A Mother's Trial (17 page)

“What’s the matter with her? Why is she convulsing like this? Why does she need that bag?” Priscilla said, the tears beginning to track her white cheeks.

Sara forced a calm response. “Priscilla, Tia’s in very bad shape. This is the worst she’s ever been. I don’t know yet why she’s having a seizure but it may be due to the high level of sodium. The Valium and Phenobarbital should control the seizures. At this point we’re more concerned with her breathing. If an inadequate amount of oxygen is getting to her brain, that can cause convulsions, brain damage, coma. That’s what the blood gases measure: the amounts of oxygen and carbon dioxide in her blood. It tells us whether she needs to be helped to breathe.”

“And that’s what that bag’s for?”

“Yes. The blood gases show that the pO
₂
—the index of the concentration of oxygen in her blood—is okay. But the pCO
₂
, which measures the content of carbon dioxide in the blood, is elevated. That’s why we’re helping her breathe. The chest X ray may show us why she’s having this problem.”

Steve came in then, and Priscilla threw herself into his arms. “I’m so scared, Steve! I’m so scared!” she cried.

Sara swallowed against her own fear. She walked over to where Tia lay and looked down at her. The ventilator bag covered her nose and mouth—her face had disappeared. Where are you, Tia? Come back, she thought. But the X ray didn’t look promising.

It showed a right-side infiltrate in the lung. Tia had inhaled some of her own vomit and that was causing the respiratory failure. And Tia’s breathing was worsening. Her respirations were decreasing and another blood gas analysis showed that the carbon dioxide was building up. The mask and bag weren’t sufficient.

“Call Anesthesiology,” Sara said.

At nine A.M. the bag was replaced by an endotracheal tube. But Sara realized that Tia needed a mechanical respirator, and Kaiser-San Rafael wasn’t equipped with a pediatric machine. She would have to go to San Francisco.

Sara went out to tell Priscilla and Steve, who were waiting outside. They clung to each other as she told them the news.

“We’ll move her as soon as she’s stable and as soon as we can get the special ambulance over here from San Francisco. I’ll go with her,” Sara said. They didn’t ask her how bad it was. They looked at each other and didn’t ask. So she didn’t say anything more.

16

They had moved a child out of room 369 so that Tia could have her own room back, somebody told Priscilla. It felt like home, coming back to San Francisco, she realized. How different this hospital seemed now. It wasn’t like San Rafael, where they had chosen to throw Tia out last Christmas—that was the way Priscilla perceived what had happened. Tia’s condition put too much strain on the staff, Dr. Stein had said during the Christmas Eve meeting. Their hospital wasn’t designed to care for a child as seriously ill as Tia. Priscilla saw that as just an excuse. She believed they had handled Tia fine. It was too much trouble for them; that was the inference she drew. Steve had raged at Stein.

“You want us to take her to San Francisco? What if she’s in shock? You know how she gets!”

“Well, if she’s critically ill, of course you can bring her here,” Dr. Stein had said.

“We’re not goddamned doctors! We shouldn’t have to make that decision about Tia. I’ll call a damned ambulance and charge it to you!” Steve had screamed.

After the meeting, Priscilla’s outlook toward Kaiser-San Rafael changed completely. Although at a subsequent meeting a treatment protocol had been drawn up establishing that in an emergency Tia was to be brought first to San Rafael, Priscilla felt betrayed. Suddenly Kaiser-San Francisco seemed welcoming and friendly, and San Rafael the enemy.

When they brought Tia to San Francisco now, comatose and in deep shock, the staff hurried to set Tia up in her room, hooking her to the mechanical respirator. Mike Applebaum came in immediately to examine her. Sara was on call at San Rafael and had to return there, but she promised to stay in touch. Jim Hutchison had been to the San Rafael E.R. before they had moved Tia—Steve had called him—and he had prayed with them, trying to offer comfort. He was planning to come over to San Francisco later, he told Priscilla.

She wanted friends around her. Tia’s room was filled with equipment and only one person at a time could stay with her.

There was no room even to sit down. So Priscilla and Steve alternated, and when Steve was in there, Priscilla had to sit in the tiny Waiting Room at the end of the ward. She didn’t want to be alone.

Jan and Jim Doudiet arrived—they were close friends from the baby-sitting co-op. Jan, a nurse, was pregnant with her second child. “Are you sure you ought to be here?” Priscilla asked her after a while.

