The Day It All Changed

It was the weekend after Thanksgiving. Our family was loaded up in the van and we were headed out for a day trip to meet some friends at a waterpark. It was a mild day, but we’d thrown our coats in the back of the van along with our towels and swimsuits just in case. I had bags of snacks and piles of books. The kids were in good moods, and were all reading. Samuel, our youngest, was finally big enough to move out of his 5 point harness car seat into a booster seat. This meant he could sit in the very back of the van now, and he’d been enjoying this privilege for the past week. He loved feeling big, and I loved that he could fasten his own seatbelt. Jana, in third grade, had a stack of five chapter books on her lap.  My book lover, with enough books to read for two solid days. Michael, our middle child, was lost in a Star Wars story, and muttered light saber sound effects as he read. The background noise of my life. Jeremy and I chatted in the front seat.

We pulled up to an intersection and stopped at a red light, the last in a row of several cars. As the light turned green, Jeremy glanced in the rear view mirror and gripped the steering wheel. “Too fast!” he shouted. We lurched violently.

“Jeremy, are you OK?” I was shaking, panicked. What just happened?

“We have to get the kids!”

“But are you OK?” Were we just in an accident?

“Oh God, the kids!”

He wouldn’t answer my question.

Behind me I saw Michael and Samuel, both unconscious, heads hanging. Jana looked dazed and was slowly nodding her head up and down as if she was trying to stay conscious. Blood started to cover her face as I watched. She touched the blood with her fingers and looked at it.

“It’s OK honey, it’s just a bloody nose. You have a bloody nose, but you’re going to be OK.” My voice was unsteady. Her head drooped. We were deep in the ditch between the lanes of the highway. What just happened?

Jeremy somehow climbed into the back of the van. He held Samuel’s head up, but couldn’t move him because his legs were trapped and he was stuck in his booster seat. “Oh God, oh no, please, save my children.” Jeremy was praying.

Someone was talking to me through the window.

“My kids, my kids are in the car! Call 911!” I told him frantically.

Michael regained consciousness and started to wail. My seat was leaning strangely back, reclined almost all the way to his seat behind me. The space inside the car was all wrong, scrunched.  I unbuckled him and pulled him onto my lap. “It’s OK, we’re going to be OK,” I tried to reassure him. I kept shaking.

Then there were a lot of people. Police officers, firefighters, concerned drivers. Trying to open the van doors. Trying to get in through the back. The EMT’s came with a backboard, and someone was taking care of Jana. I was still confused, what happened? Get the kids out of the car, they are scared! Shhhhh, Michael, it’s going to be OK.  My head hurts.

Somehow my phone was right there. I called one of our friends. “Hey there!” His cheerful voice didn’t fit. “Chris, we’ve been in an accident. Samuel’s unconscious. Please tell the church to pray!” I didn’t know what hospital we were going to.

I think they got Jana and Samuel out of the car first, but I don’t remember how they did it. A firefighter took Michael off my lap and put him on a backboard. They secured a neck brace under his chin. Another firefighter helped me out of the car, and pulled me up the steep grassy embankment to the road. Cars were lined up as far as I could see, and a lady was sitting by one of the firetrucks, wearing a neck brace. She must be from the car that hit us. I turned and stared at our van. The back third of it was crumpled into nothing.

Jeremy was distraught and sobbing, but we were pulled in different directions. I went with Michael into a firetruck, and Jeremy was talking with the police. They started an IV on Michael, and handed him a little stuffed horse. He was shaking too, and his eyes were wide and scared. Three helicopters landed on the road. I listened to the discussion, which hospital was best equipped to handle these injuries? The first two helicopters took back off, and then Michael and I were led to the third. Someone put headphones over my ears and snapped my seatbelt harness as if I was a child. Jeremy would ride to the hospital with the police.

I couldn’t stop shaking, but my head was calm and detached as we took off. I tried to see the helicopters carrying Jana and Samuel ahead of us, but I couldn’t. From the air I could see the traffic was backed up forever behind all of the emergency vehicles and flashing lights. The land was beautiful beneath us. It should be nice to see the countryside from the air like this…farms, woods… Something inside me said I should be really scared, all my kids were being flown in helicopters, not to the nearest hospital, but to the best trauma center. But I couldn’t feel worried about it. Instead I remembered stories of medical helicopters crashing, killing everyone on board. But I couldn’t feel worried about that either. The sound of the helicopter was loud and somehow soothing, reverberating in my head. Farmland turned into apartments and traffic, and I tried to identify the roads we were over. Soon we were circling the hospital.

