Authors: Annabel Smith
“I know you feel like celebrating,” she said, “but you should all go home and get some rest.”
“I couldn't possibly sleep!” Rosa exclaimed.
“Take a tablet if you have to,” Magdalena said sternly. “Whiskey will be gone for tests for most of the day, so you won't miss anything, I promise you. I don't want to see any of you back here before four, okay?”
“Will you make sure she sleeps?” Magdalena asked Charlie's mother.
Elaine nodded. “I think I'll need a tablet myself,” she said. “I'm wound up like a spring.”
x x x
When Whiskey was first admitted to the hospital, all those months before, it had seemed to Charlie that he had undergone virtually every test known to medical science. They had rolled him in and out of the X-ray machines so many times, Charlie had feared that if the accident itself hadn't permanently damaged Whiskey's brain, the amount of radiation flooding his head would finish the job. But once Whiskey's condition had stabilized, all the testing had stopped.
As soon as Whiskey started to move, it was like the beginning all over again. When Charlie and Juliet returned to the hospital later that afternoon, Whiskey was in the X-ray suite. Mike was outside, watching through a glass panel. He had been at the hospital all day while the others caught up on sleep, sitting with Whiskey between tests.
“Any news?” Charlie asked him.
“Nothing yet. They say they won't know until they look at the results of all the tests together, and compare them against the earlier ones. But he's still moving.”
“You've seen it?” Juliet asked excitedly.
“No. But the nurses told me they've had to retake some of the X-rays because of the movement.”
“Where are the girls?” Juliet asked.
“I arranged for them to stay at a friend's place.”
“So you can stay tonight?”
“You bet. I'm hoping to be here when he comes around. That's what I came all this way for in the first placeâto meet this guy. And you, of course,” he added, grinning at Charlie.
Charlie grinned back. “Where are Mum and Rosa?” he asked. “Not still sleeping?”
“Hardly. They've been back an hour or so. They got a ticking off from Magdalena, I believe.” Mike laughed. “They're at the café nowâthey didn't want to watch the tests.”
Charlie nodded. Some of the X-ray machines had tiny chambers into which Whiskey had to be rolled on a gurney, and Rosa, who was claustrophobic, couldn't stand to watch.
“What are they doing now?” Juliet asked, looking through the window.
“I think they said an EEG. It doesn't look too pleasant.”
“It's just recording his brain waves,” Charlie reassured Mike. “What other tests have they done?”
“I don't know all the names,” Mike said. “They did one where they injected dye into his blood. They said it would help them distinguish damaged tissue from healthy tissue.”
Charlie tried to recall what he had learned about the tests immediately after the accident. “A CT?” he asked.
Mike frowned. “That doesn't sound right. It was something magnetic.”
“Magnetic resonance imaging?”
“MRI, that's the one,” Mike said.
“How many more to go?”
“This is the last one for today.”
“Looks like they're finishing up,” Juliet said.
The three of them watched in silence as the electrodes were unplugged, the paste cleaned from Whiskey's scalp. As the orderly wheeled Whiskey out, Charlie noticed his eyes were closed.
“Have they given him something to make him sleep?” he asked, alarmed.
“Not that I know of,” the orderly said.
“Is it normal for him to be asleep after all that?”
“You'd have to ask the doctor,” the orderly said apologetically.
Charlie watched tensely as Whiskey was wheeled away.
Juliet put her arm around him. Mike knocked on the window to attract someone's attention.
A nurse came out to see them.
“Did everything go okay?” Charlie asked her.
“I'm afraid we won't have the results until tomorrow.”
“I don't mean that,” Charlie said. “Whiskey looks really out of it.”
“We wondered if you might have given him something to make him sleep,” Mike added.
“He's probably worn out after all the testing,” the nurse said.
“Surely he wouldn't be able to sleep with you poking around at his head like that,” Charlie said.
“There's no discomfort to the patient when the electrodes are removed,” the nurse said reassuringly. “The testing can be very tiring for patients, even if they seem unaware of what's going on. It's nothing to worry about.”
“He looked shocking,” Charlie snapped. “Don't tell me it's nothing to worry about.”
Mike put his hand on Charlie's shoulder. “This is a very tense time for us,” he said to the nurse, “and we're a little uneasy about the way Whiskey looked.”
“I'll ask Dr. Chang to come out.” They watched through the window of the suite as she spoke to him, waited while the doctor carefully washed and dried his hands.
“Why don't you let me do the talking?” Mike said to Charlie.
Charlie nodded. He didn't want to make another scene, have a counselor called.
The doctor finally emerged, shook hands with each of them. “Emma tells me you're concerned about William.”
“We are a little,” Mike said. “The thing is, for quite a few months now, he's had his eyes open, except at night, when we've closed them, so it was unexpected to see his eyes closed. And we're certainly not trying to tell you how to do your job, it's just that we know you don't see Whiskey every day like we do, so you might not know it's not normal for him to have his eyes closed.”
