Crash (2 page)

2

The Crash Scene

Two things became immediately clear. I should have worn socks, and I should have brought my inhaler. I am not a runner but I am an asthmatic, and those two truths now combined to make breathing very difficult. I ran along the same route Neil and Trista had just traveled. The air was dry and cold; it hurt to breathe and made my nostrils stick together each time I inhaled. My eyes stung and watered in the bitter cold so I squinted, trying to see far ahead of me, listening for sirens and scanning the landscape for flashing lights but found neither. I crossed Spofford and ran up Plant Street. I wanted to slow, to stop, to catch my breath. But I forced myself on.

Farther ahead, at the end of Plant Street, I caught a glimpse of blue flashing lights. I quickened my step, but there were no ambulances. Six cruisers with their lights flashing were arranged haphazardly along the road. Officers in uniforms talked among themselves, but nobody talked to me. I didn’t understand what they were all doing there.

I bent over, hands on my knees, my breath coming in short gulps and long painful exhalations. I knew the smooth muscles around my airways were constricting, trapping air inside my lungs, daring me to find a way to push it out. I pursed my lips and forced my breath out slowly, trying to stent my airways open. It was no use. I couldn’t breathe. I could hear myself wheezing, tinkling strains, musical, rhythmic. A little cat sigh with every breath.

I felt a hand on my shoulder.

“C’mon. We’ll drive you to the hospital.” It was Maureen, her son, Kaes, by her side. They lived on this street. On Ferry Road. Maureen’s daughter, Jess, was Trista’s best friend. Kaes hung out with both my boys. At first I didn’t comprehend what Maureen was saying to me. I thought she could see me struggling to breathe, thought I might need emergency attention. I waved her away.

“No . . . I’m . . . all right,” I said. Then I saw the look. The subtlest exchange between her and her son. And I knew. They weren’t talking about me at all.

“Did you see them?” I demanded of Kaes. He looked down at his shuffling feet.

“No,” he admitted.

“Then . . . you don’t . . . know . . . that it was . . . them,” I cogwheeled. “Maybe . . . it wasn’t . . . them.” I knew I sounded ridiculous. I could barely choke out a sentence, and I was denying what was clearly everyone else’s reality. I could tell from the looks on their faces, from Mary’s panicked voice on the phone, and from the cops’ stringent avoidance of me. It was them.

Maureen’s gentle, plump fingers found their way to my waist, edging me across the street.

“C’mon.”

She opened the door of her car and ushered me inside then climbed into the driver’s seat. Kaes sat silently in back. I did not fasten my seat belt. I remember feeling reckless and wild and unsafe. I was starting to let my mind grasp the fact that my child had been hit on Ferry Road. And if it had happened to him, I wanted it to be able to happen to me, too. I wanted to be there with him, vulnerable. Panic was now mixing with the cold and the exertion to make breathing a concentrated effort. Trying to prolong expiration by pursing my lips just wasn’t cutting it any more.

I gradually became aware of a sound. A low groan. An animal noise. Something wild and raw, on edge, not human. But it had a rhythm to it. I gradually became aware that its rhythm matched my own respirations. That’s when I realized that
I
was the sound.

3

The Bad Mother

Maureen dropped me off at the entrance to the emergency room and went to park the car. I don’t remember seeing her again that night. I gave my name to the triage nurse who sat behind a tiny square glass window.

“My boy was hit on Ferry Road,” I told her, noticing that my breathing was starting to ease. Still tight, but I could get out a sentence in one breath now. The nurse looked awkwardly down at her feet. I was becoming familiar with that look, and I didn’t like it.

“Wait right there,” she said to the floor as she backed out of her cubicle and disappeared into the belly of the ER. I looked around the waiting room. An old man with stained pants sat in a chair framed by his walker. The heel of his foot tapped the floor at superhuman speed as he stared blankly in front of him. A child with a loud croupy cough was on the floor exploring the contents of his mother’s purse while she watched a TV set mounted on the opposite wall. Torn copies of
People
magazine lay randomly on chairs. I stood frozen in front of the triage booth, waiting for permission to see my son.

