Crash (7 page)

16

A Hasty Getaway

Over the next two days, Neil became more alert. He still slept a lot, but he had more spontaneous words, more facial expression, and more eye contact. He was deemed well enough to be transferred from the trauma ICU to what they called the step-down unit. Here we had a private room with a view of the city streets. It was quieter here, away from the constant lights, the relentless noise of beeping monitors and alarms, and the ever-present eyes of the ICU nurses.

But although Neil’s mind was clearing, the horrific reality he faced through that lifting haze haunted and depressed him. He seemed to give up. He spent his time in bed with a blanket pulled up over his head. I never heard a sob or saw a tear, but he always emerged from those covers looking weak and spent. He refused to eat. He declined physical therapy.

“You’ll never walk right if you don’t exercise your leg, Neil,” the orthopedic surgeon told him.

“I don’t care if I ever walk again,” he spat back.

I asked for a psych consult—someone to evaluate his emotional stability, help him deal with his terrible loss. I told Neil someone would be stopping by to talk to him.

“Fine,” he snarled. He aimed his one-word answers at us, hurling them like missiles in response to anything we said to him. Then, the blanket over the head.

We continued our “never leave him alone” policy. At first it was to protect him from the news of Trista’s death. Now it was to protect him from himself.

“Think of it as a suicide watch, Dan,” I told my oldest son, the words catching in my mouth. I didn’t really think Neil would do that. Then again he’d never lost a girlfriend before.

We waited all day for the psychiatrist’s visit, or at least a resident. It was getting late. I finally went out to the nurses’ station to ask when the psych team was coming.

“Oh, they’re not,” the nurse informed me, a little too cheerily.

“Why not?” I asked, horrified that, number one, they weren’t coming, and that, number two, I wasn’t told.

“The team won’t come unless a patient is actively suicidal,” the nurse said, her voice now devoid of cheeriness.

“And how exactly are they supposed to make that determination without
actually seeing THE PATIENT?”
I asked. When the nurse took a step back, I realized just how loudly I’d raised my voice, but I was furious. I knew I’d better get a grip or someone would be calling Security on me.

I walked back to Neil’s room and leaned against the wall outside the door, my heart pounding, my eyes stinging with pent-up tears. I tried to gather my thoughts and rein in my emotions. I felt that the hospital, my medical community, was failing us. First there was the social worker who was “here and not here,” unwilling to stay a few minutes beyond her scheduled shift to see one of her families through. And now no one was coming to evaluate my child’s mental health even though to me he was clearly at least passively suicidal. How could a world-class trauma center not recognize the emotional trauma that goes along with the broken bones and bleeding brains?

I walked back to the nurses’ station and said in my calmest, quietest voice, “I want my son transferred back to Anna Jaques Hospital.”

“I’ll call the residents,” she responded, her hand already on the phone before I’d even turned away from the desk to return to Neil. Here at Brigham and Women’s Hospital, Neil’s care had been excellent, the staff attentive and diligent. But we knew that there were so many sicker, more critical patients here. We could see it in the halls where staff raced to silence alarms and check beeping monitors. We knew it from our time in the waiting room, listening to other families rally then grieve. We heard it in the staff’s upbeat assessment of our child. “He’s gonna be just fine.” Here a traumatic brain injury in which the patient speaks and stands was no big deal. Back home at Anna Jaques, Neil would be a very big deal. There he would be known. The son of a businessman in the community. A member of the synagogue. A classmate of the sons and daughters of the doctors and nurses caring for him. If the acute phase of Neil’s injuries was behind him—he wasn’t getting surgery on his brain; he’d had the first operation on his leg; if all he needed was rehab—I wanted to take him back to his hometown where family and friends could more easily visit and support him.

Back in his room, Neil slept. I told Saul about my encounter with the nurse and the missing-in-action psych residents. Saul sighed and shook his head.

“We should go back to Newburyport,” he said, independently coming to the same conclusion I had. It made me feel better about my volatile encounter and my spontaneous demand for a retro-transport.

Neil had a few visitors that afternoon. Suzanne Bryan, his drama coach, was there. We had snuck her in after visiting hours the night before as “Aunt Suzanne,” but now she was here legitimately, along with a few of Neil’s friends. Brendan brought him comic books. Neil smiled at the pile, each edition carefully wrapped in a clear plastic sleeve. But Neil couldn’t stay awake for long. So we took the conversation out into the hall.

“Thanks, Brendan,” I told him. “You get the prize. That was Neil’s first smile since the accident.”

Later, Neil’s friends Travis and Greg brought a movie and a VCR. The movie played. Neil slept.

“I’m sorry I’m so tired.” He apologized each time he woke. “I’m sorry I’m in so much pain.” The boys finally went home.

By the next morning we still did not know the status of our requested transfer back to our hometown. We asked the nurse to check on things for us.

Soon an alarmingly young-looking resident came in to round on Neil.

“He’s all set to go,” he proclaimed.

“What do you mean?” I asked

“He’s discharged,” the resident explained, still smiling, as if this were good news. But it wasn’t good news to us. Neil wasn’t ready to leave the hospital. He was weak. He had lost weight. Having refused physical therapy for the past two days, he had not even stood on his own, let alone walked or done stairs. Dan had even been carrying him to the bathroom. Then there was the issue of his fragile mental health.

“But he’s not ready,” I stammered.