“Is there a chance that the tests you've done could have caused him to regress?” Juliet asked.
The doctor shook his head. “I understand your concern,” he said, “but there's nothing we've done that would affect William's condition, either positively or negatively. It's absolutely normal for a patient in William's state to sleep deeply after a day of testing. In fact, it's a good sign, because a return of sleeping and waking cycles is an indicator of coma arousal.”
“Are you quite sure that's all it would be?” Mike pressed him.
“Whiskey's been monitored all day, as normal,” the doctor said patiently, “but if you like, I can call across and have the ward nurses double-check everything.”
“We'd appreciate that,” Mike said, shaking hands with the doctor again.
Charlie felt ashamed of his outburst. He remembered how Mike's arrival in Melbourne had felt like the last straw. Now he wondered how he would have gotten through the long months since Whiskey's accident without him.
x x x
Though it had not yet been confirmed in any official medical sense, once Whiskey began to show signs of emerging from his coma, Charlie's mother had suggested they set some ground rules that might help Whiskey in his transition back to consciousness. Charlie suspected the suggestions had come from Victor, whom he knew she still saw, but the ideas seemed sensible, so he did not question them.
The first suggestion was that Whiskey should never be left alone, that there should always be at least one member of the family sitting with him. This suggestion was based on the assumption that Whiskey would recognize his mother, his brother, his wife: of course, they all knew Whiskey's brain may have been damaged in such a way that he might not recognize any of them. But to know this, theoretically, was different to behaving as though it might be a reality. So they had all agreed to this first suggestion. It made sense to every one of them that seeing a familiar face might alleviate Whiskey's distress at being confronted with so much that was unfamiliar. But it did raise the issue of what to do about Mike.
Though it had seemed impossible to imagine when he first arrived, in the months since Whiskey's accident, everyone had come to feel that Mike was part of the family. No one wanted to insult him by suggesting otherwise. And yet, Charlie could not help thinking that to Whiskey, Mike would not be familiar. Even if Whiskey recognized the rest of his familyâwhich was, in itself, a long shotâit seemed ridiculous to hope that he might recognize a person he had seen only in photos, spoken to on the phone a handful of times, a person whose existence he had been aware of for only a matter of months.
“Do you think there's any chance Whiskey would remember the plans he made for Mike to visit?” Charlie asked Juliet when they had a moment alone together.
Juliet took a long time to answer. “I don't really know anything about the brain,” she said, “or about the way memory works, and I hate to say this, but before the accident, the idea of Mike being your brother was still so new, so tenuous really, it seems unlikely to me that Whiskey would remember anything about him at all.”
When Charlie talked it over with his mother, it turned out she'd had the exact same conversation with Rosa. They all felt that to present Mike as part of the family might be very confusing for Whiskey.
“What do you think we should do?” Charlie asked his mother.
“We'll just have to tell Mike the truth.”
Charlie pulled a face.
“We have to put William's needs first,” his mother said. “Mike will understand.”
“Do you want to tell him?” Charlie asked her, though he already knew what her answer would be.
“I think it would be better coming from you. You're closest to him.”
Charlie knew his mother was right. He waited for an opportunity to talk to Mike about it. But by the time that opportunity presented itself, Mike had already worked it out for himself.
“I've been thinking about Whiskey coming to,” he said to Charlie, “and I think for now, it might be better to introduce me as a friend of yours. It's not exactly a lie. And it's much less complicated than the truth.”
Charlie wondered, not for the first time, where Mike had gotten his common sense. Given that he seemed to have so little himself, he thought it must have come from Mike's adoptive parents.
On the day after Whiskey's tests, Charlie, Juliet, Mike, Rosa, Elaine, and Audrey were all at the hospital when Dr. Marinovich came to deliver the results. It went without saying that they could not discuss Whiskey's condition in front of him, nor could they all go outside at once. Someone had to remain with Whiskey and wait to hear the news. Charlie volunteered.
“I'll stay with you,” Juliet said reluctantly.
“You go with Rosa,” Mike said to her. “I'll wait with Charlie.”
Except for Mike and Audrey, they had all seen Whiskey move, some of them more than once. In the moment, they had all perceived the movement to be voluntary, to be evidence that Whiskey was returning to them. And yet, there was a part of Charlie that still did not dare to believe it could be true, a part of him that wondered if, in their desperation, they might have only imagined Whiskey moving, shared in some collective hallucination, as a group of weary travelers might see the same oasis in what was only a barren desert.
As the women left the room, Charlie once again felt fear and hope doing battle within him. He wanted to stand by the door, to watch through the small, square window as the news was delivered, but he was not confident his legs would hold him. He dropped into the chair beside Mike, sick with anxiety.
