Parkview Hospital
Riverside, California
The ambulances pulled up in front of the emergency room, sirens still wailing. In moments, the paramedics had unloaded the gurneys from the ambulances and were wheeling them inside. One of the drivers carried Lizzy in, wailing but unhurt.
Quickly, doctors and nurses surrounded the new patients, wheeling them into the back for examination and treatment. There was no time for paperwork or to obtain their charts, but fortunately Jack was lucid enough to inform one of the doctors that their usual medical care was conducted at Riverside Medical Clinic, which was affiliated with Parkview.
Everyone was taken into the treatment area of the emergency room, even Lizzy, in spite of her lack of outward injury. Sometimes internal injuries couldn’t be diagnosed without an examination. For the others, the emergency was obvious, but Lizzy was also brought in immediately anyway. In most cases, less severely injured or ill patients had to wait until the more severe cases were taken care of, but Lizzy had no supervision and couldn’t be expected to watch herself, especially under such frightening circumstances, so she was brought in immediately, if only to keep her safe.
*****
Jack stood beside the X-ray table, extending his painful arm for X-raying. His jaw had also been X-rayed, though he had a feeling that it wasn’t broken, since he could speak clearly enough and move it.
The technician finished the X-rays and nodded to Jack, indicating that he could go back the tiny emergency room cubicle he had been assigned to.
Once there, he sat down on the bed, waiting for the doctor. He was feeling better now, his head clearer. He was almost glad for the pain in his jaw and arm—it gave him something to think about besides his worry.
Where were Rose and Paul? They’d both been badly hurt in the accident, or at least it had appeared that way to him. He hoped that appearances were wrong, that they weren’t as badly injured as he thought, but Paul had made no response to anything during the ambulance ride and had had to be intubated so that he could breathe. Rose had needed the Jaws of Life to extract her from the mangled car, and when he had tried to get her attention before that, she had been too stunned and confused to answer him.
At least Lizzy seemed to be all right. They had her to thank for calling 9-1-1 and getting the help that they needed. Rose had taught her what to do in an emergency, and Lizzy had learned it well.
But what if there was something wrong with her? Some insidious internal injury that hadn’t been immediately apparent? Internal injuries could be more dangerous than external ones sometimes.
Jack continued worrying until the doctor came back in with his X-rays. Looking up at him, he braced himself for the news of whatever was wrong with him.
"Mr. Dawson, I have your X-rays here," the doctor told him.
"What do they show?"
"Your lower arm has a small fracture." He showed Jack the X-ray, pointing it out to him.
Jack nodded. "What about my jaw?"
"Just badly bruised. I’m going to prescribe you some anti-inflammatory painkillers and have that arm put in a cast."
Jack nodded, glad that at least it was his left arm that was broken, not the right one, which he needed for drawing and writing. And his jaw was only bruised, so it would be okay, also.
"How long should it take to have the cast put on?" he asked. "My wife and kids were in the accident also, and I’d like to see how they are."
"That depends upon how cooperative you are and how fast the cast sets. I suggest we take care of that immediately."
Jack nodded, once again leaving the cubicle.
*****
Rose lay on the narrow emergency room bed, an IV attached to her arm. The other arm had been put in a sling after her dislocated shoulder had been treated. It hurt, but she had been given some mild painkillers, which helped the shoulder as well as the pain from the ugly bruise on her forehead, sustained when she had hit the dashboard. The airbag had failed to work, making things worse for her, but at least she would be all right once she healed.
What couldn’t be helped, though, was the grief and anguish she felt inside. She turned her head away, trying to hide her tears, as a nurse came to check on her.
Her injuries hadn’t been as serious as she had feared, but they had been sufficient for her body to let go of the new life she was carrying. She had never miscarried before, and while the pain had ended and the bleeding had been stemmed, she was still grieving for her lost child, for the little person who had never had a chance to be born.
The whole event had been painful and terrifying. First the collision, and the sound of sirens in the distance. Then the Jaws of Life ripping the door away, and the paramedics taking her from the car while Lizzy screamed. Then the ride to the hospital, sirens blaring, and the agonizing cramps in her lower abdomen, and the flow of blood—so much that she had needed a blood transfusion when she got to the emergency room. She had known that she was losing the baby, but she hadn’t quite believed it until the doctor examined her and confirmed what she already knew.
