Chapter 5

An ambulance awaited us on the Fargo runway, lights and siren on. A full team of paramedics joined Dave in the back, and the driver asked me to join her up front in the passenger seat. Her face was taut with what looked like concern for Dave and compassion for me as she gripped the steering wheel. “We’re just a few minutes from the hospital, and there shouldn’t be any traffic,” she told me, “but we’ll keep the lights and siren on so we can get there as quickly as possible.”

Once inside the ambulance and seated for the drive, I called Dave’s parents. My mother-in-law picked up. “Hello?”

“Louisa?”

“Yeah, Alli? Why aren’t you in the air?” she asked.

“We’re in Fargo, North Dakota. We made an emergency landing.” I could hear how unnaturally calm my voice was, quiet and toneless, even as my entire body trembled. We never know how we will respond to a crisis until one actually lands on us. I would have suspected myself to be shrill and hysterical, or at the very least crying. But there I was, my voice faint, eyes dry, my mannerisms blunted by shock and confusion. “Dave lost consciousness on the plane.”

Silence on the other end of the phone line…a mother’s mind racing to make sense of an unexpected and wholly unwelcome statement. “Is he awake now?” she asked.

“No.”

She put me on speaker. “Nelson is here. What…what happened?”

“We don’t know,” I said. “His right pupil was dilated, he couldn’t see out of it, and then he just passed out.”

Dave’s father joined the line beside his wife. Nelson Levy is a brilliant medical doctor and PhD, a neurologist who has spent the past forty years conducting medical research and developing pharmaceuticals. I was glad to have him on the phone.

“Alli? It’s Andy.” By the grace of God, Dave’s brother Andy also happened to be at his parents’ home that night. He, too, is a doctor. At the time, Andy was wrapping up his third and final year of residency at the University of Chicago before he and his wife, Erin, were to move with their two small children to Denver, where Andy would begin his three-year fellowship in cardiology. Andy and Erin had probably gone out to the Levys’ home in the suburbs eager for a relaxing weekend with family. Familiar as I was with the nightly rhythms of the Levy household, I could see the scene perfectly; I could imagine them all gathered in the kitchen. They had wrapped dinner, had just gotten the kids down to sleep, and were probably about to settle in to watch a movie in the family room. Well, sorry guys, I thought. All of that mundane stuff, that ordinary stuff, that lovely lovely normal nighttime stuff…that has just been blown up by what I have to tell you.

But immediately I had a neurologist and a cardiologist on the line and on our team, and that was no small comfort. I shivered as I clung to my cellphone in the front seat of the ambulance, lights on and siren blaring, tearing across the quiet, starry landscape of the Fargo night.

I didn’t really know much at that point—I had no idea why Dave was unconscious or how they intended to treat him in the emergency room—so I promised that I would call back as soon as I knew more.

“Alli?” Andy kept me on the line another minute, the concern evident in his voice.

“Yeah?”

“Obviously none of us knows why Dave is unconscious right now. If this is a stroke, then every single second matters; we could be talking about the difference between Dave living or dying. When you get to the hospital, they’ve got to move, they’ve got to get him an MRI immediately. You insist on that, and you do not take no for an answer. OK?”

“OK.”

“OK. Good luck. We all love you, and we’re here for you.” Andy is the fifth of the six Levy brothers, the brother closest in age to Dave, the baby. Andy and Dave, two years apart, grew up together—played on the same sports teams, had been the closest of friends through high school and then at college. I’d known Andy, probably one of the most soft-hearted and sensitive men I’ve ever met, from our days in college, too. I could hear the raw emotion in Andy’s voice now as he choked back fear and anguish, as he juggled the dual demands of a brother’s breaking heart with his medical mind suddenly kicking into overdrive, working hard to sift through the minimal data we had in order to search for answers. “OK. Call us back, ’K?”

“I will.” We hung up.

A few short minutes later we arrived at the hospital. I noted, with no small amount of relief, that Fargo’s Sanford Medical Center was about four minutes from the airport, as opposed to forty, which, in a state as large as North Dakota, would not have been a surprise.

Dave’s stretcher was lifted from the ambulance and wheeled into the hospital. As I staggered behind, entering the front of the ER, stunned by the blindingly white lights, I turned to see one of the EMT team members standing beside me. Before I understood what was happening, the man pressed a wad of twenties into my hand and said, “We collect a fund for the family members…for moments like this.”

Moments like this. I considered his words. What was this moment? What was happening?

He continued: “For a hotel, or food, or whatever you need.” I looked down at his hand, and then back into his face, speechless. My mind had not even gotten there yet, to the fact that I would be here in Fargo, and I would need to make arrangements for myself somehow. Food and a hotel? What is going on? I thought once more. What is happening?

“We’ll be praying for you, miss,” the EMT said. This overpowering act of kindness brought me closer to the brink of tears, as I mumbled, barely audibly, “Thank you. Thank you so much. Please pray. Please do.” But I had not cried yet; I could not. In that moment, I needed answers, and I needed to be ready and available to provide answers to the medical professionals who would surely be asking me questions.

