Crossing Oceans

  My father licked his lips. “Jenny, you can’t be serious about letting that quack have anything to do with her care.”

  “If he can help . . .”

  He gave me an incredulous look. “He killed your mother.”

  I thought about trying again to dispel this long-held belief of his, but in his irrational state of mind, the only thing it would accomplish would be to further infuriate him. “Daddy, I know you think he messed up, but you don’t get to be chief of staff for no reason. What if he can help her?”

  He shrugged. “I don’t care what he can do. He’s not touching my granddaughter.”

  The gravity of his words shocked me. Was hatred really a more powerful emotion than love? “Listen to yourself.” Unable to stand the sight of him, I walked away.

  He stood alone in the hallway, wearing his bitterness like some warped badge of honor.

  Down the hall, as far away from him as I could get and still see the doors to the PICU, I leaned my back against the wall and waited for Dr. Preston to reemerge. A custodian rolled a container of murky fluid past me, sending a waft of bleach my way. I bent my arm over my face to keep from smelling it. I hadn’t vomited in nearly forty-eight hours and I wanted to keep it that way.

  After more than an hour, Dr. Preston strode through the pneumatic doors, accompanied by another man. This doctor couldn’t have been much older than I was. His face was almost as red as his hair. The poor thing wore the expression of someone about to face a firing squad. With a hand on the man’s back, Dr. Preston guided him toward me. “Dr. McNeal, this is Isabella’s mother.”

  Shaking his hand left mine cold and wet. I looked at my palm, then at him.

  “Oh, sorry. Just washed them.”

  Dr. Preston gestured to his companion. “Dr. McNeal is an associate of Dr. Reid.”

  “Nice to meet you,” I said.

  Dr. Preston turned to the redhead. “Tell that child’s mother why you have her on a paralytic.”

  He gave Dr. Preston a questioning look. Dr. Preston simply stared at him.

  “Well, Ms. Preston,” Dr. McNeal began.

  “Lucas.”

  His face mottled. “My apologies, Ms. Lucas. If your daughter was to wake up and feel a ventilator forcing air into her lungs, that would be pretty frightening, as you can imagine. She would panic and might try to rip the tube out. This obviously would—”

  “Wait,” Dr. Preston said. “Would you repeat what you just said?”

  “Repeat what, sir?”

  He bent his head to the side like a confused dog. “The part about if she woke up.”

  “If she wakes up and finds a ventilator—”

  Dr. Preston put his glasses back on. “But she’s in a coma; that’s what Dr. Reid told her mother.”

  The man furrowed his brow. “You know as well as I do that they can come out of it without warning.”

  Dr. Preston nodded like a simpleton. “Yes, that’s right. That’s right. But if she’s on a paralytic, how would we know if she started coming out of it, do you suppose?”

  Sweat beaded on the younger doctor’s forehead. “After a while we’ll wean her from the medication and reevaluate.”

  “Oh, stupid me. I thought that airway pressure release ventilation had eliminated the need for paralytics.”

  “We’re not using APRV.”

  Dr. Preston’s nostrils flared as red crawled up his neck. “Yes, I’ve been made aware. So we have her on continuous respirations and paralytics. How long are we going to leave her in this forced coma?”

  Confusion and alarm filled me. I looked back and forth between the two doctors, but they were focused on each other. “Forced? I thought—”

  Dr. Reid stepped off the elevator wearing a wrinkled lab jacket and flew up the hall in long strides, looking as irritated as Dr. Preston.

  At the sound of his footsteps, David’s father turned. “Oh, look, it’s the great Dr. Reid.”

  Dr. Reid glared at him. “I got your emergency page. This couldn’t wait until tomorrow?”

  “Oh, I’m sorry, Dr. Reid. Did I wake you from your nap?”

  “I’ve been on call for two days straight. I need to sleep sometime.”

  “I realize you need your beauty rest more than most, but this is important. You see, someone told this young woman that my granddaughter was in a coma.”

  He threw me an accusatory look. “She is.”

  Dr. Preston’s eyes narrowed. “A chemically induced one.”