A minute passed, the longest in history.
“I can't bear it,” Mike said eventually. He went to the window.
“Can you see anything?” Charlie asked.
“It's good news!” Mike exclaimed.
“How do you know?”
“I can tell by their faces. It's definitely good news.”
“Are you sure?”
“I'm absolutely sure!”
Charlie had expected to feel elation, to want to jump up and down, whooping and hollering. But when Mike pulled him out of his chair and hugged him, Charlie didn't make a sound. There was nothing to say. He had everything he wanted, and the relief was overwhelming.
* * *
In the week that followed, Charlie spent every possible moment at the hospital. He saw Whiskey open his eyes in the morning, and close them at night, saw him move his arms, his legs, his head. When the machines that had kept Whiskey alive for all those months were at last unplugged and wheeled from the room, Charlie and his mother opened a bottle of champagne and toasted their great fortune.
As soon as Whiskey's transfer to the rehabilitation facility had been arranged, the psychologist who had been assigned to Whiskey's case asked Charlie to come in for a chat.
“I'm responsible for Whiskey's emotional well-being while he's at Rosehill,” Dr. Parvati said, “and I know family and friends play a critical part in that. I'm speaking to all Whiskey's close family members to let them know how they can contribute to Whiskey's recovery. I understand you've been a regular visitor to your brother at the hospital, but there might be certain things we do differently here, and I'd like to take you through some of our guidelines, if you don't mind.”
“If it will help Whiskey,” Charlie said.
Dr. Parvati nodded. “I'd like you to put yourself, for a moment, in Whiskey's shoes. Try to envision waking up one day in an unfamiliar room, with no memory of how you came to be there. You can't move or speak, and you don't know why. Strangers are coming and going at all hours of the day and night. Among the strangers are people who are familiar to you, but you can't quite place them. As you can imagine, Whiskey is probably feeling shocked, confused, frightened, disorientated. My job is to minimize those feelings, make him feel as safe and comfortable as possible on his recovery journey. In light of this, the first of our guidelines is that at this stage, you don't mention either the accident or the coma.”
“Why is that?”
“Because Whiskey may not yet understand that these things have happened to him.”
Charlie nodded.
“The other thing we recommend is that, for now, you don't refer to the past.”
“What do you mean? Surely you're not suggesting we can't mention anything about his life before the accident?” Charlie was incredulous.
“I know that seems extreme,” Dr. Parvati said, “and it's not forever. But yes, for now we ask you not to speak of Whiskey's past at all.”
“Well, what on earth do we talk about with him?”
“Keep things in the present. Talk about your day, about his day. We'd like to get him grounded in the here and now before we attempt to stimulate his memory.”
“But surely we want him to remember.”
“Absolutely, we do. Don't think we won't be stimulating Whiskey's memoryâthat's an essential part of the rehabilitation program. But memory is a delicate thing. Even for those of us who work with it every day, there is much we don't understand. Whiskey must be allowed to recall things at his own pace. I know that can be difficult. I understand that you might feel desperate to know if Whiskey recognizes you, but pushing a patient to recall things from the past can put emotional pressure on them, which can be counterproductive. You have to try to put his needs first. Apathy, fatigue, and depression are common responses in post-coma patientsâwe need to do everything we can to keep Whiskey positive.”
x x x
Charlie came to Rosehill most days, after he had finished his shift at the café. Sitting in on a session with the occupational therapist, he watched as Whiskey was guided again and again through the motions of picking up a small, oblong block. After a time, Charlie found himself growing agitated by the process and he was relieved when Mike arrived. He stepped outside, and they watched for a while through the window.
“He's never going to learn it,” Charlie said dejectedly. “Carl's shown him dozens of times, and he isn't getting any closer.”
“I thought the same,” Mike admitted. “I asked Carl at what point he would give up, accept that Whiskey wasn't going to get something.”
“What did he say?”
“He used a good analogy to explain what he's trying to do. He told me to think of the brain as a mechanism for delivering messagesâlike a postal system. He said if a courier was delivering a parcel within this system, usually they would deliver their parcel by the quickest, most efficient route. But, if for some reason this route was closed to them, they would have to find an alternative route. They might make a wrong turn, have to retrace their steps a few times. But if they persevered, eventually they would reach their destination and deliver the parcel.”
“But what does that mean for Whiskey?”
“Apparently, if the usual pathway along which a message travels is damaged, there is still a possibility for the message to get through. Every time Carl shows Whiskey how to pick up that block, his brain is trying to find a way to get that message to the muscles in his arm, his hand. So far, it looks like that message has been lost every time, before it manages to reach its destination. But if he keeps trying, eventually Whiskey's brain might find the right path, get the message through. Carl said though it might appear that Whiskey isn't getting any closer to picking up the block, his brain might actually be getting very close.”
