Authors: Hideaki Sena
“Dammit!” he shouted, turning
the steering wheel sharply as he peeled out from the middle lane and made a
U-turn. Car horns blared everywhere like, pigs, but he paid no attention to
them. He circled around to the hospital’s back entrance, skidded into a parking
area reserved for personnel, and dashed inside through a loading bay. On the
way he managed to grab hold of a passing nurse to ask where the emergency ward
was.
The hallway felt endless as
Toshiaki ran with all the speed he could muster, his leather shoes making
skittish sounds upon the linoleum floor. His lips shaped Kiyomi’s name in a
continuous murmur. He turned right at the next passageway, nearly knocking over
an elderly woman in his haste. Noticing her at the last moment, he jerked his
body around to avoid her and continued hurriedly down the corridor. He refused
to believe it. What had gone wrong? Hadn’t Kiyomi smiled that morning like
always? Toshiaki thought of, breakfast. They ate fried eggs with fish and miso
soup with tofu. Not that there was anything unusual about it. It was as common
a breakfast as one could imagine, a meal that implied she meant to continue
their life just so. This was all too sudden.
They’d left together that
morning. Kiyomi was going to the post office and took her own car. She had just
gotten the car, a used compact, six months ago because she needed it for
shopping. She liked cute things and was attracted to its red color.
“Excuse me, but are you
Kiyomi Nagashima’s family?”
Toshiaki caught his breath.
An aging nurse had come running up and was peering into his face.
Toshiaki cleared his throat,
swallowed, and forced out an affirmative reply.
“Kiyomi-san is in critical
condition,” the nurse explained. “It appears she sustained a strong impact to
the head from the accident. When she was carried here, she was already
hemorrhaging badly and not breathing.”
Toshiaki walked past her and
sat himself down on a couch in the hallway. He gazed at the nurse’s face in
blank amazement, unable to wrap his mind around what she had just said.
“Can you save her?”
“We’ve taken her straight
into the operating room for emergency treatment. Her condition is serious... I
would advise that you summon her relatives.”
Toshiaki groaned.
Kiyomi’s parents came at
once. Her father managed a surgical clinic in an old housing district nearby
and lived right next to his workplace, only a few miles from the university
hospital.
Both their faces were pale.
Kiyomi’s father asked Toshiaki how she was holding up. When he learned of her
critical state, he gulped, closed his eyes, and slumped onto the couch.
Kiyomi’s mother, normally the
epitome of unwavering composure, was badly disheveled. Concealing her face
behind a handkerchief, she showered the nearby nurse with cries of anguish.
Toshiaki stared blankly at the hunched figure of his mother-in-law. He hadn’t
expected this. He realized with a jolt that Kiyomi’s parents were human beings
after all.
When he was invited to Kiyomi’s
house for the first time, Toshiaki’s impression was of a peaceful, elegantly
dressed family, smiling, sipping tea, enjoying each other’s company surrounded
by high-class furniture. Her father was an easygoing and reliable man and her
mother, while reserved, wore an inextinguishable smile. He had always thought
them perfect, like a family one might see on TV. He could hardly picture the
couple before him now as the comfortably tranquil pair they always presented
themselves to be. Theirs now was a show of raw emotion.
“Calm down “Toshiaki’s
father-in-law chided his wife, but he was unable to mask the trembling in his
voice. She turned around with a start, her eyes wide open. Then, letting out a
great sob, she leaned her body brokenly into her husband’s.
It was well past noon, but
they had no appetite. They relocated to the waiting room at the nurse’s
suggestion and sat down, staring absentmindedly at the clock. The nurse came
occasionally to update them. By applying massage, they had been able to restore
Kiyomi’s respiratory function, but she was lapsing into gasping fits and was
now on a respirator. After undergoing some CT scans, she had been moved to the
Intensive Care Unit.
After thirty long minutes, a
doctor finally came in. They all rose from the couch. The man wore glasses and
had a certain aura of frailty. He was still young, probably in his early
thirties. But his facial features were chiselled, and his eyes gentle. Toshiaki
had a good feeling about him. The doctor introduced himself as a brain surgery
specialist. He turned his face almost defiantly towards them and explained
everything in the most sincere tone.
“Kiyomi-san was suffering
from a serious cerebral hemorrhage. As soon as she was brought to our ward, we
operated on her brain and attempted to resuscitate her heart and lungs. She’s
breathing now with the aid of a mechanical respirator; she has lost the
capacity to breathe on her own. We will continue to medicate her with heart
stimulants and keep a close eye on her. However, she is in a deep coma right
now. It’s extremely regrettable for me to have to tell you this, but she is
heading toward brain death...”
Kiyomi’s mother hid her face
to smother the pain-stricken voice that escaped from her mouth as a strange
ah.
Toshiaki did not know how to
respond. Terms like “mechanical respirator,” “deep coma,” and “brain death”
coiled into a vortex in his head. He could hardly believe that his beloved wife
was being described in such terms.
Suddenly, Toshiaki sensed
heat. He looked up. His body felt hot, like it was on fire. The room hadn’t
gotten any warmer. It felt more like he’d ignited from within. The temperature
shot up. Unsure what was going on, Toshiaki looked around him, but his vision
clouded with crimson and was soon gone. He opened his mouth to scream, but only
a dry rasp came from his throat. The back of his throat had vaporized. Flames
would rise from his fingertips at any moment. He was going to burn, he thought.
He was about to start burning.
“What will happen to her?”
The heat left him. His
mother-in-law was interrogating the doctor.
“We are monitoring her brain
waves, blood pressure, and heart rate. If the blood flow to her brain stops,
she will start losing brain cells. We are performing CT scans to monitor the
situation. After reviewing the results, we will examine whether brain death has
occurred.”
