A little crust has formed overnight on Vivian’s eyelashes. Her nurse is clearly busy with the code down the hall, so Taylor takes a washcloth and wets it, applies it gently to remove the debris. Then she moves the cloth to Vivian’s arm to softly scrub off the tape residue from what looks like a previous IV attempt.
Taylor rinses the cloth and then continues to sponge-bathe Vivian, careful not to provide too much stimulation as to increase her intracranial pressure. The most important thing in a traumatic brain injury is to simply allow the brain to heal. Though healing isn’t always guaranteed, even with time. Head injuries are tricky; the skull is a closed space, jam-packed with brain, blood, and cerebrospinal fluid. When the brain swells, it simply has nowhere to go.
The resident enters the room, pulling Taylor out of her thoughts.
“I put in some new orders,” he says.
“Oh, I’m not her nurse. I work in the ER; I admitted her. I, uh, I just came to check on her.”
“Oh, okay. Do you know who her nurse is?”
Taylor shrugs. “Sorry. There’s that code in 614, so maybe she’s helping in there.”
The resident starts to leave but then stops. “You said you admitted her?”
“Yeah. Why?”
The resident shakes his head. He’s young, with a round, boyish face that makes him look even younger than he probably is. “I’m just trying to understand. The paramedics said she was at a party, drinking, right?”
“Yeah, apparently she had a few and took a tumble down the stairs.” Taylor pauses, then adds, “She was even talking about champagne before she crashed.”
The resident scratches his head. “Okay.”
“Why do you ask?”
“Well, it’s just that her blood alcohol level was normal. She wasn’t drinking at all, or if she was, she already sobered up by the time she fell.”
Vivian
Present Day
Vivian is in a coma. She knows that now. She sits—or rather she lies—in a hospital bed whose motors vibrate as they gently rotate her side to side. It’s like being on a slow-moving roller coaster.
She’s never liked roller coasters.
“The bed moves to prevent ulcers,” a nurse explains to a student who comes in to observe.
Vivian also doesn’t like her that much. The nurse—not the student. This nurse chews gum quite loudly. It’s a pet peeve of Vivian’s, people who chew gum loudly.
Funny how she still cares.
But she does.I’m more than this, she finds herself thinking.More than this bed, more than this body.Her thoughts soar upward, outward, expansive, the gray mist surrounding her brain temporarily thinning. And then, she wonders:Am I high from the painkillers they must be giving me?
“TBI,” the doctors say, when they come to do rounds and stand in front of what she presumes is the door. Her door—aprivate one, no less. Though she supposes all rooms on this floor—the ICU, probably—have single beds. A prize for being the sickest.
The doctors and nurses utter “TBI” enough times that it finally clicks: traumatic brain injury. She remembers there was a patient with a TBI on the TV showHouse. Rachel likes to tease her that she acts like she knows medical lingo because she binged that show.
Vivian has always had a knack for details. As she congratulates herself for recalling what TBI means, given her state, the pain strikes with a sudden force. It’s a hot, searing pain that flashes in between her temples. It wipes her of any thought. When she comes to again, there’s another nurse on duty. It’s likely even another day.
This is her reality—if she can call it as such. It’s more of an in-between. She hovers inside her body, on the fringes of her brain, even. She climbs through the coils of brain tissue like mounds of a hill until they feel like squishy pillows upon which she must sink, sleep overcoming her.
She is asleep more than she is awake. She is hazy more than she is clear. But when the mist evaporates, she starts to remember. She takes stock of the haphazard memories that float around her and begins to reorganize them, putting together a sequence of events. It’s like the second-grade homework her goddaughter, Lucy, has to do at Locust Prep. The sequencing activities. The logic. What comes first. What comes next.
(1.) First the girl wakes up. (2.) She gets dressed. (3.) She eats breakfast. (4.) The girl unlocks the door. (5.) She gets on the swing set in the backyard. (6. 7. 8.) She soars upward. (9. 10. 11.) Outward. (12.) At the highest point on the swing, she spies another neighbor’s backyard, another swing set. (13.) The world, the girl realizes, is comprised of many, many backyards.
For seven-year-old Lucy, the door opens to a world just beginning. The door leads to nascent possibilities. Infinite possibilities. Each unique. A life not yet mapped.
But now, suddenly, the only door Vivian can recall opening is to the Knox.