I don’t know what kept me cemented to the ground like that. Part of it, I’m sure, is genetic. I am my mother’s daughter. My mother was a true Southern belle, demure and deferential. I have inherited her shell of calm, and it has stood me in good stead through the years. My fellow residents, even my attendings, were always glad to see their names next to mine on the on-call roster, making assumptions about what an outward veneer of quietude said about inner confidence. Even today, many parents I have dealt with have been grateful for that composure when we have faced fear and trauma and bad news together.

Maybe the reason I just stood there was because I’m a doctor. I know the rules. I expect people to follow the rules in my ER, and here I was, in someone else’s ER, conforming to theirs.

Maybe it was just residual denial and fantasy. Maybe I was playing a game. As long as I didn’t lose my cool, as long as I kept it together, it couldn’t possibly be my child in there.

That’s when Mary blew in.

“Where’s my daughter?” she screamed. Then she flew by me, past the triage booth, out of the waiting room, and down the hall into the ER. She did not stop at the little glass window. She did not give her name to the nurse at the triage booth. She did not wait right there.

I followed her into the ER, feeling like a bad mother for following the rules.

4

The Other Side of the Stretcher

When Neil was a sophomore in high school, he played Tybalt in
Romeo and Juliet
. He had few lines but a formidable stage presence, with his fierce anger and menacing bluster. He learned the complicated fight choreography, expertly clashing sword against sword, first with Mercutio then Romeo. Advancing. Retreating. Slicing. Thrusting. A rhythmic dance. The theater was silent except for the soft shuffle of gliding feet, boots landing on stage in perfect balestra, swords clanking, first high then low.

And then the death scene. Romeo plunged his dagger deep into Tybalt’s chest. Neil’s chest. My son. He fell to the ground. Juliet dropped to her knees and cried over him.

“ ‘Tybalt, my cousin! O my brother’s only child!” ’

“Doesn’t that make me your nephew?” Neil would joke during rehearsals, cracking Juliet up every time. But on opening night he wasn’t joking. And Juliet wasn’t laughing. She was weeping, and so was I.

His fellow actors came on stage and lifted Neil reverently onto a slab of wood and then covered him with a pure white shroud. They walked slowly, as if marching to a silent dirge. They placed him carefully onto a makeshift bier, two foot-high blocks of wood pushed together at the back of the stage.

And there he lay for the rest of Act III. Scene after scene played out. Romeo. Friar Lawrence. Lady Capulet. Nurse. Their lines were silent to me, their movements unseen: My eyes were glued to the body at stage rear. Neil’s shroud was made of a gauzy fabric. I could see his facial features beneath its flimsy folds. I tried to detect some movement. A breath. A twitch. But there was none.

It filled me with sorrow and dread watching my son, dead on stage. The rest of the audience was at a play. But I was at a wake, staring into a coffin and waiting for the victim to rise.

“I’m sorry my son keeps killing your son,” Hal’s mother joked after the performance. We chuckled together, but for months I could not shake the feeling of doom that enveloped me since Neil’s onstage demise.

Now, three years later, an ER nurse was taking me to my boy. And there he was again, my son. Behind a curtain. Under a shroud. On a bier. But now the stage was an ER cubicle, and the curtain here was stark white, not velvet red. His shroud was a sheet pulled up to his neck; his bier, a hospital stretcher. His clothes were lying in piles on the floor around him, cut from his body in haste. I tried to detect some movement. A breath. A twitch. His head was wedged between two big Styrofoam blocks secured by thick white adhesive tape to protect his neck. I laid my hand across his forehead and his eyes fluttered open.

“Hi, Mom.”

He knew me. I felt a rush of relief. But he drifted immediately back into unconsciousness, and my brief elation gave way to a gathering knot of fear. A doctor came in and gave me the rundown on my son. I did not know this woman. I didn’t know any of the medical personnel here at Anna Jaques Hospital. My admitting privileges were at a different community hospital twenty miles away, Lawrence General.

“What happened?” I asked her.

“The police are still trying to piece it together,” she told me. “It looks like a hit-and-run.”

I tried to follow her message, to stay focused on what she was telling me. But those words—hit-and-run—seemed to take over the part of my brain that paid attention. At first she told me his only injury was a broken leg. I lifted the sheet between my thumb and forefinger and peeked underneath while the doctor continued her update. Neil’s lower leg was badly deformed; his fractured shinbone strained against his skin at an unnatural angle. Dark blood pooled just beneath the surface. My stomach turned in response. Though I have scrubbed in on dozens of strangers’ surgeries over the years and patched together many patients’ gashes and scrapes, I have always been totally squeamish when it came to the slightest wound on one of my own.

