I nodded, biting around the skin on my nails. I hadn’t even considered touching Riley.
“It’s very common for stroke patients to lose their speech, just like Riley has. Sometimes it comes back, often very slowly. She may try to talk to you, but the words may not come out right—or at all. That might be confusing and a little scary for you.”
Riley couldn’t talk. Got it. Dad reached over and gently moved my hand away from my mouth to get me to stop chewing on my fingers.
“As you probably know, Riley has some paralysis, which is also very common after a stroke. One side of her body has been affected, but often, just like speech, as she recovers, she may get the use of her arm and leg back. She also has some facial paralysis on the same side, so she will look a little different.”
Riley couldn’t walk. Got it. Knew that. One side of her face was paralyzed. Did not know that. What did that look like?
“Any questions so far?” Another long pause.
“No,” I said quickly, earning me a you said that too quickly face from Monica.
“Another thing to try to keep in mind is that things can often change quickly in intensive care.” She waited, letting that sink in.
“What do you mean? Change how?” asked Dad, looking caught off guard for the first time in the conversation.
“We say the only thing certain about intensive care is uncertainty. Patients can seem very sick in the morning, only to look and sound more like themselves by lunch, only to seem to slide back a bit the next day. Try to take each moment—good or bad—as it happens.” More silence sinking in.
Now Monica pulled out a generic picture of a grown-up in a glass cube room, like the ones in the PICU. “This is not a real patient,” she explained, “but these are some of the things you may see.” Dad and I got a crash course in some of the equipment in the room and what they monitored—the most basic of which were vital signs, or “vitals,” and those were the numbers on her monitor. If you’ve ever been to the doctor (and I’m hoping you have), you’ve likely had your vitals taken. One of the numbers is your temperature, one is your heart rate (HR), one is how many breaths you take in a minute (RES), BP is blood pressure (which is the force of the blood pushing through your arteries—think of water in a hose), and one that you may not know is called SpO2,20 which, Monica explained to us, is how much oxygen is being carried in your blood. It’s measured by a clip that goes over the tip of your finger.
Dad wasn’t looking at Monica. He was looking at me. Trying to read my face. The more she talked, the more anxious I became. The pink ottomans and the fish tank weren’t really helping me anymore. Only when she added that Riley would probably be asleep, or possibly sedated,21 did some of my panic subside. When Riley was ready, her friends would also be allowed to visit, but nobody knew for sure when that would be. For now, it was just us. Just family. Just the team.
“And I think that’s probably enough for right now. Do you have any questions? Nora? Mike?” We didn’t. “Also, Nora, I know you want to see Riley, but it’s important for you to know that you can change your mind about visiting her. That’s okay too.”
“Really?”
Monica seemed quite certain of this, but Dad shot me a look. Monica caught that look. She really was a child life specialist. Dad stood up and shook her hand and thanked her for her time. So I did the same.
“I’m here for Riley, but I’m really a part of your team too,” she assured us. “Anything you need, just ask.”
Could you repeat the part about choosing whether or not I want to visit Riley? was what I wanted to ask, but I didn’t. I smiled, I sauntered over to the doughnuts, then back to my spot in front of the fish tank. I named the yellow one AFib and the blue one P-SOCKS.
* * *
“So you had a chat with Monica?” Mom asked as she poured a cup of coffee for herself when she came into the family room kitchen a short while later. She looked completely disheveled.
“Yeah,” I answered. “She’s nice.”
“Was it helpful?”
“I guess so.” I did guess so. Or maybe it was too early to tell. My parents had a short conversation out of earshot before Dad and I left to follow the happy blue river to Riley’s room.
