The Death Class: A True Story About Life (26 page)

She looked at the ice. How are Dunkin Donuts’ cubes so cold? she wondered. Why do they always take so long to melt? She blinked. It took her a moment to absorb what had just happened. The SUV had T-boned Norma’s vehicle. Its front bumper was now inside the party bus. She remembered her last thought before the SUV careened into her driver’s-side door: I am going to die!

The cops would arrive soon. What if she was bleeding internally? She was still alive, but she might still die on the scene. I need to find my driver’s license. If they needed to identify her body, the police would need her license, she thought. The party bus plates were registered under Norm’s name. She had to tell him she’d been in a car accident.
She reached onto the floor to retrieve her phone. Ouch! Overwhelming pain. She fumbled for the phone and grabbed it.

“I’m in an accident!” she shouted, breaking into tears when Norm answered. “I’m really, really hurt.”

“Where are you?”

She told him Wooding Avenue and Highway 1, next to the Skylark Diner. He called 911, and within minutes a sheriff’s deputy was outside the party bus shouting “Are you hurt? Are you okay?”

The deputy tried to pry the door open but couldn’t. Norma pulled what was left of the handle and tried to push the door open, but the SUV had trapped her inside.

Her shoulder ached, but her chest hurt the worst. Trauma workers rushed up and began cutting away pieces of the vehicle. “Am I having a heart attack?” she kept asking when they finally made their way inside. “I think I’m having a heart attack.”

Paramedics rolled Norma like a log onto a hard wooden spinal board, used for patients who are believed to have neck or back injuries. They strapped her down with a neck brace and head block immobilizer. The inability to move made her pain feel even worse.

Norm looked panic-stricken when he arrived a few minutes later, offering to ride in the ambulance with her, but Norma told him not to. She told him to drive his car and follow the ambulance so they could ride home together later that day. She had survived so far. The pain in her chest didn’t appear to be a heart attack. Her injuries must not have been that bad. She figured it wouldn’t take long to get treated in the hospital and go home.

The paramedics began cutting away her yoga pants and shirt. She tried to make an awkward joke. “You know how your parents always tell you to wear clean underwear in case you get in an accident?” Well, she said, “I’m not wearing any underwear!” It didn’t matter to them. A paramedic told Norma they were taking her to Robert Wood Johnson University Hospital. She knew it was ranked as a Level I trauma center by the American College of Surgeons, which meant it was equipped to treat the widest scope of the most serious injuries. I don’t need a Level I trauma center, she thought.

“You’ll be okay, sweetie,” a paramedic told her.

Stop calling me “sweetie,” she thought.

At the hospital, doctors still wouldn’t remove the excruciating spine board or head immobilizer. They had to make sure her back, neck, and head were not injured. They rolled her on her side to examine her back. She grimaced and moaned in agony. Clear. No major injuries. Her neck. Clear. Then they put her through a chest X-ray machine at the hospital: she had five broken ribs.

But what about her heart and her head? Neither had been cleared yet. A nurse came in with the X-rays. “You need another CT scan.”

Why another? They had done an MRI already. She tried to refuse. This time, medical staff would inject her with radioactive contrast dye to enhance images so they could see all of the vessels pumping and the inflammation. She knew the dye would make her feel like she was going to wet herself on the table. She didn’t want that. “I’m a nurse,” Norma said. “Just tell me what is going on.”

The nurse had such a serious expression on his face that it made Norma nervous.

“Your aorta may have been dissected.”

She felt her stomach turn. Dissected aorta. She knew exactly what that meant: it was a tear in the aorta’s wall, the main part of the heart that pumps blood through the arteries to the rest of the body. A severe rupture would result in catastrophic blood loss. More than three-quarters of people with aortic ruptures die, and such an injury is the cause of nearly 20 percent of auto accident–related deaths. If the diagnosis was true, she had about thirty minutes before she bled to death. If they rushed her into open-heart surgery immediately, surgeons might have to crack the rest of her ribs to try to repair the aorta. It was a perilous procedure.