The doctor’s words drifted back to me. “CAT scan . . . Just a precaution . . . Out at the scene.”

I tried to follow the gist. Neil would be okay. He had a broken leg. They were CT’ing his head as a precaution because he had lost consciousness right after the crash.

I’ve talked to hundreds of parents in emergency rooms and ICUs. I’ve been the bearer of bad news or at least uncertainty more times than I care to remember. I know people shut down. I know they can only take in so much. I’ve learned to slow my pace, to read the signs in patients’ eyes and faces that this is enough. The well is full and I should stop dumping information into it. And now here I was on the other side of the stretcher, trying to comprehend what was happening. My son recognized me—that was good. But he slept if you let him—that was bad. He was not asking what happened. He was not asking for his father or his girlfriend.

I could not be alone. I had to reach Saul. But I couldn’t leave Neil alone either. I stepped out into the hall, clinging to the curtain that hung from the ceiling and separated Neil’s cubicle from the bustling corridor as if it were some kind of mooring that anchored me to my son. As if by holding onto the curtain I was protecting myself from being swept away from him. I recognized the fire chief, Steve Cutter, pacing nearby. Our kids played soccer together years ago (a lifetime ago!). His hand rested lightly on his two-way radio.

“Steve, can you get a message to my husband? He’s playing volleyball at the Salvation Army.”

“I’ll see what I can do,” he said and strode off, happy to be on a mission.

I returned to my son’s side. There was no chair in his cubicle so I stood over his stretcher, looking down on his sleeping face. I ran my hand through his long brown waves. His eyes opened sleepily.

“Hi, Mom,” he said again. But it was as if he were seeing me for the first time. I shivered.

A nurse entered and deftly released the brakes on Neil’s gurney with her foot while simultaneously swinging the bed around and wheeling him out the door and down the hall. She called to me over her shoulder, “You can follow us to CAT scan.” I fell in line behind the speeding procession.

We passed Trista’s cubicle, next to Neil’s. It was humming with activity. Monitors beeped. Doctors barked orders. Someone was crying. Mary was wailing in the hall outside her daughter’s room. I kept my focus on my son. The nurse wheeled him into the radiology suite, motioning toward a couple of lonely plastic chairs in the bare hallway. I took a seat and waited.

A faraway jangling sound drew my attention down the long corridor. A uniformed police officer was striding up the hall, his heavy keys bouncing against his leg as he walked. He was escorting my husband to us. Saul broke away from the officer when he spotted me and I rushed to meet him. My husband is a big man with strong, broad shoulders. He owns his own restaurant supply store, and he is accustomed to moving industrial refrigerators and wrestling two-ton walk-in coolers into place. But as he raced down the hall to me, his arms open to gather me up, his frame was heavy and bent.

“He’s okay,” I blurted out, more because I could see how panicked Saul was than because I believed it was the truth. We fell into each other’s arms.

“I thought he was dead, Cal.” Saul’s voice cracked. His face was buried in my neck, muting his words. I tried to console him as best I could.

“He’s okay. He’s okay,” I repeated, trying to convince myself of the truth of the words as I spoke them. Saul’s shoulders shuddered with small sobs. I had rarely seen my husband cry. I had never seen him this wracked. We held each other. I was relieved to see him. I was glad to have someone to talk to, to be scared with, to hold onto.

But I realized that no one was going to relieve me of the burden of duty here. I would be the interpreter, the bridge. This was my world: ambulances, hospitals, ERs. If there were medical decisions to be made, I would need to gather all the necessary information and make them. With the facts and on my own. I could not let my guard down. I did not feel strong enough for this.

As we withdrew from our embrace, I locked eyes with the police officer who had escorted Saul to me. He quickly looked away, perhaps discomfited by the raw display of emotion. He slowly turned and headed down the hall, his mission here over. I tried to fill Saul in on what I knew. The broken leg was a definite, but after that I was on shaky ground. The CAT scan had been presented to me as a mere precaution. Probably overkill—doctors just being thorough. But the more Neil slept and the more he repeated himself every time he saw me, the more I worried about his brain.

The scanner door opened, and the nurse pushed Neil’s stretcher back down the hall toward his room. Saul bit his lip and touched Neil’s head as they moved.

