Medicine & Nursing

Intracranial Pressure

September 25, 2021

She came in early one morning, comatose, silently pale, her breath rising and falling together with the ventilator, hooked to a hundred machines, monitors blinking, real time data, IV pumps lining the pole like birds on a wire. Day before yesterday she was trimming hedges, climbing ladders, raking the yard, making plans for Thanksgiving. Day before yesterday she was whole, complete, functional, capable, making memories, living life, combing her hair, telling stories with friends.

Then, without warning, some weak spot gave way in her brain, some vessel decided enough was enough and blood began to spread through the white matter of memories, of conscious thought and decision, an evil red flood obliterating hopes and dreams. The diagnosis is grim, cerebral hemorrhage, prognosis uncertain.

The surgeons place a drain, straight down into the ventricles, leaving an aerial-like appendage sticking out of her skull, pointing straight up, a fiber-optic wire and a tube emanating from within, a human technological hybrid. The wire is hooked to a monitor that gives continuous readings of pressures inside the skull; the tube drains fluid once it reaches a certain level. Our goal is to keep pressure down, save the brain, conserve whatever is left inside, preserve life, return the trimmer to the hedge, the climber to the ladder, the raker to the yard.

Her family comes in, some in shock, some realistic, eyes red, weeping, sharing memories. They can’t believe they’re here, can’t believe she’s here, can’t believe she’s on life support, overwhelmed by the blinking lights, the soft glow of machines and monitors.

I try to explain, gently, the methods to our madness, the small pole sticking out of mother’s skull, the appendages here and there, the lines and tubes. They ask me what I think, will she make it, will she ever be back to normal? I shrug slowly, turn my face, tell them the truth, we’re doing everything we can, but chances are slim she’ll come out of this. Eyes meet, eyes fill, they turn away, sit down heavily, not believing.

Then another figure steps inside. Another daughter. This is the special one they whisper to me, the one the patient worried about, prayed and lived for, the black sheep of the family, history of depression, anxiety, no money, empty dreams. She sits beside her mother, lays her head on the bedrail and begins to cry, great sobs from deep inside, a million memories pouring over her heart like white-water over rugged stone.

That’s when I notice the monitor, the one measuring the pressure in the brain. The numbers start to rise, as the daughter hangs on to mother, as daughter pours out her soul, her tears falling on the sheet. The number keeps rising until the alarm goes off. The daughter looks up, leans back, and takes a deep breath. The numbers on the monitor begin to fall, to go back to normal. The daughter leans forward again, cries softly, whispering, reliving old times, sharing memories, saying please don’t go, I love you, I need you, I can’t do it without you. And the pressures begin to rise again, again the alarm sounds.

I stand in a trance, spellbound, unbelieving, in awe. Something deep inside this coma-stricken mother is responding to the mournful sound of her beloved, her grief stricken daughter, flesh of her flesh. Doctors and surgeons, nurses and therapists, we all try our art, apply the treatment, order the interventions, but nothing reaches, no response, nary a nod.

But somewhere in here we missed the soul and the soul connected, somehow; connected beyond me, connected beyond all of us, connected with the soul of her daughter.

Hours later as the black sheep continues to whisper and to weep, the mother passes from this life into the next. As the monitors cease to flash and blink, I walk from the darkened room, pensive, sober, thoughtful. I like to think that for a moment the soul in the body of the sick and dying mother met with the soul of her daughter and that they talked, shared a sweet communion, and had the chance to say goodbye…

BF – 2015

You Might Also Like

No Comments

Leave a Reply