  Dr. Reid gave David’s father a look that could have killed. “As per protocol, Dr. Preston, after I saved the child’s life, I assessed her faculties and found her to be completely unresponsive.”

  Dr. Preston’s mouth turned up in a hint of a smirk. It seemed to me a small miracle that he had made it to his age without someone beating the life out of him. “For which we are eternally grateful, Doctor. Thank you for doing your job. I was told that we got her back on the very first shock, but that certainly doesn’t take away from your claim to heroism. Now then, since you’ve been given your proper due, would you please tell me how you’ll know if she becomes responsive?”

  Dr. Reid’s eyes looked like they were in danger of popping out of his head. “We’ll wean her and reevaluate.”

  The redheaded doctor broke in. “That’s what I just told him.”

  When Dr. Preston turned his attention to him, the young doctor looked as though he might soil himself. “When?” Dr. Preston asked.

  Dr. Reid’s words were sounding increasingly clipped. “I haven’t set up those parameters yet.”

  “The longer she’s on the ventilator, the lower her chances of a full recovery, wouldn’t you agree?”

  My gaze ping-ponged between them. The tension in the air was thick enough to suffocate, but something told me that this exchange might mean the difference between Isabella living and dying. Though I didn’t fully understand the debate, I realized they had two very different opinions on what was best for my daughter. I wanted to hear it out.

  Dr. Reid tapped his large sneaker against the floor. “I realize this, Doctor, but hypoxemia might also have equally dire consequences if she doesn’t breathe on her own, don’t you think?”

  “I gave the orders to wean her,” Dr. Preston said.

  They stared so hard and long at each other that I half expected one of them to draw a pistol. It was Reid who ultimately lost the staring contest. “You have no right to do that; she’s my p—”

  Dr. Preston took a step forward, entering Reid’s personal space. “In case your memory is as poor as your doctoring, let me remind you that I’m chief of staff. They’re all my patients.”

  Dr. Reid closed his eyes and tucked his lips in his mouth in what appeared to be an attempt to calm himself. “If she wakes up,” he finally said, “she’s going to be terrified. We are trying to prevent that. I don’t call that bad medicine.”

  “Why isn’t she on APRV?” Dr. Preston asked.

  Dr. Reid pressed his fingers against his temple. “No matter what I say, you’re going to attack it.”

  Dr. Preston donned a smug expression. “That’s the first intelligent thing you’ve said.”

  Dr. Reid looked at the ceiling as his foot continued to tap. “I understand that you’re going through a stressful time, so I’m going to—”

  “You’re going to extubate my granddaughter.”

  Dr. Reid’s foot stilled. “You’re insane.”

  “That may be so, but that’s the course we’re taking. I had the nurses titrate the paralytic. Guess what? Isabella is responding to pain stimuli. She’s wiggling her toes. She’s trying to open her eyes.”

  I gasped at the news. As much as I wanted to run to her, I knew I had to stay behind and hear the rest of the conversation.

  Dr. Reid jerked his head back in surprise.

  A severe expression replaced Dr. Preston’s previous smug one. “That’s right, Doctor. And after I took her off the archaic continuous respirations you had her on and moved her to A
PRV, her spontaneous breaths picked up.”

  Dr. Reid rubbed at his chin. “What are they now?”

  “Ten per minute.”

  “Not enough.”

  “Not yet, but I believe once the medication wears off completely and we extubate her, her lungs will have to work. I predict that they will.”

  Dr. Reid’s foot started tapping again. “She’s not ready.”

  Dr. Preston took another step forward. “Listen, you sniveling brat, this is my granddaughter. My flesh and blood. This isn’t some spitting contest that you can win with the evil Dr. Preston. I know you, the rest of the doctors, the nurses, and probably even the candy stripers hate me, but it doesn’t matter. What matters is that I have earned my position and I’m going to use it to save my granddaughter’s life.”

  Dr. Reid turned to me as if expecting me to intervene. When I didn’t respond, he turned back to Dr. Preston. “If we extubate her without weaning her down for a day and she codes, you will not only lose your position as chief of staff, I’ll make the case to the board myself that you lose your license to practice altogether.”