“Hi, Dad,” Neil said, monotone, then closed his eyes again. Saul looked at me with a smile and a sigh of relief. My heart cracked. I felt almost nostalgic for that sense of relief that I too had experienced just moments ago when I realized Neil was alive and knew me. But even though Saul was only minutes after me in responding to our son’s accident, I felt like I was light years ahead of him in understanding the magnitude of what was happening. Not just because of my medical training but because Neil was repeating himself. His recognitions were without emotion. He seemed a shell. The blanker he was, the more I worried about damage to his brain.

Saul and I sat together waiting for the doctors to tell us the results of the scan. Saul caught me up on how he was informed of the accident. A uniformed police officer had walked into the Salvation Army gym and interrupted their volleyball game, asking for Saul by name. There were a couple of jokes among the players.

“Uh-oh, what’d ya do, Saul?”

“How many parking tickets do you have anyway?”

But it soon became clear that something was very wrong.

“Your daughter’s been in an accident, sir.”

“He just kept saying it, Cal, over and over. I told him I didn’t have a daughter. Did he mean my son? But he just kept saying, ‘I can’t give you any more information than that, sir.’”

Saul’s head dropped into his hands again.

“I thought he was dead,” he said again, his voice a whisper.

I rubbed his neck, kissed his shoulder. But I knew none of it was a comfort to him. The only thing that would comfort him would be a piece of good news about Neil. Our chairs were close to where a group of scrubs huddled in front of the light box and murmured over someone’s films. I wanted to join them, to render my own interpretation of the images. I strained to hear their words over the ambient bustle. “Brain.” “Fracture.” “Bleed.” I knew they were talking about Neil. When they turned and walked toward us like one organism, I squeezed Saul’s hand hard.

“Your son has a fractured skull,” one of the scrubs explained. “There’s a tiny bit of bleeding at the site,” another added. “Nothing big really, but we’d like to transfer him to Boston. In case.”

In case he needs a Richmond bolt,
I thought.
An intracranial pressure monitor.
Anna Jaques was not equipped to do brain surgery on a child. I tried to push visions of Neil’s shaved and bandaged head out of my mind. While I was glad he was being transferred to a tertiary trauma center with the best neurosurgeons in the world, I was terrified that he might actually need one of them. I squeezed Saul’s hand, trying to interpret the situation for him.

“It’s just a precaution, honey,” I said, hoping this was true.

They led us back to Neil’s cubicle. He was more agitated now. His leg was hurting him. He thought he was in a gym. After each arousal he fell back into a deep sleep. Saul and I stood over him, our hands on his shoulders, feeling helpless and scared.

The noise level outside our cubicle rose. I could hear Mary wailing. Police walkie-talkies crackled. Trista’s brother, Bud, was pounding his fist into the arm of a metal chair in the hall, sputtering over and over, “I’ll kill him. I’ll kill him.”

“I have to go say good-bye,” I told Saul and stepped into the hall. I followed the sounds of Mary’s cries and found her outside Trista’s cubicle. I put my hands around her shoulders, trying to console the inconsolable.

“Have you seen her?” I asked. I had only seen Mary in the hall outside Trista’s room.

“I can’t; I can’t,” she sobbed.

But what if Trista didn’t make it? What if this was Mary’s last chance to see her daughter alive? I had helped countless distraught parents see their intubated and unconscious children for the first time. I had done it as a nurse, a resident, and an attending. I explained the machines, the tubes. I held their hands and answered their questions. I was good at it.

“C’mon with me. You have to see her.” I gently led this mother, this woman I was just beginning to know, to her daughter’s side. A crowd surrounded Trista’s stretcher. Her head was taped between two Styrofoam blocks, like Neil’s. She was intubated. A respiratory therapist knelt against her, pressing air into her lungs rhythmically with an Ambu bag. A nurse was securing her heart monitor to the stretcher’s side rails with Velcro straps.

“I can’t,” Mary screamed again and collapsed on the floor next to the stretcher. Mary’s husband, David, lifted her gently, and together they moved into the hall. I stepped closer to Trista. I’m not sure why the local ER crew made room for me. They didn’t know I was a doctor, but maybe they let me in because Trista was stabilized or because they thought of me as a surrogate mother, given Mary’s inability to see her child this way.