We landed, and someone guided me by the arm under the chopper blades, across the landing pad, into the hospital. I think I went to Michael’s room first. The peace of the helicopter was gone. He was surrounded by busy staff so there wasn’t space for me to go next him. Someone asked for an insurance card, and I made sure a nurse knew that he couldn’t eat any gluten or dairy. I told them he was celiac, just to be sure they would take it seriously. Then I was taken to see Jana in the next room. She was also surrounded, so I stood back, watching, numb. She started vomiting large amounts of blood. I noted that the staff cleaned it up in seconds, impressive. But deep panic grabbed me inside, and for the first time a sense of seriousness pushed through the numbness. Something is really wrong, she’s really hurt. She’s bleeding internally. Someone, a doctor, or nurse, came beside me and said that vomiting blood is common when you have a broken nose, they see it all the time. The blood drains into the stomach, causes irritation, and then you vomit. I wasn’t reassured.

More business. People everywhere. Where was Samuel? Jeremy arrived. Really quickly, actually. The drive should have taken over an hour, but he got there shortly after I did. How fast did they go? He was upset and scared, while I stayed calm (strong, they said, but that’s generous, it was really shock). Soon we were putting on heavy lead vests to watch the kids have CT scans, and then Jeremy was whisked off to his own CT scan when he admitted that both his head and his leg were hurting. The doctor said something to me about Jana having a facial fracture near her eye, not a broken nose. An ophthalmologist came by to see if her injuries were threatening her eyes, and they were not. Maybe she would need surgery to repair the fracture, but they weren’t sure. And really, where was Samuel? They weren’t letting us see him, and this was significant, but I pushed it away. I couldn’t think about that now.

Some friends arrived.  Our pastor came, and friends from Bible study.  I remember feeling sad I pulled all these people away from their families and Thanksgiving leftovers. I think at one point I handed my friend Kelly a styrofoam container with an uneaten sandwich. Otherwise I don’t remember much of what they did or where they were.

One by one the kids were moved out of the ER. Michael was taken to a regular pediatric unit. He was still wearing the neck brace, had a concussion, and had thrown up. But nothing was broken, and he was stable. He was most unhappy about a little scratch on his chin. He was going to be OK.

Samuel and Jana were moved to Pediatric ICU.

We had not seen Samuel since he was pulled out of the van. Around 3pm the PICU doctor found us and invited us into a little windowless room with sad walls the color of masking tape. He was kind and gentle. He explained that they weren’t sure what happened, but that Samuel’s brain had been deprived of oxygen for some amount of time. They couldn’t find any specific injury to explain the lack of oxygen, but somehow it had happened. He was still unconscious, and on a ventilator. They put a probe into his brain to measure the pressure, the amount of swelling and pushing of his brain on his skull. Normal pressure is low, below 10. Samuel’s, he said, was at 70. He said there was very little they could do, but wait and see what would happen. They were going to keep his body temperature low, as that might help his brain respond. They would support him as much as they could. But there were no interventions to cure his brain. Sometimes the brain pressure peaks and then decreases, and brain functioning begins to return. We would wait and see. His eyes filled with tears and he shook his head slowly. “I’m so, so sorry”, he said.

Jeremy and I were strong. We cried, but we clung to hope. I reminded Jeremy of a man we knew who had a horrible brain injury just a year earlier, and he’s now fine. How awful that this was happening, but this was going to be God’s stage for a spectacular miracle. Tomorrow, or maybe the next day, Samuel would start breathing easy. His eyes would open, and he would be happy to see us. And everyone would know how it wasn’t the doctors or medicine, but God had reached in and healed our baby. And maybe we’d have some changes to make at home, supportive services for him, or something like that. Wheelchairs, physical therapy. No problem. We would take care of him no matter what. My biggest fear was that the injuries would take away his clever and curious mind.

