3 April 2014
1005 hrs
Jenny and Elizabeth
Whom do you see when you look at me? Of whom do I remind you? What door in your memory does my own shadow
darken?
I see you in your remembering;
something flashes across your face whenever you look up from your life and see
me standing there. Yet you don’t know me
from then. You don’t know me from the Before . . . Or do you?
Am I that lover, lost so many years ago . . . so many lives? Have I found you yet again- dense neutron
star that I am (and be detected only by my effects on the bodies around me)? Am I too thick to realize who she is that
stands before me?
Who is she that looketh
forth as the morning, fair as the moon, clear as the
sun, and terrible as an army with banners?
Do our lives, yours and mine, bump
against one another every so often? Does
your Heart see that which is left of my own, and recognize it?
From which life do you know
me? Have there been more than one? Do I, this sad soul, chase you across Time
until you eventually catch me; do I lose you over and over, time and time
again?
Have I ever helped you? Helped you in the many ways I sense you have
helped me?
Am I the enemy forgiven by a Heart
that I do not deserve? Do I break that Heart
yet again? Will I?
With a coldness you look at me from
behind your stoic face . . . and I am
the only one who sees it. All the faces
you wear do not hide you from me.
And you see me also. You come to me in the night and you watch me
dream. You see my wishes on the breath
of my mind. Hoping you are not cold
because I somehow harmed you.
Is it possible to be too jaded to
be the Bodhisattva of Compassion? Do I
qualify to be the Bodhisattva of Wisdom of I fail at the other?
In the vast rooms of my mind, where
the quiet and dark shapes loom, I find myself awash with desire. I wish I were this Being of Higher
Light. I seek not the Highest Light, but
does my desire yet cause another’s suffering?
The opposite of whom I wish to be?
Do you see these powers that I
wield; this cold stick or sword that can only warm with the blood of
another? Do I wield these powers wisely
or with compassion?
My Heart and Mind were there for
your taking. Is so much ever enough?
Staff Notes
28 June, 199-
1533 hrs, Neurophys. Consult
Jenny Anne Miller*; 11 y/o
white female
CC: Status Post Hypoxic Event
Pt is comatose rated 3 on
Glasgow coma scale;
unresponsive to deep pain stimuli; neg for sternal rub and
toenail compression;
unreactive to application of ice water to corneae et
external auditory meatus . . .
Recommend ECS
encephalography to rule out encephalopathy from anoxia
Recommend
ECS encephalography to rule out electrocerebral silence from anoxic event
*names have been changed to protect the guilty
Cerebrovascular Intensive
Care Unit
I stand at Jenny’s bedside in the
CVU, wishing the mother would leave. I
perform the neurological examination knowing full well what to expect. It is perfunctory, this exam; rote memory
pushing me through it.
The mother tells me that her own
name is Elizabeth. I wonder why she
thinks that matters to me. She knows my
name from my lab coat.
Before these mothers enter my life I
am someone. After they leave it, I am
someone else.
Fathers are at the bedside too, but
they leave, omnipresent only in spirit.
They hang in the room as vapor after they are gone, like the smell of
smoke long after the fire.
Fathers are the ones who go out and
Get Things Done. Fathers go home and
gather toothbrushes and clothes, preparing for the siege against the
hospital. They mumble that the hospital
staff can just try to keep them from
their sick child. Let them try . . . not
realizing that visiting hours are relaxed for the parents of the very ill . . .
that they are nearly forgotten altogether when the child is dying.
Fathers gather up the piles of
unread mail and newspapers that have fallen through the slot in the front
door. They take these unimportant papers
and put them on some table in some room.
Fathers grab a family photograph, needing it there as a talisman not
realizing it will bring them no comfort.
Not realizing that the dead do not rise as Lazarus. “Jenny
. . . come forth . . .”
He will probably take that
photograph and place it on the nightstand next to the bed, that vast and barren
wasteland. He’ll place it somewhere
close; minimal head movement can place in the mind the whole family before . .
. and after.
The Father, at the last moment,
perhaps in afterthought, will fetch a stuffed animal. The one he thinks is her favorite. Fathers think that love heals.
Fathers go to work.
Mothers, on the other hand, are
always at the bedside, always thinking terrible things. They hover like a she-bear, sniffing for life
at the stillness of their young, wary of the interloper wandering too
close.
It is in this fashion that Elizabeth
faces me. As at a standoff, we circle
the bed of her silent child, both alert, both wishing for the same things. It is only I who has accepted the horror of
knowing that our wishes will never come true.
She wants to trust me, and I need
her to.
Elizabeth is a name from the
gospels. The cousin of Mary (the Mary
who becomes the mother of Jesus), she sings a song when the angel Gabriel tells
her she will give birth to the John that will become The Baptizer.
Here
in the CVU there is no Angel nor Savior.
Here there is no washing away of sin.
Here there is no absolution; the forgiveness of oneself is forever out
of reach, here. No matter the
circumstances, one will ever convince the parent that their child’s death was
out of their control, and the Elizabeth that stands before me, across this vast
ocean of her daughter’s bed, does not sing.
