"I think being scared is okay, Matt. Because Peter is my son and you are a part of him and will soon be my legal son then I'm a little bit afraid too. The doctors are good. I've already checked them out. They know what they're doing so I have faith that they'll take really, really good care of you boys."
Just then Peggy stuck her head in the door and said that it was about time for the boys to be taken to the operating room, and that she wanted us altogether for a few minutes.
Easily, I picked Matt up and together we went into the lounge where the rest were gathered. The room got quiet when I walked in carrying the boy who would soon become a welcome addition to the family. I said, "Matt and I've been talking about a number of things. We've decided on a couple of things that I think everybody will approve of. First, Matt's going to be joining our family, and secondly, we're kind of afraid of what's going to happen today, but we ended with a third thing, and that is that we have faith that the doctors will do their jobs well. Maybe if we all got into a group hug and said a prayer or two then we'll all know that everything is going to be okay. This family has a lot of love to spare, and the Big Guy has a lot more love than we can ever imagine or experience in this lifetime."
The boys all gathered around. Matt and I were at the center. Tears came to my eyes as everybody was touching everybody in some way. Even Peggy was looking on… her eyes were moist.
David said, "Dear God, please bless our family today, keep us safe, guide the doctors' hands and their minds, give them inspiration, and never let them give up hope if something comes along. Amen.
Peter continued, "Hey, I know we don't talk too often. Sometimes I wonder if I believe in you but I know there is some Power out there taking care of us. You kept me alive until I got here with my family. You definitely blessed me with Nicole, and you gave me the greatest gift of all – my David. So thank you. And yeah, definitely, what David said. Thanks."
Jeremy was next, "Yeah, I don't talk to you too often either. I'll work on that but I give no promises. Sorry. Anyway, take care of my brothers. Keep them safe. We need them here with us. Thanks."
The room got real quiet all of a sudden. All you could hear was several people breathing then Nicole began cooing in her cute baby way. Peter snorted when she grabbed his nose hard. He then sneezed. That cracked the room up. Nicole giggled. She was so happy in her daddy's arms. Tears began freely flowing from my eyes – not in sadness but with joy. Here were 3 generations of a family all huddled together.
I don't know why I did it and don't even know where it came from. I looked to Peggy. Tears were freely flowing from her eyes too. She said softly, "Having families together like this break me up all the time. I never get enough of it." I motioned for her to join us. She did. She stood by my side… the side where Matt's head was lying on my shoulder. She put her hand on his forehead.
Ann said, "Peter, Matt, you both are going to be okay. You have great doctors and a great hospital. Mainly though, <Ann looked to Peggy>, you have a wonderful hospital staff to take care of you."
Ron said, "Peter, your daughter needs you. Matt, you're Peter's twin brother which already makes you family. You are, for sure, Nicole's uncle Matt. Be good in surgery when you're asleep. You have a niece who needs you."
With that said, Peter handed Nicole to Matt. He cradled the little baby's body in the crook of his arm with me supporting his arm because he was so weak by that point. Tears freely flowed out of his eyes. My tears were freely flowing, running down my cheeks and onto Matt's arm. I looked around to my family. There were no dry eyes to be seen anywhere.
I hadn't seen Antoine since earlier that very early morning. He hung to himself and stood back away from the group. I wondered why that was so but then I realized he may not have felt a part of us since we were essentially strangers.
Then he did a remarkable thing. He hummed a melody that I immediately recognized. David looked up. Peter looked to Antoine. Jeremy's eyes flickered recollection. Then as one, without exclusion, we began singing "He Lifted Us Up".
By the time the song ended there were no further wet tears instead my family was happy and hopeful.
After Nicole was passed between family members she was returned to me. I held her close and whispered in her ear, "I love you."
She looked into my eyes. Her face lit up. She began cooing. I don't know what it was about my nose but she grabbed on hard and pulled it to a side. What she did next – she kissed me in her baby like way. Maybe she didn't actually kiss me but it sure felt like she did. I immediately kissed her back, told her I loved her again then handed her to Ann. If everything went wrong I did know for a fact that she was in good hands.
One by one each of my brothers drew me into a hug, whispered their encouragements and faith and hope. Poor Angel lost his composure. I squeezed him hard and he squeezed me harder. In front of God and my family, nurses and the cute black guy – we kissed delicately. I assured him I'd be just fine. We kissed one more time then David stepped up.
We looked carefully at each other, drew our eyes in together then once again in front of everyone we kissed passionately but not necessarily hungrily.