“Of course, Priscilla. Don’t be silly,” Jan said.

“I need you, Jan. You’ve got so much faith. I need that now.”

“She’ll make it. Prayers can help. I believe that so strongly,” Jan said.

“You know, Tia can breathe on her own,” Priscilla remarked. “The respirator’s just to assist her.”

“That’s good, Priscilla. It’s possible she could come out of it at any time.”

“But they say her condition’s critical. They’ve never said that before.” Priscilla began to weep heavily. Jan put her arms around her and hugged. Bob Hamilton arrived. Like the Doudiets, the Hamiltons were longtime users of the babysitting co-op. The three families exchanged their children all the time, and they were close friends. Cyndy Hamilton was staying with Erik and Jason. Priscilla and Steve would be here all night.

Dr. Diamond came by. He had been Tia’s principal doctor when she had first been hospitalized in San Francisco the previous April. He looked in on Tia and then stopped to talk with Priscilla.

“How is she?” Priscilla asked.

“She’s very sick. Do you understand how sick she is?” he said.

“Well, I’m worried about brain damage when she comes out of it. You know she’s stopped having seizures, but she’s been making this strange noise and arching in a way they say indicates maybe she has brain damage.” Priscilla was crying again, the tears a steady unnoticed stream.

“That’s quite likely,” Diamond agreed soberly. “But these things are unpredictable.”

Jim Hutchison returned. Priscilla didn’t have to explain anything to him. They stood with their arms around each other and he prayed with them. From time to time a staff member stopped to offer reassurance.

In a while Nancy Dacus came to the hospital. Her daughter was Erik’s age and Nancy had founded the baby-sitting co-op with Priscilla in 1972. She was also a member of Aldersgate, and was involved with the American Association of University Women (AAUW) with Priscilla. And she had lost an infant daughter in 1973, from an unknown virus. She held Priscilla, and then Steve.

“I think you need something to eat,” she said to Priscilla.

“No, you go. Take Steve,” Priscilla said.

At seven that evening, Priscilla and Steve sat silently in the Waiting Room with the Doudiets. Suddenly the hospital P. A. system came to life, calling a Code Blue in pediatrics. Someone had stopped breathing. At once Steve stiffened.

“It’s Tia,” he said.

“No, no,” Priscilla said calmly. “It’s not.” But then she saw Dr. Coolman run by.

“I’m going to check,” Steve said. He was out and back in a minute.

“It is! It is Tia! They’re all standing around her bed working on her. Oh, God!”

Priscilla rushed to Tia’s room. It was crowded with nurses and doctors. After a few minutes Lou Guill, the resident in charge, came out to her.

“It’s all right, Priscilla. What happened is that periodically the nurse has to take Tia off the respirator and suction her, and when she did it this time, Tia stopped breathing. We’ve got her going again. But I want you to know that she can’t breathe on her own anymore.”

Priscilla began to cry. “And her heart wouldn’t beat without that drug you’ve got her on, right?” she asked. Dr. Guill nodded her head.

“Yes, she needs Isoprel to maintain blood pressure,” she agreed.

“Can I go in now?”

“Yes, of course.”

Priscilla stood by Tia’s bed. Tia was hooked up to an IV, a heart monitor, and a catheter. Her mouth was distorted by the ungainly tube exiting from her trachea. Priscilla picked up Tia’s hand. It was entirely relaxed and cold. Shakily, Priscilla put her own hand to her face. One of the doctors in the room, a woman Priscilla didn’t know by name, turned to her and spoke gently.

“We almost lost her. She’s okay now but I’m not sure we’ll get her through the night.” Priscilla didn’t answer. “So you might want to sit with her,” the doctor went on.

“Yes.” Priscilla looked around helplessly.

“Here, I’ll bring you a stool.”

“Lou?” Priscilla addressed Dr. Guill.

“Yes?”

“I want Sara here. I know it’s late but—”

“I’ll call her. There’s a phone right here. You can speak to her yourself.” When Sara came on the line, Priscilla took the phone.

“They said she might not make it through the night,” Priscilla sobbed. “I need you—please come.”

“I’ll be right there.”

When Sara arrived, she walked straight to Priscilla, taking her in her arms. Priscilla broke into fresh tears and looking up saw that Sara was crying too.

“I’m sorry. I need you to be here,” Priscilla sobbed.