  “If something happens to my granddaughter,” my father said from behind me, “he’s going to lose more than his license.”

  Chapter Twenty-seven

  While other teenagers had to be prodded and pleaded with to go to sleep at a decent hour, I never had to be asked. I wanted to go to bed early just so I could have plenty of time to lie there and dream of my future with David. Staring at the ceiling, I’d fantasize about what sort of life we’d someday have. I imagined a wedding both simple and elegant.

  My bridesmaids would wear champagne-colored silk, while I would be a modern-day Cinderella dressed in a strapless white gown lined with lace and pearls. David would be dashing, of course, in his tailored tuxedo. We would gaze dreamily into one another’s eyes, feeding each other cake and promises as our families toasted the beautiful life we were about to embark upon.

  Often I imagined David placing a finger over his lips and leading me down the hall to the doorway of our daughter’s bedroom. Hand in hand we would watch her sleep, in awe of her sweetness, the love we felt for her . . . and for each other. Somehow I’d always known we’d have a daughter, even though the rest of the details didn’t quite work out as I’d fantasized.

  Now, years later, my dream had twisted into a nightmare. David’s hand clutched mine as we stood beside Isabella’s hospital bed, marveling not at her innocence but at her inner strength—hoping it would be enough to see her through. Instead of praying over her future occupation, husband, and friends, my only concern at that moment was whether or not she would live.

  Though the PICU guidelines stated only two could visit at a time, Dr. Preston ensured that exceptions were made for us. It was clear from the glares the staff sent his way when he wasn’t looking that they resented his interference, but thankfully no one took out their frustrations on us or Isabella.

  David and I tried to stay close to our daughter but out of the way, while my father and Mama Peg stood almost flush against the wall. My father never took his glowering eyes from Dr. Preston, and I think everyone understood if there was one death today, there would surely be two.

  Dr. Reid occupied the position at the head of Isabella’s bed. He held a clear bag with which to pump air into her mouth if needed. At the foot of her bed stood a nurse and a respiratory therapist. Dr. Preston explained he would be the one to remove her tube and if she didn’t breathe on her own, it would quickly be reinserted. Though he was adamant that he didn’t believe it would be necessary.

  Isabella’s eyes fluttered open, then closed again. Dr. Preston leaned over her. “Isabella, it’s Grandpa. Listen, darling, we’re going to take the tube out of your throat now. It’s going to feel uncomfortable, but it will be over quickly.”

  Her mouth twitched.

  He gently pried the white tape holding the tube in place from her skin. “When it comes out, you’re going to need to take some deep breaths for us so we don’t have to put it back in. Okay?”

  I heard soft footsteps behind me and turned to see Lindsey slink into the room. With bags under her eyes and strings of disheveled hair hanging loose around her face, she looked like she was in equal need of a nap and a shower. Her weary gaze flitted from Isabella to Dr. Preston and finally rested on David’s hand intertwined with mine. When her eyes met his, he dropped my hand and reached for hers.

  Feeling cold and alone, I hugged my arms around myself.

  “Here we go,” Dr. Preston said. He grasped Isabella’s ventilator tube. “When I count to three, sweetheart, I need you to hold your breath.”

  My heart froze as the gasping sound of the ventilator fell silent.

  “One.”

  Lord . . .

  “Two.”

  Please . . .

  “Three.”

  Make her breathe. Oh, please, make her breathe.

  Everyone’s eyes were riveted on Isabella as Dr. Preston, in one fluid motion, pulled the tube from her mouth.

  “Breathe,” he commanded.

  As seconds passed, her skin took on an unnatural purplish-red color. She made a gurgling sound, but her chest didn’t rise. Another second passed. Then another. Panic filled me as I waited for someone to do something, anything. Dr. Reid stared hard at Dr. Preston.

  “Come on, child, breathe,” Dr. Preston said.

  Dr. Reid pressed a clear mouthpiece over Isabella’s lips, ready to pump air into her from the bag attached to it.

  Dr. Preston pushed him away. “Not yet.”

  I moved to her side and pleaded in her ear. “Bella, it’s Mommy. I need you to breathe. Baby, please, please breathe.”