I took off my necklace and my ring, handed it to him then said, "You keep this safe for me. I'll need them later on. I love you David."
Dad put Matt down to stand on his own two feet. Both dad and I supported him though because he was getting very, very weak. He needed the operation. I would do whatever it took to keep my brother alive. I was absolutely determined to make it work.
Just then Drs. Borkwin and Rasmussen walked in.
Matt walked to Dr. Rasmussen. He said very softly, "Take good care of us, okay? If it comes to a choice between either Peter or I then please keep Peter alive. David needs him."
Dr. Rasmussen replied, "We'll take good care of the both of you. Matt, every time I go into the operating room I ask the Great Healer to guide my hands and my mind. It's not any kind of elaborate affair and I don't go to church or anything. I don't believe the way they do. But I do believe in Something. Are you guys ready because if you are we are?"
I nodded. Matt turned to me… I nodded again so that he could see I was ready. He smiled then looked to Dr. Rasmussen and said, "We're red-eye. Let's get this show on the road."
Dr. Rasmussen smiled.
Just then a lab technician arrived to take some more blood from me. Dr. Rasmussen explained that my blood sugar had been moderately high the previous night and that he wanted the test repeated.
Two more doctors then Dr. Miller arrived. The room was definitely full despite its expansive size.
Dr. Rasmussen explained that Dr. Borkwin and Dr. Herman would start my operation first. They did that to make sure my kidney was okay. They explained that there was no absolute way to tell until they got inside of me. He explained that he would be the surgeon who would actually remove my kidney and implant it into Matt.
He went on to explain that Drs. Miller and Waite would perform the early stages of Matt's operation.
If my kidney was deemed to be suitable then and only then would the transplant go forward. He explained that if my kidney was not the right one then he'd go ahead and perform the arterial-venous shunt procedure for Matt so that he could resume dialysis.
When no questions were asked he said, "Okay, the staff from the operating room will be here shortly, if they aren't already here. We should be underway in about an hour. Jim, it is our policy to not allow children in the preoperative holding area however since David is Peter's significant other then he'll be permitted to be with you – but he must be with you at all times."
Dad replied, "Thank you Dr. Rasmussen. David?"
David walked to Dr. Rasmussen and said, "Please take care of Peter… and our brother Matt. They were apart for too long… please keep them safe. And thank you for being the rules for me."
Dr. Rasmussen nodded and then the doctors left the room.
Sure enough, the operating room staff had arrived with their hospital beds. One of the staff checked my arm band to make sure I was who I said I was. I got on the cart after they were assured of my identity. They raised the side rails then Peggy injected some medicine in my IV. While I didn't go to sleep… I was sure woozy, my vision was doubled, and I felt totally relaxed.
Matt walked over to my bed on his own power. He leaned down. Tears were freely flowing out of his eyes and down onto his cheeks and then onto his hospital gown. He leaned over and kissed my lips. I raised my arms up and hugged him deeply and kissed him back.
While David and I were hugging and kissing, the lab technician arrived back. Dr. Rasmussen accompanied her. He said to dad, "Peter's blood sugar is 150. Ordinarily I would halt the operation. But I'm agreeable to giving him a low dose of insulin so that we can proceed with surgery. This is against protocol. But, I'm willing to proceed. His blood sugar was 175 last night. I'm surprised he's not having symptoms suggestive of hyperglycemia."
Dr. Miller spoke up, "Gene, his blood sugars were consistently high when he was here before… I suspect they are stress related because in the office they've been consistently normal. He's also receiving glucose in his IV. I'm going to change his IV fluids to normal saline. When he's in surgery we'll change it to Lactated Ringer's solution."
Dr. Rasmussen agreed. They talked with the residents and went into much more medical detail, none of which I understood.
Peggy walked over to my bed. She leaned down and said, "Honey, they're giving you sugar in your IV's. They're going to stop the sugar fluids and replace them with non-sugar solutions. Does that make sense?"
"Yeah, thanks for explaining what's going on."
"Okay, I'm going to give you some more medication… this will make you very, very sleepy. Tell everybody you'll see them later."
I did as instructed then she injected some more medicine in my IV.
The next recollection I had was being wheeled into the operating room where the air was frigid ice cold.
Drs. Borkwin and Herman were by my side as the anesthesiologist told me to start counting backward from 100.
99 98 97
When Peter was wheeled away I suddenly got this tremendous sense of dread and fear. My heartbeat beep beep beep on the monitor went faster and faster. Peggy walked to me and laid her hand on my shoulder. I took hold of her hand. She said, "I'm going to give you some medicine to relax you. You won't go to sleep but you'll get sleepy."
