Deep waters, p.2
Deep Waters, page 2
The word slices felt like too much, but he seemed to be following me. “Say you tossed three raisins into some dough and baked the loaf. The computer images could locate each raisin without cutting the bread. MRI lets you see inside someone’s brain without surgery.”
“Hmm.” He nodded, but remained concerned.
I sat forward on the edge of my chair, elbows on knees, face in hands. “I’m going to call Dianne.”
A glimmer of hope flashed into Glen’s eyes. “Good idea.”
Dianne was a wise and solid friend who led a more balanced life than anyone else I knew: long-distance kayaker, Buddhist, nurse, and more recently the hospital’s education director.
From a pay phone, I dialed her office. “Dianne, Jim’s had a stroke—in his brainstem. Glen and I are in the ER, here at Bartlett.”
In minutes, she arrived, arms extended. “Oh, Beth, Glen. This is so out of the blue.”
I caved in to her strong embrace but fought the impulse to cry. She squeezed my wrist. “What’d the doc say?” Dianne and I had grown close during the two decades we’d hiked, fished, and boated with our spouses in Glacier Bay National Park.
“What happened?” She put her arm around Glen. Nine years earlier, an hour after his birth, she’d held him tenderly in that same building.
I sketched out the morning’s events. Partway through, a technician wheeled Jim in. The three of us rushed to him. Eyes still jittering side to side, percussive hiccups now jolted his body, and a kidney-shaped plastic pan sat near his head. “Di-Dianne. Glad you’re here,” he managed, then seemed to drop back onto the pillow even though he hadn’t raised his head.
She clasped his shoulders and held his shaky gaze. “I’m so sorry.”
The doctor returned and told us his MRI was inconclusive. “I’ve ordered an MRA of his cranial blood vessels—magnetic resonance angiograph—which should tell us what blood vessels are damaged.”
“Have you given him—what’s it called?—tissue plasminogen activator?” I asked. “Isn’t there a three-hour window when it works?” This was taking too long. We were running out of time.
“We can’t do that until we know what caused the stroke,” he said. “TPA can help dissolve clots, but if there’s hemorrhaging in his brain, it could cause more bleeding. We need a clear MRA before we start treatment. And I’m waiting to hear back from a neurologist in Seattle.”
After he left, Dianne and I spoke softly, each with a hand on Jim who rested fitfully. Soon he was wheeled off for the imaging, and Dianne had to leave. I was at the nurses’ station when a familiar man, about Jim’s height—six feet—but thinner, turned the corner.
“Beth?” It was David Job. “I thought that was you,” he said. “What’s going on?” We knew David, an avid wilderness photographer and a respiratory technician at Bartlett, through an annual Easter brunch a mutual friend hosted.
“Jim’s had a stroke.”
He drew his head back in disbelief. “Jim?”
I described what had occurred.
“Have you reached his doctor?”
“He’s on vacation. I left a message for the doctor covering for him. She’s supposed to be here any minute.”
David put his hand on my shoulder. “I have to check in at my office, but I’ll come back.”
Before entering the waiting room, I paused to gaze at our son. Bathed in light from a window as he read his book, he looked so much like his father in photos from that age—same blue eyes, blond hair, wiry build. A sharp vulnerability caught in my throat, a collision of love and fear.
We’d had our son late, when I was forty-three, Jim forty-seven. Jim and I had moved to Alaska after being together only a year. We first lived in a cabin, then on our sailboat. Teaching at the university in Juneau and research on marine mammals in Glacier Bay kept my schedule full as my love for Jim and Alaska deepened. I’d always wanted children, but fulfilling years flew by before I pried the topic open.
Jim had been married before. He and his wife spent half of each year in remote field camps in the Bering Sea studying red foxes and walruses. She did not want children. He’d had a vasectomy for her. Eight years flew by before I asked Jim to consider a vasectomy reversal. Through two more clock-ticking years—months of graphing my basal temperature and cycles of rising hope dashed—I tried to get pregnant. Then, one night, I waited in the upstairs bathroom for the test strip to change, the smell of Dial soap on my hands. I set the plastic wand on the counter out of view, touched my toes, up and down, up and down, no peeking until after the 180th second. One blue line, and the magic began.
