Impact (52 page)

She is as stiff as if he had slapped her. “Of course not.”

Still angry, he walks to the window and looks out. No one lurks beyond the hedge to spy on them. The liberation somehow makes him sad.

“I didn't want to take this case, you'll remember,” he says without turning back.

From behind him she murmurs, “I know.”

“But I did, which means I contracted to do anything within my ethics and the law to let Jack win.”

She doesn't answer.

He turns to face her. “I'm going to call Jack as a witness.”

Mute but resolute, she shakes her head.

“I have to.”

“You can't, Keith. They'll make him look like a fool.”

“That's not the worst thing in the world, Laura. It's not nearly as bad as being a pauper.”

They exchange accusations that range far beyond the threat to her husband's dignity. “If he's close to cogent,” Tollison persists, “I'm going to put him on the stand.”

“I can't let you do that, Keith.”

“The only way you're going to stop me is if you've got a court order saying he's not well enough to testify. Which is going to be hard to do, since I'm supposed to be his lawyer.”

He has frightened her. “Keith, I … what's gotten into you? Why are you
doing
this?”

“Because I'm going to try like hell to win this thing for Jack, and at the same time I'm going to do something for you.”

“What?”

His answer hurts so much he winces. “Give you a reason not to see me again. A good one. One even I can understand.”

“I don't know what you're talking about.”

“You will next week.”

“You sound like you're planning something horrible.”

The charge makes him giddy. “I'm just going to do what any lawyer does—I'm going to sell my client. At first I was going to sell
you
, but you decided not to claim a loss of consortium, so selling you wouldn't get me much. For a while I thought I would sell you anyway, that the jury would help you by helping Jack, but it's not working. They're only thinking about Jack, wondering if his brain is a mangled mess or if all he's got is an Excedrin headache, the way Chambers made it sound. So I have to give him to them, but it's a problem. The product didn't used to be all that great, if you remember.”

Her breaths are cavalcades of noise. “So what are you going to do?”

“I'm not going to sell them what he was, I'm going to sell them what he is.”

“That sounds so … callous.”

His words are cold. “It's not
your
job to say what's moral in that courtroom; it's Judge Powell's, and he's doing fine at it. He's doing so well that when Chambers trots in his SurfAir people, the jury may buy the entire bag of bullshit unless Jack convinces them he needs their help more than the airline does.”

She shakes her head. “You're so
angry
, Keith.”

“Sure I'm angry. I'm angry at what I'm having to do to give you what you want in the world, and that what you want in the world no longer includes me.”

“I—”

He shakes his head. “Forget it, Laura—we've got work to do.” He brings his briefcase to his lap. “I brought the videotape with me. Both sessions, edited together. I want to go over your comments, just the way you'll give them on Monday.”

“If you think it's necessary.”

He motions for her to take a seat in front of the TV set, then extracts the cartridge. “There are a couple of things to keep in mind. Don't exaggerate—Jack's situation is dramatic enough without the jury thinking you're trying to pump it up. If you use technical terms, be sure to explain them. And if you need me to stop the tape to give you time, just say so.”

“Okay.”

“Look at the fireplace and pretend that's the jury. Talk to them.
Persuade
them. That's what trials are all about.”

He stands as she swivels to do his bidding. “I'm going to be just like I'll be in court, so I'll start by asking you how long you and your husband have been married”

“Since 1972.”

“Any children?”

“No.” She hesitates, then foresakes the sooty jury and looks at him. “I can't have any.”

He is off course already. “I didn't know that.”

“I was waiting for when you needed to.”

“Jesus, I—” It is all he can do to stay on track. “At the time you got married, what was your occupation?” He looks at her.
“The jury
, Laura. Remember the fucking jury.”

Astonished by his outburst, she turns quickly to the fireplace. “I was a practical nurse working in various clinics in the San Francisco Bay area.”

“What training did you have?”

“Two years nurses' study at San Francisco State.”

“How many years of practical experience had you had?”

“Six, but only two full-time.”

“Prior to March twenty-third 1987, was your husband in good health?”

“Yes.”

“No physical or mental problems of any kind?”

“No.”

“Good. Where were you when you first learned of the SurfAir crash?”

She looks back at him with the gentleness of memory. “I was getting ready to attend a benefit ball.”

He takes her through the night and the morning after, what she learned and when, where she went, what she saw. She covers the essentials and re-creates her first glimpse of her husband in the hospital with more drama than he'd hoped. As he guides her through the days when her husband's life hung in the balance, and the long wait for him to return to consciousness, she becomes the spinner of a legend.

“During the time your husband was in a coma, was he treated at home or in the hospital?”

“At the hospital for three months, then I insisted they send him home.”

“After he came home, did you participate in his care yourself?”

“Yes. Because of my nursing background, the doctors felt that with training I could become Jack's primary caregiver. And I wanted to, of course.”

“Can you give me a general idea of the kind of care your husband received?”

She hesitates, nods, closes her eyes. “The early stages of his treatment, while he was still comatose, were dictated by the effects of prolonged bed rest on the body. For example, the heart of a supine individual works thirty percent harder than the heart of an active person. Its blood volume also increases, causing a drop in pressure, which may cause thrombus, or blood clots. Bed rest interferes with chest expansion, so respiration is reduced, which can lead to pooling of secretions and pneumonia. Bone and muscle strength are reduced significantly—muscles begin to atrophy from the third to the seventh day in bed; without therapy, three percent of muscle strength is lost daily. Inactivity also causes loss of bone matrix and calcium, which can lead to osteoporosis. Fibrosis can form in connective tissues, leading to contracture that can permanently limit movement. Kidney stones may form from increased urinary calcium. Decubitus ulcers—bedsores—begin to form within twenty-four hours, particularly on bony prominences.” She opens her eyes, then inhales to fuel the exposition. “These are just a few of the difficulties facing a person confined to bed rest for a lengthy period. Naturally, we undertook various treatments to combat them.”