“I wish someone had explained it to me like that before,” Charlie said.
x x x
After he had been at Rosehill for a couple of months, Whiskey was assigned a speech therapist, a tiny birdlike woman, the only person Charlie had ever heard pronounce the
H
in Whiskey. Though any real communication took place through a system of hand signals, Whiskey was moaning and mumbling, squinting and frowning, and straining into the mirror Lucinda held up for him, trying to make his mouth move like hers.
“He's doing well, isn't he?” Charlie asked Lucinda after one of the sessions.
“He's responding well to the therapy, yes,” Lucinda said carefully.
“How soon do you think he might start talking?”
Lucinda seemed surprised by Charlie's question.
“Not whole sentences or anything,” Charlie clarified. “I know that takes time, but a few words perhaps⦔
Lucinda was looking at Charlie with concern. “You obviously care for your brother very much, Charlie,” she said gently, “and I don't want you to get the wrong idea, because after what Whiskey's been through, he's doing very well indeed. But coma arousal is a slow process, and Whiskey is a long way off from talking, a very long way.”
“But he's responding to everything you do,” Charlie protested.
“It's true that in relation to the state Whiskey has been in, his responses represent a huge leapâplease don't think I underestimate that,” Lucinda said. “But most of what you're seeing from Whiskey at the moment are reflexes, innate responses we're born with, and as such, they are only the first stage of coma arousal.”
“So what's the next stage?” Charlie asked. He wished Juliet was with him, or Mike.
“The second stage is what we call perceptivity, which refers to learned or conscious responses. Talking is, of course, a learned response. In fact, most aspects of communicationâgestures, body languageâare learned. After a prolonged coma, many aspects of perceptivity need to be relearned.”
“And how long does that usually take?”
“Have you been shown the results of Whiskey's tests?” Lucinda asked carefully.
Charlie saw the pity in her face, and it carved a pit out of his stomach.
“The biggest concern is the damage to the cerebellum, at the back of Whiskey's brain,” she said. “The damage to that area is most likely what's preventing Whiskey from walking. But it's also affecting his fine motor skills. Once we've learned it, we take it for granted, but talking is actually an extraordinarily complex process. Every sound we make requires a precise arrangement of the lips and teeth and tongue. It requires the synchronization of a range of muscles that would usually be coordinated by the cerebellum. In addition, Whiskey has sustained damage to the temporal lobe, which houses our memory for words and names. It's possible⦔ she started, then trailed off.
“Go on,” Charlie said, though a part of him did not want her to.
“We'll do our very best, of course. But taking into account the damage to these two areas, there is a very real possibility that talking is one skill Whiskey may never be able to relearn.”
x x x
Charlie had thought he would be able to manage without Thomas once Whiskey came out of the coma. But it had been almost a year since Whiskey's accident, and after his conversation with Lucinda, every time he saw Whiskey, part of him asked,
What
if
this
is
as
far
as
his
recovery
goes? What if this is all that's going to be returned to us?
Surgeons, neurologists, psychologists, nursesâthe staff at Rosehill had all told Charlie the same thingâthat after nine months in a coma, Whiskey's recovery would be slow and arduous, that he might be in rehab for as long as he had been in the hospital. No matter how many times he'd heard this, and from how many different sources, Charlie had refused to believe it. Whiskey's bones had set, his wounds healed. He had been disconnected from every one of the machines that had come to seem like a part of him, discharged from the hospital they had feared he would never leave. Charlie was convinced that recovering from the accident, surfacing from the depths of the coma, had been Whiskey's greatest challenge.
He had been clinging to the fact that Whiskey's frontal lobeâthe part of the brain that was responsible for personality and emotionsâwas undamaged, which meant, theoretically, that Whiskey would still be Whiskey. And when he was away from him, Charlie found it easy to remember Whiskey as he was before the accident, to imagine he could become that person again. But after a while, Charlie found it increasingly difficult to reconcile this image with the Whiskey he visited at Rosehill.
After weeks of Marco badgering him, Charlie made another appointment with Thomas. Thomas reminded Charlie about the cycle of grief.
“We don't experience grief only in the face of death, Charlie. We also mourn other losses. It's reasonable to expect that you're going to experience grief about some of the things Whiskey has lost, especially the loss of aspects of his character, which you believe made him who he was.”
“I'm not grieving,” Charlie said.
“You're in denial about the reality of Whiskey's condition. That sounds like grieving to me.”
“I'm not in denial,” Charlie said.
“If you're telling yourself that Whiskey should already be walking and talking, that in a matter of weeks he'll be back at home, the same old person he used to be, believe me, Charlie, that's denial. Whiskey's recovery is going to take time. It may be months before the full extent of the brain damage becomes clear. He might never be the person he once was. You need to forget about the old Whiskey, and start getting to know the new Whiskey. Ultimately, you're going to have to accept him for whoever he is now.”