She tried to console herself. Helga was right; it was healthier to wait longer before having another baby, at least until Paul was weaned. Maybe there would have been something wrong with the baby anyway, and that was why she lost it so easily. She and Jack had only planned on having two children anyway.
But all the logic in the world couldn’t change how she felt. Her unborn baby, her child, had died, and she had never had a chance to hold it, to care for it, to get to know it. Maybe it would have felt worse if she had, maybe she would feel worse if it had been Lizzy or Paul that had died. She didn’t know.
She couldn’t lie to herself. They might not have planned on having a third child, but if she had really been set on not getting pregnant again, she would have gone to a pharmacy and gotten the morning after pill when they forgot to use a condom. To be sure, she didn’t want to expose Paul to the extra hormones, but she could have fed him formula for a few days while pumping and throwing out her own milk so the supply wouldn’t diminish.
Rose closed her eyes, pretending to be asleep, as someone entered the cubicle and came to stand beside her. She didn’t want to talk to anymore doctors or nurses at the moment. She wanted to be allowed to get up and go to her children and husband, but she knew that she was supposed to be resting and wouldn’t be allowed to go anywhere.
She opened her eyes, though, when someone touched her arm. "Rose."
She looked up into Jack’s worried face and immediately sat up, ignoring her painful shoulder and the IV in her other arm.
"Jack!" She threw her good arm around him, yanking painfully at the IV. "Jack! Thank God! I was so worried about you."
"I’m going to be okay, Rose. I just have a broken arm and some nasty bruises." He touched her tear-streaked face. "What about you? What did the doctor say?" He looked at the bruise on her forehead and the sling on her right arm.
"I’ll heal. I have a minor concussion, but it’ll get better. My shoulder’s dislocated, but it’ll heal, too. But…" Her eyes filled with tears again.
"What is it, Rose? What’s wrong?"
"Jack, I lost the baby." Her words ended in a sob, and she put her head on his shoulder, crying uncontrollably.
"Oh, Rose. Rose, I’m so sorry." He put his arms around her, rubbing her back and rocking her gently.
"I should be able to have more babies later, if I want, but…but I wanted this one."
"I know, Rose. I know. I wanted it, too. At least you’re going to be okay, though. That’s something."
They stayed that for several minutes, just hugging and trying to comfort each other, until another doctor stepped into the cubicle.
"Mr. Dawson?"
Jack looked up. "Yes?"
"We need to you to come up to pediatric intensive care. It’s about your son…"
"What about him?" Rose demanded, pulling out of Jack’s embrace and looking at the doctor. "What’s wrong with him?"
He hesitated. "Mrs. Dawson…it’s very bad."
"I’m coming, too." She began to move off the bed.
A nurse who had followed the doctor in rushed to her side. "Mrs. Dawson, you need to stay here."
"No!" Rose got to her feet, reaching for the IV pole. "My baby is hurt, and I’m going to see him, if I have to crawl to get there."
Seeing that there was no dissuading her, the nurse sighed. "Mrs. Dawson, please sit down. I’ll bring you a wheelchair."
Rose sat back down on the edge of the bed, looking at Jack with a stricken face. What was wrong with Paul? How severe were his injuries?
When the nurse brought a wheelchair, Rose sat down in it quickly, wanting to get to her son as soon as possible.
*****
When they reached pediatric intensive care, there was no keeping Rose in the wheelchair. Grabbing Jack’s arm for support, she hurried forward, dragging the IV pole with her.
Paul lay on a tiny bed, hooked up to a respirator. Rose’s face paled at the sight of him, lying there so still and silent. It was like the time that Jack had been injured and had gone into a coma. But this was worse. Even without medical training, Rose could see that it was worse.
Half of the baby’s face was smashed, the bandages only partially hiding it. If he survived, he would need extensive plastic surgery to repair the damage. His head was also misshapen by the blow, leaving one side looking oddly flat.
Rose looked up at Jack, who was also staring at their son, fists clenching the rail that kept the baby from falling out of bed. At last, he looked away and turned to the doctor.
"What’s the prognosis?" he asked, trying to keep his voice steady.
The doctor hesitated. "Mr. Dawson…"
"Just tell me what it is."
