Crossing Oceans (23 page)
“Why isn’t she on APRV?” Dr. Preston asked.
Dr. Reid pressed his fingers against his temple. “No matter what I say, you’re going to attack it.”
Dr. Preston donned a smug expression. “That’s the first intelligent thing you’ve said.”
Dr. Reid looked at the ceiling as his foot continued to tap. “I understand that you’re going through a stressful time, so I’m going to—”
“You’re going to extubate my granddaughter.”
Dr. Reid’s foot stilled. “You’re insane.”
“That may be so, but that’s the course we’re taking. I had the nurses titrate the paralytic. Guess what? Isabella is responding to pain stimuli. She’s wiggling her toes. She’s trying to open her eyes.”
I gasped at the news. As much as I wanted to run to her, I knew I had to stay behind and hear the rest of the conversation.
Dr. Reid jerked his head back in surprise.
A severe expression replaced Dr. Preston’s previous smug one. “That’s right, Doctor. And after I took her off the archaic continuous respirations you had her on and moved her to APRV, her spontaneous breaths picked up.”
Dr. Reid rubbed at his chin. “What are they now?”
“Ten per minute.”
“Not enough.”
“Not yet, but I believe once the medication wears off completely and we extubate her, her lungs will have to work. I predict that they will.”
Dr. Reid’s foot started tapping again. “She’s not ready.”
Dr. Preston took another step forward. “Listen, you sniveling brat, this is my granddaughter. My flesh and blood. This isn’t some spitting contest that you can win with the evil Dr. Preston. I know you, the rest of the doctors, the nurses, and probably even the candy stripers hate me, but it doesn’t matter. What matters is that I have earned my position and I’m going to use it to save my granddaughter’s life.”
Dr. Reid turned to me as if expecting me to intervene. When I didn’t respond, he turned back to Dr. Preston. “If we extubate her without weaning her down for a day and she codes, you will not only lose your position as chief of staff, I’ll make the case to the board myself that you lose your license to practice altogether.”
“If something happens to my granddaughter,” my father said from behind me, “he’s going to lose more than his license.”
While other teenagers had to be prodded and pleaded with to go to sleep at a decent hour, I never had to be asked. I wanted to go to bed early just so I could have plenty of time to lie there and dream of my future with David. Staring at the ceiling, I’d fantasize about what sort of life we’d someday have. I imagined a wedding both simple and elegant.
My bridesmaids would wear champagne-colored silk, while I would be a modern-day Cinderella dressed in a strapless white gown lined with lace and pearls. David would be dashing, of course, in his tailored tuxedo. We would gaze dreamily into one another’s eyes, feeding each other cake and promises as our families toasted the beautiful life we were about to embark upon.
Often I imagined David placing a finger over his lips and leading me down the hall to the doorway of our daughter’s bedroom. Hand in hand we would watch her sleep, in awe of her sweetness, the love we felt for her . . . and for each other. Somehow I’d always known we’d have a daughter, even though the rest of the details didn’t quite work out as I’d fantasized.
Now, years later, my dream had twisted into a nightmare. David’s hand clutched mine as we stood beside Isabella’s hospital bed, marveling not at her innocence but at her inner strength—hoping it would be enough to see her through. Instead of praying over her future occupation, husband, and friends, my only concern at that moment was whether or not she would live.
Though the PICU guidelines stated only two could visit at a time, Dr. Preston ensured that exceptions were made for us. It was clear from the glares the staff sent his way when he wasn’t looking that they resented his interference, but thankfully no one took out their frustrations on us or Isabella.
David and I tried to stay close to our daughter but out of the way, while my father and Mama Peg stood almost flush against the wall. My father never took his glowering eyes from Dr. Preston, and I think everyone understood if there was one death today, there would surely be two.
Dr. Reid occupied the position at the head of Isabella’s bed. He held a clear bag with which to pump air into her mouth if needed. At the foot of her bed stood a nurse and a respiratory therapist. Dr. Preston explained he would be the one to remove her tube and if she didn’t breathe on her own, it would quickly be reinserted. Though he was adamant that he didn’t believe it would be necessary.
Isabella’s eyes fluttered open, then closed again. Dr. Preston leaned over her. “Isabella, it’s Grandpa. Listen, darling, we’re going to take the tube out of your throat now. It’s going to feel uncomfortable, but it will be over quickly.”