I kissed our son on the top of his head and sat next to him. Parenting good-natured, curious Glen had exceeded my expectations.
“Who was that?” he asked.
“David Job. A friend.” I draped my jacket across my neck and chest, like a backward cape. Eyes closed, I leaned against the chair, legs straight ahead, and worried over the doctor’s words, the delays, and Jim’s new symptoms.
“Beth. Glen.” The soothing voice belonged to Kim—our neighbor, who was also a nurse. “Dianne told me what happened.” The mother of our son’s closest friend, dark-haired, petite Kim held us in her concerned gaze. Word travels fast in a small hospital. For that, I was grateful.
She sat beside Glen and took his hand. He seemed startled, about to cry. Her son, Tenzing, and Glen had bonded in preschool. They shared long summer days building forts in the green belt between our homes or messing with skateboards, and short winter days bundled up outdoors tromping in the snow and sledding down steep mounds Jim created with our snowblower.
I answered Kim’s questions until they wheeled Jim into the room. He lifted his head. “Hey, Kim,” he rasped as if she’d dropped by the house for a cup of tea.
We all rose, and she set a hand on him, holding Glen at her side. “How’re you doing?”
He shook his head.
His left eyelid drooped. Had I missed that symptom earlier? I laced my fingers into his free hand. “Did they get what they need this time?”
“They-they”—a ragged cough interrupted—“didn’t say.”
Kim cranked the metal gurney to a better height.
“Ho-holy crap,” he muttered.
She spoke soothingly to Jim and urged Glen and me to get breakfast in the cafeteria, but I didn’t want to leave. What if the doctor came by with questions for me? Every minute mattered. Stroke outcomes are better with immediate treatment. Time was running out.
Jim cleared his throat. “G-go eat. I’ll be okay.”
I could skip a meal, but Glen needed to eat.
It was noon when we left for the cafeteria.
3
RISE TO THE OCCASION
“Hey, Beth.” David got my attention from the hallway after we’d returned from lunch. Glen was with Kim. “I need to talk to you—in private.” He gestured me away from the nurses’ station. We stood face to face. His hazel eyes drew me in. “You know, Bartlett’s a great hospital.” He stroked his goatee. “I love my job. Everyone works hard. They’re good at what they do.” His face tensed. “But this situation is serious. We’re a small county hospital. Jim needs experts, and he needs them now.”
I took in each word, absorbing the weight of their truth.
“You’ve got to get him out of here—to Anchorage or Seattle. That’ll only happen if you’re firm with his doctor. When she gets here, you have to insist he’s medevacked to a bigger hospital.”
My breathing became labored as if I’d broken the surface after a long dive.
He continued, “There’s this odd situation between the insurance and doctors. It costs a lot to evacuate someone out of Juneau. The docs are under pressure from insurance companies to keep patients here. Your nature is to be agreeable, but you need to do this. For Jim. You’ve got to insist he gets on that Learjet and taken to a larger center. You’ll be doing your doctor a favor. If you don’t push this, she’ll be reluctant to order it. If you do, she’ll have to try.”
Juneau was surrounded by mountains, glaciers, and ocean with no roads out—no big medical centers nearby. Since we’d arrived at Bartlett, I’d passed the responsibility baton off to the medical team. I’d relinquished my decision-making role, expecting them to do what was best for my husband. But now our friend was telling me to step forward, take command, steer this crisis down a different path.
David glanced at his watch. “I’ve got to get back to my office. If you have any problems, call me.” He placed his business card in my palm.
“Thank you.” I hugged him hard. Taught to respect authority, politely follow the advice of professionals, my pulse quickened with dread.
“The other thing.” He glanced over his shoulder. “There’s one medevac jet for all of Alaska. It goes back and forth. You need to get on their list right away. If another, more critical, emergency comes up, they’ll bump him. And I don’t know if the plane is in Seattle or Anchorage or here.”
Hand trembling, I dialed the clinic operator. “I need to see Dr. Reinhart in the ER right away. Call back if she can’t be here in a half hour.” She was already an hour late.
