Chalk

Posted on June 18, 2011 by stephenarcher

A 16 year old girl went to ride her horse in her pick-up. Three hours later her mother found the truck upside down in the berm, the tires hav­ing long since stopped their lazy spin­ning in the air. Her daughter’s seat belt was on. She was uncon­scious. It took sev­eral hours for her to make her way to my ER. The ambu­lance got a flat tire 20 miles from nowhere in East­ern Ore­gon. We sent the heli­copter. Mean­while the ambu­lance crew, hav­ing changed the tire, got her to a small hos­pi­tal. There, she got expert care and was even­tu­ally flown to our hos­pi­tal for spe­cialty care. I met her in the ER.
The Glas­gow Coma Scale or GCS is a mea­sure of con­scious­ness. 15 is nor­mal and it means you come when called, make spon­ta­neous and pur­pose­ful move­ments. A GCS of even 14 indi­cates a head injury. A GCS of 10 is grave. Hers was 3 from the moment she was found. Deep coma. No pain can find her as far as we know. Her heart beats, but she can’t breathe on her own and she does not move for any­thing. She tol­er­ates every inter­ven­tion with­out anes­thet­ics, although we give them anyway.
I am the new father sit­ting across from this beau­ti­ful girl’s mother and father, telling them about the Glas­gow Coma Scale at 4 in the morn­ing. As I talk I see them fall into them­selves like a build­ing being razed by the Loizeaux fam­ily. What I see has that same eerie and time delayed feel­ing that the build­ing has after the charges fire: noth­ing hap­pen­ing and then the crit­i­cal spans snap qui­etly and it col­lapses in on itself, all the parts razed and con­tained in the weird empty foot­print of the struc­ture that had been there. I am the new father try­ing to hear with their ears now. I am sure it sounds like hol­low clang­ing after the first few sec­onds, so I wait to see if they can recover enough to hear. They don’t. They can’t. What I say turns in to clin­i­cal data. I feel like I am tak­ing all the color out of her life and mak­ing a black and white chalk line draw­ing. All the vibrancy is reduced to this num­ber on a scale that has the word coma in it.
As I am walk­ing back to the ICU to keep work­ing on her, I check in with myself. I can’t feel much. I know I am capa­ble, but there is noth­ing there. I am in the num­bers, the doing, work­ing. How is this pos­si­ble? I remem­ber think­ing about my son as I started talk­ing to this fam­ily and I lit­er­ally just stopped that think­ing and every­thing it might bring. I could not have worked with the emo­tional upheaval, but I could feel­ing it ris­ing like a wave being ridicu­lously held back. I am feel­ing it now. Grief for this fam­ily from East­ern Ore­gon, for their daugh­ter, for the vil­lage that has raised her. I feel grief for my own son’s pains and tri­als yet to come, for my own hav­ing come and some that stayed, but none which have been like what I saw in that wait­ing room. I have seen it many times.
What I believe is this: we humans, even the chil­dren and their par­ents and the vil­lage, can sus­tain almost any­thing even­tu­ally if we are con­nected to one another. We can’t take much of an insult if we are alone. I have no idea if I am right, and I guess it doesn’t mat­ter since belief isn’t about right or wrong. For me, for my son, I can’t stop the inevitable pain that will come. I will work hard to teach him the skills to be con­nected when the pain comes. I hope he has the will that binds the fam­ily I saw in the wait­ing room that night.

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