I nodded appreciably.
My pulse rate did not decline. Instead my fear and worry increased. Peggy then injected some additional medicine in my IV… which made me very, very sleep but did not allay my fear.
I became aware of another presence close by. I looked up. Antoine had walked over. Now that wasn't the right thing for him to do if they wanted to get me relaxed. Yet – he did walk over, rested his arms on the side rails, and then did something I didn't expect for him to do: he laid his hands on top of mine, closed his eyes, and said nothing. His warm hands on mine felt very relaxing and reassuring… I felt myself fading out very quickly.
After Matt was taken away to the operating room, the rest of us went downstairs to the cafeteria where we ordered breakfast, sat around and chatted. There was, of course, a sense of tension however it wasn't too great or big.
David saw her first.
He saw Peggy walk in for her break. He got up and walked over and invited her to join us. She did. She said, "This is breaking hospital rules… I'm supposed to be thoroughly objective and uninvolved with my patients' lives… who are they kidding?" She chuckled.
"In case I haven't told you thank you… thank you for all you've done for my boys and for me too. We've had a lot of anxiety about their operations… you've helped us a lot … so thank you."
Peggy turned to me and said, "Thank you for thanking me. So tell me about your family…"
She really wanted to know; she really cared about us. If it weren't for the situation at hand, or under those circumstances, I'd have asked her out for a dinner date… but as it were… I didn't.
The boys and I went around the table telling her a bit about our family. She seemed intrigued as was Antoine.
I asked Antoine, "Son, I don't want to put you on the spot, okay, please understand that I don't wish to intrude on your person. I have a question though."
"Go ahead. I will answer your question. You are trustworthy."
"What did you do to calm Matt down…? I've got to know."
Nervously, Antoine looked to Peggy. Something passed between them. Some thought. Some wave length. Something. Antoine said to Peggy, "Matt is a special person. We will become, ahhhhh, very good friends."
Antoine then looked deeply into my eyes and said, "Sir, I know things about people. We shall become very good friends. I hope this answers your question."
I shuddered… but instead of shuddering nervously I shuddered peacefully.
Peggy looked at her watch. An hour and fifteen minutes had passed since she'd arrived in the cafeteria. She didn't look worried but she did definitely look exhausted. She said, "I've been on the clock since 3pm yesterday… the boys are in surgery. They are my only patients. How about we head upstairs? I'll stick my head in the OR and see how they're doing."
All were agreeable so we gathered up our stuff and dropped it in the window that takes refuse to the back kitchen area. We then took off upstairs.
Peggy left and returned dressed in scrubs. "I'll be back in a few."
I stood up, walked to her then gave thank for her special nursing capabilities, and care for our family.
A few minutes later she returned. Her demeanor had changed drastically. Worry lines adorned her beautiful face. She had a sense of urgency about her that was unnerving yet she presented herself as being ‘okay' to the boys.
Immediately, I got up and followed her into a conference room.
Without wasting a second she said, "Jim, Peter's having critical complications. He's basically bleeding out. They are unable to get the bleeding to stop. They are rapidly running out of options. Things are not looking good. I'm sorry. He's young and strong though. These are very strong assets and strengths for him."
My chest tightened. My throat tightened. I felt the pulses of my heart beat begin pounding my temples as if they were being pummeled in a boxing match. I was on the losing end of the fight. Tears sprang from my eye sockets, ran down my cheeks then pounded on my chest.
"What can I do for my son, Peggy? Surely I can do something. I have to do something. I can't just sit, wait here and do nothing. Can we donate blood or something? Anything, just name it."
In silence, we joined hands then quietly said our own words in our own ways.
When Peggy drew her hand away she said "I'm going back to Peter's OR. I'll let you know how the operation is progressing once I know something."
Silently, I looked into her eyes then nodded. In an unusual move, she took me in her arms hugging me tightly then took off.
Left in a state of shock and disbelief, I got up then went into the waiting room where my family and Antoine were gathered.
I didn't say anything at first. David got up. He started pacing back and forth and back and forth and back and forth…
I got up, went to David, grasped his shoulders and led him to a chair beside me.
With much difficulty I said, "Peter's experiencing complications that are very serious. He is in very critical condition. We need to pray again. Dear God…"
Just then 17 boy-young-men entered the waiting room. Allen and Angel immediately got up and walked to them. They talked for a moment before joining our family.