Her mouth twitched.
He gently pried the white tape holding the tube in place from her skin. “When it comes out, you’re going to need to take some deep breaths for us so we don’t have to put it back in. Okay?”
I heard soft footsteps behind me and turned to see Lindsey slink into the room. With bags under her eyes and strings of disheveled hair hanging loose around her face, she looked like she was in equal need of a nap and a shower. Her weary gaze flitted from Isabella to Dr. Preston and finally rested on David’s hand intertwined with mine. When her eyes met his, he dropped my hand and reached for hers.
Feeling cold and alone, I hugged my arms around myself.
“Here we go,” Dr. Preston said. He grasped Isabella’s ventilator tube. “When I count to three, sweetheart, I need you to hold your breath.”
My heart froze as the gasping sound of the ventilator fell silent.
“One.”
Lord . . .
“Two.”
Please . . .
“Three.”
Make her breathe. Oh, please, make her breathe.
Everyone’s eyes were riveted on Isabella as Dr. Preston, in one fluid motion, pulled the tube from her mouth.
“Breathe,” he commanded.
As seconds passed, her skin took on an unnatural purplish-red color. She made a gurgling sound, but her chest didn’t rise. Another second passed. Then another. Panic filled me as I waited for someone to do something, anything. Dr. Reid stared hard at Dr. Preston.
“Come on, child, breathe,” Dr. Preston said.
Dr. Reid pressed a clear mouthpiece over Isabella’s lips, ready to pump air into her from the bag attached to it.
Dr. Preston pushed him away. “Not yet.”
I moved to her side and pleaded in her ear. “Bella, it’s Mommy. I need you to breathe. Baby, please, please breathe.”
The room stood so quiet that the tick of the wall clock sounded like a drum.
“That’s enough,” Dr. Reid said to David’s father. “Reintubate.”
Everyone came to life as if a director had called, “Action.”
“No!” Dr. Preston bellowed.
Everyone froze again.
How much time had passed? I wondered. Had it been one full minute? two? How long could they wait?
My head swam. “Please,” I cried. “Someone, please do something!”
No one moved. Isabella opened her mouth as if she wanted to breathe but couldn’t remember how. I clamped my eyes shut.
Oh, God, please, please, please . . .
I heard something that sounded like a tire leak and looked at Isabella. Her chest rose as she sucked in a breath.
“Another one, Bella. Take another one,” Lindsey said, her voice the calm center of our hurricane.
Isabella turned her head, fixed her glazed eyes on David, and pulled in another breath.
I counted the seconds between the rise and fall of her chest.
One Mississippi, two Mississippi . . . five . . .
Breath.
One Mississippi, two Mississippi . . . four . . .
Breath.
The nurse put a nasal cannula like Mama Peg’s around Isabella’s ears and slid the clear prongs into her nostrils. When Isabella’s breaths became rhythmic and regular, everyone clapped while I could only sob.
When Dr. Preston turned around, his eyes were red and wet. It took me a moment before it registered that he’d been crying too. As long as I’d known him, I’d never seen him shed a tear. I wouldn’t have believed it possible had I not seen it for myself.
He looked up to the ceiling and exhaled, then addressed the respiratory therapist and nurse. “I’ll want her vital signs every fifteen minutes for an hour, then Q two. Get a blood gas and—”
“What are her respirations?” Dr. Reid asked.
The nurse answered, “Fourteen.”
“Very good. Her oxygen saturation?”
The respiratory therapist grinned. “Eighty-five percent and rising.”
Dr. Reid pulled his stethoscope off his neck and listened to Isabella’s lungs. After a minute, he turned to Dr. Preston with a smile. “She sounds most excellent.”
“Of course she does, Doctor,” David’s father said smugly.
Dr. Reid looked at him, then left the room.
I kissed Isabella’s damp forehead. “Bella, can you hear me?”
She stirred but didn’t open her eyes.
Dr. Preston stood beside me and gently forced her lids open with his fingers. He pulled a penlight from his lab coat and shined it in her eyes. “They’re dilating.” His tone told me that was a good thing.
“When will we know if she’s going to be okay?” I asked him.