“I need you to get ahold of Melissa,” she said to Norm. Her older daughter was still in law school near Philadelphia. “Have her start coming this way.”

And Becca? Her younger daughter had been in the middle of taking a high school final that morning, and Norma and Norm had not disturbed her with news of the crash yet. But Norma thought it looked as
though they would have to now. Norm dialed Melissa, whose boyfriend agreed to drive her to the hospital. Then he called Becca.

“How was your final?” he asked.

“Fine.”

“Good,” he said. “Mommy’s been in an accident.”

“What?” Becca shouted.

Norma got on the phone. “My car got bumped,” she said, not wanting to worry her too badly yet. “I’m a little dizzy. But I’m fine.”

“You’re crying,” Becca said.

“I’m not crying. Does it sound like I’m crying? I’m fine.”

The nurses came back and whisked Norma away and into the CT scan again. When it was over Norma and Norman waited in the trauma unit for results.

The doctor had both good and bad news: it was not a dissected aorta; it was cardiac compression and myocardial contusion, or heart bruises.

Norma exhaled. I am not going to die.

But the doctor said he was concerned about her head scans.

What now?

He told her she had a small subarachnoid hemorrhage—bleeding between the brain and the tissues covering it. If it got worse, she could end up with vomiting, disorientation, seizures, loss of brain function, stroke, and again, death. More than half of people who suffer from subarachnoid hemorrhages die, and many who survive battle life-changing mental and motor impairments. Norma had seen what happened to such people who were her patients. Little by little you lose the ability to think and speak; I could be drooling on myself for the rest of my life, she thought. They might have to do neurosurgery. I’m going to have a hole in my head.

It all depended on the size of the brain hemorrhage and the amount of swelling.

The brain bleed was small so far, the doctor told her. If it shrank, she might recover without serious complications or surgery. They would have to keep her in the hospital for however long it would take to be certain she was not at great risk. It could be days. Or weeks.

N
ORMA WAS SUPPOSED
to give a final exam at Kean that night. When she failed to appear, students tried calling her cell phone with questions about the weekend’s homeless drive. No answer.

Isis from the teen homeless shelter called, checking in as usual, and becoming distraught after Norma didn’t call back.

The next morning, Becca posted a message on her Facebook wall: “Mommy got into a car accident yesterday . . . her ribs are broken, she has a small bleed on the outside of her brain and her shoulder may be broken as well.”

By evening, word had spread across Kean University about Norma’s accident. The men and women in prison were notified too, as were the girls from Isaiah House. Isis broke down in tears.

A steady stream of students, neighbors, faculty, and friends began showing up in Norma’s hospital room, bearing flowers and cards. Entire fraternities and sororities flooded the hospital. Be the Change volunteers dropped by in clusters. Others left dozens and dozens of messages. Norma felt as though she were on an episode of the old television show
This Is Your Life.
The only two people who did not show up at the hospital were Jonathan and Caitlin.

Norma posted on Facebook, “I was discharged from the hospital late Thursday and now home recuperating from 5 broken ribs, a cardiac compression injury and head trauma. I can’t even express how thankful I am to be okay and for all of you in my life who inspire me every day. I am so lucky!”

The mental health homeless project went on without Norma, and that was fine. In the days that followed the accident, Norma had not seen Jonathan and Caitlin, but she wasn’t worried. More than anything she was tired: tired of mitigating clashes over a community service project and even more tired from her injuries. Her family had convinced her that this was the one time in her life she needed to concentrate on helping herself. She needed to focus on getting better.

Spring 2010

Jonathan still thought of his brother at every New Jersey turn. When he drove his truck past the apartment complex in Roselle Park where their father had killed their mother or past the water where they’d used to fish with their dad in Nomahegan Park, or when he crossed the tracks in Linden where his brother had last laid his head—each place brought its own bittersweet memory, and lately they seemed more bitter.