Monica’s generic photo of a stranger in intensive care did not actually prepare me for the sight of Riley in intensive care. I bit at the inside of my cheek as I took in her neck and chest, her wrists, even her face, checkered with tape and tubes. Her cube room looked like the control room of a spaceship—screens, double monitors, machines and computers connected to tubing and wires connected all over Riley’s body connected to bags and poles and dripping liquids. Riley’s bed was tilted forward, her head raised at an angle, a constant beep announcing her heartbeat. I thought she would be different. I thought I would see Riley, recognize Riley. I thought even though she couldn’t talk and couldn’t swallow and couldn’t walk, she would be Riley now that she was in a room with a real bed and a team. But she wasn’t. Despite all my managed expectations, a wave of nausea hit me and I backed away from the open door. Dad stayed right beside me.
But Aunt Maureen was smiling at me and gesturing for us to come in. “Look who’s here, honey,” she crooned to Not Riley, stirring her. Her sleeping chair was still open and unmade. She didn’t look like she had slept for a minute. Before I could even step into the room, she pointed to the sink. “Hands first, thanks, Nora.” Right, I had already forgotten that part. The most important thing, Monica had said. I beat my dad to the sink and washed my hands as long as I could. Cleanest hands in Brooklyn. Maybe the United States. Then he was next to me, nudging me out of the way.
“Uncle Mike and Nora are here to say hello,” Aunt Mo was saying. Arrgh! I thought Riley was going to be asleep! I looked over her head at the numbers blinking on a screen.
“Hi, Riley. How are you doing today?” Dad’s voice was low and soft, a hospital kind of voice. Riley turned her head our way in slow motion. Only one of her eyes was completely open, like a broken doll. She didn’t say anything, but her machines beeped steadily. Beep beep beep. The very last thing she looked was comfortable.
I managed a small wave despite the pit in my stomach. Riley slow-motion turned her head back toward Aunt Mo. Saliva dribbled out of the side of her mouth as she murmured a garbled string of sounds. Aunt Mo gently wiped her face and listened closely, as if the sounds made any sense. “Good girl! Good work!” she cooed. Riley closed her eye.
“She’s so happy to see you both,” Aunt Mo said, her own eyes bright despite the dark circles underneath. “She’s been awake a bit today and I can see her brain is sparking, can’t you?”
“Absolutely,” my dad assured her, while I nodded. I didn’t see any spark. I didn’t see any anything but spit and tubes. Dad pulled a chair in a little closer to the bed and sat down. When I sat down, I slid my chair a little bit farther from the bed.
“Did you get any sleep?” Dad asked my aunt.
“Enough,” answered Aunt Mo. That was a lie. She looked like she hadn’t slept in days. The dark circles made her look ghostly pale. She was the same color as Riley.
“Lots of machines, right, Nora?” she said to me. I found something new to look at—a small black ball hovering in a plastic spigot on the wall. It was plugged into an outlet marked OXYGEN. I instinctively checked her P-SOCKS—ninety-seven. Okay. Ninety-seven was good.
“We spent a little time with Monica,” Dad went on before I could answer. “The child life special—”
“Child life specialist!” Aunt Mo finished over him. “Who knew there was such a thing? Riley and I met her earlier this morning. We liked her. Didn’t we, Riley?” There was no answer from Riley. I was relieved that Aunt Maureen didn’t look like she was waiting for one either. “What did you think, Nora?”
“She was nice,” I agreed. She said I didn’t have to be here, I wanted to add. I didn’t. But you knew that.
“It’s a good thing . . . that they have that. Child specialist, I mean.” Dad was
looking at me, like I had some wisdom to impart, being a child and all. “Family room is nice too.” I began to understand that small talk was the name of the game here. Not medical talk. Not P-SOCKS, not even, Is she getting any better?
“Isn’t it, though! That’s where your mom has been sleeping,” Aunt Maureen told us. “I had to practically drag her down there last night and unfold the bed myself. Some of those chairs open up like this one. It’s a nice room.”
“They have doughnuts, too,” I said. Yep, I talked about doughnuts.
Beep beep beep.
“I saw that,” Aunt Maureen enthused. “Maybe tomorrow on your way in you could bring a dozen doughnuts or some bagels. You know there’s a good bakery up by the gas station . . . at home. . . . You know the one, Mike?”
