Accident (9 page)

The door to the conference room looked ominous as they pushed their way through, and there were three men in surgical gowns and caps waiting around an oval table. Their masks were down around their necks, and Page noticed with a shudder that one of them still had blood on his gown, and she prayed that it wasn't her daughter's.

“How is she?” She couldn't restrain the words, it was all she wanted to know. But the answer was not as simple as the question.

“She's alive, Mrs. Clarke. She's a strong girl. She sustained a tremendous blow, and an ugly injury. A lot of people wouldn't have made it this far. But she has, and we hope that's a good sign. But there's a long way to go right now.

“What she has sustained are essentially two kinds of injuries, each with its own particular complications. Her first injury occurred at the moment of impact. Her brain was decelerated against the skull, and to put it simply, pretty badly shaken around. It may well have been rotated, and in the process, nerve fibers probably got stretched, and arteries and veins would have gotten torn. This can cause a tremendous amount of damage.

“Her second injury actually appears to be more frightening than the first, but may not be. She has an open wound where the skull was cut through, and the bone of the skull had been broken. Her brain is actually exposed right now, in that area, probably where she was struck by some sharp piece of steel in the car just after the impact.” Page made a horrifying little sound as she listened, and clutched Trygve's hand without thinking. She felt ill thinking of what they had just said, but she was willing herself not to faint or throw up. She knew she had to absorb what they were saying.

“There's a good possibility …” the chief surgeon went on relentlessly. He knew how unpleasant this was for them, but he also knew that he had to explain it. They had a right to know what had happened to their daughter. He was assuming that Trygve was Allyson's father. “There's a good chance that the area away from the open wound is actually undamaged. We often see very minor long-term disability from these open head wounds. It's the first injury that has us worried. And of course, the obvious complications from both situations. She's lost a fair amount of blood, and her blood pressure would have dropped severely anyway from the trauma. She's badly weakened by the blood loss. In addition, there's a loss of oxygen to the brain. How much we don't know, but the damage could be fairly catastrophic … or very slight. We just don't know yet. Right now, we need to get in there and help her. We need to lift the bone that was depressed in the fracture, to relieve some of the pressure. We need to address the wound. And there's some additional repair work we're going to have to do around the eye sockets. She sustained a tremendous blow, which could ultimately blind her.

“We have other concerns too. Infection, of course, and she's having quite a bit of trouble with her breathing. That's to be expected, in this type of injury, but again it could cause some catastrophic complications. We're keeping the breathing tube through her trachea that the paramedics put in and we've had her on a respirator since she got here. We've already done a CT scan on her which gave us some very important information.” He looked at Page, who sat staring at him, and for a moment he wondered if she had understood him. She looked totally dazed, and the girl's father seemed no better. He decided to try talking to him, since the girl's mother seemed so unable to absorb it.

“Have I made all of this clear, Mr. Clarke?” he asked hopefully, sounding frighteningly calm, and almost without emotion.

“I'm not Mr. Clarke,” Trygve croaked, as overwhelmed as Page by what he had told them. “I'm just a friend.”

“Oh.” The chief surgeon looked disappointed. “I see. Mrs. Clarke? Do you understand me?”

“I'm not sure. You're telling me that she has two major injuries, basically a shaking of the brain, and an open wound which results from a fracture of her skull. And as a result of the damage, she may die, or she may have permanent brain injury …and she may be blind … is that about
it?”
she asked with tears welling up in her eyes. “Did I understand it?”

“More or less. Our next concern after the surgery will be a possibility of what we call 'third' injury. There could have been second injuries as well, but she avoided them by wearing her seat belt. In third injuries, we look for acute swelling of the brain, blood clots, and severe bruising. This could be a very serious problem. It's not likely to occur until at least twenty-four hours after the injury, so it's a little difficult to predict at this moment.”

Page asked the one thing she'd wanted to ask ever since she'd heard, but she was also afraid to hear the answer. “Is there any chance she'll ever be okay again … I mean normal? Is that possible, given all that's happened?”