"He’s had two negative EEG’s. Examinations show no blood flow to the brain. I’m not sure if you know what this means…"
"It means brain death," Jack replied, clutching the rails on the bed. "I’ve studied the brain enough to know."
"Then you also know that it’s…irreversible."
"Yes."
Rose knew what it meant, too. She had spent enough time studying with Jack to have picked up some of what he was learning.
"No!" She moved toward the doctor. "There must be some mistake. He’s just a baby. Babies’ brains aren’t as developed as those of older children and adults. How can you be sure?"
"I can show you the EEG’s."
"Yes. Show us. Jack, you know about the brain. What’s your opinion on this?"
Jack looked at the EEG’s, trying to find some sign that the doctor was wrong, that there was still some brain activity in the baby, but the EEG’s were completely flat, showing no sign of brain waves.
Still, he grasped at straws. "Did you medicate him at all? Were Phenobarbital or other mind-altering drugs administered?"
The doctor shook his head. "No, and blood tests for those substances were negative. They hadn’t been administered any time within the last twenty-four hours."
"I don’t think they’ve ever been administered," Rose spoke up. "Just antibiotics, cough syrup, vaccines, and baby Tylenol. That’s all he’s ever been given. I haven’t taken any drugs myself, either, so he couldn’t have gotten them through my milk."
"And those wouldn’t cause a negative EEG." He looked at the stricken parents, clinging to each other for comfort. "I’m sorry."
Rose turned back to her son, reaching to touch a tiny hand. He didn’t respond.
"Oh, Paul…" Her eyes filled with tears again. "My baby. My little boy."
Jack stood beside her for a moment, one arm around her, the other hand reaching to touch the baby’s face, careful not to let the cast bruise him.
"Jack," Rose whispered. "What are we going to do?"
"There’s nothing that we can do, Rose. He can’t live without brain function. The only reason that his heart is still beating is because of the respirator. It provides the oxygen needed to make the heart beat. When it’s stopped, his heart will stop, too."
"And there’s nothing that anyone can do for him." Rose’s voice was flat and dull.
"No. I wish there were. Even if the technology existed to transplant a brain, or grow a new one, it wouldn’t be Paul. It wouldn’t have his memories or personality, and it wouldn’t know us. Basically, he’s dead."
"No." Rose looked down, tears falling on the infant. "It’s not right. He’s just a baby. He hasn’t even lived a year yet." With a sob, she pulled away from Jack and began pacing the small room. "It isn’t fair. How can he be dead? The driver of the other car…I found out what happened to him. He walked away. He walked away. He wasn’t injured at all. In fact, he blames us for wrecking his car. He was drunk, and he hit us, and he wasn’t even hurt! And Paul’s dying! He’s just a baby, and he’s dying! And we’re hurt, and I lost my unborn baby! Why did this have to happen? Why? "
Jack strode across the room as she stopped, leaning against the wall in anguish. "I don’t know, Rose. Nobody does."
His voice broke. Rose stepped away from the wall, embracing him as a tear ran down his face. "Oh, Jack…"
"We have to make a decision, Rose. We could leave him here, on life support, but he won’t get better. Or, we can have him taken off the ventilator, and…let him go." He could hardly get the words out.
Rose buried her head in his shoulder. "I don’t want to let him go."
"He’s dead, though, Rose. Leaving him on life support…would only keep him going for a while. He’ll never move, or make a sound, or anything. He’ll just…lie there."
"I know." Rose returned to the baby, holding his tiny hands. Mouth trembling, she decided, "We have to let him go. It isn’t fair to him to keep him here when his life is over. If we let him go…he can go to be with his great-grandfathers, and your parents, and my father. He won’t…be alone. Maybe he’ll even have his little brother or sister with him."
"All right." Jack put his arms around her, looking at the still, silent infant.
The doctor, having overheard their words, stepped forward. "If you will sign these papers, please…"
Rose took them, looking at Jack, who was leaning over the bed, stroking the baby’s hands and feet while his tears fell on the sheet. She quickly looked the papers over, and was about to sign them when another thought occurred to her.
"Doctor?"
"Yes?"
"Aside from his head, how badly is he injured?"
"It’s just the head injury, and some minor cuts and bruises."
Jack looked up at her. "Rose, you can’t be hoping…"
Rose shook her head. "No. I know that there’s no hope for him. But…could he be an organ donor? He was a healthy baby, up until now. Maybe some other families won’t…won’t have to go through this…if their sick babies can use Paul’s organs."
