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.