“I do. We will. Absolutely.” I caught Dad checking his watch while Aunt Mo went back to studying Riley’s face. “Should we . . . ?”
Beep beep beep.
“Oh yes,” answered Aunt Maureen, glancing away from Riley for the briefest moment. “I think Riley has had enough excitement for now. Don’t you think so?” She was looking at Riley, not asking us. This time she looked like she might be waiting for an answer. Did Riley answer sometimes? She tucked some of Riley’s dark hair behind one ear. Even Riley’s hair seemed limp. “We’ll see you guys again later. After some rest.” She stood up and Dad leaned across the bed and kissed Aunt Maureen on the cheek.
“We’ll be back soon, Maureen.”
“And thank you for coming, Nora. If you find your mother in the family room, see if you can convince her to take a nap—or at least eat something. She’s exhausted.”
Beep beep beep.
“I will.” I smiled. With that, we were done. That was an intensive care visit.
* * *
“How did it go?” Mom was waiting for us outside the room. I wondered if she had been watching us through the glass, to see how we did in there.
“Good,” answered Dad. “Good.” I nodded in agreement. I was a team player and I had done my job. To sit in a chair and exchange awkward tomato-soup smiles with Aunt Mo. The numbers blinked. Riley beeped. The tiny oxygen ball floated in its own plastic space and its very own outlet. My expectations had been managed and I was excused for the day. Was that good? Sure. Okay.
I spent the next few hours dozing off in front of the fish tank, working on summer math homework, flipping through the channels on the television and giving in to my doughnut urges—all three of them. Dad did mostly the same, minus the homework.
We had planned on another visit with Riley, but she was in and out of her room all day with more tests and more scans to track the swelling in her brain. Mom appeared in the family room at seven thirty with a bag of dirty clothes to take home, since both she and Aunt Mo had finally changed.
“Maybe a quick good-bye to Riley before you head home,” she ordered in the form of a suggestion.
Dad and I walked hand in hand back to Riley’s room, my stomach knots kicking in about twenty feet from her door. As we got closer, I heard it—my aunt Mo crying. I tugged on Dad’s arm and he stopped a few feet from the door. Through the window, we could see Aunt Mo’s head on Riley’s chest and a hospital blanket draped over her shoulders. I got the feeling my mother had wrapped her sister in it before she left the room. I also got the feeling that Aunt Mo had waited for my mother to leave before she cried.
I stared at Riley’s heart rate on the monitor.
Seventy.
Beep, beep, beep.
Sixty-eight.
Beep . . . beep.
Dropping.
Sixty-five.
Beep.
Riley must have just fallen asleep. Aunt Mo hadn’t just waited for my mother to leave, she also waited until Riley couldn’t see or hear her cry, either.
“Okay,” Dad began, “we should . . . maybe . . . um . . . leave them . . . alone. We’ll see them first thing in the morning.” But Dad didn’t move, and I didn’t either. From the window, I stared at Riley and listened to her heart slow down.
Beep.
Wait.
Beep.
Wait.
Beep.
The crying stopped. Aunt Mo was asleep now too.
“Good night, Riley,” Dad whispered, his voice catching.
* * *
In the car, I tossed the bag my mother had given us onto the floor, and the clothes Riley had been wearing on the Cyclone spilled out next to the empty water bottles and food wrappers. I gathered them up quickly and made a neat pile on my lap, the denim shorts first, then her purple bra, and finally her black tank top, carefully smoothing out the wrinkles. I sniffed them, expecting coconut, but they smelled like sweat and deodorant and hospital. I put them back in the bag and let it slide to the floor.
* * *
15 In hospital lingo, the “Pick You.” Babies are treated in the Neonatal Intensive Care Unit—the NICU—pronounced “Nick You.” Grown-ups who need extra watching are in the plain old intensive care unit, which, if the rule applied, would be pronounced “Ick You,” but the rule is not applied, so it is pronounced “I-C-U” (I see you). For obvious reasons, I think.