“Possible, as long as we all understand that there are degrees of normal. Her motor skills could be affected, for a time, or even indefinitely. They could be affected
in
minor ways, or very major ones. Her reasoning processes can be affected, her personality could change. But on the whole, yes, if she is very, very lucky, and blessed with a small miracle, she could be normal.” But he didn't look to Page as though he thought it likely.

“Do you consider that likely?” She was pushing and she knew it, but she wanted to know.

“No, I don't. I think it's unlikely to sustain this extensive an injury and not see any long-term ill effects, but I do think that if all goes well, they could be relatively minor …
if we're lucky.
I'm not making you any promises, Mrs. Clarke. Right now, she's in a lot of trouble, and we can't ignore that. You're asking me for best case, and I'm telling you what's possible, but not necessarily what will happen.”

“And worst case?”

“She won't make it at all …or if she does she'll be severely impaired.”

“Meaning what?”

“She could remain in a coma permanently, or be extensively brain damaged if she regains consciousness at all, loss of motor skills, powers of reason. She could in essence be severely brain damaged, if she has sustained too great a shock, too many injuries, and we are unable to repair them. How much swelling occurs in the brain will have a lot to do with it as well, and how successful we are in controlling the swelling. We'll need all our skill, Mrs. Clarke, and a lot of luck …and so will your daughter. We'd like to operate immediately, if you'll sign the papers.”

“I haven't been able to reach her father.” Page felt a lump in her throat the size of her fist. “I may not be able to get hold of him until tomorrow …I mean today …” She felt and sounded panicked as Trygve watched her, aching for what she was going through, and unable to help her.

“Allyson can't wait, Mrs. Clarke …we're talking minutes here. We've already done a CT scan on her, as I said, and skull X rays. We have to get in as soon as possible, if we're going to save her, or any normal brain function whatsoever.”

“And if we wait?” She had to ask Brad, she was his child too. It wasn't fair to him to proceed without him.

He looked at her honestly for a long moment. “I don't think she'll live another two hours, Mrs. Clarke. And if she does, I don't think there will be any viable brain function left, she'll probably be blind too.” But what if he was wrong? What ever happened to the theories about second opinions? The trouble was, they didn't have time. They barely had time for one, if he was saying Allyson wouldn't live another two hours without brain surgery. What choice was there?

“You don't leave me many options, Doctor,” Page said miserably, as Trygve squeezed her hand, and she held his tightly.

“There aren't any, Mrs. Clarke. I'm sure your husband will understand that, when you reach him. We'd like to do everything we can.” She nodded as she looked at him, not sure if she trusted him or not. But she had to, she had no choice. Allyson's life depended on their skill and their good judgment. And what if she lived, but was totally brain damaged as they had warned, or was in a coma for the rest of her life? What kind of victory would that be? “Will you sign the consent forms now?” he asked quietly, and after a long moment's hesitation, she nodded.

“When are you going to operate?” she asked hoarsely.

“In about half an hour,” he said calmly.

“May I be with her until you do?” Page asked, feeling panicked. What if they never let her see her again? What if this was the last time she ever saw her? Why hadn't she held her for longer that night before she went out? Why hadn't she said all the things to her she had meant to say in her brief lifetime? Without even knowing it, she found herself crying again, as the doctor leaned over and touched her shoulder.

“We're going to do everything we can for her, Mrs. Clarke. You have my word.” He looked around at his two associates, who had said very little in the past half hour. “And you have one of the best neurosurgical teams in the country. Trust us.” She nodded, unable to say more to him, and he stood up and offered to take her to her daughter.

“She's deeply unconscious, Mrs. Clarke, and she's sustained a number of minor injuries as well. In some ways, it looks worse than it is. A lot of what you'll see will heal. Her brain is another story.”

But nothing he said to her prepared her for what she saw when they let her into the room where Allyson lay, watched by a resident and two specially trained ICU nurses. There was a breathing tube in her throat, another tube in her nose, a transfusion in one arm, an IV in her leg, and machines and monitors everywhere. And in the midst of it all, beautiful little Allyson, her face so battered, her own mother could scarcely recognize it, and her head covered by a sterile drape that concealed the hair they were going to cut off in only moments.

