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Chapter Fourteen

Brian


I got myself all pumped up with excitement, imagining court cases with heat and energy and passion and the judge yelling the verdict in my favor. In my head, Atticus Finch was my lawyer and as I won the case to sustain Nick's life support, the double doors of the courthouse would be thrown open by Nick running in to announce that he was awake and that the time I'd bought him fighting his case was what had provided him the time he needed, and he forgave me for everything we'd been through. But the imaginary scenario was shortlived - it only lasted the time it took me to shuffle from the elevator through the various handwashing stations and into Nick's ICU room. I was still elated as I snuck across the ICU ward (everyone seemed to be busy in another room, there was a lot of shouting happening and I said a quick prayer for the occupant of ICU-8) and into Nick's room. I backed in, closing the door behind me gently, and then turned around.

And that's when my elation ended.

I stared at him, my back against the door, my breath stolen away. He was laying so still, so un-Nick-ly still. They'd shaved him, because he was clean-shaven and last time I'd seen him he'd been sporting some fuzz around his chin. He had a pretty good sized gash across the side of his head, and a line of his freshly-blonde hair was shaved away for the gash and it's bold, black stitches. His near hand was laying palm-down across his chest, and his finger tips were a dark color, just like the nurse had warned me the first time we'd come. Generally, he looked a lot better this time than he had then - the first time the gash on his head was fresher. I mean all that wasn't as bad as I expected, really, but the tubes and wires they had connected to him --- that was bad.

There was a giant tube shoved into his mouth that kept his mouth wide open and I could hear the air being pushed into his lungs and evacuated in an even pattern. In..... out. In..... out. It paused each time, as though waiting for him to expel the oxygen himself before withdrawing it for him, as though even the machines were holding their breath waiting for him to wake up. There were other tubes, too, going in. Including a skinny yellow one that was pumping what I guessed was nutrition into him but I wasn't sure. It was taped along side the big wide tube and disappeared into his mouth as well. Then there was a cannula in his nose and a bunch of round heart monitor dots across his chest with skinny red wires running away to the side where a huge screen counted the beats of his heart. Three different machines beeped at different intervals creating a continuous beeping - almost a music - that filled the room. He had three IVs in his far arm, which was strapped down to keep him from moving it, I guess. Not that he was moving at all.

The only wire on his body that wouldn't have freaked him out was the wire of one earbud that Kevin had strung under the big tubes and into Nick's far ear. He'd left the iPod laying on Nick's chest, the cord to it curling back around and disappearing on the other side of the bed, keeping the device charged. He'd left a note with it that requested nobody turn it off.

Music is a form of lifeline for this man. Please don't remove unless necessary.

I stood there, unmoving, not daring to for a few moments, just staring at him. Every bit of excitement had left my body, like the air leaving a balloon, and I felt deflated. My mouth was so dry from shock... Finally, I moved slowly, keeping my back to the wall, staying as far away from him as possible, and took the chart off the end of his bed.

I scanned it. I didn't understand a lot of it. But I tried to remember keywords I could use in researching later to figure out how bad off he really was. Presented with a subdural bleed following motor vehicle accident, bleed was isolated and edema repaired via evacuation of excess fluid, no visible shift was scrawled across the bottom of one page in a messy handwriting. No sign of stem pressure. I was pretty sure that was good. Glasgow score: and the number 5 on a scale of 3-15 was circled.

I put the chart back on the end of the bed, mumbling my new-found vocabulary under my breath so I wouldn't forget it.

I glanced out the wide window looking out into the bay of rooms surrounding a central nurse's station. They were still crowded around the other room. I looked up and noticed a curtain and drew it in hopes of not being caught just yet. I had a feeling the middle of the night was past visiting hours.

Then I turned to Nick.

I crept closer to the bed, holding onto a guard rail that lined the side. I stared down at him for a long moment, trying to figure out what to say. My throat felt raw. I reached out a shaking hand and picked up his iPod. "What'cha listenin' to, buddy?" I asked.

I turned the iPod over and tapped the screen to make the display show. Kevin had put on a playlist of our own music. "Oh Lord," I laughed, "I'm sorry, dude. You can blame Kevin for that. He probably thought it would wake you up hearing something that familiar though." I hit pause and scrolled back through the menu. "Let's see... what would you wanna listen to..."

I muttered to myself and I started going through the stuff stored in the device. "You know, I'm such a terrible friend, I don't even know what you've been listening to much lately?" I sighed. "Let's see what's on your most played list," I suggested. I clicked back to playlists and found the top 25 played. Lights, Eye of the Tiger, Free Falling, Faithfully, All Apologies, Everybody Hurts, Come Together, Summer of '69, Fly, Losing My Religion... "Been on a classic kick lately, I see," I said.

I clicked back out and was about to go back to artists to put Journey on when I noticed a playlist toward the bottom of the screen. It was titled Brian.