I started getting angry, very angry that security was breached… but before I could say anything Allen said, "It's okay dad. I authorized them just before you returned from talking with Peggy. They're here to support us. This is Benjamin, Aaron, Steve, Kolja, Blaine, Adam…"
There were too many boys to remember each of their names.
The boy, Kolja, walked up to me, put his hand on my hand then assisted me to my knees. The rest joined us. I fervently and tearfully prayed with every fiber of my being, "Dear God, please do not take my son away from us. He's a good boy. If you must have him then please take care of him for us … please guide the surgeon's hands, make them an instrument of your healing powers. Amen."
"Wait everybody. Dear God in heaven. Please take care of our Peter. Hold him in your loving arms and keep him safe and bring him back to us. Please do not make a gift giver, a very loving and caring and gentle person but only a memory. If you do take him home, please make his passage gentle. Please make sure his passage lands him in my mom's loving and waiting arms. Thank you. Amen." David said passionately, chocking on each and every word.
Operating Room #3
Dr. Brown, the anesthesiologist spoke up in alarm, "You guys have got to get that bleeding stopped… this patient is losing ground very fast. He's about bottomed out and there's not a damn thing I can do up here that hasn't already been done."
Dr. Borkwin hammered, "I can't see a god damned thing. There's too much blood. Keep pumping that blood in. Tell Dr. Miller to get in here… has he started the recipient's operation yet? Get the cardiopulmonary bypass machine and tech in here NOW. Give me the Cooley aorta clamp. I'm going to clamp off the aorta."
"Yes he has. He's aware of the situation in here."
"Put him on the comm. I need to talk to him. Herman suck that blood out of there; I can't see a damned thing. Where's that fucking clamp?!!!!!!!!!!!!!!!"
A voice said, "We're getting a cardiovascular tray… it's on its way."
"We don't have time. I have the patients' aorta in my hand. It's bleeding out. Is there anything in our kidney set that I can use to clamp this bleeding off?"
Just then the beep beep beep beep went … silent.
Dr. Brown announced, "We have cardiac arrest. Time is 9:37am."
Just then Drs. Miller and Waite quickly entered the operating room. Dr. Miller began giving Peter external cardiac massage while Dr. Waite scrubbed in.
Dr. Borkwin screamed, "Where's that fucking CV set? I need that damned clamp NOW!"
On my way back to operating room #3 where Peter was fighting for his life, I started thinking about how families are resilient, even in the direst of circumstances. Each family has a heartbeat, no matter how dysfunctional it may appear to be, or is, or is not – as the case may be. I saw a miracle occur. This family pulled me into it. Here I am a professional nurse. I'm largely a non-believer in the theocratic bullshit of modern day religion -yet- I was unable to deny the existence of Something or Somebody or Some Power in our lives. I've felt it. I've seen it. I've experienced it. I felt the spirit energy flow through the Blake family as if it were my own, and mine was theirs … then it came to me … what I had experienced was and is a circle of love, a circle of survival, a circle of unbridled passion.
Arriving in OR #3, the first thing that caught my eye was the cardiac monitor … it was now showing no trace of life for the patient lying on the operating table with doctors and other professionals all around it … the atmosphere in there was surreal yet death hung in there like a shroud.
The anesthesiologist looked up from his instruments, dials and tubes with a grave expression on his face. He shook his head no although the surgeons were still frantically working in this patient's belly, they were hunched over it like they were conductors or something … the operating room is very much like a theater. Each person has his or her assigned role, and performs it. Generally the play goes without a hitch … yet today was different … today a life hangs in the threads between life and death.
I stood there in one spot for maybe 15 minutes or so until the dreaded words "Okay, enough. Let's call it. 10:54am. Does anyone object?" were said by Dr. Miller. I couldn't swear to it, but his eyes looked like they were moist. Were there unshed tears being held back? My own tears began to well up. How do you tell a family that their 15 year old son has … experienced… the worst possible scenario…
Just then the second year resident, Dr. Waite entered the operating room. He shucked his white doctor's lab coat and tossed it to the floor. He walked over to the operating table, peered in and then asked, "What's gone wrong?"
Dr. Borkwin barked, "Just who the fuck do you think you are? You're a second year resident!"
I knew Dr. Waite. I'd known him since he was a little boy. We largely grew up together. Our families ate together. We played together. Our parents were close. We were friends. Yet… when you challenge a doctor's authority… well, it is often a career suicide event.
As it were that wasn't the case.
I said to Dr. Borkwin, "Let him try anything. You're ready to call the code… I object."
