Nathan
Moving through the hospital at a pace much faster than a stroll, I finally made it to the Intensive Care Unit, breathing hard. Panting as if I’d just run a marathon. The drive over had been the longest ever, filled with anxiety and anticipation for what I’d find. I had tried waking my sister-in-law and giving her the good news; thought about asking if she wanted to ride over and share in the excitement with me, but she was still passed out in our guest room, with no hope of waking up anytime soon. So I left her a note. Rushed out of the house, barely remembering to lock the door as I hopped into the back seat of the taxi.
As I approached Marva’s room, I slowed to an even pace, caught my breath and regained my composure. Loud voices from inside the room rang out. There was a team of hospital professionals in the room. Marva’s doctor, a couple of nurses, the anesthesiologist were gathered around her bed, and seemed to be trying to revive her. Someone was performing CPR. I wanted to ask what they were doing, but I was paralyzed. I couldn’t quite understand what I was witnessing.
Amy, Marva’s nurse, spotted me, came out into the hallway, and pulled me into a corner, away from the chaos.
“What’s going on in there?” I asked her.
“Marva went into cardiac arrest. She had a blood clot in her leg from lying still for so long—that blood clot moved rapidly to her brain and caused her to go into cardiac arrest. The doctor was called in almost immediately and began to resuscitate,” she said.
“When? I mean how?”
“They’re doing all they can to revive her, Mr. Sullivan. She’s been placed on a respirator.” She pulled me toward the family waiting area. “Why don’t you have a seat in here, and I’ll grab you a cup of coffee.”
“I don’t understand. You just called less than an hour ago and said she was doing well.”
“She was responding earlier tonight. Her eyes were following me around the room, and she even attempted to say something to me. I was so excited, I couldn’t help but call you. I’ve grown quite fond of both you and Marva, and wanted to share the news.” She looked distraught. “But then, I don’t know what happened. Everything happened so suddenly.”
I barely heard anything else after she said resuscitate. I sat in one of the cushiony plaid chairs in the waiting area and stared into space for a few moments. Amy disappeared and was back with a Styrofoam cup filled with steamy hot coffee. I took it, but didn’t drink right away. Couldn’t. I sat there, anxiety overtaking my body. I wanted to get into that room and find out what was going on. Wanted to know what happened in just the short time it took me to drive over to the hospital. How could she have gone into cardiac arrest when she was responding to stimuli less than an hour ago? So many questions, but none of them were getting answered.
Before long, Dr. Garrett appeared in the doorway of the small waiting room. I stood.
“Mr. Sullivan, may I speak to you for a moment?”
He and I were the only two in the room and I invited him to say his peace right there.
“I’m listening,” I told him.
“She’s breathing right now, but only by way of a respirator. We performed CPR and have her stabilized as best we can. Because we don’t have any preexisting agreements from her or your family, it’s up to you whether or not we continue to sustain her breathing that way. But you must make a decision quickly—within the next twenty-four to forty-eight hours.”
“A decision?”
“If you decide to leave her on the respirator long-term, we will need to perform a procedure called a tracheotomy. That’s a surgical procedure in which an incision is made into her windpipe to form an opening. A tube is then inserted through the opening to allow the passage of air and removal of secretions. Instead of breathing through her nose and mouth, Marva would then breath through the tracheostomy tube.”
“I don’t know what to say. I can’t make a decision like this on my own. She has family…she has parents, who…”
“We’ll monitor her progress on the respirator for the next twenty-four hours, Mr. Sullivan.” He swallowed hard. This was hard for him, too. “But I have to be honest with you. The blood clot was very large, and there’s very little hope that she’ll begin breathing on her own.”
“But there is hope?”
“Very little.”
I lost control of my legs. What exactly was he telling me?
He held on to me; steadied me.
“I don’t understand.”
“It’s a difficult situation when the patient doesn’t have a living will, or hasn’t taken measures to instruct us on what their desires are. It puts the family in a terrible position…having to make such the decision for them…”
I observed Dr. Garrett for the first time, with his jet-black wavy hair, perfectly trimmed mustache, a white medical jacket with his name embroidered on it. Underneath he wore khakis and a striped dress shirt. He was young; probably had just completed his residency. How many patients like Marva had he treated in his short career? I wondered.
“So what you’re suggesting is that we pull the plug on her.”
“What I’m suggesting is that Marva’s unable to make her own decisions right now, and it’s up to you and your family to decide what’s in her best interests. And time is of the essence. You should decide quickly. At least within the next day or so.”
“So let me make sure I understand you correctly. You need to know within the next twenty-four hours, if we’re going to leave her on the respirator long-term. That way you can perform that surgical procedure…the trac…”
“Tracheotomy.”
“Right. Tracheotomy.” I was trying to rearrange the details in my head. “And because the blood clot is large, there’s little hope that she will begin breathing on her own.”
