Chapter 2: The CCU

At some point during the night, the sun came up. Not that I noticed. In the CCU, hours melt into the darkness, and time stands still. It’s partially the routine, the endless mind-numbing dreariness of the place and the situation–that, combined with no news to speak of, no signs of recovery. How long can you sit and stare at a comatose person? Eventually, the mind checks into its own little world. I’m trudging through the drudgery–a voluntary choice created by uncontrollable circumstances. On the second day, the temperature is still high, Dad is still barely hanging on and I am still at the CCU, waiting for something to happen. On the second day, the emergency is still there, no matter how badly we all wish for it to go away and stop scaring us.

The only solid proof that I have that the morning, is, indeed here is the shift change going on at the nurses station. At the appointed hour, the tired, bleary-eyed night nurses give way to the day staff–all bright-eyed and ready to roll. It’s here, at the nurses station, where everything happens. It’s more like the bridge on a ship than a work station, with a pecking order and specific assignments, all based on the seniority of the staff members.

And the most senior nurse is caring for Dad. I suppose that’s bad and good news. In the evening, that was Susan, and it was she who first gave me a reason to believe we could get through this okay. Tall and frail looking, she nonetheless had a demeanor of someone in control of everything. Her functional, shoulder-length hair told the world she had no time, and the sleeves of her paisley uniform, pushed up over her elbows were testimony to a person who did not like anything getting in her way. But what made me feel better were the eyes. Her eyes didn’t lie–I knew by looking into them just where things stood. I saw also that they cared–for Dad, for the family, for the fact that here we were, a lost family, in her ward in the middle of the night.

“Brian, why don’t you go home? We’ll call if something happens.”
She knew it was useless. I was here for good–and if she kicked me out, I’d just sit by the door in the hall. I wasn’t going anywhere. As soon as she realized that, then Susan began to make things easier for me. Gone were the time limits on how long I could sit next to Dad–the only time Susan gave me the boot was when some procedure required privacy. She pointed out all the hidden hallways and shortcuts in the hospital, so I could go down and get a cup of coffee when I felt like a breather. Best of all, Susan showed me the way to a side door, concealed by trees and a tucked away around the corner from the ambulance entrance. It was the only door hidden from security guards and cameras, and a great place to step out and get a breath of fresh air. It became my haven to wake up and recharge.

It also became an impromptu church. I felt–for no solid reason–that God could not hear me in the CCU–all the walls and machines were squelching my silent prayers. Outside, I could talk to him–man to God–by looking up at the stars and asking him why.

Even outside, looking up at the stars, I never got an answer I liked very much.

Susan and I built a relationship on repetition. I’d ask the same questions every time I came into the room, and she’d give me the same answers. When she got tired of answering, she showed me how to read the machines–what the numbers and the beeps meant, and how I could interpret the meaning. “Okay, Brian, here’s the thing. If that red LCD number starts going up and down more than 10 degrees, call me. We want his temperature to gradually go down, so it should stay steady at around 104–if it gets higher than 106 and stays there for a minute or more, call me.”

“All right–what if it goes down under 100?”
“It won’t.”
“Do you see that machine on the other side of the bed? That gauges you Dad’s blood pressure–because he’s had a history of high blood pressure and cholesterol, we’re watching that like a hawk. Right now, his pressure is pretty good–if it starts changing, call me.” I was set. Not only could I sit in the room for as long as I liked, but I also got to do something useful–or at least feel useful.

“Susan, his temperature is staying at 105–is that okay?”
“Well, we’d like to see it come down. I’ll be in to give him some Tylenol in a minute.”
Sure enough, the Tylenol would cool him down to 103–for me, that meant we had a safety margin, but to Susan, that meant that his infection was not going away. From that point on, every tick of the machine, every change in a number sent a wave of panic through me. But I held on, and it would always come back to where it had been all along–no change for better or worse. In the ultimate battle of tug-of-war, Dad was fighting the grim reaper to a draw.

“When his temperature starts staying at 100 or 101, call me in,” Susan said. All night, the temperature reading had never gone that low. “When it does, that will probably indicate that his infection is going away.” That was the key–to fight back the mysterious infection Dad had somehow developed in his back. To make matters worse, no one yet knew what it was, so they were pumping his body full of Tylenol and antibiotics to kill off whatever it was. I sat next to Dad and looked at him. Man and machine–with the machines doing all the work of living. There was a tube for food, one for aspirin, one for medicine, one for oxygen. The machines hooked up to his arms were all around the sides of the bed and over his head. With all this technology, how could he fail? Everything his body needed, they could put into a bag and feed him through his veins and up his nose.