Dr. Borkwin wheeled around, his hand still deep inside of Peter's body… he started to say something… but stopped.
He said to Dr. Waite, "I have the aorta. Would someone please gown and glove Dr. Waite, sooner than later preferably?"
Once Dr. Waite was properly attired Dr. Borkwin stepped aside. He looked at Dr. Waite, "You'd better come up with a miracle, son." Dr. Borkwin said semi angrily.
Dr. Waite stepped up. Dr. Borkwin stepped aside. Immediately Dr. Waite's hands disappeared inside of Peter's abdomen. He said to the team, "The patient has a posterior aorta tear at the proximal renal artery junction. Stop CPR. Give me a DeBakey vascular clamp and a DeBakey forceps. Get me a pre-clotted #37 Gortex graft. Resume CPR. Keep the blood flowing. Call Dr. Rasmussen, I'm taking the kidney down while we're waiting for the graft. The kidney will be out in 5 minutes. We'll conform the donor specimen in the recipient's OR."
A sliver of a ray of hope made its dawn on my heart. I prayed for a miracle.
Four minutes later, the graft arrived; Dr. Waite delivered the donated kidney to Dr. Rasmussen. Dr. Rasmussen took off for OR #4 where Matt's open belly lay wide open; waiting for the gift of life. Was the gift of life… the last gift Peter would ever give? I wondered. Yet I hoped that it wasn't.
Dr. Waite said, "I have full exposure now. This patient actually has a congenital aortic aneurysm. It's small but it's a killer. Give me two more DeBakey clamps, suture, the graft… I'm ready to go… NOW. Stop CPR. Time?"
"11:14am. CPR is adequate. His pupils are fine. But we've got to do something very quick. Otherwise we're going to lose him." Dr. Brown announced.
"I'm working as fast as I can. Dr. Herman, Dr. Borkwin put those clamps right here…."
And so the operation went.
"I can't do this with you pumping Dr. Miller. I need you in the chest. Go in through the diaphragm, please."
A nurse gowned and gloved Dr. Miller. "Scalpel."
And so it went, Dr. Miller began internal CPR which maintained Peter's blood pressure and perfusion to his brain and other upper body vital organs.
Dr. Waite asked, "Time?"
"One hour fifteen minutes."
I looked at the clock… it read 12:15pm.
"Okay, we're done here. I have just removed the clamp from the aorta. Dr. Miller, please initiate cardioversion, keep those fluids running full bore, don't quit."
Dr. Miller announced, "Clear."
Dr. Rasmussen entered the operating room. He said, "The donor's kidney function is perfect; he's producing urine sweetly. How's it going in here?"
"We've just completed an aortic aneurysm resection and grafting. It was in a hard to reach and hard to fine area. It was located posterior to the right renal artery. It was actually an AV malformation. A sonogram wouldn't have picked this one up. The only way…"
"Dr. Waite, get your hands out of there else you're going to get shocked." Dr. Miller barked.
Dr. Waite removed his hands as instructed. He continued, "The only way it would have been detected is through an arteriogram. The defect's definitely a congenital abnormality. Anyway, clamp time was a little over an hour; the defect is completed; his brain is currently being and always has been adequately perfused though he's lost 4 times his volume."
The room shushed as Dr. Miller readied the paddles. He said, "100 joules, charge."
Dr. Miller quickly looked around the table and after finding nobody touching Peter he shocked Peter's bare heart with the paddles.
On the 8th try, the conversion was successful. The room broke out in joyful exclamations as Peter's heart reverted to a normal sinus rhythm though its rate was slow. He was medicated appropriately which raised his pulse and blood pressure to normal levels.
"Okay, let's close and get out of here. Notify ICU. Give him 4 more units of whole blood, 2 units of fresh frozen plasma and two units of platelets. Give him 4 milligrams of calcium glutamate IV. Be sure and tell ICU that he'll be on a vent." Dr. Waite said.
Dr. Rasmussen returned to OR #4 and began closing Matt's incision.
While the tension in OR #3 was still high it was definitely lower than it had been. Peter's heart continued to beat on its own in a normal rhythm.
Dr. Borkwin scrubbed out but not before reverently saying to Dr. Waite, "Good call Doctor. Thanks. Okay, I'm going to go talk to the family."
Dr. Waite said, "Suture."
