Chapter 4: TBI – “If”

2010 - Lonsdale Quay in North Vancouver

2010 – Lonsdale Quay in North Vancouver

Spending most of the day, every day, in the I.C.U. with Pat meant that I was aware of every blood test result, every time they tested him for responses, and I reacted in some way to each little thing that went on, asking as many questions as I could to keep myself in tune with whatever was happening.  There were times that I was asked to leave because they didn’t want me to see certain things, concerned that I would find them difficult, but after they got used to my presence and knew that I understood certain procedures, they eventually let me stay.  I remember the first time I questioned why I couldn’t stay while they checked him for responses and was told that sometimes they have to pinch and prod and some people think it’s mean.  I assured them that if they thought kicking him in the butt would wake him up and bring him back I would gladly do it myself so they could go ahead and do whatever it took and I wasn’t going to say anything.  I might have shocked them, but after that they let me stay.

I learned that different nurses had different ways of explaining things, and that some paid more attention to details and family needs than others who, while still doing their jobs carefully, missed the fact that we were suffering too.

From my journal, January 10, 2013:

I found out today that the answers I get from nurses depend on the questions I ask and how they are asked. I have been of the understanding that Pat is being kept in a coma by sedation because of trauma, but today it was explained that it is not an induced coma, but that he is in a coma all on his own. The sedation is administered to keep his breathing from becoming erratic. Therefore, the state of his awareness that I witness when they interrupt sedation regularly to “wake him up” and assess his responses is his actual state of consciousness. This was a devastating thing to hear as I have been holding onto hope that once sedation is completely taken away, he will be able to be roused to a conscious state.

Also, they said that there is a word used in his file that indicates things might take longer because in a high speed collision the brain is often shaken around to the point where certain things can be torn, possibly swell, and then need to heal back together, somewhat like what happens when a person has a concussion. So I have been trying to focus on the “small bruise” that was first mentioned to me and now realize that there could be more damage unseen…

Last night, after five days of holding his hand and trying to stretch over everything just to kiss his forehead once in a while, a nurse asked if I would like her to adjust things so I can get closer to him and hug him. I have needed to hug him since Saturday night and I guess no one thought of it before, while I have been trying to stay out of the way of all the cords, tubes and machines. She lowered the bed rail – so simple – and I was able to put my arm around him and lay my head on his chest and next to his face. This made a big difference for me and gave me strength.

I learned eventually to ask fewer questions (not because they didn’t want to answer, but for my own sake) because I wanted to spend my time with Pat peacefully and not concerning myself with one detail after another.  I knew he was in bad shape overall and that things would continue to fluctuate day by day, and that I could trust the doctors and nurses to take care of him.  They were diligent and I was confident they knew what they were doing.  So I began to focus more on just being with him, talking to him, and doing things I thought would help him to be comfortable.

And then on the morning of January 18th before I had left the hotel, I received a call from the Intensivist asking for permission to move the breathing tube from his mouth to his trachea, and telling me that the MRI hadn’t shown anything new.  They were seeing no reason for him not to wake up.  I said it is just a matter of time then, waiting for when he decides to wake.  She responded “or if”, because with such a bad accident brain trauma can be worse than they see.  Her “if” was enough to crush whatever little bit of strength I had upon waking up, and I crumbled in a pile of tears.  The logical side of my brain (and my daughter) told me that they have to say these things and not give false hope, that they can’t say words that will later be recalled as promises they shouldn’t have made.  But the emotional side of my brain lost ground as soon as she said out loud something that I had already feared but dismissed — in attempts to stay positive that he would wake up and be OK because God had saved his life — and I was bluntly reminded that I could indeed lose him completely to this unconscious state. They had no answers and I had run out of questions.  All I could do was wait.

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