“You know on television, when someone wakes up from a coma, they are always perfect,” I mused. “Smiling and happy, as if nothing happened.” It wasn’t a question or even a declarative statement. Just a simple ironic observation. “Reality is a bitch.”
Declan sat next to me. His gaze, too, was on Rosie.
“But she’s awake, Kate. She’s awake. She wasn’t this morning, and now she is.”
I turned to look at him, and he met my eyes. He was correct, of course. I should be thankful. That thought alone brought me to tears. “You’re right,” I admitted. “You’re right.”
I squeezed Rosie’s hand. She turned her head ever so slightly in my direction and I waited for something more, but nothing came. Taking a deep breath, I worked to encourage myself just to be happy about that. That her eyes were open. That she seemed to know my voice, was aware that I was there.
Hearing light footsteps enter the room, I looked up to find Dr. Ryan approaching the bed with another man in tow. She introduced him—Dr. Franklin. He was from the neurology department, and the pair had been reviewing Rosie’s MRI. It seemed they had news.
“Should we go somewhere else?” I asked, suddenly concerned about what Rosie would hear and what she might think if they were delivering bad news about her condition.
Dr. Ryan smiled kindly. “There isn’t any reason to go somewhere else unless you would be more comfortable.”
In all honesty, I just wanted to be by my daughter’s side. So I told them it was fine to stay put. “So, what did the scans reveal?” I asked, steeling myself for the worst news.
Dr. Ryan turned to Dr. Franklin and communicated something with her eyes. Then she turned back to me. “Kate, I realize that this has been a challenge since day one—”
I put up a hand to stop her. “Really, I can handle this. Please don’t sugarcoat things for me, tell it to me straight. This isn’t the first time I have been through a living hell.” I swallowed hard. There was no reason right now to be anything but brutally honest—and I knew that this wasn’t the first time that Dr. Ryan had to deliver tough news, either.
The neurologist cleared his throat. “Well, Ms. O’Hara, it appears that Rosie’s brain was denied some oxygen during her seizures, which in turn caused some brain cells to die. This usually only takes a few minutes. Ultimately, when the brain is denied oxygen, there is a disruption of the transmission of electrochemical impulses, which impacts the production and activity of neurotransmitters. These regulate many cognitive, physiological and emotional processes. So while Dr. Ryan’s original concern about Rosie having experienced a hypoxic brain injury is true, her brain wasn’t completely denied of oxygen, so that’s a positive.”
I nodded, trying to digest his words. “So what does that all mean, now that she’s conscious? Can we correct the damage that has occurred?”
I knew a little about closed head injuries and brain injuries. Just a little. I knew that you could work toward recovery, but it was hard and a very long process. And there were no guarantees. I remembered several cases throughout my career: some brain-injured patients had been working to regain their full faculties for years.
Dr. Ryan took a deep breath, but Dr. Franklin stepped in again.
“Unfortunately, it’s hard to predict at this early stage. It simply comes down to a waiting game to see what functions Rosie recovers and what progress she makes.”
I ran my hands through my hair and considered this. “But we at least know that she’s responding, talking, even?”
Nodding his head in agreement, the neurologist said, “Yes. That’s part of it. But this is about more than simple cognitive functions like speech or vision. We also have to consider that Rosie may suffer some...physical disability.”
This caused me to swallow hard. “Meaning?”
“Meaning that she might not gain full function of her arms and legs and may even experience spastic movement or rigidity. Additionally, because of the correlation between cognitive function and coordination or learned movements, she may well have forgotten everyday tasks, like tying her shoes or how to brush her teeth.”
In that moment, I had a burst of memory of Greg and me teaching Rosie how to tie her shoes, only a few short years ago. She had learned to do that once; I knew I could help her learn how to do it again. I was determined to be positive.
“So just relearning some skills. I understand.” I nodded thoughtfully. That didn’t sound so bad. My girl was a tough cookie; I knew she could handle that much.
Dr. Ryan, however, was looking at me hesitantly. “Kate, we need to stress it might not be that simple.” I started to speak, to assure her I understood. This might not be simple, but we would deal with it. We wouldget through it. She and I had survived so much already.
But I was quieted from offering further commentary when I heard the physician’s next words.
“Until we know the full extent of Rosie’s injuries and have the chance to monitor any potential progress she makes from here on, I need you to understand that there is a strong possibility that Rosie will have special needs. She may never recover all of her cognitive function, she might not be able to walk again, and it’s highly likely she will need specialist care. This is the reality, and I’m sorry that it’s not better news. Our rehabilitation team here at the hospital will work with you through everything and address issues as they occur. You have to be ready to look at this from many perspectives—medical, emotional, financial...”
I was listening to every word, but I found myself hung up on the phrase “special needs.” I tried to picture Rosie in a wheelchair, needing assistance with simple things, like feeding herself and walking. Somehow I couldn’t picture it, and I suddenly also couldn’t picture my future. How would Ieverreturn to work? And specialist care... Where was the money for all this going to come from? What was going to happen to us?
I had been so foolish, thinking that if she would just wake up life could get back to normal. If Rosie opened her eyes, then bam! Everything would be OK.
I squeezed my little girl’s hand again. I pleaded with her to give me something, anything, that showed she—my tough-cookie five-year-old—was still there. That she was present with me, ready to fight with me.
What I was rewarded with was the smallest twitch of her fingers. It could have been anything, but I was going to take it as a good sign.
I looked at Declan then. His gaze was sympathetic, but there was something else in there, too. And, suddenly, he offered me his hand. His grasp was firm, communicating something:I will help you.