He turned a small black wall knob. A tiny ball rose within a clear cylinder as he adjusted her oxygen level. “That’s a good question, which I can’t answer. This is the one thing that’s completely out of our hands. We just have to wait and—”
A horrible raspy sound came from Isabella.
I looked down at her. With the exception of her breathing, she lay as still as a corpse—eyes closed, mouth slightly parted. Dr. Preston and I looked at one another questioningly, then back to her. I fixed my eyes intently on my daughter, refusing to blink so that I wouldn’t miss any movement. Her lips moved so slightly I wondered if I imagined it. A thin string of spittle bridged her parted lips. “Maaa . . .”
My gaze flew behind me to David, then back to her.
I leaned over her. “Baby, I’m right next to you. Can you hear me?”
Slowly, she blinked her eyes open, looked right at me, and whispered. Her voice was so quiet and sounded like gravel, but I could still understand every beautiful word. I turned around and repeated what she’d said. “She’s thirsty.” I started to laugh. “Isabella said she’s thirsty!”
“She’s thirsty!” David exclaimed as he picked up Lindsey and spun her.
My father slapped Dr. Preston on the back so hard the sound resonated throughout the room. He jerked his hand back as if suddenly remembering their feud.
A nurse left the room and returned with something that looked like a synthetic lollipop. When she slid it into Isabella’s mouth, my daughter clamped down so quick and hard that the nurse came close to losing a finger.
“What’s that?” I asked her.
“It’s a damp sponge. She needs to take it slow at first.”
“Oh, for pity’s sake,” Mama Peg said. “Somebody get that child a glass of water.”
The nurse tucked a strand of hair behind her ear and looked to Dr. Preston for direction.
He nodded his approval. “I’d do what Peggy says if I were you. You don’t want to tick off a Lucas. They’re as mean as bulldogs.”
My father’s mouth twitched as he fought to repress a smile.
I squatted by my daughter’s side. I knew I should give her time to recover, but I just had to know. “Sweetness, why were you in the lake?”
The room grew still as everyone waited along with me for her answer.
She set her palm on my cheek. I slid it to my mouth and kissed it.
The nurse handed me a plastic cup filled with water. I held it to Isabella’s lips and she drank. After she’d taken in several sips, I moved it away again. She swallowed and grimaced. “My throat hurts.”
“It’s from the tube,” the nurse said, not looking up as she continued writing on Isabella’s chart. “We’ll get you some medicine that will make you feel better.”
I brushed a curl from Isabella’s cheek. “So, sweetness, please tell us why were you swimming all alone.”
I squeezed her small hand to encourage her. It felt warm again, as if life had suddenly reentered her.
My daughter looked at me with her golden-brown eyes and gave me a look that seemed to say,
Don’t you know?
“I was trying to get to you, Mommy. So we could be together forever.”
Her answer left me speechless. As tears streamed down my face, I kissed her sweet lips and turned around.
“I don’t understand,” David said.
Mama Peg placed a hand over her heart. “Oh, my heavens. She was trying to cross the ocean.”
I nodded as I wiped tears from my face.
My father cleared his throat the way men sometimes do to keep from crying. “You used the same analogy your mother used with you.”
I nodded again, still unable to form words.
David and Lindsey shared a puzzled look.
The nurse took the cup from my hands and gave sips of water to Isabella, while I explained the metaphor to the Prestons.
When I finished, David said, “Jenny, it’s clear she needs more time with you. Take a few more days with her. There’s no hurry.”
Lindsey yanked her hand from his. Her doe eyes flashed him an intense look I didn’t comprehend. “No, David. Not just a few days.”
His expression hardened into stone as he crossed his arms. “Lindsey . . .”
“No, you listen,” she said. “We have forever with her; Jenny doesn’t. That little girl needs her mother right now. They belong together.”
David opened his mouth, but a cool look from Lindsey silenced him.
“We have forever,” she repeated softly. “Forever, David.”
When I was pregnant, it was the oddest thing, but my sense of smell became so intensified it was like having a strange little superpower—albeit a useless one. The moment I walked into a grocery store, I’d know they were frosting a cake, steaming shrimp, or giving away samples of granola three aisles down. I don’t know if it was hormones causing it or why I should experience that same phenomenon now that I was dying, but suddenly my olfactory abilities could rival a bloodhound’s.