I returned to the curtained-off bay, purposeful strides masking frustration.
Kim said they’d taken Jim away for tests. “I should get back to my floor. Will you be okay?”
I said yes but I didn’t want her to leave. I sat in a rigid chair next to Glen. My mind raced. What if Dr. Reinhart wouldn’t listen to me? I wanted to consult with our family physician. For seventeen years, Lindy Jones had been our doctor. Throughout my pregnancy, he’d had long conversations with Jim about sailboats and coached us through Glen’s last-minute C-section delivery. I folded my arms across my ribs, willing Lindy to appear and help me navigate this treacherous terrain. But he wasn’t even in Alaska. I decided to push for Seattle, not Anchorage. My cousin and several friends lived in the area, and Seattle’s medical centers and universities were top-notch.
Finally, a nurse summoned me. Jim’s doctor stood beside the nurses’ station. “Elizabeth,” she said, “I’m so sorry.”
We shook hands.
A compact professional I’d met once before at the clinic, she flipped through Jim’s chart. “We’re waiting for the results from the MRA.”
I stood tall and said, “My husband needs to go to Seattle right away.”
She looked at me but didn’t respond.
“This is an unusual type of stroke and he needs to be medevacked to Virginia Mason today.”
Although she had not been moving, Dr. Reinhart seemed to stop in her tracks. She stared at her clipboard and raised another page. “The consensus is,” she said, words measured, “to keep him here twenty-four hours for more analysis.”
I bristled. “I’m convinced the outcome from this stroke—if he stays here—will not be as good as if we get him to a medical center with more expertise.”
Her eyes narrowed.
I met her gaze. “I want him medevacked to Seattle today.”
She let the flap of pages drop. “I’ll see what I can do.”
Outside, lacy crusts of snow dripped and popped, fueling Salmon Creek as it gurgled down the mountain to the sea. Bald eagles, some perched in treetops, others in flight, peppered the landscape with high-pitched, thin calls, ill-suited for such handsome, steely-eyed birds of prey.
Inside the hospital, inside our stark fluorescent world, the afternoon droned on, air stale with antiseptic and human discomfort. Metal carts squealed along corridors, pushed by soft-soled technicians. Jim slept. Kim returned and took Glen outside to a nearby trail, then to the cafeteria. Steady in the face of what we’d experienced, Glen welcomed the distraction.
Jim woke, sweaty and confused. “It feels like the world is spinning.”
I pressed a cool cloth to his forehead. “We’ll get you through this, hon.” I spoke as if I knew the way forward.
Kim was buzzed back to her floor. Doctors came and went. A nurse appeared and announced she was adding Phenergan to his IV to reduce vertigo and nausea. Technicians dropped by to check his monitors and adjust pillows. I went back and forth to the nurses’ station, as much to ask about the status of the medevac jet as to burn energy. No news. I checked my watch. Nine hours since he’d staggered up the stairs.
It felt like we were slogging through heavy snow, trudging toward a whiteout horizon, getting nowhere. Meanwhile, in trauma bays next to us, other families dealt with crises and moved on as if we existed on two separate but layered tracks—ours slowed to a crawl as theirs sped up. I wanted to take my husband’s and son’s hands and lead them out of the numbing labyrinth, back to the light of day. What I’d give to return to our mundane Tuesday morning. Before.
Dianne arrived with coffees for us and a carton of milk for Glen. While she and I spoke in hushed tones, knee-to-knee, Jim remained groggy. Soon a woman approached. “Are you Elizabeth Mathews?”
“Yes.”
“I’m Sharon with Airlift Northwest.” She scanned her notes. “The request for your husband to be medevacked was denied—”
“What?” I stood, knocking my chair back. “But he’s got to go!”
She pressed her lips together, then said, “I’m not finished.”
Glen set his book down and came over to stand by me.
“Apparently,” she continued, “your doctor called them back, and they finally approved.”
“Oh, thank you.” I rubbed my forehead. “I’m sorry I blew up.”
“I understand,” she said. “The initial refusal seems to be why it’s taken so long. We now have him scheduled for the next evacuation to Seattle, and we need you to complete some paperwork.” She handed me several documents.
