THE NEXT MORNING we awoke gradually and took our time getting ready to go to the hospital.  We lacked the urgency of the day before since we now knew that Mary Elizabeth had stabilized and we were no longer under the cloud of a potentially negative prognosis.  I took a few minutes to notify my immediate colleagues in London and New York about what had happened and that I wouldn’t be in the office.  Charlotte was in good spirits, still buoyed up by her decision to be positive about her mother’s future. So with that in mind, we made a plan for the rest of the day which involved spending some time at the hospital and then going to the Tower of London, which wasn’t far from the there.  That evening we were planning dinner with Ellinor and Jon so we had a full day planned.

With three children, I usually didn’t have too much of an opportunity to spend so much time with just one of them.  I had always known that Charlotte was extraordinary – from her wry sense of humor to her oddly adult perspective. But it was these character attributes that saved me in those early days from panic or collapse.  As the enormity of the situation began to sink in, I relied more and more on Charlotte to provide a distraction and to watch over.  My custodial duties kept me busy, and being able to show Charlotte around London was – present circumstances notwithstanding – an amazing opportunity, which Charlotte was clearly embracing.  In the week that Charlotte spent with me in London before heading home, our relationship changed significantly from what could be described as a conventional father-daughter link, to something much more.

As anybody knows who has been there, going through an extreme hardship with another person forges a bond that is not easily broken.  Charlotte and I had in the space of a few days developed a mutual respect and desperate need for one another that was new.  She had to face what no child should have to (but so many do) and met that challenge with grace (her apt middle name) and courage which was remarkable.  I think she was forced into an untimely maturity, and had the opportunity (however awful) to contemplate and consider some very adult challenges.  So I wish that she didn’t have to go through this ordeal, but at the same time, I was glad of her steady presence by my side.

We took another taxi to the hospital and I paid the driver the £17 fare, thinking that we needed to find another way to get to the hospital.  Looking at maps, it was easy to see how far the hospital was from the hotel, but hard to know what lay between.  Having heard all kinds of things about the East End, I was nervous about striking out on my own – especially with a child, and given my own childhood in New York City, where I had been no stranger to crime.  Nonetheless, I pored over the Underground maps to see about public transportation options and found that the District Line, which had a stop at Whitechapel Road directly across from the hospital, connected with a few key lines which made getting there a distinctly cheaper, although more time-consuming, possibility.

We were buzzed into the ITU and asked to wait in the interview room.  We were joined a few minutes later by another doctor, who introduced himself as a consultant who had an interest in strokes.  I was surprised that a consultant would be talking to me – especially at this time – and honestly a little bothered that I was being approached by some non-employee with a passing interest in strokes.  I was thinking about saying something when it dawned on me that this man was in fact the head of the stroke unit, and the physician in charge of my wife’s care.  Again, I had to get used to the peculiar nomenclature of the British medical system, learning that a Consultant is the same thing as an Attending physician.  Right, so Registrars were Residents and Consultants were Attendings.

We settled in to the interview room again and the doctor outlined the case to me, which I had heard several times already, but listened again, this time taking notes.  Essentially, Mary Elizabeth suffered a bleed – nobody knows why – in her brainstem and mid-brain.  The bleeding (which had stopped almost as soon as it started) was causing her coma, although they had her sedated as well.  They had performed a CT Angiogram the night before and luckily didn’t find any damage or defect in the blood vessels in her brain.  Additionally, there had been no further bleeding and now they were waiting for the overall swelling to subside.

After the obligatory we-must-take-this-one-day-at-a-time speech, the doctor outlined what he thought the prognosis would be.  It wasn’t encouraging.  She would never work again, would likely suffer weakness on her right side and require permanent assistance with walking – if she ever walked again – which apparently was the least of her problems.  He couldn’t say when she would wake up, and what kind of deficits she might have when she finally did regain consciousness.  She would likely have some significant cognitive deficits – affecting the way she would think and process information.  Again, he cautioned us that anything could happen and we’d have to take things as they came.  I asked about travel and he said there was no way she would be able to be transported anywhere in the near future.  I wanted to know about bringing Charlotte home and he recommended that I not leave for the time being and to find alternative arrangements to have Charlotte brought home.  Surprisingly, he gave me his email address and spent some time talking to Charlotte about her interests and if she had any questions.  It turned out that he had a son about the same age as her so I imagine he felt a little closer to this case.  He struck me as a serious, straightforward but compassionate man and I felt comfortable that Mary Elizabeth was in his care.

We finally went in to see her and she looked pretty much the same, except that she responded once or twice to requests such as squeezing her hand, or once when asked to open her eyes, her eyebrows moved slightly.  Most of my questions to her went unacknowledged and when they opened her eyes, her pupils were fixed, dilated and unresponsive to light.  She was still on the ventilator, but I understood at this point that she was breathing mainly on her own, and the vent was a precaution against any irregularities which might impair her ability to absorb oxygen – one of the many things which was being measured at any given time.

It was extremely poignant to see my wife so incapacitated.  I had a hard time actually believing what was happening and somehow harbored the unlikely hope that she would open her eyes, stretch her arms and get up.  On an intellectual level I understood the seriousness of the situation, but on an emotional level I just wasn’t there yet.  While her condition was extremely serious and I felt as if anything could happen, we were in a strange kind of stasis.  There wasn’t anything we could do, other than stay by her side and talk to her as if she could hear – we’ve all seen programs on television where the coma patient awakens and reports that she heard and felt everything around her so we included her in conversation and I would ask her questions and ask her for a hand-squeeze or nod in response.  But we felt in a kind of limbo where we were powerless to change the situation.

There was a kind of relief in letting go a little and I began to understand better some of the prayers and hymns I had heard growing up about putting yourself into God’s hands and releasing your cares and concerns.  It was hard to do, but a sense of relief came with it.  We stayed for another hour, chatting and clearing out when the nurse had to check vitals or perform some task, so after a while, we decided we were in the way so we headed off to the nearby Tower of London for a rainy afternoon of medieval pain and torture.

Go to next chapter: Medieval Pain & Torture