Dr. Borkwin walked over and stopped in front of me. He said, "Nice call. Thanks. It was too close Peggy. I don't much believe in miracles …" then he nodded and walked away. He stopped just as he was about ready head out of the room. He turned around with a smile on his face and said "This was a miracle, Peter was dead. Now let's hope he didn't suffer a heart attack or a stroke from the blood loss and shock his body went through. He is by no means out of the woods."
I nodded knowingly.
At first, I thought I'd go with Dr. Borkwin to talk to Jim and the family… instead I decided to stay with Peter so I could continue praying.
After dad stopped me from pacing on my crutches I sat down and began banging my good foot on the floor. Dad put his hand on my knee to stop me. I got up and worked my way to the opposite end of the waiting room.
Angel followed me and sat down at my side. He reached for my hand, clasped it firmly and began attempts to engage me in conversation.
I spat angrily, "Just leave me the fuck alone. I want to be alone. Go to the fucking room and get my fucking Leg. Do something useful!"
I immediately regretted what I'd said to Angel but it was said. I reached up to Angel but he took off with Allen on his heels. I felt worse. I felt dejected. I'd hurt my brother. I'd cursed him in anger.
Twenty minutes later they returned with my Leg. Not giving a shit that I was in a crowded waiting room, I removed my shoes and pants, affixed my Leg, got dressed again then took off down the hall. I didn't care where I went… I just needed to go. I couldn't take any more not knowing about the love of my entire life. I found a very long hallway then started pacing it back and forth back and forth back and forth up and down up and down and around and around.
Dad intercepted me on one of my rotations. He took me into his arms but I pushed him away saying "Dad, I just want to be left alone." Then I continued my trek be damned the pain I was experiencing.
Determinedly and decisively and parentally dad intercepted me at a corner of the hall. He grabbed me in his arms. He said, "You can't keep doing this David. You're going to hurt yourself."
I looked down the hall. All the guys, including the surf team were looking at dad and me.
Everything started spinning… the hallway, me, dad, the guys, the lights, the floor … the floor; I felt coolness on my face. Dad was brushing my hair with his fingers saying something about getting paramedics NOW!
I then passed out.
I can't tell you when or how much time elapsed… I came to… I was in dad's arms. I fell limp fully and completely in his hold… and passed out again.
Once again, thankfully, I came to… everything was in a fog but I quickly became aware… vital signs, stethoscope, light in my eyes, hands on my chest, hands on my stomach, more hands on my legs, a cool air swishing on and through my crotch and stump, hands touching my legs, my foot was on fire, my legs ached, dad said "shit" once or twice, he'd put his arms tightly around me then would release me then tighten up, tears… lots of tears.
I opened my eyes. People. People were all over the place. They looked distant yet they were close to me and to dad.
A voice said, "Sir, your son is bleeding. We need to take him to the ER."
I then screamed as a sharp shooting pain totally enveloped my body. It started at my left big toe then traversed through my leg, through my groin, through my belly, through my chest and on up my neck stopping in my head.
Crying uncontrollably I said to anyone listening, "My leg, my left leg – it's being stabbed."
Somebody, not dad, not a voice that I recognized, asked, "Your right leg looks just fine."
I screamed, as another white hot poker landed on my leg, "It's my left leg… somebody's stabbing it. Stop!"
Dad jostled my head. He said, "David, you're having a phantom pain. We're going to take you to the ER. You have a nasty ulcer on your stump. It's bleeding. It's raw hamburger meat."
"No. I'm not going anywhere. Where's Peter? Has he died? Take me to him! I've got to see him."
"Are you guys ready to load him up?" Dad said to someone. I looked up and down and saw hospital staff and a bunch of other people looking at me and standing around gawking. I looked further and found that they'd cut my underwear off. They had one of those flimsy hospital gowns draped over my glands… I didn't care. I wanted Peter. I started fighting dad.
The next sounds, other than dad telling me to settle down, were of a baby crying. It was getting closer and closer and closer until it was very, very near.
I opened my eyes widely. Ann stood above my head. She was helped down by Ron and then leaned into my face and began rubbing my temples. That calmed me down more than anything. The next thing that happened was that Ron laid Nicole on my chest. She immediately stopped screaming and fell asleep. I put my arms around her thus freeing Ron to begin massaging my shoulders and neck while his wife Ann massaged my head.
One by one, my brothers but not the surf team embraced me and Nicole and kissed me either on the forehead, the cheeks or my lips. I calmed down considerably.
When the gurney arrived all of the guys took a portion of me and very lovingly, gently and caringly lifted me onto the stretcher. In their own very special way they each touched me somehow, somewhere … all very meaningful.
