.  Their focus heightened.  Another question.  “Mrs. LaFata, can I give you a hug?” 

I stop.  Everything stops for a moment.  Here he comes.  Last week he blamed me for being grounded, and now he is hugging me in front of the entire class. 

And they all follow.  Single file.  One by one, until I am surrounded by a herd of them.  Thirteen juniors who have shared their struggles with me for two semesters.  Thirteen adolescents with their own problems, their own apprehensions.    In that moment I am no longer separate from them.  We are fourteen human beings, frightened of all things beyond our control. 

I lose it then.  And I will always love them for it.

Tuesday, November 5, 2013

Sanitize.

 






IT was innocent, really.

A sneeze…which called for some hand sanitizer.  Afterwards I gave you a hug.  I am careful now, not to let you see how much the little things mean to me; how I could cry every time you hug me, or how as you talk to me it is difficult to focus on what is being said, only that you are speaking and not lying there…motionless…dying…

You have come so far, and I can’t help but be happy that while we are in a hospital room again, you are awake and cracking jokes.  I silently thank the universe for the dinner I just had with you, complete with those ridiculous cafeteria sugar cookies.

Leaving you I see them as I walk the hall.   The family members huddled in each small room around the lone television.  Some of  them holding spoons to their loved ones’ faces, some of them barely holding onto anything at all…

I enter the elevator and press the “L” for lobby as I’ve done so many times before, and as I brush the overgrown bangs from my face it hits me. 

The smell.  THAT smell.

To most, I am sure that it must be what “clean” smells like.  Rubbing alcohol and lavender, it might resemble healing…it might even be pleasant. 

 But I know what fear smells like, and this is it. 

It smells like a life ending, a gasping last breath.  It smells like a dark hallway and their faces as I come running into the emergency room. 

It smells like April, and the upward eyebrow tilt of my friends as I tell them about you…about your accident.  It smells like the faith I so desperately wished for that night, as I watched my mother cry.

It smells like what I felt when I first saw you, dried blood covering your ears and nose….the mud on your pillow, your damp hair…the smell of that soaking wet bag they handed to us, the clothes that were cut from your body in their efforts to save you.

In the corner of the elevator I can see her.  Your nurse from that first night.  I watch her eyes as she tells us we may never speak to you again.  As she prepares us for your departure mid-shift on a Thursday morning,  I think she looks young.  I think you would like her. 

Suddenly, I’m standing under the overpass alone.  I can hear the cars rushing on the highway above, families headed to brunch and children's soccer games.  I can see the blood on the guard rail, the red fingerprints…had you tried to grab ahold?  It’s windy, but the bent blades of grass are telling me your story.  I can picture your struggle, and as you pull yourself to the side of the road, I am right beside you, willing you not to give up.

I walk a bit farther down this road…a road I must have passed thousands of times but never gave a second glance.  Can those families see me out their shiny windows?  Do they notice me, as I try to piece together the potential last moments of my baby brother’s life?  The gravel writhes under my sneakers, and I pretend that the darker pools I see in the dirt are simply mud puddles…the same ones we used to jump through as kids.  There is a blue latex glove strewn in the grass…had it belonged to your saviors?  My personal heroes, the ones who held your hands in the rain. 

I descend to the lobby completely paralyzed.  Hadn’t I moved past this part?  Why was it still so scary?  How could a smell bring me back here?  After all we have been through, shouldn’t I be stronger than this?

The doors open, and the tears stop.  As I round the corner I can see the parking lot.  Sunlight.  I am almost running now.