  The room stood so quiet that the tick of the wall clock sounded like a drum.

  “That’s enough,” Dr. Reid said to David’s father. “Reintubate.”

  Everyone came to life as if a director had called, “Action.”

  “No!” Dr. Preston bellowed.

  Everyone froze again.

  How much time had passed? I wondered. Had it been one full minute? two? How long could they wait?

  My head swam. “Please,” I cried. “Someone, please do something!”

  No one moved. Isabella opened her mouth as if she wanted to breathe but couldn’t remember how. I clamped my eyes shut. Oh, God, please, please, please . . .

  I heard something that sounded like a tire leak and looked at Isabella. Her chest rose as she sucked in a breath.

  “Another one, Bella. Take another one,” Lindsey said, her voice the calm center of our hurricane.

  Isabella turned her head, fixed her glazed eyes on David, and pulled in another breath.

  I counted the seconds between the rise and fall of her chest. One Mississippi, two Mississippi . . . five . . .

  Breath.

  One Mississippi, two Mississippi . . . four . . .

  Breath.

  The nurse put a nasal cannula like Mama Peg’s around Isabella’s ears and slid the clear prongs into her nostrils. When Isabella’s breaths became rhythmic and regular, everyone clapped while I could only sob.

  When Dr. Preston turned around, his eyes were red and wet. It took me a moment before it registered that he’d been crying too. As long as I’d known him, I’d never seen him shed a tear. I wouldn’t have believed it possible had I not seen it for myself.

  He looked up to the ceiling and exhaled, then addressed the respiratory therapist and nurse. “I’ll want her vital signs every fifteen minutes for an hour, then Q two. Get a blood gas and—”

  “What are her respirations?” Dr. Reid asked.

  The nurse answered, “Fourteen.”

  “Very good. Her oxygen saturation?”

  The respiratory therapist grinned. “Eighty-five percent and rising.”

  Dr. Reid pulled his stethoscope off his neck and listened to Isabella’s lungs. After a minute, he turned to Dr. Preston with a smile. “She sounds most excellent.”

  “Of course she does, Do
ctor,” David’s father said smugly.

  Dr. Reid looked at him, then left the room.

  I kissed Isabella’s damp forehead. “Bella, can you hear me?”

  She stirred but didn’t open her eyes.

  Dr. Preston stood beside me and gently forced her lids open with his fingers. He pulled a penlight from his lab coat and shined it in her eyes. “They’re dilating.” His tone told me that was a good thing.

  “When will we know if she’s going to be okay?” I asked him.

  He turned a small black wall knob. A tiny ball rose within a clear cylinder as he adjusted her oxygen level. “That’s a good question, which I can’t answer. This is the one thing that’s completely out of our hands. We just have to wait and—”

  A horrible raspy sound came from Isabella.

  I looked down at her. With the exception of her breathing, she lay as still as a corpse—eyes closed, mouth slightly parted. Dr. Preston and I looked at one another questioningly, then back to her. I fixed my eyes intently on my daughter, refusing to blink so that I wouldn’t miss any movement. Her lips moved so slightly I wondered if I imagined it. A thin string of spittle bridged her parted lips. “Maaa . . .”

  My gaze flew behind me to David, then back to her.

  I leaned over her. “Baby, I’m right next to you. Can you hear me?”

  Slowly, she blinked her eyes open, looked right at me, and whispered. Her voice was so quiet and sounded like gravel, but I could still understand every beautiful word. I turned around and repeated what she’d said. “She’s thirsty.” I started to laugh. “Isabella said she’s thirsty!”

  “She’s thirsty!” David exclaimed as he picked up Lindsey and spun her.

  My father slapped Dr. Preston on the back so hard the sound resonated throughout the room. He jerked his hand back as if suddenly remembering their feud.

  A nurse left the room and returned with something that looked like a synthetic lollipop. When she slid it into Isabella’s mouth, my daughter clamped down so quick and hard that the nurse came close to losing a finger.

  “What’s that?” I asked her.

  “It’s a damp sponge. She needs to take it slow at first.”