As the orderlies were getting ready to cart me away to the ER, Drs. Miller and Borkwin were walking toward us. When they arrived, Dr. Rasmussen took the lead talking while Dr. Miller stood at my side, on the side of my amputation.
Dr. Rasmussen said, "Let's go to the suite so that we can talk. Mr. Blake, Peter is alive but he's very critically ill. This is not the place to talk."
Instead of immediately going to the ER the orderlies rolled my cart with my family following behind us to Matt and Peter's suite. One of the orderlies raised the head of the bed so I could look Dr. Borkwin directly in his eyes. I found that they were telling the truth, or would tell the truth. I relaxed… somewhat.
Our family joined hands while Antoine settled at the head of my bed, lightly stroked my forehead with one hand and my temple with his other. I was relaxing even more. I felt in control of my emotions.
Dr. Borkwin said, "Peter is not dead. He is very much alive. The only thing I can really say at this point in time is that nothing short of a miracle occurred in that operating room. As you know Peter experienced a very serious life threatening and very, very near fatal complication. He lost his entire blood volume four times. For a time he was bleeding faster than we could replace it."
"Dr. Waite, one of our residents intervened. Normally, we do not permit a resident to take over however our options were very limited at that time. Dr. Waite found and repaired an aneurysm of his aorta. The aorta is the largest blood vessel in the entire body. It takes blood directly from the heart to the rest of the body. It has several branches which perfuse his lungs, stomach, bowels, kidneys, liver, spleen and other organs. At the top of the ascending aorta are 3 vessels that provide nourishment to the brain. His aneurysm was located just below and behind the renal artery. This is most likely a congenital defect but it could have been produced by a blunt force trauma to his belly. In any event, the aneurysm ruptured. Because of the blood loss Peter's heart stopped for a period of time but we were able to get it restarted. Thus far it is working as it should be. He has a good blood pressure and pulse. Preliminary signs show that his brain is functioning as it should be but we won't know if any long term damage occurred from blood loss until he wakes up. We will keep him in a drug induced coma for several hours, possibly for a day or two. At that time, we'll wake him up so that we can perform tests to gauge his responses."
"Dr. Waite will be down later to explain exactly what he did to save Peter's life if you would like to hear."
I answered, "Yeah, I'd actually like to thank him myself. When can I see him?"
"He's still in surgery closing Peter's incision. He'll probably be another hour or so, maybe a little less, he's fast." Dr. Miller said professionally.
Dad asked the question of the century, "Doctor, I've heard what you've said… is Peter going to be okay?"
Dr. Rasmussen appeared. Dr. Miller answered, "That remains to be seen. By all indications I'd expect Peter to make a full recovery however the next 24 to 72 hours are a very critical time for him. We'll be looking carefully for continued bleeding. He's lost all natural abilities to clot blood. He's receiving blood products and vitamin K in his IV to bolster his system until it returns to its normal state."
"Secondly, Peter could have had a stroke. This would be caused by the severe stress his body experienced and the wayward clotting mechanisms. We'll not know for sure until we attempt to wake him from the coma."
"Third, Peter could have had a heart attack… for the same reasons."
"The last major complications are, of course, infection and his clotting abilities, and he may very well develop complications from the incision I had to make in his diaphragm so that I could perform internal CPR. The diaphragm is a large muscle that performs probably 90% of respiratory actions. It will be irritated at best."
"The good part… and I hate to only say bad things… is that Peter's young, strong, otherwise healthy, and he has a large support network."
"When can we see him?" Dad asked cautiously.
"Like I said Drs. Waite and Herman are closing his incision right now. As I told you, it is a very large incision so it will take a while to close. After that, he'll be transferred to the PSICU (Pediatric Surgical Intensive Care Unit), and they'll need time to get him settled in. So, to answer your question, I'd say 3 hours give or take some."
Angel spoke up with a question, "Do you have to put him into a coma? Why can't you just wake him up so we know if he's okay?"
"That is an option. Usually, we induce coma to permit the brain time to heal itself from the shock and trauma. It's not required. But it's recommended."
Angel persisted, "Can you wake him up, see how he's doing then if necessary put him in the coma?"
I reached for Angel hand. Automatically he clasped it firmly.
Dr. Rasmussen spoke up, "I think that's a reasonable request." To Drs. Miller and Borkwin he said, "I think it's worth taking the chance. Let's get a neurology consult."