A knot between my shoulders loosened, as I silently thanked Dr. Reinhart. “Can I fly with him?”
“It’s not up to me.” Her tone was flat. “Captain has the final say. There’s not much room. For him to consider it, you’ll need to complete this other form.”
While I wrote, clipboard on my knees, Dianne moved to the seat next to Glen. “As soon as your mom’s done with those, you should head home to pack. They never know exactly when the jet will take off. When they’re set to go—when they have your father ready—they’ll leave. They won’t wait.”
“Are we flying to Seattle with Dad?” Glen asked.
“Sweetheart, we don’t even know if I’ll be allowed to go. It’s a special jet for emergencies.” I turned to Dianne, “Would they let someone Glen’s age come?”
She hesitated, then spoke. “They don’t normally let kids on these flights. How old are you now?”
“Nine,” he said. “And a half.”
“Let me check on this.” She stood. “I know one of the flight nurses. I’ll talk to her while you get your stuff. Remember, essentials only.” She left.
Glen and I sprinted to the car. Holding hands, we cut diagonal across a patch of grass to the parking lot. He slowed our pace and stared up at me. “Do you think I’ll be able to go?”
We stopped walking. His earnest gaze made my chest tight. I did not want to leave him but had to prepare him. “Probably not.”
His shoulders drooped and he spoke slowly. “But I want to be with you and Dad.” His voice broke.
“If you can’t come, you can stay with Tenzing and his family—go to school together.” I thought being with his friend might change his mind.
He shook his head. “I don’t know if I can do that.” The corners of his mouth quivered down. “I just . . . wouldn’t stop thinking about Dad.”
I swallowed hard. “We’ll pack your bag—in case. But we need you to be prepared to stay with Tenzing.”
I drove toward our home in the valley, at the edge of too fast and not fast enough. We flew down the highway along Gastineau Channel, a shallow stretch of indigo ocean between the mainland and Douglas Island. To the east rose steep mountains. Jim had led us on hikes there, up rocky stream beds, down narrow, cobbled valleys.
As the snow receded, Arctic terns and humpback whales would soon return. New life erupted around us—pressing toward a full-throttled Alaskan spring.
Driving home, window down, my hair whipped about. What else should I be doing? It was all happening so fast. No time to fall apart. Ocean-tinged air tripped me back twelve years to another dangerous situation when I’d had to perform. No mistakes. Back then, Jim and I lived on our sailboat in Glacier Bay. We’d survived that storm, we could get through this one.
Late that October, prepping for a deer-hunting expedition, we discovered our sailboat’s transmission wouldn’t go into gear. I fetched tools while Jim disassembled, diagnosed, and repaired the gearshift.
A day late, beneath building clouds, we left Bartlett Cove and motored west to the Inian Islands, a deer-hunting, salmon-fishing, and marine-mammal viewing hotspot. The mountainous, wooded islands crop out where Cross Sound connects Icy Strait to the wide-open Pacific Ocean. Twice a day, the Gulf of Alaska floods into and out of the Strait’s narrow channels. Known for severe rip tides, locals call South Inian Pass “the washing machine.”
Once inside the cove, I took the helm. At the bow, Jim released the anchor, and a hundred feet of chain rumbled down after it. “Reverse,” he called over his shoulder. I shifted into gear, inhaling the forest-scented breeze. Rubber boot on chain, he felt for tension to make sure the anchor grabbed.
Years earlier, in California, when he was offered the position leading the research division at the National Park, he invited me to move to Alaska with him. We’d met while teaching a month-long humpback whale ecology course together on a schooner. In Gustavus, the first home we’d shared was a log cabin heated by a wood stove. The next year, we purchased and moved onto our sailboat. He was the one with a passion for boating. I grew up in Indiana, climbing trees, roller-skating on bumpy asphalt, and scheming with my best friend to buy a pony. My youthful dream was to live on a farm, raise horses, a garden, and children.
That evening, as we inched backward setting anchor, ravens in the alder-tufted forest exchanged deep-throated, klaa-whocks! With a forecast for twenty-knot northerlies, we tucked in close to the steep, lee shore.