Then we were allowed to see him. The first thing I noticed was the brain probe. It looked like a large bolt and screw sticking out of his head, right above his forehead. It was horrible. They had to drill through his skull to put that in. This is serious. I pushed the thought away, the numbness wasn’t ready to let go. The rest of him looked peaceful. He didn’t have any visible injuries or bruises. He was only wearing a diaper and a neck brace, and not covered with blankets. They were keeping his body cool to help his brain swelling go down. I think he was laying on cooling pads. His hands were cold, and felt like death. Click, swoosh, click…the ventilator was soft and rhythmic. He was hooked up to about 12 different monitors, all with buttons and blinking lights. If he was awake he would have loved them, would have tried to be good and not touch them, but his little fingers would have reached for them anyway. He couldn’t resist buttons and lights. But he wasn’t awake. He was very, very still. Click, swoosh, click… Eyes closed, sleeping. So cold.

Jana was settled into her room in the PICU. She was also in a neck brace, and we were told her injuries were more severe than they had discussed in the ER. She had a fractured skull, and not one, but multiple facial fractures (I asked how many, and the surgeon said “imagine how a glass shatters”). The bone holding up her left eye was crushed.  Her eye was swollen shut and bruises were now spreading across her face. The doctor in the ER had stitched a small gash on her cheek, but it still dripped blood. Somehow she didn’t need any pain medicine. They were concerned because her internal facial injuries were bleeding and that blood was pooling on the lining of her brain, so they came to check on her every hour. “What’s your name honey, do you know where you are? Do you know what happened to you? Squeeze my fingers. Sorry to do this, but I’ve got to open your eye and shine a light. There, all done. You did great. You are so brave.”

Night came, and we settled in. The kind doctor arranged for Michael to be moved to an empty PICU room, even though he didn’t need that level of care. That way all three kids were on the same hallway, making it easier on Jeremy and I. Our friend Leah slept in Michael’s room so he wouldn’t be alone. Jeremy stayed with Samuel, and I stayed with Jana. Our other friends went home.

Jana tried to sleep between neuro checks, but was restless. I sat in the chair next to her all night long. There was a couch in the room, but it was behind her bed. When she woke up, afraid, she couldn’t see me laying on the couch. So I stayed in the chair. She became more and more irritated at the neck brace as the night went on, sleeping only minutes before trying to move and waking up, agitated and afraid. And every hour the nurse would come in, shine lights in her eyes, ask her questions, take her pulse. The minutes crept by. I slept a little with my head resting on the edge of her bed.

Sometime in the middle of the night she seemed to be in a deeper sleep. I took the risk of leaving her and went to check on everyone else. The night staff chatted quietly, ignoring me either because it was 2:30am or because I was that mother and they didn’t want to make eye contact. I don’t know which. I remember the floor was cold under my socks, and some removed part of my brain vaguely told me I shouldn’t be walking around a hospital without shoes on. Michael’s room was dark, and he was sleeping. There were more lights in Samuel’s room. Jeremy was wrapped in a blanket, asleep, on the couch behind Samuel’s bed. A doctor I hadn’t seen was there with a nurse, making some adjustments to the array of monitors, machines, and I don’t know what. I talked to him about something. Click, swoosh, click…

And then he said it. “No one would blame you at all if you pulled the plug right now.” I think I just stared at him. And then I stared at Samuel, trying to blink back the tears that came anyway. It felt wrong to cry in front of that doctor. He was clinical and harsh and spoke of Samuel as if he was pointing out a cheap broken toy that needed to be thrown away. Horror ripped away the numbness, but grief was messy and out-of-place in this doctor’s antiseptic presence. I wanted him to leave, but he didn’t. So I turned and fled, past the averted eyes of the night staff, back to Jana’s room.

I couldn’t breathe. Someone had driven a knife into my heart, surely this was a real knife in my heart. The words of hope the kind doctor had given us that afternoon, they were empty. They were the 1% chance of hope. Or less than that. There really was nothing they could do for Samuel. His chest was rising up and down with the click of the ventilator, but he was not coming back. 24 hours earlier we were warm and safe and comfortable, sleeping in our beds at home. Turkey leftovers in the fridge, pumpkin pie half gone. 18 hours earlier the kids were putting on their swimsuits and picking books for the car ride, so excited to spend the day with friends at the waterpark. It just didn’t make sense, it didn’t seem real. I think if I had been anywhere else I would have screamed. But there was Jana, restless but eyes closed. I sat on the floor and sobbed silently into a pillow instead.

Sometime towards early morning Jana’s pain started. It took the nurse about an hour to get approval from a doctor somewhere, and then they could give her something. Morphine. And finally she slept.

There wasn’t any morphine for my heart.