Toshiaki could hardly tell
where the doctor’s voice was coming from. He blinked. He saw a hand. It was his
left hand. He tried closing and opening it and saw that his fingers were
moving. They did not flare up as he half-feared.
By the time he came to his
senses again, Kiyomi’s mother had drawn near to her husband, and the doctor was
informing them that the first brain-death examination might have to be
conducted that evening. Toshiaki felt dizzy and sat on the couch, still reeling
from his hallucination. There was a throbbing in his temples.
“Are you okay?” said the
doctor.
Toshiaki waved him away.
Kiyomi was going to die.
He felt deceived. Everything
seemed to be happening in some distant world. His entire body was still
flushed.
What was that anyway?
he wondered amidst the banging in his
head.
What on earth was that
heat
?
3
At 6 pm the three of them
were allowed into the ICU.
When they entered the room,
they were instructed to change into pale green sterilized gowns and hats and to
wear special masks. In addition, they had to sanitize their hands and feet. As
for Toshiaki, he was already familiar with this type of procedure, having
performed many experiments on animals in which prevention of infection, and
therefore the wearing of such garments, came with the territory. But he never
imagined he would be wearing them in a hospital setting. Because Kiyomi’s
father was a surgeon by profession, he became a respectable figure in this
attire. Only Kiyomi’s mother, visibly annoyed by the sensation of the roughhewn
gown against her skin, was unaccustomed to it.
It was an unexpectedly large
room. There were a number of stretchers lined against the wall and half as many
machines used for blood transfusions. Two small monitors were installed in the
wall from which countless tubes and wires extended. In spite of all the
technology, most of the other beds were unoccupied, giving the room a dormant
atmosphere.
Kiyomi was lying down on the
second nearest bed. Tubes had been inserted into her nostrils. Toshiaki
followed them with his eyes. They ran from her nose into a bucket-shaped object
and continued from there into a white machine that had several manual controls
and a meter with a needle, which quivered left and right within its prescribed
arc. It wasn’t a large machine, but every time the needle jumped, a hissing
sound issued. This was the respirator, according to the doctor. The wall
monitors were both aglow with Kiyomi’s brain wave activity.
They all gathered around and
gazed upon her. Her head was shaven and wrapped in cloth and bandages, but the
rest of her was covered with a simple sheet and no other injuries could be
spotted. Aside from the scars on her head, she looked completely unscathed.
After leaving the room, the
doctor led the way to his office. He offered them a seat and sat down at his
desk. Films of Kiyomi’s CT scans had been posted to a light box on the wall. As
he showed them the brain wave data, the doctor began to explain more about her
condition. Brain death, he said, was an irreversible state that occurred when
the brain stem was deprived of blood and ceased to function. This was distinct
from a “vegetative state” where the brain stem was still functional. The
hospital was required to verify any potential patient’s condition with an
officially sanctioned examination in accordance with Welfare Ministry
standards. Additional brain wave response inspections, along with more CT
scans, were also available at their hospital.
“These are the results of the
first exam, conducted at five o’clock.”
The doctor handed them a
spreadsheet which contained the results of Kiyomi’s auditory brain stem
response, pupillary dilation, and respiratory tests. The doctor explained each
in detail. He emphasized that there were no noticeable changes in her brain
wave activity in the face of stimuli and that she was not breathing on her own.
If she were taken off her respirator, she would cease to breathe, her heart
would fail, and her temperature would plummet.
On the right side of the form
was a blank chart in which the second examination’s results, to be conducted
the following afternoon, were to be recorded.
“We will see if the second
test yields the same results. By that time, over six hours will have passed
since the first, and this is how we ensure that no mistake is being made.”
Toshiaki was only half
listening to the doctor’s words. He could not dispel Kiyomi’s peaceful
expression from his mind.
“We will leave her as she is
for now, on the respirator. I would recommend that you discuss, as a family,
the issue of when to take her off it. Until then, you have my word that we will
do anything in our power to sustain her. We will keep her on a nutrient-rich IV
and periodically shift her lying position so she won’t develop bed sores.
Please understand, though, that while she may be breathing, Kiyomi-san is
already, in fact, dead...”
They all returned later that
evening to the ICU and sat at Kiyomi’s bedside. Her father had begun to regain
some emotional stability by now, while her mother was still unable to make
sense of things, overwhelmed as she was by her tears. The day’s hardships had
etched weary circles under her eyes. She laid herself down, completely
exhausted. Kiyomi’s father, realizing the day had been too much on his wife,
thought it better to return home and left with her in his arms.
Toshiaki was unable to sleep
and stayed behind.
At around ten that evening, a
nurse came in to give Kiyomi’s body a rubdown with a hot towel. The petite
nurse exuded nothing but sweetness. Still in her early twenties, she possessed
a genuine sincerity, and the special attention she afforded to Kiyomi struck a
chord in Toshiaki’s heart.
As he helped the nurse with
her work, Toshiaki again felt the warmth of Kiyomi’s skin. A few beads of
perspiration dotted her back and saliva had welled up in her mouth. Her skin
was still firm, cheeks flushed with a pale rouge. Toshiaki had never seen a
so-called “vegetable,” but as he looked upon Kiyomi’s body it was impossible
for him to distinguish her from that harsh term.
“Please talk to your wife,”
the nurse said with a smile as she went about emptying Kiyomi’s bedpan. “It’ll
cheer her up.”
Toshiaki did not doubt the
nurse’s advice and so he held Kiyomi’s hand, talking to her continually
throughout the night. He told her about his day, shared memories, and talked
about the things he loved most about her. He felt a warmth from her palm
passing into him. Her chest rose and fell regularly as the hiss of the
respirator echoed through the ICU.