Deep waters, p.4
Deep Waters, page 4
We’d been terse with each other that Sunday. There’d been so much to do to get the house ready. And wrapping up my semester required an extra push. Always a hard worker, Jim had bought the supplies and a gallon of the shade of white I’d chosen. He was there on the ladder above me wearing those coveralls. I put on some dance music to make the job more fun. But he hadn’t lightened up. God, if I’d known this was going to happen, I thought, I would have been nicer. Because I’d resented his sour mood, I’d ignored it. Only as images flashed in my head in front of concerned professionals did I appreciate that his gruffness might not have been because we had to paint the walls, but because it was our weekend together. My work demands were an ongoing issue. Why hadn’t I switched gears? Stopped to ask him what was wrong? Treated him better?
“Also last night, during dinner,” I continued, “I’m not sure if this is relevant, but he took a bite of spicy rice and choked so hard he had to leave the room.”
“Has that happened before?”
“Never. My son and I were worried. I thought I might have to do the Heimlich maneuver. But he came back and told us he was okay.”
The doctor’s eyebrows rose. “One of his vocal cords may be paralyzed. It’s not uncommon with medullary strokes.”
“What does that mean?” I hadn’t heard that term.
“Medullary refers to the medulla oblongata—the central region of the brainstem. That’s the likely site of damage. It’s like your brain’s motherboard.”
I squeezed Jim’s hand. The comparison to a computer’s motherboard troubled me.
Dr. Neilsen peered at his face. “The way your eyes are jittering involuntarily is called nystagmus. It’s no wonder you feel dizzy—yours is the speeding rotational type. That, with the facial and eyelid droop,” she gestured to the left side of his face, “are signs of what’s called Horner’s syndrome. Your specific symptoms help us diagnose which nerve pathways have been compromised.”
“What caused this?” I asked.
She told us they’d know more after reviewing the new MRA. “It’s late. You and your son should get some sleep.”
“I don’t think Jim will sleep with these hiccups,” I said.
“We’ll give him something to help.”
He looked at me with gratitude—or was it fear?
“You okay being alone tonight, hon?”
He nodded but his expression didn’t change.
“Glen and I’ll be here first thing.” I loosened my grip, but his fingers lingered in mine until I hugged him, bent awkwardly across a rail. I inhaled him deep into my lungs.
It didn’t feel right to leave, but we all needed to sleep.
Glen and I walked hand in hand down an illuminated street to the hotel I’d reserved adjacent to the medical center.
In bed, my body felt like a flattened plank. In an altered state of exhaustion and denial, I watched car lights scroll across the ceiling. Glen’s rhythmic breathing finally nudged me away from the day’s events like waves against a shore.
I woke before six, showered, and tiptoed out to get coffee in the lobby. Back in the room, I settled at the small table and made a list: Buy spiral notebook, ask about hiccups, email Alex to check on our boat, call Jim’s sister.
At six thirty, I jiggled Glen’s foot. “Hey, sleepyhead.” A smile blossomed across his dreamy face. He stretched and slowly emerged from the tangled bedsheet cocoon. His expression darkened. “How’s Dad?”
“I don’t know, but we’ll head right over.”
Glen led the way across a glass-enclosed overpass connecting the inn and the hospital to the intensive care unit, all part of the Virginia Mason Medical Center, a thriving teaching hospital in the heart of Seattle. In the bright hall, we passed orderlies, two doctors deep in conversation, and other visitors. The tasteful artwork on display, sounds of doors sliding open and closed, and murmurs of people in motion exuded a professional sense of purpose and action that failed to quiet the urgent voices in my head.
We found Jim sleeping, half a dozen cords attached to his chest. Waveforms of green, amber, and blue pulsed across a monitor. A saline bag hung from a stand and fed the needle taped to his forearm. Even in a relaxed state, the left side of his face appeared different—more asleep than the right.
“Let’s let him rest,” I whispered, “while we get breakfast.”
Glen mimed writing on a pad of paper.
We left a note.
When we returned, his bed was surrounded by another swarm of white-coated physicians, three from the night before plus two others. Glen and I hung back, in the doorway. The head of his bed was raised, but Jim couldn’t see us. His torso was tilted to one side.