A team of medical professionals in scrubs had assembled around Dave’s unmoving body, stripping him of his clothing, hooking him up to an endless jumble of wires and cords and machines. I remember them tearing his shirt—a shirt we had gotten the previous October during a road trip to Dave’s childhood summer camp in Mentone, Alabama. I recalled how excited the camp director had been to see Dave reappear after so many years, how he remembered Dave so vividly, recalled how Dave had been named “Honor Camper” and had won the camp’s big athletic competition for his team at the end of one summer. How he had insisted Dave take a “Camp Laney” T-shirt with him when we departed. How he had told Dave to come back with his own son someday, to volunteer as the camp doctor. How, when we had driven back down from Lookout Mountain, Dave had told me that winning that end-of-camp athletic tournament had been possibly the proudest moment of his entire childhood. Now they tore his Camp Laney shirt down the middle, rending it in half to get at Dave’s inanimate body, a strong, muscular, two-hundred-pound form that belied the shadow of death that was closing in around it.

Dave remained unconscious throughout all of this, his facial expression one of bizarrely sublime peace. I wondered what was going on inside that head. It was so strange, seeing him as if he had simply slipped into a deep slumber. How many times over the years had I seen him asleep? It had looked just like that. Couldn’t he just wake up? In a testament to just how shocked and disoriented I was, the following completely irrational thought skidded across my mind: OK, so we clearly aren’t going to make it to Seattle, but maybe he’ll wake up in time for us to make it to Hawaii. Maybe we will still be able to have that awesome trip, with our plans for the bonfire luau and the snorkeling and reading on the beach.

The head ER doctor, a young man in green scrubs and with a close-cropped haircut, greeted me with a flurry of questions. What had happened on the plane? Was Dave a smoker? He had heard from the doctor on board (who had told the team of EMTs) that Dave had had a seizure on the plane—did he suffer seizures regularly? Had Dave ever had a seizure before? Had Dave complained of any pain recently? Any numbness?

I wanted to launch a rapid-fire volley of questions back at him: What was going on? Would Dave be OK? Would he wake up? But the guy was clearly stumped and clearly flustered. What was a young guy, a doctor, doing passing out on a plane? This was not exactly a typical situation for this ER doc, or a low-pressure one at that, what with the guy’s pregnant wife sitting there. He did not know any more than I did in that moment, and I did not want to get in the way of him doing his work, so I did not ask the question that was heaviest on my heart.

Is my husband going to die?

Dave was wheeled out of the room for a series of tests while I hung back, curled up in a chair, my body trembling. I was so cold.

“Miss?” A nurse peeked her head in, found me sitting there alone. “How are you doing?”

I shrugged, the tears pooling in my eyes for the first time, even as the words evaded me. How could I answer that question? How was I doing? How was Dave doing?—that was what I needed to know in order to answer this nurse’s question.

“Miss, you need to do your best to stay calm and take care of yourself.” The nurse gestured toward my belly. “Would you like me to do a Doppler, to make sure everything is…well, so you can hear the baby’s heartbeat? Wouldn’t that make you feel better?”

To make sure everything is OK with the baby, she had wanted to say, but she had caught herself just in time. What must all of this be doing to the baby, I wondered, for perhaps the hundredth time. Surely my womb was not exactly the most pleasant and peaceful of environments at the moment. I could feel the stress and adrenaline churning through me—I could sense it in the uncontrollable shivering and the quivering of my hands. And so I did my best yoga breathing, trying to keep my body as calm as I could, trying to provide as habitable an environment as I could manage for my baby, given the hell in which we had both suddenly found ourselves.

I shut my eyes, and the silent tears streamed down my face. “No,” I said, shaking my head. I could not do the Doppler right then. The sound of our baby’s heartbeat made me weepy and emotional under the happiest of circumstances—in the obstetrician’s office, with Dave standing beside me holding my hand. I could not handle that tsunami of emotions in the present moment. And, to be honest, a part of me was petrified. Why had this nurse suggested that I listen for the baby’s heartbeat? Was there some risk that all was not OK with the baby? Would I lose my husband and my baby in one night? What on earth would I do? I could not handle it, not right then. I needed all my focus to be on Dave. The baby was OK; she had to be. We needed her to be.

In an effort to stay calm while Dave was out of the room, I pulled out my iPod and clicked on my music. I went for my go-to playlist for calm, relaxing music, a list of slow classic rock songs that Dave had made and labeled “Classic Rock Mellow,” songs that he had introduced me to in our twelve years together—Pink Floyd, Led Zeppelin, Bob Dylan, and so on. This was Dave’s favorite playlist. But as I clicked through the songs, I saw every single title with a fresh stab of excruciating pain. Not only were they Dave’s favorite songs, songs imbued with memory and meaning between us, but the titles!

Helpless

Wish You Were Here

Comfortably Numb

Stairway to Heaven

Knocking on Heaven’s Door

Are you freaking kidding me? I groaned, clicking off the music. I called Dave’s family back to let them know that we were at the hospital and that I was awaiting information. Had they ruled out stroke? they asked. I did not know. Had they hooked Dave up to the MRI immediately? I did not know; I did not know what was happening. Nelson and Andy wanted to speak to the doctor as soon as he returned.

