Tuesday, July 2, 2013

Monday Morning (Story)

It was just another Monday morning, a little after 10, overcast, drizzling outside and I'd emptied the dishwasher of clean stuff and started rinsing and loading the dirties when I heard the crash. Danny's bathroom was right above the kitchen where I stood. He'd fallen again.

I raced up the stairs. His bedroom's furniture crowded the upstairs den, waiting for the newly sanded, century-old pine floor to receive new coats of stain and polyurethane before reoccupying their usual resting places.

Dan's balance isn't so good these days. He wears an orthotic brace on his left leg and uses a cane whenever we go anywhere, but around the house he usually gets around fairly well without those accessories. In the 23 years since his traumatic brain injury, he's had several falls and several visits to the emergency room.

There he lay, sprawled across the floor of his restroom. He was shaking. His face looked strange; muscles contorting but expressionless; his eyes rolled over to one side of his head. His breathing was short, shallow and quick. 

"Danny," I said as I kneeled down to him, putting my hands on his face and shoulders, "brother's here. I've got you." He was sweating, unresponsive. He was having a seizure.

By the time the EMTs arrived a few minutes later, the seizure was over. But he'd have two more before they could get him in the ambulance, each one worse than the previous. As he began his third seizure, they injected him with phenytoin, an anti-convulsant. This time his limbs tensed drastically, his feet aiming out like a ballerina on points, his arms stretched to their limits. The image of him all those years ago as he lay posturing – involuntarily flexing all the muscles of his limbs – on his fourth-floor Neuro ICU bed, tubes going in and out everywhere, an absent look on his face as a whirlwind of healthcare activity swirled around him, rushed back into my mind.

Danny's right knee was skinned. So were spots on his left forehead and temple. Had the seizure begun as a result of hitting his head? Or did the seizure begin first and cause the fall? We have no way of knowing.

Danny and I reached the hospital at 11:30 am and he was moved to a bed in the hallway, hooked up to monitors and blood was drawn. By then he was in his usual good spirits: smiling, making jokes, flirting with the nurse who took his blood pressure.

From the moment he hit adolescence, my brother has been a true ladies man. After all the trauma, all the surgeries and therapies, the IVs and casts and splints that Danny's had, little is able to get him down. In spite of everything he's been through, his personality, his humor, his character remains intact. The only thing that troubles him is the loneliness of his physical condition. Dan would like to be married, to have a wife and children like I do, to have friends he visits with and goes out with. But his disabilities make companionship difficult to find. His old friends from before his accident just aren't around anymore. Online dating and social networking provide little relief.

Room 3 was cool and open. The thermostat was set at 73 degrees, a near perfect temperature for falling asleep unless you're rail thin and dressed only in athletic shorts and a t-shirt. The floors throughout the Critical Care emergency ward were tiled in purple, gray and off-white vinyl, the privacy curtains a light sea foam, the sand colored walls marred with gray scuffs. Hums, buzzes, beeps, footsteps and squeaks, the creaks of old wheels that needed oiling, it all formed a cold electro-mechanical accompaniment to the intermittent moans and groans, the labored howls, the prolonged wretching, the cadential shrieks, the chorus of pain.

Amidst the hellish din and the fevered blur of activity moved the aloof faces of the nurses and their aids, immunized to the suffering by intense exposure to it. I watched a little as they worked, becoming aware of the unique strength of the medical worker's constitution, a temperament that allows them to get their jobs done in an atmosphere of extreme duress. Throughout our stay we were treated with great courtesy and concern, a true psychic balm for our raw nerves.

After Danny's first CT scan our parents arrived. Dr. F___ (a tall, thin man, gray, mid-to-late 60s) told us that there was a bit of bleeding on the left side of the brain.

"We'll do another scan to make sure it's not an aneurysm or a bloodclot."

Would the bleeding stop? Would Danny need an operation? We wouldn't know until the test results came back. Shortly after Danny had that pivotal car crash just two months before his 19th birthday, his neurosurgeon removed a small part of the skull to allow the fluid to drain and the swelling of his brain to go down. He still has a soft spot about half an inch square from the surgery. Did he now await a repetition of such a procedure?

By around 5 pm discharge was underway. Daniel's final diagnosis was nontraumatic subarachnoid hemorrhage. We were all relieved to learn from the staff neurologist that the bleeding had stopped and should "take care of itself." Dan would have to see another neurologist and begin taking anti-convulsants. But he wouldn't have his brain tinkered with.

Where does that leave us now? My heart wants me to be there always, to always catch him when he falls. But my mind knows it's not possible. My mind recognizes our very helplessness, the feeling that no matter how close you are to your siblings, your children, your parents or friends, no matter how protective you are, no matter how much you love them, their well-being, their health, their survival is truly out of your hands.

It's the feeling my family had in July of 1990. It's what I felt as I held Danny's head in my hands and watched him convulse as we waited for the ambulance. It's an old feeling, long dormant, now awakened in us all.