“Mr. Taggart’s experienced an acute neurological event,” Dr. Neilsen said to the group. “Jim, Dr. Cortez is going to give you some simple tests.”
The doctor from the night before, the one with the crew-cut, stepped in close to Jim and said the tests would help them localize which cranial nerves were involved. “Follow my hand with your eyes, not your head.”
Jim’s okay hand signal was interrupted by a hiccup, but compared to the day before, he was alert.
The doctor held a pencil up and traced a large plus sign. “See how the nystagmus is more pronounced when he looks to the left,” he said to his colleagues.
“What’s that tell you?” Jim asked.
“Your stroke was on the left side of your brainstem. Push your right hand against my fist. Now press down.” The neurologist repeated the test on the other side. “Not much difference,” he told the note taker. “Can you shrug?”
Raising his shoulders made him slump farther to the left against the pillows. I suppressed an urge to enter the room and help him sit up straight.
“Okay. Close your eyes, and touch your nose with your right index finger.”
Glen and I leaned in to watch. Jim’s arm swooped up, and he touched his nose.
“Now same thing, left side.”
Jim, eyes shut, raised that hand, but his fingertip landed on his forehead. “Well.” He smiled. “I-I guess I failed that part of the test.”
The neurologists chuckled.
Glen and I smiled at each other.
As the doctors filed out, Dr. Neilsen saw us and stopped. “Hello. This must be your son. Those tests we did with your father help us figure out how the stroke’s affected his nervous system. Your dad’s got a lot in his favor. He’s a strong and active person.”
Glen listened attentively.
“Brainstem strokes are rare, though, so there’s not much research. But he’s come to the right place. We have top-notch neurology and rehab departments. We think he’ll pull through.”
What did she mean by pull through? I wondered. Survive? Spend the rest of his life in a wheelchair? Return to normal? What I’d give to return to our lives as biologists in Juneau, raising our son. Before I could formulate a question, the doctor patted Glen on the shoulder, said goodbye, and walked briskly down the hall.
Glen and Jim hugged through a round of hiccups. “How’s your hotel?” he asked, voice gritty.
“It has an elevator,” he said, like it was an amusement park ride.
I told Glen I needed time alone with his father. “How about you read in the waiting room?”
He made a sour face.
I flashed my no-debate face. “The chairs out there look comfortable.”
“Ohh-kay.” He slung his pack onto a shoulder and moped out.
I took Jim’s hand in mine and asked how he was doing.
“You-you don’t want to know. I’m so thirsty—didn’t sleep much. They woke me up to take my blood pressure every hour. I swear. And these damn hiccups are about to drive me nuts. One minute I’m on top of a ladder painting.” He shook his head. “Now I’m here.” He scowled. “How’s Glen holding up?”
“Pretty well. I’m glad he’s with us.”
“Hmm.” He adjusted a pillow. “I don’t like him seeing me like this.”
I smoothed the hairs on his arm. “Brendan called. Dianne contacted him. He’s flying through Seattle this afternoon, on his way to Juneau from DC.”
Brendan was Jim’s closest friend. He’d recently moved from Alaska to Washington DC, but his son and ex-wife still lived in Juneau. The two men had met in their late twenties on a US Coast Guard icebreaker during a two-month survey of bowhead whales in the Arctic. Among the scientific crew of eight, they hit it off right away. As the massive Polar Sea sliced its way through ten- to fifteen-foot-thick winter ice, or rose and fell through huge waves, they often stood watch, binoculars and clipboards in hand. Along with the other biologists, they also surveyed the expansive landscape in Sikorsky helicopters manned by two pilots. Day after day, they scanned endless stretches of pack ice buckled by pressure ridges and dotted with ringed and bearded seals and an occasional group of walruses. Thousands of birds, hundreds of belugas, and sometimes a handful of bowhead whales aggregated in narrow, open-water leads. During those intense months in the barren, frozen landscape the two men had forged a tight friendship.
“He’s arranged a layover here to see you.”
“That’s awfully nice.”