16 The same-color shirt and pants that doctors and nurses sometimes wear. They’re called scrubs because they’re the clothes surgeons wear when they wash up—or “scrub in”—for surgery. Medical professionals’ clothes can get kind of gross—bloody, even—so they can throw away the scrubs if they get really disgusting. I like them because it makes the doctors and nurses easy to spot.
17 Emergency room.
18 In case you forgot, a brain and nervous system doctor.
19 Heart doctor.
20 You might think it is pronounced, well, Spoh Two (rhymes with Low Two). [I mean, wouldn’t you if, say, you were in class and it was your turn to read out loud and the sentence was “Her SPO2 was not good.”] In hospital-speak, however, it’s “Pulse-Ox,” which I took upon myself to shorten to P-SOCKS. Seriously, P-SOCKS. Your P-SOCKS right now should be more than 96 percent. Which means your blood is carrying 96 percent of the oxygen it is capable of carrying. A P-SOCKS less than 90 means something is wrong. A P-SOCKS less than 80 and you are heading for big trouble. In my defense, if I had known Riley had AFib and lousy P-SOCKS, I never would have dragged her on that stupid roller coaster in the first place.
21 Taking mediation that puts you in an even deeper sleep than regular sleep, mostly so your body can rest and heal.
DAY 3
I had a sneaking suspicion that Monica may have mentioned something about my visiting “options,” because on the drive to the hospital the next morning, Dad told me that I would be “visiting” Riley just once a day. I could do that. I could do once a day. Mom and Dad would sit with Riley together while I stayed behind in the family room.
Dad had been a man with a mission this morning, stopping first at the bakery Aunt Maureen had mentioned to buy pastries, then at the Dunkin’ Donuts for a hundred Munchkins, and then the bagel store for a dozen bagels. He would have made six more stops if Aunt Mo had asked. It took both of us to carry all the food into the family room.
“Good morning.” Yesterday’s magazine lady was back again. I wonder if she slept here too, like my mom had done again.
“Good morning,” I answered, sliding the Munchkin box onto the counter. “Help yourself.” She did. Two chocolate Munchkins and a bagel.
A cooking show was on the television without the volume—same as yesterday. Maybe that was comforting too? It didn’t really do anything for me, but there were a few people in front of it this morning. For me, it was the fish tank. I looked for fish food before I sat down in front of it but didn’t see any. I hoped it was someone’s job to feed them. It seemed like a good question for Monica.
“T-Cell and Squamous.”
“What?” I turned from the fish to see that a lanky kid had slipped into the chair next to mine. He looked like he was maybe fourteen.
“T-Cell and Squamous. The fish. That’s what I call t
hem. What do you call them?” He had a big smile, like Riley’s but with crooked teeth. His pale-green T-shirt was not doing his complexion any favors. Or did everybody here eventually turn gray?
“AFib and P-SOCKS,” I answered. “How did you know that I named the fish?”
“Everybody does,” he answered. “I think it’s a primal instinct for kids to name small animals in captivity.”
“I’m not a kid,” I shot back.
He ignored my protest. “What would you do if you found a pet hamster in here? I mean, you’d name it, wouldn’t you?”
“I guess I would,” I admitted. I would name it Hermione, I thought suddenly, without really thinking about it. So maybe it was a reflex more than an instinct.
“Jack.”
“You would name a hamster Jack?”
“Me.” He laughed. “My name is Jack.”
“Nora.”
“You or the imaginary hamster?”
“Me.” I laughed. “Nora Reeves. The imaginary hamster is Hermione.”
“Imaginary kitten?”
“Frances.”
“Imaginary snake?”
“Voldemort. Too obvious, right? Let me try again. . . . Penelope.”
“I’d love it if they had a snake in here. Wouldn’t that be cool?”
“I don’t think snakes are particularly calming. Fish are calming.” Or so I had learned in the last twenty-four hours.
“There used to be three fish.” He gestured toward the tank. “One of them died.”
“I knew it!” I practically screeched, like I had just solved a murder.
“I scooped it out with a paper cup from the kitchen and flushed it.”
The disgust must have been obvious on my face.