“That is correct. But we will monitor her progress for the next twenty-four hours, and that will give us some idea of how she will recover from this. My guess is that she won’t ever be removed from the vent. There’s very little hope that she will ever breathe on her own.”
“But there is hope?”
“Yes. But very little,” he said. “It’s up to you and your family to decide if this is what you want for Marva long-term.”
“Can I see her?”
“Sure.”
I followed Dr. Garrett into Marva’s room. As a machine pumped life into her, tears filled my eyes. I couldn’t stand to see her suffer, but I knew it would be too difficult to let her go. I stood there for several minutes, staring; motionless. Then I stepped out into the hallway and called our parents. I knew it would be at least a couple of hours before they could get here, but I hoped they would put a rush on it. I paced the floor. I needed to think things through, find myself a clear and definite position before they got here. Needed to know where I stood in all of this.
I began to engage in self-talk. “Where do you stand on this, Nate? Would you want to be on a respirator, with no promises of recovery; no quality of life? What would Marva want? You know her better than anyone. Would she want this?”
My mother, Helen and Poppa Joe walked briskly toward me. Mama reached for me and pulled me into her bosom.
“How you holding up, baby?” she asked.
“Not so good.” I broke down and cried into her chest like I did when I was ten and had fallen out of the tree in Miss Robinson’s front yard. Had broken my arm that summer, and it had been Mama who’d rocked my tears away then, and she was still rocking my tears away, even now. I crumbled.
“It’s gonna be alright, sweetheart.”
Helen and Poppa Joe bolted for Marva’s room. Helen stood over her bed, her face soaked from the tears. Poppa Joe stood in a corner, a frown on his face. It was the frown of a father who couldn’t protect his baby girl any longer. A frown of defeat, and hurt, but he knew he had to remain strong for his wife. I wasn’t as strong as Poppa Joe.
“Where’s Daddy?” I asked my mother.
“He’s parking the car. Be in here in a minute.”
“I don’t understand what happened,” Helen said once she’d stopped crying long enough to talk. “You had just called us and said that she was responding. What happened, Nate?”
Her tone was accusing; sounded almost as if she was blaming me, or questioning whether or not I was responsible for the sudden change in Marva’s condition.
Dr. Garrett walked into the room.
“Hello, I’m Dr. Garrett. The physician on duty tonight.”
Helen pushed her way toward him. “I’m Helen, Marva’s mother.”
“Nice to meet you, ma’am.” Tall and Curly shook my mother-in-law’s hand. “It’s not unusual for a patient to get a blood clot from lying still for so long. It moved to her brain so quickly…”
“Why didn’t you revive her?” Helen spat the words like venom.
“Ma’am, we did all we could to resuscitate. We were able to stabilize her as best we could.”
“So the machine is breathing for her?” Poppa Joe asked.
“Yes, sir,” he said, his olive face showed true compassion. “However, I think you should decide quickly as a family if she should remain on the respirator long term, or if you wish to have her removed.”
“Removing her is out of the question!” Helen said.
“Sweetie, let’s go for a walk.” Mama grabbed Helen’s hand and ushered her out of the room.
Poppa Joe and I stood in silence as my father entered the room.
“Hey there, son.” Daddy hugged me, and I hugged back.
He stole a glance at Marva, but avoided any conversation about the situation. Avoidance was his way of dealing with painful things. I’d received sensitivity from my mother; definitely not from him.
“How’s it going, Daddy?”
“That Atlanta traffic is a bugga bear, I tell you. Folks here drive like they ain’t got good sense.”
“Traffic here never lets up.”
“You right about that,” he said, and inched toward the door. “I’m gonna just step out here into the hallway. You holler if you need me, son.”
“I will.”
“You all right, Joe?” he asked, grabbing Poppa Joe’s shoulder on the way out.
“Fine, fine,” Poppa said, and continued to stare at his daughter. “It’s a painful thang for a father to see his child so helpless like this. A painful thang.”
Daddy shook his head, but didn’t stick around much longer. Poppa Joe and I stood staring at Marva as if by some miracle her state would suddenly change before our eyes.
My phone vibrated and I excused myself from the room. I’d left a message for Tracee to call me back immediately, and she was returning my call.
“Hi, Daddy. I got the message and called as soon as I could,” she said. “What’s going on?”
“Baby, your mother’s not doing well. I think you should get a flight out tonight. I know you have classes, but this is important.”
“Okay, Daddy. But what’s wrong?”
“We’ll talk about it when you get here,” I told her. “Put the charges on your credit card, and call me back with your flight arrangements.”
“Okay,” she said. “But you’re scaring me.”
“I don’t mean to scare you, sweetheart. But you need to be very brave right now. Braver than you’ve ever been in your life. You understand?”
“I understand, and I’ll try my best. But I don’t know how brave I can be. Especially when I don’t know what’s going on,” she said.
“I think you’re probably braver than you think.”
“I hope so,” she said softly. “I’ll call the airline and get the first flight out.”
“Good. Call me back.” I hung up quickly and returned to Marva’s side.