You’d do the same for him, I thought. Before entering the room, I hadn’t made up my mind whether to share what else Brendan had said, but something pushed the words out. “He’s offered to take Glen back to Juneau.”
Jim pondered the option as if it was a math puzzle.
Brendan’s son, Corwin, was like an older cousin to Glen, Brendan like an uncle. Touched by his offer, I didn’t know how I’d hold up without our son’s stabilizing presence—moments of normalcy I needed. We’d always operated as a tight triangle. Could I shoulder the added strain of being split up?
A nurse entered and set a large Styrofoam cup heaped with chipped ice on Jim’s tray. She peered into the other cup. “Where’re you puttin’ all that ice?” she teased. Taped above his bed, a sign read: Diet—Nothing by Mouth except ice chips. Meds—crushed in purée.
“When can I have water?” Jim cleared his throat.
“Not until your choking risk goes down.” She slid her hands into the pockets of her smock. “We all take swallowing for granted. We use about twenty-five muscles to swallow a piece of bread.”
After she left, I lifted spoons full of flaked ice to Jim’s mouth until he grew too tired to suck on them. I lowered the head of his bed, and he dozed fitfully. We did not return to the conversation she’d interrupted.
6
SLOW BOAT TO SIBERIA
When Brendan strode into Jim’s room, Glen and I leaped up as the three of us chimed out his name. I hugged him hard. “It’s so good to see you.”
“You, too.” With an Irishman’s rugged looks, thick hair, and bushy mustache, he was the only person I knew with an adventurous drive larger than my husband’s.
Like a German shepherd crossed with a friendly retriever, Brendan could be appropriately fierce and commanding in a wilderness—or academic—situation, but he was also one of the most thoughtful, engaging, and fun adults we knew. A natural leader, Jim’s friend was a pivotal mentor to me at the university.
He squatted to take Glen’s shoulders in his hands. The gesture brought back my memory of the first time he’d scooped one-week-old Glen from my arms with care and confidence. He’d cradled our son, his gaze a beam of light, large strong hands coaxing coos from our tiny boy. Seeing our nine-year-old now held by those weathered hands made me feel as if I were the one being shored up. “How’re you doing?” Brendan asked Glen.
“Okay. How’re you?”
“I’m all right. Thanks. You’ve all been through a lot. Good thing your dad’s so darn tough.” Brendan held our son’s gaze until he nodded, then stood and went to Jim, who lay on his back. “Hey, man. What the hell’s up? I thought I told you not to be painting any damn skylights.”
The two friends embraced.
“D-damn is right,” Jim bunched a pillow under his head.
Brendan scooted a metal-legged chair in close. “Seriously. You’ve thrown us all for a loop. You’re the one who runs up glacier trails and rides a bike to work in winter.”
Interrupted by hiccups, Jim described what had happened. To give them time alone, I invited Glen for a walk.
Shortly after we returned with coffee for Brendan, a physical therapist pushed a walker into the room. “Mr. Taggart, today’s your day to get out of that bed.”
Brendan stepped aside to give her room.
She helped Jim ease up and slide his legs over the mattress edge.
“What about all this?” he gestured to the IV bag stand and tubes attached to his arm.
“It’ll be okay.”
He scowled, putting a hand on the walker. “I-I don’t need this.”
“It has to be parked in front of you. Your fall risk is too high.” She held his arm. “One, two, three!”
He rose, body tilted and wobbly.
“Way to go, hon!” I said, but I felt queasy.
Brendan motioned me out to the hall. He rubbed his jaw. “What’s his prognosis?”
I told him we still didn’t know, and that they’d only recently gotten usable images. “We should have a better idea soon.”
“If anyone can get beyond this, it’s Jim.” He clasped his hands, and his thumbs circled each other as he thought. “How about you? How’re you holding up?”
“I’m doing okay.” What I didn’t say was how I would have liked to hold those strong hands or fall apart in his arms—in someone’s arms.
“Have you thought about my offer?” he asked. “To scoop up Glen? He could stay in Juneau with me and Corwin until I head back to DC, then with Tenzing’s family. I can take him to school.”
