WHEN I AWOKE the next morning, the first thing I saw were the rooftops of London’s East End stretching north from the hotel in the thin December sun.  The low roofs were mainly tile and punctuated by the spires of churches and the new blocks of flats that had sprung up where the bombs had dropped in the 1940s.  Towards the west rose a remarkable tower with a flag atop it snapping smartly in the breeze.  I would later learn that the unique hexagonal tower was that of St. Anne’s Limehouse, one of the Nicholas Hawksmoor designed churches from the early 18^th century.  The hotel’s floor to ceiling windows provided me an expansive view from the bed since I had forgotten to draw the curtains the night before.

As I lay there – alone – the events of the previous evening instantly came back, and I realized –  with some surprise and relief – that the phone hadn’t rung in the middle of the night with a nurse on the other end bearing bad news.  But it was quiet in the room, and it looked like a conventional Sunday morning outside.  I checked my blackberry, thinking that perhaps the hotel switchboard had been closed after all, but there were no calls and only the few auto-generated emails that would come through on a Sunday morning.

Everything seemed normal, but there was a surreality that permeated everything – from the view out the window to the rosewood veneer on the wardrobe that held the television.  It was all perfectly ordinary but at the same time horribly and unthinkably wrong. How dare the view be so normal!  How dare the curtains hang just so as if nothing was wrong!  It almost felt hurtful that the only evidence of Mary Elizabeth’s illness was her absence.  Perhaps if the drapes were shredded, the doors hanging off the hinges, or if there were fist holes in the walls it would have been easier to reconcile the state of our lives with the current surroundings.  I wonder if that’s why people in great distress sometimes trash their surroundings – some outward sign of an inward torment.  The need to show people just how bad it is.

At any rate, I didn’t quite feel up to trashing the hotel room, so I got up to see how Charlotte was doing.  Her rollaway bed had been set up next to the windows in the living room of the suite and because they were floor to ceiling, she could lay in bed, her chin propped in her hands and look out the window.  When I came in she was awake and observing, cat-like, everything there was to be seen outside the windows. There was a massive construction project going on next to the hotel that was fascinating.  They were digging a tunnel under a section of the Thames to house the new Crossrail line that will have a stop at Canary Wharf.  We would find out later that this is the largest construction project in all of Europe.  Charlotte’s main observation was that amid all the heavy machinery, piles of rubble and building supplies stood a well-groomed topiary tree in a neat white wooden planter.  It was quite incongruous but quite charming.

Charlotte seemed in reasonable spirits, whereas I felt mostly numb.  We took our time getting dressed and after breakfast, headed downstairs to get a taxi to the hospital. Not being in the back of a speeding ambulance afforded us a much better view of our surroundings and it was clearly not the touristy sections of London through which we were traveling. There were a few architectural highlights – churches mainly and what looked like large municipal buildings.  There were also many pubs, with names like The George or the Jolly Beggar which we passed enroute.  We saw the pastiche of fried chicken restaurants, old row houses and modern blocks of flats – the mishmash of the modern east end of London.

We got to the hospital sooner than I thought we would and we arrived at the front entrance on Whitechapel Road, which was a lot different from the dark alley emergency room entrance the night before.  This being a Sunday, the sidewalks opposite the hospital were lined with tented merchants selling everything from bootleg movies and electronics to traditional Indian saris and spices.  It looked exactly like the souks that Mary Elizabeth and I had seen on our trip to Morocco several years earlier. The resemblance wasn’t a coincidence of course because most of the people who lived around the hospital came from the arab world, or the south asian subcontinent.

We made our way back up to the Intensive Treatment Unit on the third floor, and after we were buzzed in, were met by Sanet, Senior Nursing Sister and member of the Relative Support Service.  Compassionate, kind and supportive, she led us into the so-called interview room we had been in the previous night.  By the light of day, we could see that the window looked out over Whitechapel Road and we had a bird’s eye view of the stalls below, as well as of the surrounding neighborhood.  As is so often the case with old buildings in cities, the street level facades keep changing to suit the current retail tenant, but the upper floors often remain unchanged.  In this case, some of the 19^th century architectural details and signage of the buildings were visible, including the rather elaborate Whitechapel Road tube station which was directly opposite the hospital.

The room itself, if only by virtue of the window, was a step up from the family room downstairs in the emergency department.  The furniture was a little more comfortable (and not quite so seedy) and there were bookshelves and literature racks, along with a couple of framed prints.  Naturally, there were piles of boxes and a little rubbish in the corner, but overall it was a much more cheerful place to wait.  We were still on tenterhooks however, waiting for the doctor to tell us about Mary Elizabeth’s condition and dreading what the day might hold for us.

