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Authors: Cj Flood

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Thirty-five

Sam’s room was freezing, and he didn’t look much like my brother. The skin that wasn’t bruised or bandaged was a pale yellow colour. The ventilator sucked and
puffed away, and the drip trickled, and Sam rocked his head back and forth on the pillow. His eyes flickered. Mum took one hand, while Dad went round the opposite side and took the other. I stood
by Dad, my fingers scuffing Sam’s wrist.

Mum talked to him, and he turned his head to her, and away again, and his eyes rolled, right back into his head, so we could see the reds of his bottom eyelids, and he let out this terrible
moan, low and brainless-sounding, like a zombie. My fingers flinched away then made their way back, ashamed of themselves.

A terrified look passed between Mum and Dad. I wanted them to put their arms around me.

Mary came over. ‘Keep going,’ she urged. ‘He might be able to hear you.’

Mum started again. She told him we were all here, waiting to hear his lovely voice, and not to worry, he was going to be fine, but there was no rush, because we weren’t going anywhere

none of us
– we loved him and we’d wait as long as it took, and the groaning stopped then, and I was so relieved, until he shut his eyes again.

Mary came closer and checked a few things. She told us we were doing great, that it was good to talk to him, that it might be only a matter of time before he woke. She told us how patients
waking from comas could be so agitated and confused at first that they tried to leap out of bed or yank their tubes out.

‘All excellent,’ she said. ‘The more frightened they are the better: brain’s a-go-go.’

She smiled at each of us encouragingly, and I felt strong and capable, like after a pep talk at half-time.

‘Come on, Sam,’ I said, leaning over the bed. ‘You can do it.’

I grabbed his hand, not caring that Dad’s came with it. He was my brother, and whatever Dad thought of me, I wasn’t about to let him clear off without a fight.

‘Wake up!’ I shouted, and Dad shot me a look because there were two other families crowding around relatives in the small Intensive Care room. I saw how his knuckles were yellow, and
Sam’s fingers purple at the tips from where he squeezed so hard.

Mum smiled at me; a tight, scared little smile.

I shouted again.

And nothing happened.

The noise began, rumbling from somewhere deep inside Sam. It set my nerves on fire. Any hopeful feelings died because it sounded so lifeless, so nothing like him at all.

‘You’re all right, boy,’ Dad tried to soothe, but he sounded heartbroken, like he was telling Sam that he’d love him no matter what.

I felt Mum giving up beside me.

Sam’s eyes opened, and he stared straight ahead, and it was like he saw nothing at all.

Thirty-six

Days passed and things didn’t get better. On Thursday we were taken into a small room on the seventh floor. There were no windows.

There was me, then Dad, then Mum on padded grey chairs. Mary stood behind us. She had one hand on Mum’s shoulder. In front of us was a desk. Leaning against it was one of the consultants:
Dr Lloyd. The room was that off-white that schools and offices and doctor’s surgeries always are. There were shelves full of textbooks on two of the walls. There were no family photos. It
didn’t look like anyone in particular’s office.

Mary squeezed my shoulder and my stomach dropped. I could hear Mum’s breathing, and Dad’s. They were breathing too heavily, and too fast.

Dr Lloyd looked from one to the other of them, and occasionally at me, as she talked about Sam. Her grey and white pinstriped skirt was the same colour as her hair.

‘Thank you for coming to talk to me today. I won’t waste your time. I am terribly sorry to have to tell you that we are going to test your son for brain stem death. The EEG scans
were flat. They showed a complete lack of brain activity.’

Dad’s head thudded against the wall. He closed his eyes.

Mary stroked Mum’s shoulder. The consultant carried on.

‘When the brain stem stops working, the brain can’t send messages to the body to control even unconscious functions like breathing, blinking, swallowing and coughing. Equally, it
can’t receive messages back from the body. When this is the case, the person has no chance of recovery. We believe this is the stage your son is at.’

I stared at the rough, lined carpet. At the little balls of fluff.

‘I don’t understand,’ Mum said. ‘How can you
know
there is no chance of recovery? How can you be so sure?’

Dr Lloyd explained about the extent of the damage Sam had taken to his head. She talked about the tests they were proposing, but I couldn’t follow what she was saying. Something about
corneal reflects and gag reflexes. Fixed pupils and water being injected into ears. Mum couldn’t follow it either, but she wouldn’t stop asking questions.

‘I’m so sorry to say this. We believe your son is alive only because the hospital is keeping him that way. The tests have shown no activity in the brain whatsoever after a rapid
decline since the seizures.’

Mum talked about miracles. She asked about those stories you hear where people comatose for years wake up and learn to play the piano. She couldn’t stop talking. Like maybe if she never
stopped, what the consultant was saying could never start being true. Dad stared with closed eyes at the ceiling.

Dr Lloyd told her that these stories were very damaging, that they got people’s hopes up unfairly; that they were often propaganda from religious groups.

‘Such patients wouldn’t be declared brain stem dead in the first place,’ she said.

She looked at us, and I hated her for being so unaffected.

‘If Sam shows even the
slightest
response to the tests, we will review the whole situation. This is hard for you to accept, but you must prepare yourselves for the worst. We will be
very surprised to see a response.’

Mum looked like she might tear Dr Lloyd’s face off.

Instead she asked questions. Sometimes she asked the same question again and again. She leaned further and further forward on her chair.

Dr Lloyd glanced at Mary. She gave the tiniest nod.

‘The doctors can perform the tests with you present, if it’d help,’ Mary said. ‘It can help relatives to understand their loved one has really gone. If he has. But
it’s very traumatic. It can be hard to forget.’

Mum’s face lit up at this. She turned in her seat to look at Mary.

‘We don’t recommend it,’ Dr Lloyd added. ‘Absolutely not. It is very much the last option.’

Mary bent to talk quietly in Mum’s ear about how it was our choice what happened next, but I couldn’t hear. Mum was breathing too noisily.

Dad put one arm across each of us as if we were unseatbelted children in a car he was driving too fast.

‘No,’ he said, very quietly. ‘We don’t want to see that. None of us will see that. Do the tests.’

Thirty-seven

The three of us sat in the windowless room, in the comfortable chairs, while the tests were carried out. Dr Kang had stayed for a while explaining things to us but I
didn’t have much idea what she’d said. Apart from that we needed to be prepared for what might happen – but that was impossible.

If Sam didn’t respond to any of the tests his support would be withdrawn. If that happened, there would be some time where we could say goodbye before they removed all the breathing tubes
and intravenous lines. She told us that we could take as long as we needed, but there wasn’t enough time in the world for that.

Shortly afterwards, Sam’s heart would stop beating. We could stay with him as he passed away, of course, she said. But that was our decision.

She had asked about the possibility of Sam being a donor – but Mum couldn’t take it. She said no, louder and louder, covering her ears like a crazy person. Dr Kang turned her
attention to the floor and then told us about the tests.

She and Dr Lloyd would do them together. All of them sounded unbearable, and that was the point. A person shouldn’t be able to stand them.

I was worried. If Sam didn’t respond and they had to turn the ventilator off, would it feel like choking? Dr Kang said no. She said it wouldn’t feel like anything, because if they
had to turn the ventilator off, Sam would already be gone. She said he wouldn’t suffer, but how did she
know
?

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