Jim and I had not returned to this topic, but the option had pestered me. Brendan was like family. I valued his opinion. He believed removing Glen from the Virginia Mason equation was best, but I disagreed. I needed to be a strong advocate for my husband, and Glen stabilized and recharged me. Although, I worried there could be some harm to our son witnessing his father in this damaged state, Jim perked up whenever they interacted. My decision to stay together as a family was because I believed it maximized Jim’s odds for a better recovery, and that was best for all of us, especially Glen.
“We sure appreciate your offer, but I’ve decided to have him stay for now. His teacher emailed work. Plus, school’s almost over.” A splinter of angst penetrated my logic. Normally, Jim and I consulted on decisions like this.
The corners of Brendan’s mouth tucked down, but he said, “It’s your call.”
This man who cared about my husband—who had known him two decades longer than I—was deferring. He did not agree.
When we returned, Jim was on his back again. He looked worn out.
Soon a woman in floral scrubs entered. Brendan and I stood across from each other at the foot of the low bed. Glen was reading in a chair against the wall.
“I need to ask you and your wife some questions,” she said. “Are you comfortable with him being in the room?” Her elbow poked out at Brendan like a bird’s wing.
“Yeah,” Jim said.
“Do you have an advance directive?” she asked.
Jim struggled onto an elbow, confused. His jittery gaze relayed the task of answering to me.
“We do.”
“Does your wife know what you would want if something were to happen? If you could not speak for yourself?”
Jim stared at me, that caged-animal alarm returning.
“Have you both signed a medical power of attorney?” she asked.
My pulse quickened as I understood her job was to prepare us for worst-case scenarios: paralysis, a coma, death. “We have.”
Glen set his book aside and came to the bed. “What’s this about?” His question was left hanging, unanswered.
I looked at our friend for guidance. Alike in many ways—he and Jim sought challenges that pushed them physically and mentally. Their remote research in the Arctic had taken them to the edge before. What would Brendan want if he were in Jim’s situation and things went downhill?
Brendan registered my attention, then put his hand on our son’s shoulder. “Hey, Glen. How about if you show me where the cafeteria is? I could use some lunch.” His expression relayed this was my call—only I could judge my husband’s preferences.
What exactly was she asking anyway? What would I do if Jim fell into a coma? If we learned the stroke would turn him into a paraplegic? My head swirled. Please no. I can’t go there.
Her questions unearthed a conversation from six years earlier.
While living in California before I knew him, Jim had met a brain trauma doctor who counseled victims of motorcycle accidents. Before the mandatory helmet law, she told him, most people in serious motorcycle crashes died on the scene. Afterward, there was a huge increase in survivors, but many were basically a brain surrounded by a nonfunctional body.
After Jim told me the neurologist’s story back in Juneau, he adamantly stated, “If I’m ever paralyzed—you pull the cord. No way I want to live if I can’t walk.”
I challenged his assertion: “What if there were new treatments on the horizon? Or if you retained all your cognitive abilities?” He didn’t back down.
Through our connected gaze across the hospital bed, I believed we were recalling the same conversation. Back in Alaska, when we debated the hypothetical question, I tacitly agreed to follow his request. Faced with the actual possibility head-on, I discovered how much I wanted my husband in my life, no matter how incapacitated.
I turned to the woman with the clipboard. “Yes. We’ve talked about this. He has an advance directive. I’ll have a friend fax it.” I acted confident that the piece of paper would guide us forward. But I didn’t know if I could honor my husband’s declaration from the long-ago day in our living room, when he’d asserted his wishes from the vantage of his robust body.
To give the two friends time together, I set Glen up to read in the waiting room and took a walk outside. Seeing Brendan reminded me of all the adventures the two men had shared—and survived—which steered my thoughts back to a spring afternoon before Glen was born. Brendan and I were walking across campus to our offices after teaching marine mammalogy together. I had expressed my trepidations about a trip Jim was planning to Lituya Bay. We’d never taken our boat offshore into the Gulf of Alaska, and our destination was an eight-hour run beyond protected inside waters. Lituya Bay was known as much for its natural beauty as ships wrecked and lives lost in treacherous tidal currents while entering or exiting the fjord’s narrow and shallow entrance.