All agreed. To us Dr. Rasmussen said, "We're going to get a brain specialist opinion before we decide. If they give the go ahead then we'll agree. It's important to not stimulate the brain ‘too much' after a recent trauma. ‘Too much' is very subjective. We surgeons tend to be very conservative whereas the neurologists tend to be more aggressive in their approach to these types of situations. The bottom line is that we want to do what's best for Peter even if that means delaying your reunion with him."
Dad said, "I understand. Do what you need to do."
When the room went silent, Dr. Rasmussen asked "Are there any more questions at this time? I'll provide you status updates periodically."
Antoine spoke up, "What about Matt? How is he?"
"Oh, I'm very sorry. Matt is doing very well. Peter's kidney is working perfectly. He should be on his way to the Transplant ICU just anytime. He had no complications whatsoever. Everything went very smoothly. I'm sorry that Peter had complications. They were unforeseen. Had we known about the aneurysm we would have fixed it first then reoperated at a later time."
Antoine said to Dr. Rasmussen, "Doctor, everything is meant to be. Thank you for your expertise. I doubt that Matt would have lived long enough for the chain of events to happen as you describe, no?"
"We would have performed the shunt on Matt which would have enabled him to go back onto dialysis treatments. You are partially correct, young man." Dr. Rasmussen said factually, assuredly.
Antoine nodded his understanding.
"Are there any further questions at this time?"
Dad said, "Thank you. We're deeply indebted."
That said, the doctors, except for Dr. Miller took off for parts unknown to do whatever it was that they needed to be doing.
Dr. Miller said, "David, I hear you're having trouble with your stump. Can I take a look at it?"
To answer his question, I raised the gown up so that my entire leg was exposed to him. I said, "I had severe pains shooting from the toe clear up into my head. Why was that?"
Dr. Miller grimaced as he looked at my stump. I sat up to see what he was looking at. Shit, the end of my stump was or looked like raw hamburger.
He said, "Jim, David needs to go to the ER. He has a raw area that is troublesome. I'll want to put clean sterile dressings on it, give him prescriptions for antibiotics – both oral and topical, and perhaps a mild pain medicine. I'm on call this weekend so just anytime you can make it we'll get him taken care of. I'd also like to see him in the office on Monday. If it's not healing the way I want it to then we'll have to consider skin grafting. David you have to slow down and take care of yourself."
I nodded taking the admonishment in stride. I knew he was right on all counts.
Dad gave me his best parental ‘look'. He started to say something but at the same time Peggy walked in, walked to him, and looked at Dr. Miller who nodded.
Peggy said, "Matt has been transferred from the recovery room to the Transplant Unit where he'll be closely monitored. He's stable. He has good urine output. He talked to me though I doubt he remembers any of our conversation. His primary concern was Peter. I did not go into any detail. I simply told him that Peter is in the ICU being closely monitored. That seemed to satisfy his concerns."
Dr. Miller said, "I'd rather we not tell Matt anything of Peter's complications right now. The worry and stress is not something he needs at this time. Maybe in a day or two, depending on his progress, we'll inform him of the difficulties."
To Peggy Dr. Miller said, "Please give David a 1000 milligram loading dose of Keflex intravenously. I'll write a script for 500 milligrams by mouth 4 times a day. I'll write another script for Bacitracin. Also please give him dressings for home care. David, do you need pain medicine?"
"Nah, I can just take something over the counter. Is Ibuprofen okay?"
"Yes, that's good. Okay, I'm going to head to the ICU to check on Peter. I'll also check on Matt." Dr. Miller applied then took his leave.
Peggy said, "I'll get an orderly so we can get you treated. You have to take care of yourself. Both Peter and Matt too are going to need you as is your family."
I looked to dad, "I'm sorry dad. When I found out about Peter… it was just too much to take."
Dad looked at me pensively then said, "I understand. I did quite a bit of walking when your mom was sick… it seemed to relieve the stress, at least for a little."
When we arrived in the ER, Peggy expertly began an IV, injected the antibiotics, dressed my stump and then we took off for the Transplant Unit to check on Matt first before going to see Peter.
When we arrived Peggy led us into Matt's room after donning caps, gowns and gloves because Matt was on Contact Isolation to prevent bad bugs from entering his system. Drugged as he may have been he did carry on a semi-intelligent conversation with us. He kept asking about Matt and dad kept telling him that he was being well taken care of and that we were headed that way. Our consistent reassurances seemed to satisfy his need to know how Peter was. I maintained and did not break down.
I reached down and kissed Matt on his upper forehead. He squeezed my hand in return.
We then headed to the PSICU.
To be continued