Her only sounds are the occasional soft
murmurings. She coos as a dove, softly
into her daughter’s unhearing ear. She
speaks to me only with her glistening eyes.
* * *
The Eyes of Woman.
How they see so much more than the eyes of men. The have a sight and an insight, seeing
nearly everything there is to see. I
suspect they see in spectra of light that I myself cannot. I have never seen eyes on a woman that were
not beautiful.
Elizabeth has green eyes. My father had green eyes, too, but were
filled with wrath and hate. Hers are
emeralds; hard and bright and sharp to see through lies and slash them into
bloody pieces. Eyes that could very
nearly turn me to stone.
Elizabeth’s eyes question me, and in my own she finds
no answers. She looks into them deeply,
seeing past the helplessness, seeing the abyss she is soon to face. This pit grows deep and wide inside us and
she fends off, for now, the encroaching darkness. Had I a Heart, I would have beaten it on the
stony shores to get her an answer that would not kill her inside.
She read it, this hallowed wish, and the tiniest part
of her loved me for it.
I know my job.
I excel at matters of the brain, the cord . . . the branching
nerves. I can help almost anybody,
provided they have a nervous system. But
Jenny is beyond my reach.
It is not I who have failed. Jenny’s brain, in its betrayal, failed
her. Despite this sad knowledge, I can
milk no comfort from it. Elizabeth’s
life has a new chapter, this experience of meeting me. And as it is with all mothers in this
terrible place, this Horrorshow, this experience is bookended; Fear on one end,
Heartbreak on the other. This is the
splintery cross I bear in these rooms; these oubliettes that imprison their
loved ones.
For all of my knowledge of this mystery within our
skulls, it is the unhealing Heart that is smashed upon the anvil of my
intellectual vanity, this ever-elusive salve that awes me as it shatters in my
chest and spills warm. The hammer
strikes, rhythmically, a no no no . . . and
I hear it in Elizabeth’s own too-tight chest.
I beat it, this Heart, into something resembling a
weapon rather than a tool. I am
responsible, with my Great and Terrible Words, for this- the pain she feels,
and I cannot stop hurting her as long as she is making me do it.
I see her reaching toward the sky with clenched fist,
pulling down my hand, my cathartic hammer smashing against her soul within the
forge. I need her to lash at me. She only needs from me my answers.
I need her venom, spit hotly into my eyes, stinging as
the sting of scorpions. I need her to
hate me, not to love me. I do not need
her forgiveness, yet she will, thanking me for the things I cannot do. I cannot save her child. I break under her selflessness, her
kindness. Her beguiling gratitude.
* * *
Staff
Notes; (cont.)
28 June 199-
1550 hrs; Neurophys. consult
Pt brought into ER via Silver Cross Ambulance at ca. 0700 hrs.
this date
Assessed by trauma surgeon
on call, Dr. -------
Emergency surgery performed in OR 7 to repair transected femoral
artery, RLE.
Wound site 4 cm distal to
groin; wound approx. 6 cm (see surgical report)
Pt found seizing in street by neighbor going to work.
Pt on surgery service; neuro consult as requested. Mother is at bedside and is reliable
historian.
General status (mother
states) Pt neg for hx of vertigo; neg for syncope, LOC, seizures or paresis
* * *
After the first few moments I stood
at the bedside, the girl’s mother asked, “Can you help my baby?”
“I already am . . .” I say, as
comfortingly as I can since I haven’t a Heart.
This is my answer. It is always
my answer, for that is always their question:
“Can you help my baby?”
I already am . . . Shamelessly, it is a true answer, though
too often it is not the kind of help for which the mothers pray. She has already promised god something in
exchange for a miracle, and in the lousy timing that is my lot in life, I enter
the room as if I were the answer to it.
Yet it is a lie, is it not? Will she
forgive me this falsehood? Would she see
it and still be comforted inside my sin?
Can I help the mother, and if so, do I?
Perhaps if in some way I am helping
the child, it reinforces the truth and ameliorates the transgression. The fact would then become truth.
I get that my confidence comes
across, more often than not, as arrogance and conceit. Yet I cannot make myself care what others
think. I concern myself only with the
The Puzzle, and the Solving of It. This
is what I do well.
I know. I understand the Mystery. This enigma of Jenny. What intrigues me is the riddle of her
mother.
She paints recognition on the canvas
of her face. Her eyes say that she knows
me; I am somehow from her past . . . and after a lifetime of searching, somehow
she has found me.
I trust I am an eidetekker. I trust that I remember every expression
on every face I have ever seen.
Thousands of faces a week, each one seared into my mind’s eye, but I do
not trust the genesis of their memory.
Where was it we met for the first time?
I do not remember when the memory was made.
As I look into those emerald eyes, bright and clear as
the piper’s song on the lea, she also gazes into mine. And herein lies the drawback: This turnabout
seems sorcery. What is the familiarity
she sees that I do not? Of all the souls
within me, which is the one that stirs her own?
Whom does she find inside of me?