Not very dignified–but it worked. The machines could not do the one thing that was most important of all–that was up to Susan. She would drop by once and awhile to see how things were, and every time, the first thing she did was put a cool hand, ever so gently, on his forehead. Then she’d get a wet, soft cloth and wipe down is face.

And I could almost see him smile.

Looking back, I don’t think the medicine, aspirin or any other modern contraption had as much to do with Dad’s condition improving as a gentle, caring hand and a wet, soft cloth.

—

Even though I had prepared for it, prayed for it, sat around and waited for it, it still took me by surprise. One minute, it’s the usual drill–the next thing I know, Dad’s staring at me with eyes as big as saucers and a strange smile lighting up his face.

“Dad! Are you awake?”
No answer.
“Can you hear me?” Nothing but silence, and those big eyes staring right through me.

“Susan!”

Dad is beginning to come out of it. The eyes, the body movement–little by little, he’s acting like he has something to say, and it’s agitating him that he can’t get the words out. “Grab his hand, Brian, and start moving it,” Susan said. “Gently, now, your father doesn’t have much strength. Just keep it moving, and keep talking to him.”

“He’ll come through.”
Sure enough, he starts to whisper–just barely–soon after Susan’s shift was over. As she was leaving ,she took me by the side and told me–one final time–to go home. “Look, Brian, I left instructions for the new nurse to call your Mom–and you–if anything happens. You really ought to at least consider going home and going to bed.”

For the first time, it actually sounded like a good idea.

The nurses on the morning shift are different. While friendly in their own way, they’re much more business like and professional–but they had to be, for the horde of specialists were due in at any minute, and everything had to be perfect. Despite their cries, the patients were all scrubbed–so as not to offend the sensitive palate of a passing doctor. The rooms has to be tidy–no tissues or clothing out of place, nothing to get in the way of their important work. Patients were trapped inside beds tightly tucked and straightened, and everybody, even us, went on the strictest visitor rules.

For Dad, the specialist was none other than the esteemed Dr. Rau. He had justly earned the reputation as a sour and sullen man–and one of the very best Oncology specialists in Orange County. For Mom and the girls, it was a good and bad deal: they had the best working hard to save Dad’s life, but unfortunately, the best had an ill and stiff bedside manner. Rau was not prone to bend rules or hedge the truth a little–you got it straight and bitter, no sweetener with which to help get it down. He was here to do a job, a thankless, despairing job. As such, he was a thankless, despairing type of man.

His first job was to tell us when Dad was going to die. For Oncology specialists, that’s what it boils down to: trying as hard as humanly possible, then shaking your head and walking away when as hard as possible isn’t good enough. The odds are not good, and if Rau saves just one of his patients, he’s a tremendous success.

We’re thinking his one patient has got to be Dad. We just can’t convince Rau of that.
“So, all we’ve got to do is get the fever down, and then Dad can start chemotherapy, right?” Carole is trying to understand what’s going on, and trying to read into what Rau really thinks.

“Well, it’s not that simple,” Rau says. “Your Dad has an infection, and we don’t know what it is yet. We’re hoping that the massive doses he’s received all night have helped, but your Dad is old, and we didn’t catch the Leukemia until the late stage. We’ve got quite a bit to do before we even consider chemotherapy.”

For all of his grave airs, there was one thing about Dr. Rau that no one could ignore: his large and shiny melon of a head. When he frowned–he did that a lot–and even on the rare chance when he smiled, the skin on top of his forehead would wrinkle up like the skin on a nose.

Which was exactly what his head was doing as he told Mom what Dad had to live for. “Should he survive this crisis, the treatment for Leukemia and the side effects of chemotherapy might kill him.”

“Well, I don’t see why you’re telling me this now. It’s not as if we have a choice,” Mom shot back at him.

“I’m just letting you know exactly how it is.” He droned on or awhile, trying to convince everyone things weren’t quite so sunny. That there was a long road to go, and most of it was fraught with valleys and pitfalls.

All we could think about was standing on the mountain with a rehabilitated Dad.
“I know you want me to tell you everything will be better,” Rau said. “But I can’t, and you must know what you’re facing. Chemo is very powerful and very dangerous. It’s basically about wiping everything out and starting over again, with new blood cells.”

Something about what Rau was saying irritated the hell out of Dad. As he lay on the bed completely helpless, listening to his stuffy doctor tell his wife about spinal taps, blood transfusions, chemo and the unlikely chance that he could be one of the few that made it, we could see him start to fume.

“Now Sheila, you’ve got to understand what will happen here, if Rich makes it out of this,” Rau said in his sternest school teacher tone. “If he makes it to treatment, he will be constantly suffering from nausea, will probably become sterile, and will definitely lose all of his hair.”

“At least mine will grow back.”

With that, the wrinkles on Rau’s shiny, sweaty head got a little deeper. Dad was on his way back.

 

Chapter 3