Sunday, April 27, 2003

It's like re-entering a bad dream to read about Alan's brain injury in Where is the Mango Princess?, a document of his wife Cathy's perspective on the events surrounding his boating accident and subsequent recovery.

My Dad's story is hauntingly similar in his hospitalization period after going into cardiac arrest last October. Dad keeled over with a heart attack at home in his chair one Saturday night, while Mom was talking to him about dinner. He was "down," as they say in cardiac parlance, for about 5-6 minutes after he went into "v-fib," with no oxygenated blood pumping to his brain. This usually causes death, but in Dad's case, he went into a coma lasting about 36 hours, followed by a recovery that continues presently. The neurological damage of this trauma--anoxic amnesia-- is often described as similar to traumatic brain injury, like hitting a car windshield in a car accident. The brain becomes injured, often permanently, by the lack of oxygenated blood supply.

Alan, the subject of Where is the Mango Princess?, was hit in the head by a speedboat. He was out for longer, but he and his family went through many of the things I remember from Dad's hospital stay. I had put that period out of my head recently and reading about Alan is bringing back memories. They're not all memories I want to relive, but they are vivid.

The total uncertainty of the outcome was the spookiest similarity to Alan's story. At Beth Israel Hospital in Boston, there was a large staff of doctors taking care of Dad. It's a teaching hospital, and so there were always a revolving set of young physicians assigned to patients there. Each of them and each nurse had a different approach to dealing with our family. When Dad's body had stabilized, the big question was whether he'd come around at all from the neck up. None of the team really knew what to expect my Dad's outcome would be, so they would each offer their own combination of comfort and caution.

In the book, Cathy wrote about 'Dr. Asshole,' who wouldn't give comfort or information to her in the first hours after her husband was brought into the hospital. Cathy was savvy enough to insist on his replacement and got another neurosurgeon.

In our case, the neuro team had a variety of reactions. One woman resident was guardedly hopeful, but spelled out the possibilities for Dad as ranging from no recovery to good recovery, with lots of options in between. Another young man on the staff was much more downbeat, saying that we should first of all regard Dad's condition as 'extremely serious,' as if we hadn't noticed that he'd been unconscious and on a respirator for over a dozen hours. He kept minimizing the chances of any meaningful recovery, saying that we might never see any improvement--that Dad might be like this indefinitely or just die.

One of the nurses went even further, sitting my Mom down for a heart-to-heart, telling her and one of my sisters that they had already said their goodbyes to Dad, even while he was only around a day into his coma. Another nurse, Colleen, was a beacon of cheer, saying she was confident that Dad would come around. She was the one who yelled, "Good morning Bill!" into his ear during the third day of his coma. Dad's eyes popped open like a shot, as if he had been scared into looking back into the world, hoping to find out what the commotion was.

I'd felt excited the previous day to have seen Dad open his eyes a tiny bit. I swore I'd seen him peek out from behind the slits for a couple of moments. My sisters had a similar experience that Sunday, but by the next morning, I'd begin to wonder if we'd been kidding ourselves as to the meaning of it all. When he responded to Colleen's greeting, all of us, from Mom to my sisters and Dad's sister Peg were all in the room, whooping like we'd witnessed a miracle. I guess we had.

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