Sanet gave Charlotte colored pencils, papers and a stack of children’s books which she really appreciated and dove into immediately.  As we were waiting and making small talk with Sanet about her childhood in South Africa, the thought struck me that perhaps we were waiting to be told the worst news, as one of the people offered to us the night before had been from bereavement support, and I had begun to be more alert when “teams” of people came to talk to me. But I reassured myself with the fact that had anything gone wrong, they would have notified us immediately.

A young Indian doctor showed up shortly thereafter and after introducing himself as a registrar (the equivalent of a resident and another term I would have to get used to) quite quickly told us that after another more detailed CT scan, they had discovered that the bleed in Mary Elizabeth’s brain hadn’t entirely surrounded the brain stem, and there was now a good chance that this would not be immediately fatal after all.  Well, what he said I believe was that the bleed would very likely not kill her, but there were a variety other complications that could arise which would.  Not great – but better than the night before I suppose.

He went on to say however that she might never regain consciousness again since one of the things that the brainstem controls is arousal.  When, how fast and to what extent she would recover was completely unknown and he was the first among many to tell us that we had to approach this one day at a time.  They were still unable to ascertain what had caused the bleed in the first place and were therefore unsure about whether it would reoccur.  In the meantime, they would track the swelling in her brain, which was a normal reaction to a stroke but which could not continue unabated.  Once her condition had stabilized, they planned to do a CT angiogram and an MRI which would help them figure out what caused the bleed and to what extent her brain had been damaged.  She was starting to breathe on her own intermittently which was encouraging, but she continued to be on the ventilator until she was able to breathe independently.  Again, when that would be was unknown.

It would be another hour before we could see her, because of more tests and other things, so I took the time to make a few calls and send a few emails.  I had decided to keep the news to a very tight circle of friends and family until I knew a little about her condition.  In particular, I didn’t want to tell Clark and Louisa – our other two children – until I could truthfully assure them that Mary Elizabeth would be okay.  I wasn’t ready to make that call yet – and it was still the weekend, so I didn’t let anybody at home know what was going on just yet.

Mary Elizabeth and I had made plans to have dinner on Monday with a college friend of mine from the University of Chicago. A scientist who had been living in London for several years, Ellinor and I had been intermittently in touch in the 25 years since graduation. Thanks to Facebook, we had rekindled our friendship and agreed to meet and introduce each other to our spouses – and Charlotte.  Still trying to figure out the right numbers to push on my mobile phone I reached Ellinor and told her what was happening. It turned it that she had also had first-hand experience with debilitating neurological pro blames, having contracted a central nervous system infection some years earlier that left her temporarily paralyzed at the time, and still affected her today. It was a strange circumstance in which to renew our friendship, but I was grateful for more friends in London, and we decided to keep our date the following evening – with the notable absence of my wife.

At long last they were ready to let us in to see Mary Elizabeth, who was pretty much the same as she had been the night before – lying quietly in bed breathing on the ventilator with her eyes closed.  She had a number of tubes and IVs attached as well as a dozen or so leads which fed into monitors at her bedside.  We talked to her and held her hands – Charlotte on one side and me on the other, but it felt awkward talking to somebody who wasn’t there.  I was uncomfortable at first – as was Charlotte – but after a while, we eased into it.  There were two other patients in the room – one who had been in a horrifying car accident and had a shattered pelvis and several other problems (including being in an altered state and not realizing he couldn’t leap out of bed which is what he was trying to do) and the other who was older and seemed near death.  Their relatives were there as well, and quietly focused on their patients.  It was a dark room, and not very tidy – reflecting the general state of the hospital.

Charlotte occupied her time by making drawings and schematic diagrams of our favorite things which we hung up on the walls behind Mary Elizabeth’s bed.  Although she came up with this idea completely on her own, I encouraged her since I wanted the hospital staff to know that Mary Elizabeth was a mother and loved by her family since she was in a coma and couldn’t charm them herself.

We lingered for a little while longer until Michael spontaneously appeared with a few books and a stuffed bear for Charlotte. He wasn’t allowed in to see Mary Elizabeth, so we visited on the stairs for a while.  Although he offered to take us to dinner, Charlotte and I were feeling exhausted and wanted to go back to the hotel, order room service and relax.

In the ensuing hours, something quite extraordinary had happened.  Charlotte had made up her mind – quite resolutely – that Mary Elizabeth was going to be fine – grim prognosis notwithstanding. The minute she heard that the stroke would not be immediately fatal, she made up her mind that her mother would get better.  She predicted that she would be almost 100% recovered, but that she might walk with a cane.  While I was less sure than she was, and trying to find hope someplace, Charlotte’s childlike certainty that Mary Elizabeth would recover very much helped to buttress my outlook, and to help me perhaps to share some of her optimism.

We left the hospital and took a taxi back to the hotel, now a little more familiar with the route and headed upstairs to our room for room service and the BBC, not sure what the next day would bring but glad to have each other’s company.

Go to next chapter: Hope Glimmers