“Oh, he’ll do fine,” the resident smiled, his teeth astonishingly white. His optimistic pronouncement reminded me of Chuck/Mitch’s one-minute ER assessment. We asked to speak with the head of the ICU, the trauma surgeon who had been so concerned about a basilar skull fracture that first night in intensive care. But the attendings had switched rotations, and the new one seemed in agreement with his resident. He showed us stable head CTs and x-rays of Neil’s newly aligned leg bones as evidence of his readiness.

“I’ll get your paperwork ready.”

“What about physical therapy at home?” I asked hopefully.

“Oh, kids bounce back so quickly. I don’t think he’ll need that.”

And he was out the door. We felt defeated. We looked over at our thin, pale, sleeping son. He did not look very bouncy to us. Saul looked at his watch.

“Trista’s funeral is at 12:30,” he commented. “I’d like to try to make it.” I nodded.

Neil suddenly sat up in bed.

“I want to go to Trista’s funeral too,” he announced. The idea was preposterous. He couldn’t stay awake for more than an hour. He was still on IV fluids. Besides drinking a few smoothies, he really hadn’t eaten anything. He was on IV Dilantin for seizure prevention and a patient-controlled analgesia pump for the pain. He had no experience with crutches.

“No one expects you there, Neil,” Saul said, trying to discourage him from this impossible plan. “They know you’re still in the hospital.”

“But they said I can go. So what do I have to do to get out of here?”

He looked determined. I had to admit that just having that goal—to leave the hospital to attend his girlfriend’s funeral—seemed to pump Neil up just a little. Put a little color in his face. Add a strength to his frame that wasn’t there before.

Now Neil was on the going-home bandwagon too, along with the resident and attending. Saul and I were quickly losing this battle. “Well, Neil, you’d need to take your medicines in pill form and be able to walk on crutches,” I offered.

“And you’d need to eat a little something as well,” his father added.

Neil thought about that for a moment.

“Then get me a sandwich, bring me my pills, and get that lady with the crutches back here,” he ordered. He tried to sit up at the edge of the bed, but the effort made sweat stand out on his forehead. His face was pale and gaunt. He closed his eyes and lay back down.

“Can you draw the shades please?” he asked in a whisper. But they were already drawn. I closed the door to squelch what little light was leaking in from the hallway.

Neil slept briefly. Then the physical therapist came. She was a tiny muscular blond woman with short hair. Her nametag read
Shari
. Neil sat up. Standing next to Neil, she came up to his shoulders.

“I’m dizzy. I can’t do this,” he complained, lying back down on the bed.

“No problem,” Shari responded cheerily. “I’ll come back tomorrow.”

Neil threw back the covers and winced.

“No,” he snapped. “I’ll do it.”

The physical therapist showed Dan how to put the air cast on Neil’s leg. Together they helped him stand, balancing a crutch under each arm. Neil made short jerky steps around the room. His long curls stuck to the sweat on his face. He blew them away. He seemed out of breath. After the brief session he collapsed onto the bed. Neil cried out when Dan swung his leg carefully up onto a pillow.

“Bring me a pain pill,” he croaked.

“I’ll be back tomorrow and we’ll do stairs, Neil,” Shari promised.

“No, now,” Neil argued, eyes closed. The therapist looked at us, panicked, and shook her head.

“Neil, you rest,” I suggested, watching Shari’s face for cues. “Maybe Shari will come back in a little while.”

“He wants to go home,” I mouthed. She looked at her watch.

“Give me an hour,” she agreed.

“Thanks,” I said.

Neil’s meal tray came. He picked at the offerings, forcing his mouth to chew, his throat to swallow. Dan helped him into the shower, his first since the accident. There he ripped his IV out, not wanting to take any chances that he wouldn’t be allowed to leave the hospital.

With tremendous reservations, but with the endorsement of the Brigham and Women’s Hospital team, we packed him up. Untouched fruit baskets, unread books, unwatched movies and unworn clothes; cards, flowers, cookie-grams all got loaded into Saul’s car. We had planned for the two-week stay the doctors had forecast. Now we were gearing up for the abridged six-day version Neil was demanding.

We took two cars home—Saul’s loaded up with hospital leftovers, mine loaded with Neil. I put the passenger seat down as far as it would go, wrapped his leg in my coat to act as a shock absorber, and had Dan climb into the backseat. Neil still winced and sucked in air through his teeth every time we went over a bump. A few blocks from the hospital, Neil announced, “I’d like to eat berries.” I pulled the car into the Star Market parking lot on Brookline Avenue. Dan ran in to make the purchase. But by the time he came back out, Neil was asleep. I put the car in gear and drove as gingerly as I could.

I cried all the way home. I couldn’t believe this was happening to us. Until now I hadn’t allowed myself to think much about the drunk driver. I needed all my energy focused on helping Neil get well. But as I drove home down Interstate 95, my wounded son next to me crying out with every bump in the road, I was filled with anger. This was all so unfair. Neil and Trista were doing everything right. Studying together on a Tuesday night. Walking home before curfew. Wearing bright-orange clothing. Walking on the correct side of the street. Neil could have driven Trista home. He had a license. But he was a junior operator, not allowed to take passengers. He was following the rules. The drunk driver had not.

As we got closer to home, Neil started to stir next to me. In a half-awake state, he instinctively placed both his hands on either side of his coat-splinted leg, shifting position carefully but still wincing with the effort. He then settled back into a fitful sleep, his brow furrowed and sweaty.