Now again, his faith in Caitlin’s transformation and the future of their relationship was fading. It was becoming clear that Caitlin might never break away from her parents’ drama. Jonathan worried that she was unable to let go of the need to try to stop her mother’s desire to die.

“Her relationship with her family was driving me crazy,” Jonathan explained. “I would be in her house sometimes and all this chaos was going on, and I would feel like throwing a table out of the window. I couldn’t deal with her family. It killed me. It brought back all this stuff—my head was not right.”

He had started coaching others to become financially independent, explaining that without the flexibility of his real estate career when his brother had been ill, he would not have been able to care for him or take days off to take him to doctor’s appointments or to Uruguay. Jonathan was thankful for the independence his career had granted him in those last months with his brother. In his financial coaching, he had begun sharing his life story with thousands of people, traveling between San Diego and New Jersey to Chicago, Dallas, Atlanta, Seattle, Anaheim, and Los Angeles,
giving presentations to crowds interested in getting into the real estate field while weaving in his own family’s story and his journey with Josh and ending on a positive message of hope. Some rooms in which he presented held between 180 and 300 people, and many came up to him afterward to share their own family stories of mental illness and death.

“My mission is about bringing awareness into the world about mental health,” Jonathan said. “But it’s broader than that now. It’s about life and being positive and overcoming adversity. It’s about the changing purpose in your life. . . . I’ve learned that as your life changes, your purpose changes too.”

On one of those business trips to San Diego in 2010, Jonathan found himself enchanted by the ever-sunny skies, blue-water beaches, warm winters, and year-round open-air cafés. It was all so different from his home state. It felt free and full of promise, not at all like the noose around his neck that New Jersey was becoming.

“I just went with my gut,” Jonathan said. “I said, ‘I’m going to move out here.’ ”

“You didn’t even consider me in this at all?” Caitlin cried when he told her.

“No,” he replied. “You’re right. I didn’t.”

“Please, can’t you reconsider this? Let me be a part of it.”

But Jonathan’s mind was made up. “The fact that I didn’t think to put you as a part of it must say something,” Jonathan told her. He needed to take care of himself, just as she needed to take care of herself first—not her family and not him.

“Her life is her life,” Jonathan said, “and she doesn’t have to spend it saving other people.” He’d learned that already the hard way. “She was fixated on worrying about her mother, worrying about her father. A lot of the mistakes I made I tried to teach her not to do. I tried to save Josh . . . I don’t take that back, but she was on the same path: to the point of no return.”

None of this changed his feelings for Caitlin, though. The two had talked about Caitlin moving to California after grad school. They tried to make it work long distance for the first year, but the talks fizzled. What
would she have done out here? Jonathan asked. She had no friends in San Diego, no family, no firm job prospects. She would have been miserable, he added, especially since he traveled every couple of weeks to give presentations.

But even if she was far away, he said, no one could take her place. He knew no one would ever understand him the way she did. Just as he had written in the letter to Josh when he found out Josh had schizophrenia: “The most important thing you need to know about me is that I feel alone. . . . and the only time I don’t feel alone is when I’m with you, or with Chris or Caitlin.”

Caitlin had braved her fear of flying on planes and traveled with him to Uruguay when he had taken Josh’s ashes there to spread over the sea. Even though it had been his decision to move, Jonathan admitted, he felt heartbroken too.

“I love her to death,” he said, shaking his head, as if even he had surprised himself by leaving her.

Jonathan had not spoken to Norma since his move to San Diego. Lately, she had not replied to emails from him or Caitlin. He sent the professor an email on Facebook: “Hey Dr. Bowe, I know we’ve been out of touch. . . . For whatever reason the project we did split us all apart and we never talked about it. All I know is that you’ve helped me in the hardest time of my life and I will never forget that. I would hate to not be able to call you or email you and vice versa. I want to thank you for bringing out the best in me.”