Mesmerized, he claps his hands. “Great. That was perfect. I'm going to start the tape.”

He walks to the TV set and inserts the cassette into the recorder. After a moment of snow, a title appears, hand lettered, crude:
JOHN CHARLES DONAHUE … AT HOME … AUGUST 15
&
DECEMBER
29, 1987. After another moment, the words dissolve into the room where Jack Donahue now spends his life.

“Do you remember when this was taken?”

“Yes.”

“Were you present each time?”

“Yes.”

“Did both sessions depict a typical period of time in the care and treatment of your husband?”

“Yes.”

“Were any extraordinary measures undertaken just for the taping, or were you engaged in routine activity?”

“Only routine activity.”

“Was your husband conscious or unconscious?”

“Unconscious, the first time. He didn't come out of the coma for another month.”

He presses a button. “Please tell us what you see.”

Images materialize. Jack flat on the bed, draped with a thin sheet, body lax, eyes taped shut, muscles thin and wasted. Two people hovering over him. Laura. A husky nurse.

“Why are his eyes taped closed like that?”

“To keep them from drying out.”

“Okay, what are you doing here?”

“To prevent pooling of secretions, we turned Jack on a regular basis.”

The tape spins on.

“These movements combat fibrosis in the connective tissues. Range-of-motion exercises, they're called—moving the joints on a systematic basis,
every
joint, down to the little fingers—Here the nurse is adducting the hips while I dorsiflect and plantarflex the foot.… As you see, when we find bedsores developing, we clean the threatened areas, then protect the prominences with a soft cloth and remove external pressure.”

Tollison glances at the screen. “Now what?”

For the first time, Laura turns away. “I don't want to do this part.”

“You have to.”

“You said you'd edit it out if you could.”

“I know. But I can't.”

“You never intended to, did you?”

He shakes his head.

She covers her eyes and trembles. “Are you sure you're not doing this to humiliate him, Keith? I couldn't stand it if I thought you were doing that.”

“I'm doing this because this is what Alec would do in the same situation.”

She turns back to the screen and her voice becomes a drone. “I'm preparing him for a bowel movement. This is after he recovered consciousness, but barely. He's turned to his right side because the descending colon is on the left. There's an incontinence pad beneath him. I usually did this about thirty minutes after his meal, to take advantage of the gastrocolic and duodenocolic reflexes. I'm stimulating his natural reflexes through massaging the anal sphincter. At times this was sufficient; when it wasn't, I used a glycerine suppository. As you see, I use rubber gloves and lubrication.”

“Did the nurses perform this as well?”

She shakes her head. “Just me. I didn't think Jack would want anyone else to … use him like that.” She glares at him. “You can't have him in court when you show this, Keith.”

“He won't be,” he says gruffly, then returns to the screen. “What's this?”

“The equipment for urination. Initially, Jack was on a Foley catheter to relieve his bladder—that's a needle inserted into the urinary canal in the penis to allow his urine to drain continuously—but prolonged use of a catheter can lead to renal failure, so at this point we were applying an external appliance. It's rather like a condom, as you can see; it remains in place by virtue of a facing cement that avoids skin irritation. It's essential that both the catheter and the appliance be cleaned frequently, and that's what I'm doing here. Now I'm putting the appliance back on his penis. At one point, I thought we were going to have to go to a bladder pacemaker, but fortunately Jack regained consciousness before that became necessary.”

“Does he still use this … appliance?”

She shakes her head. “He
hates
it. Which is sort of a problem, because he's still incontinent fairly often, and he hates that, too.” She shrugs. “We get by, I guess.”

Her words are gentle, as though she is back in the days of the coma, reciting prayers that had sustained her then. “What's that?” he asks.

“We're supporting his feet to prevent foot-drop and putting antiembolism stockings on to minimize the risk of deep vein thrombosis. There we're applying head and neck supports, and supports for the hand and hip to prevent rotation.”

“And this?”

“We recorded his temperature hourly, because infection in a comatose patient can be lethal. Of course we advised the hospital when unusual symptoms developed, such as diarrhea from the antibiotics or tube feedings, or signs of infection, which are also common.”

“Did Jack develop any of these problems?”

“He had diarrhea many times, a urinary infection twice, bedsores on countless occasions. We did the best we could, but he was unconscious for so long that … there I'm brushing his teeth, flossing, combing his hair, shaving him. I cut him badly once because he had a seizure while I … I'm bathing him here—a sponge bath. We do that after evacuations and exercises; it's important that the skin be kept clean, and we have to apply a moisturizer since his natural oils are not secreting normally. The bath was nice. I always felt he knew who I was when I did it.… It reminded me of when we used to …”

Her voice trails. Tollison presses a button that stops the tape. When her hands have fallen to her lap, he speaks with laughable formality. “Has this therapy we've just observed, which you employed when Jack was comatose, changed to a significant degree now that he's regained consciousness?”

Laura looks at him as though she had been expecting a more personal question. “Somewhat, but not completely. He still can't move his right side, so we do the ROM, range-of-motion, exercises. A therapist has started putting him through a whole battery of strength modalities. And we've only just begun a range of exercises to stimulate his intellectual capacities.”

“These therapies are done every day?”

“Yes.”

“How many aides do you employ?”

“Two. We take eight-hour shifts.” She looks at him. “And I have a young man who helps with the heavy work, moving Jack from bed to his chair, to the bathroom, things like that.”