My heart rate increased and I looked up at him. It felt like... like a message. "What's this?" I asked and I scrolled down and opened the playlist up. There was a smattering of religious songs (including a rendition of an old hymn as sung by Kurt Cobain of Nirvana), and a bunch of songs that were "us" songs, each one a key part of a memory that we'd shared. Like Down Under by Men at Work, which we'd rocked out to going to Australia the first time ever and Kevin had yelled at us for having the music too loud. Or It's My Party, the song we'd sung when we'd gotten lost looking for the baseball hall of fame. The Looney Toons theme music, which we frequently imitated when we were younger in a series of 'da, da, da-da-da-das', and the Cops Theme, which we'd sung to each other every time we ever got in trouble. Which, back in the day when we were Frick and Frack, was ... well, pretty much constant.

I was crying. I could feel the tears in my eyes even as I laughed at all the random sound effects and TV theme songs and music he'd put into this playlist. He had so many memories captured in one little folder of his iPod. I felt my chest get all tight and I looked down at him. "I miss you," I said.

I clicked play and leaned down and grabbed the second earbud that was laying on his chest. There was a chair behind me and I pulled it over as close as I could get it to the bed and I lowered the guard rail so I could lean close and put the second earbud in my ear. My forehead leaned against Nick's arm and I closed my eyes and listened as the memories played through the headset, and I imagined he was laughing at the memories with me. I could almost hear his laughter in my head and a couple times I looked up, expecting some miracle movie moment where he was suddenly awake and really, actually laughing with me. But his face was just as stoic as it'd been before.

The playlist was halfway over when the door opened and a nurse came in. She stood there for a moment and stared at me, eyebrow raised. "They're looking all over for you, you know," she said as she moved to the foot of Nick's bed and lifted the chart.

I took the ear bud out and laid it back down on Nick's chest. I sat up. She was studying the chart intently.

"How bad is it?" I asked.

She looked up.

"My cousin, he came up and visited Nick earlier - he said he's brain dead. But -- and I'm not an expert, but -- that score thing. He can't be totally gone if there's a score of 3-15 and he's a 5, right?"

The nurse licked her lips. "He scored a five because he displays decorticate response."

"What's that mean?" I asked.

The nurse moved up his other side and pointed at Nick's hand, laying across his chest. "See how he's got his hand?" she asked. I nodded. "This one would be up there, too, if it wasn't restrained. We had to restrain his arm because the bend was cutting off the circulation of the IV medication."

"What's it mean though?" I asked.

"Well, when a patient has a severe injury in the brain, they present what's called abnormal posturing. When --" she glanced at the chart, "-- Nick presented originally, he was in a decerebrate posture. That means he was really stiff. He had his arms and legs fully extended, his head tilted back. Picture someone pretending to be a wood board. That's decerebrate posturing. That's when he had the edema and his brain was swelling, putting pressure on his brain stem. The pressure on the brain stem is really bad, it can kill a patient. It's probably what put him in the coma to begin with."

"But he's not stiff anymore," I said. In fact, he looked like he was sleeping, aside from the tubes and stuff.

"No, he's not. After we isolated the subdural bleed, his doctor extracted fluid and relieved the swelling in the brain, releasing the pressure. At that point, Nick's posture changed from being decerebrate to decorticate." She waved at his hand again, "He balled his fists and put both hands on his chest and tightened up, like a mummy in a way. That was a sign that he was in pain and his muscles were reacting to the stimulus of the pain by contracting. When we ordered the morphine for pain relief, he relaxed into a normal posture and that's when his hand relaxed." She reached down and gently started flexing Nick's hand, rotating his wrist, moving his fingers, pushing and pulling his hand to flex his elbow and shoulder. "Basically, what that means is that he's responding to painful stimuli."

"So he's... he's not... not dead then," I ventured.

She shook her head.

I looked at his face.

"How are you tonight, Nick?" she asked as she moved his arms, and for a moment I thought maybe he'd opened his eyes, but he hadn't. She smiled down at him and took hold of his other arm and started flexing it the same way. She looked at me. "We flex his muscles every twenty minutes to keep him from developing a muscular atrophy from laying still so long," she explained.

"I've been in here longer than twenty minutes," I said.

The nurse moved to the foot of the bed and lifted the blankets to reach Nick's feet, which she started massaging. "Well we had a - a situation, across the ward," she explained. "Normally we do this every twenty minutes."

I looked at Nick's face.

"It's a shame," the nurse said, "His parents ordering the three day cut off." She was rotating Nick's ankles now. I looked back at her. Tears had filled her eyes and she smiled at me. "Not everything can be explained by science, you know, and I'm a believer in miracles. I see them everyday." She lifted his foot and pushed it, making his knee bend and unbend. "It's belief in miracles that make my job doing this pleasurable, because I believe that in doing this every twenty minutes I improve his future by not letting him lose his muscle memory, you know? If we didn't believe, we'd never have situations like tonight."

"What was the situation, if you don't mind me asking?" I asked.

She smiled, "Well, it was one of those miracles I was just talking about... A patient that's been with us for over two years woke up tonight."