“I know. It’s all right. I know.”

Sara stayed in the room, occasionally leaning over to stroke Tia’s face. At one point she turned to Priscilla.

“You do understand how sick she is, don’t you?”

“Yes—” Priscilla paused. “But she can’t die.” Sara turned away.

At one in the morning, Sara finally left. “I’ll be in touch, and if anything happens, I’ll be back.” They embraced again.

But nothing happened. All night long, Steve and Priscilla alternated between the stool and the Waiting Room. Tia lay without moving on a thermal blanket, her eyes half open, their small black pupils fixed and dilated. The IV continued its slow infusion. Once there was a thirty-second period of reduced pulse when the nurse could obtain no blood pressure, but it was quickly restored. Toward morning Tia’s icy hand seemed to have warmed a little. Priscilla smiled for the first time when they told her Tia’s temperature was up a fraction.

In the morning, Mike Applebaum called a meeting of the doctors involved in Tia’s care. When it was over, they summoned Priscilla and Steve. Dr. Applebaum detailed the treatment they intended for Tia.

“First, we want to wean her off the respirator as soon as possible,” Mike said. “Also we have to deal with the swelling in Tia’s brain. We don’t know the state of her brain but we do know there is damage. She is on a drug to combat the edema and we will continue with that. We’re going to do an EEG and that will tell us about brain function. And then we want to implant a blood pressure line. For right now she’s stable.”

After they left, Priscilla turned to Steve.

“They’re talking in terms of long-range plans,” she said. “We’ll deal with the brain damage somehow, if it comes to that. I’ll settle for that—just to have her with us. Do you think they’re really saying she’s going to be all right?”

“I don’t know, Pris. I don’t think they know either,” Steve said.

A little while later Tia’s EEG was recorded and shortly afterward a blood pressure line was implanted. For a time nobody spoke to Steve and Priscilla. Finally Mike came up.

“Her EEG is flat,” he said. At once Priscilla began to sob.

“What does that mean?” Steve asked.

“Well, it’s not good. But I’d rather leave it up to Dr. Leider to explain that when he comes over with Sara this evening. This is his day to be at San Rafael, but he will come over as soon as he’s finished there and do some tests on Tia. He’ll talk to you then.”

“Yes, I know Dr. Leider. He was the pediatric neurologist Tia saw when she was first hospitalized,” Priscilla managed. She didn’t ask anything more. Beside her, Marilyn Hansen took her hand. Priscilla had called Marilyn this morning to tell her fellow social worker that she wouldn’t be coming to work, and Marilyn had immediately come to the hospital to join Jan Doudiet. Jim Doudiet was to return as soon as he got off work. Even Mercedes Murphy had come for a while.

At noon, Jim Hutchison arrived. He went in to Tia and prayed over her for a minute. “I can stay as long as you need me,” he told Priscilla.

Jan drew Priscilla aside. “I want to take you to lunch,” she said.

“No. I don’t want to leave her.”

“Priscilla, you have to get out of here. You won’t do her any good if you collapse. Nothing’s going to happen.”

“How do you know? I want to stay.” But they persuaded her finally, though she sat over her plate of food and couldn’t eat, impatient to get back.

When she turned from the hall into the pediatric ward an hour later, she saw a crowd standing around Tia’s door. Screaming, she ran to the room.

“What is it? What is it? What happened?”

“Her heart stopped,” someone said.

“Oh, God! I told them! I told them I shouldn’t leave!”

“It’s all right. We’ve got her going again.”

“I didn’t want to go! They made me go!”

“It’s all right, Priscilla. She’s all right.” Jim Hutchison gripped her arm, talking right into her ear. Gradually, Priscilla calmed down. She went back to sit by Tia, but Tia was gray and cold and didn’t respond. Steve came in and stood by the bed, the tears streaming down his face. He stared at the EEG.

“Is that some movement there?” he asked once, pointing at the machine, but the nurse shook her head. He left, jerkily.

That afternoon, after Tia’s heart stopped and was restarted a second time, Priscilla and Steve finally talked with Jim Hutchison about turning off the machine.

17

His own conversion had its roots in a situation not so unlike this one, Jim realized. Until that time he had avoided religion. His father was a totally rational man who believed that the universe ended at the point his five senses ceased to record it. He was a skeptic and a materialist. And Jim—growing up in Northern Ireland—had seen nothing to persuade him that his father was not right.