It was almost impossible to recognize her, except that Page would have known her anywhere, would have found her, and recognized her as her child. She would have known her with her heart, if not her eyes, and she went to her now, and stood quietly beside her.

“Hello, sweetheart.” She bent low, and spoke softly into her ear, praying that with some distant part of her, her daughter would hear her. “I love you, baby …everything's going to be fine …I love you, Allie … we all love you … we love you …” All she could say were the same words over and over, as she cried, and stroked Allie's arm and her hand, and the one cheek that hadn't been damaged. She looked so battered and so pale, and if it weren't for the monitors, Page would have thought more than once she was dead. Her heart ached as she looked at her, unable to believe what had happened. “Baby, we all love you …you have to get better. For all of us …me …and Daddy …and Andy …”

Page stood next to her for a long time, and then finally, they asked her to leave so they could prepare Allyson for surgery. She asked if she could stay, but they said she really couldn't. She wanted to know what they were going to do to her, and they explained that they wanted to start her on some drugs, and they had to shave her head, and put a catheter in place. There was a lot for them to do, and Allyson would be aware of none of it. But it would have been much too upsetting for Page to watch it.

“May I …could I …” She found she couldn't say the words and then she forced herself to. “May I have a piece of her hair?” It sounded horrible, even to her, except that she wanted to have it.

“Of course,” one of the ICU nurses said gently. “We'll take good care of her, Mrs. Clarke, I promise.” Page nodded and turned to Allyson again, she bent close to her ear, and kissed her gently.

“I'll always love you, sweetheart …always and always.” It was something she had said to her when she was a little girl, and maybe in some remote part of her, she might remember.

Page was blinded by tears as she left the room, and she literally had to tear herself away from Allyson's bedside. It was unbelievably painful knowing that she might never see her alive again, and yet, she reminded herself again and again, there was no choice. They had to operate on Allyson now, if there was any hope at all that they'd save her.

She found Trygve waiting for her again in the hall, and he ached when he saw her. Everything she had just been through was written on her face. She looked ghastly. He had only gotten a glimpse of the child as Page went in, and it had torn at his heart to see her. Chloe had been bad enough, but this was much worse. And having heard what the doctor said, he secretly thought there was a good chance they might lose her.

“I'm sorry, Page,” he whispered, and then pulled her into his arms, as she stood there and cried for a long time. There was nothing else she could do. It was the longest night of both their lives, a never-ending nightmare. He knew that Chloe was still in surgery, a nurse had come to say that it was going well, but that it would go on for several more hours.

The nurse from the desk brought the papers for Page to sign, and after she did, Trygve insisted that they go to the cafeteria for a cup of coffee.

“I don't think I could drink it.”

“Water then. You need a change of scene. It's going to be a long day.” It was already four in the morning, and the chief neurosurgeon had told Page that the operation would take twelve to fourteen hours. “Maybe you should go home for a couple of hours, and get some rest,” he said with a look of concern. They had grown closer in the past few hours than they had in eight years, and she was grateful to have him with her. She would have gone crazy alone, and she knew it.

“I'm not going anywhere,” Page said stubbornly. And he understood. He didn't want to leave Chloe either. But in his case, his oldest son, Nick, was at home to take care of Bjorn, and he had explained as much as he knew when he left, and he'd called home since then. But in Page's case, she had Andy to worry about, and he'd probably be panicked without his mother and sister.

“Who did you leave Andy with?” Trygve asked as they sipped bad coffee in the cafeteria. Both of their daughters were in surgery by then, and Page had finally, reluctantly, agreed to go with him.

“I left him with our neighbor, Jane Gilson. Andy likes her, he'll be all right when he wakes up. And I can't help it. I can't leave now. I'm going to have to do something about finding Brad in a few hours though. It's the first time in sixteen years he forgot to leave a number.”