About an hour later the doctor was back, and he told me that the team had enough data to determine that there was no bleeding inside Dave’s brain. This was great news! This meant that Dave hadn’t suffered a hemorrhagic stroke. The only other type of stroke was ischemic, and that, the experts agreed, was very unlikely. Dave was young, healthy. He was not obese or a smoker or a heavy drinker. That type of stroke was so improbable for someone of Dave’s profile as to be practically unheard-of. And besides, that type of stroke was so bad that, had Dave suffered one, he would possibly be dead already.

So then, it was something else. They would work hard to find out just what that was, but, phew, we had ruled out stroke! Maybe it would end up being something as harmless as low blood sugar.

I heard the exhales over the phone, the audible sighs of relief issuing from Nelson and Andy and Louisa when they heard this. Next, I called my parents to tell them the update. I could hear their sighs as well. “This is such a relief. I was really worried,” my dad, the incorrigible optimist, confessed.

My dad had just announced a week earlier that he was running for president, so he and my mom had been busy lately, to say the least. This night they were, mercifully, at home in New York. Just a couple of weeks prior we had all gathered as a family in New Hampshire for my father’s announcement. We’d stood on the podium with him, so proud that he was throwing his hat into the crowded ring. Dave had not been able to get out of surgery that day, so he had watched the coverage on television from Chicago. I had told him all about it when I got home the next day. We joked that our daughter would be allowed to watch television, but only so that she could see her grandfather on the debate stage. Sitting there, alone in that Fargo emergency room, all of that felt like another world, another lifetime.

“No bleeding in his brain,” I told them. “Which means the only type of stroke it could be at this point would be ischemic, and that is very unlikely, that would have been so bad that Dave would probably not even be alive right now, so they think they can rule that out.”

“Oh, that’s so great to hear, Alli,” my dad said. “Well, let’s hope for the best, then.” I hung up, promising to call back as soon as I knew more.

An hour later, the neurologist came in. He was a young guy, but he wore fatigue and concern like a tight mask on his face. He sat down with me in that blindingly bright ER, his face heavy, all of his body language seeming to indicate something grim.

He looked me in the eyes and explained that he had reviewed all of the scans. It turned out that Dave had had a stroke—the really bad, really unlikely one. Ischemic, not hemorrhagic. Why, he could not say. Dave had just been that unlucky. “He’s had a bithalamic midbrain stroke,” the doctor told me, with Nelson and Louisa and Andy listening on speakerphone. I could read so many things on this doctor’s face as he explained: Sympathy as he broke the terrible news. Fatigue—it was well past the middle of the night and he had been called in from home. Stress. But mostly incredulity; he had never expected to see this rare stroke in such a young, healthy man. He did not understand why it had happened—he could not tell me where we would be going from here. He could not even tell me if Dave would be waking up.

We did not want to keep the doctor from Dave for even a second longer than was necessary, so we heard what he had to tell us and then let him get back to work.

Andy got back on the phone with me. “What are they telling you?”

“They are telling me that there is just no way to know anything at this point,” I answered.

“That’s exactly right,” Andy said. “It could mean anything…it could mean anything from…my brother is going to wake up and be OK to…my brother is going to die.”

I called my parents back, broke the news to them. “You guys should probably come out here…in case, you know, you need to say goodbye.” I barely finished the sentence before the words faded, breaking into sobs.

“Of course,” my dad said. “We’ll get the first flight.”

I hung up, alone once more in the bright hospital room. I was shivering. I could not make sense of what was happening. I pulled out my phone and sent out a group email to close friends and extended family.

Subject: Need prayers NOW

Please don’t respond to this right now, I can’t take calls or emails as I am in an ER and need to focus on Dave and the doctors, but I need your prayers. Dave’s and my flight had to be diverted to Fargo, North Dakota, because Dave had a stroke. He is in ER now. We need your prayers. I will let you know more when I can. Again, please no calls or texts right now. I love you. Thank you.

Hemorrhagic stroke is usually the type you hear about in younger people. Young survivors often suffer loss of speech and loss of mobility. Many patients with this type of stroke begin their journey to recovery in a state of complete paralysis, without the ability to speak or process language. With long, grueling rehab and more-than-human dedication, many of these patients manage to overcome some, even many of these deficits, but it is a terrible fate for a young person to endure. We had been praying that Dave had not suffered that.

And yet, several hours later, once we had learned what had happened to Dave, my father-in-law, the neurologist, told me that he would have given anything for Dave to have suffered that type of stroke. Paralysis and loss of speech, he knew. Hemorrhagic stroke, the doctors and rehabilitation therapists would know how to address. But an ischemic midbrain stroke in a thirty-year-old? It was so improbable that there was not even medical literature available on how someone with Dave’s profile survived or recovered from such a stroke. There were no case studies that anyone could look to for guidance. And so it was impossible for any of us to know what it meant, and what hope, if any, we could have for Dave.