Jack started to object. He didn’t want anyone to cut the child open and remove his organs. Then he stopped. Rose was right; Paul’s organs might save the lives of other children, and the baby certainly didn’t need them anymore. And once he was buried, everything would rot away anyway.
"Go ahead," he told them.
They signed the forms, including the ones for organ donation, and then stepped away as the doctors placed cannulas in the baby’s blood vessels to cool his organs. As the doctor was about to disconnect the respirator, Rose returned to him.
"Can we at least hold him one more time?" she begged, looking at Paul. Maybe he couldn’t know what was happening, but she wondered if there might be a consciousness beyond the brain, and even if there wasn’t, and he truly didn’t know what was happening, she and Jack did, and they wanted a chance to say good-bye.
"Sure." The doctor disconnected the respirator, then lifted the baby and placed him the arms of his waiting parents.
Rose pulled off the sling and took him in her arms, rocking him gently. Jack sat beside her, his arms around both her and the baby, holding the baby’s little hands for the last time.
Rose clung to the infant, whispering brokenly to him.
"Paul…Baby Paul…we love you so much. So much. Remember that. Always remember that. You’re going on to a better place, where there aren’t any car accidents and nothing ever hurts. We won’t be there…not for a long time, I hope…but there’s people there who love you and will take care of you. Your great-grandpa thought the world of you, and he’ll be there for you. And there’s other people that you’ve never met who love you, too. Your daddy’s parents are there, and so is my daddy, and so is my grandpa, who died before you were born. There’ll be plenty of people who love you and want to see you. Your daddy’s parents always wanted another baby, so now they’ll have you to love and take care of…"
She stopped, hugging him close. "You go now, Paul. We’ll miss you, but just remember that we’ll always love you, and we’ll see you again when it’s time."
"Rose." She glanced up at Jack. "Rose, he’s gone." He pointed to the heart monitor, which had gone flat.
Rose clung to the baby, refusing to let the nurse take him away. "No…not yet. Just a little longer. Please."
"Ma’am…I have to take him now if you want to donate his organs."
Rose shook her head, setting her trembling mouth and scooting away. "No. You can’t have him."
The nurse looked at Jack, unsure of what to do. He nodded reluctantly, giving her permission to take the baby.
She had to pry Paul out of Rose’s arms. Rose clung stubbornly to him, not wanting to let him go. When the nurse finally succeeded in taking him away, Rose sat in shock for a moment, then leaped to her feet, unmindful of the fact that she tore out her IV, and chased after her.
"No! Give him back! You can’t take him yet! I want him back!"
Jack caught her, holding her back as the nurse hurried from the room. "Rose, stop. You have to let him go."
"Let go of me, Jack. Let go of me! Can’t you see what she’s doing? She’s taking our baby away!"
"Rose, he’s dead, and they’re going to do what you wanted."
"I don’t care! I want him back! Jack, he’s only a baby. He can’t be dead. He just can’t be."
"He is, Rose. I wish to God that this hadn’t happened, but it did."
"You don’t care at all, do you?"
Jack stared at her, mouth hanging open in shock. "Yes, I care! I love him with everything in me. I’d trade my life for his if I thought it would bring him back, but it won’t! Nothing can."
Rose pulled away and headed for the door. She hadn’t gone three steps when she collapsed on the floor, sobbing.
Jack sat down beside her, pulling her up and holding her close.
"Jack, I’m sorry. I shouldn’t have said that."
"It’s okay, Rose. You’re…upset. We both are."
"I know. Oh, Jack, I can’t believe he’s gone. He was so little, and he’ll never grow up, or enjoy all the things that life has to offer, or go to school, or play…it’s all over, and he hardly had time for anything."
"You were the best mother he could have asked for, Rose. You gave him so much."
"I wish I’d had more time with him."
"You carried him inside you for nine months. You were with him every day for hours. You loved him and cared for him. He adored you. What more could you have given him?"
"I don’t know. I never thought this would happen. Things like this don’t happen in real life—they’re something you read about in the newspaper, or see on television. It wasn’t supposed to be this way."
"I know. I know."
Jack couldn’t think of anything else to say, so he just sat on the floor with Rose, holding her close and stroking her hair.