Does she remember me with kindness? Is the fear I see in her eyes a product of
the Now or the Then? I am, after all,
the Bodhisattva, am I not?
Does anyone feel fear as the mother feels it? Does anyone else, in the darkest of their
moments, shudder in their own ever-widening sea? Soaked through to the skin, wrinkled from the
battering waves, her persistent search for equilibrium transforming her into a
being made of tears . . .
Mothers with their eyes wide yet focusing on nothing. That for which they seek forever eludes
them. They search for a peace that will
never find them.
I never know these mothers long enough to see if peace
ever reaches their Hearts. This peace,
from my perspective, is Godot.
These women enter my life and I see them in their
saddest shattered pieces for the briefest epochs of time . . . and then they are gone.
Strangely, some of these mothers have extended
affection, even going so far as to kiss me full on the mouth. Deep, desirous passion as a fiery furnace
burning between us, in hopes that such an intimate act would delay the
inevitable. And still my Heart stirs,
albeit briefly, then returns again to its atrophied and desiccated state, dying
a little bit more each time. It happens
just so.
Most of the time however, the mothers embrace me,
thanking me, despite the fact that once they catch their breaths and go home,
they must make the ruinous arrangements of burying the newly dead.
They thank me and I blush in my shame. How do I deserve this, their . . .
appreciation? I am bound in the
powerlessness of being unable to heal.
Yet they never blame me; not as I blame myself.
And so we come back to Terror and Heartbreak, the dark
gifts bookending these mothers’ experience of me. And as the many years pass, I feel that they
will forever associate me with Death and their Loved Ones. Surely as time passes they grow to hate me,
and still I continue to evaluate the dead.
The dead, you see, are the only survivors of this world.
And it is time to tell Elizabeth that which The
Machine revealed; that which I had already known.
The expression on Elizabeth’s face is the rictus of
the Death’s Head; mouth grim and set; eyes sad . . . terrified . . . beautiful
. . .
“Fox,” she said, clinging to my name as she would a
life preserver. She said it once,
tasting it like a lover; she does not kiss me.
This mother, as all mothers do, will blame
herself.
She’ll blame herself for sending Jenny down the street
to return the large china serving platter to a lending neighbor. I picture Jenny practicing the “Thank you,” I
am certain she had been instructed to make.
That she had promised her mother she would give.
What was it that distracted her, Elizabeth’s Little
Jenny? A dog? Butterfly?
Hummingbird? A honk from a
car? A waving passer-by?
Was she simply a clumsy pre-teen
girl who fell off the curb, the borrowed platter shattering?
What pretty pattern, I wonder, was
baked onto the glazed surface of that china?
What design on the piercing shard that murders?
There was dried blood on the cuticle
of the mother’s left thumb. Just a drop,
lonely and accusing. It was missed, I
guess, in her haste to wash away her daughter’s death. There was a drop of dried blood on her ear .
. . when will she find that?
Staff
Notes (cont.)
1602 hrs
Sensory status (per mother): pt has experienced no recent pain or
paresthesia.
Currently unresponsive to all attempts at
deep-tendon reflex elicitation
Motor status:
no difficulty with gait or coordination.
No complaint of tremors, paresis, or paralysis
Mental status: comatose; 3 on the Glasgow Coma Scale
Neuro: neg
for deep pain response. Pos for doll’s
eyes; pupils fixed/dilated; pos for Babinski’s sign
DX: prob
encephalopathy due to exsanguination and subsequent hypoxic/anoxic event
Prob
electrocerebral silence
*
* *
What
do you think of when you look at me? Of
what do I remind you?
Have
I been placed, by some defensor, into
one of your dark oubliettes? Am I
imprisoned by some (real?) imagined sin you feel I have wrought upon you?
What
door in your memory does my own shadow darken?
How
profound my relief were you to acquit me.
To perhaps have missed and coveted my love over these last long
lives. Were wishing only to make it so .
. .
Knowingly,
I desire your approval and find myself treading the waters of dichotomy . . .
Within this miasma is born the suffering of
desire. Yet do I desire to love or
desire to be loved? From which does my suffering vomit? Is one sin worse than the other? Do I already have these answers?
In
these matters, I can only hope I have helped.
I Hope I Have Helped.
As
Bodhisattva, for whom am I here?
Jenny? Her mother? The nurse who changes Jenny’s IV fluids? You?
Am
I the fluid that fills her perforated bloodstream? Do I fill these vessels and still the
struggling of the thready Heart? Am I the volemia?
Am
I the small sandbag lain upon the stitched wound, compressing it to heal? Am I the sutures beneath it, holding together
the jagged lips ready to spill its crimson secrets?
What
burdens of yours need me to bear them?
What is it you ask of me?
Am
I the smith, my heavy hammer striking?
Am I the fear? Am I the wide and
terrible sea- the black storms; my high waves crashing?
Am
I the murderous china blade tearing?
Staff Notes; (conclusion)
Prognosis: poor
Obtain EEG to rule out electrocerebral silence
Will follow-up with family to discuss cessation of
life support
Notify transplant team of possible candidate for
organ harvestation
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