Post 42: Day 65, John: The Conversation

“I’m not doing this in here.”

I can’t believe they expect me to have this conversation in front of Drew, for god’s sake. And Kit. You would think she’d be appalled. Am I the only one who realizes that he can—could—might be able to hear us?

Once outside in the hall I grit my teeth and try not to let my anger overwhelm me. “I assumed we would meet in an office or conference room. Not there,” I began, motioning toward Drew’s room. A new face is in this meeting, a Dr. Newman, head of the Trauma Unit. I immediately dislike him.

“Oh, yeah. Sorry. I’ve got such a tight schedule this morning and when I saw Dr. Casey and the rest of you, I thought we’re all gathered and might as well start.”

“You thought wrong.” I am having trouble containing myself.

“Mr. Catelli, right? Catelli? I understand this is a very emotional time for you.”

“You, Dr. Newman? Newman, right? You have no fucking idea.”

Kit steps in. “Dr. Newman, we just don’t want to have the conversation in front of my brother.

“Right. You’re Kit Martz, right? The sister.”

“Not ‘the sister.’ His sister. Drew’s sister.” Kit bristles. She’s not liking him so much anymore, either.

God bless Dr. C who steps in. “I think we can all agree that this is a difficult time and we’re faced with a difficult decision.”

“I thought this was going to be a conversation. Not a summit to decide my husband’s fate.”

“You’re right. It’s a conversation.  But a hard one. I understand. I was faced with this with my mother some years back.” Dr. C exhales, and carefully reads the faces gathered. He glares at his colleague, Dr. Newman.

“Please, my apologies. Let’s start again. Dr. Creasey has briefed me on the patient’s—on Drew’s—condition and his response to treatment.” Turning to Kit and me, “Could you share your observations? I understand you spend more time with Drew than anyone. Your input will be important.”

I’m still seething. Kit steps in.

“Well, as you already know, I’m Drew’s sister. I’m also a retired nurse. Orthopedic recovery.” She pauses to let her credentials sink in. Dr. Newman nods.

“We’ve been waiting—this is day 65. We’ve been hoping for signs of recovery, especially signs of cognitive repair. You know, limb movement, eye movement, a squeeze of hand.”

“I saw Drew move his left hand four days ago. Ask Wendy, Drew’s day nurse. She was there.” I want to go on the record.

Dr. C pages through Drew’s chart. “I see her note. And while this may be a hopeful sign, I want you to be prepared to see involuntary movement at this stage. It may not necessarily indicate Drew is trying to move. His body may just be responding to random nerve impulses.”

“So you’re saying it’s nothing?”

“No, John. Not necessarily. But given everything we know about Drew and his injuries, I don’t want to raise your hopes, to give you false hope.” Dr. C pauses. After briefing me daily for more than two months, he knows I need time to take everything in. He knows better than to rush me, or try to sell me on anything.

Unfortunately, Dr. Newman does not. As Dr. Newman has reminded us, he’s busy.

“I see Drew has an Advance Directive.” Dr. Newman is getting right to it.

Dr. C sees my reaction and runs interference. “Yes. John provided the documents. We actually reviewed Drew’s case about two weeks ago. The decision was to continue to observe and watch for signs of improvement.

Dr. Newman nods. He looks to see if I have something to say, then continues. “And, Dr. Creasy, in your opinion, have you seen the improvement you would hope for in a case like this?”

“What about his EEGs? Drew’s had a lot of brain activity. Almost every day. Isn’t that a good sign?” Kit’s voice is even but strained.

I’m slightly confused. We’ve already had this conversation and we’re not of like minds. I’m the one who’s been flogging the brain activity and the slight but observable movement.

Last night, Kit wasn’t so sure anymore.

“John, I just don’t know. What I do know is that after mom died, we had a long, agonizing conversation about just this situation. You were there. You saw what we saw. It was hard, but we did the right thing.”

“She was 92 years old, Kit. Your brother is barely into his 70s. It’s not the same at all.”

“He didn’t want heroics. And he especially didn’t want machines.”

“He didn’t want them as final solutions, for years on end. For God’s sake, Kit, it’s only been nine weeks. Barely nine weeks.”

Kit cried.

“Oh, c’mon, Kit. We’re all tired and frustrated. I don’t know any more than you do. But when I talk with him late into the night, I feel like he’s still in there. I feel like he hears me. I swear, Kit, he’s not ready. And if I thought he was gone, I’d be the first one to let him go. But not now. Not yet.”

That initial conversation with Kit had been 10 hours ago.

I am puzzled at what seems to be her change of heart.

“I can see this is hard for you. It is for any family.” Dr. Newman seems to be softening. “A document is one thing. It’s pretty specific in this case. However….” He pauses, takes off his glasses and rubs his eyes. I can see now that he’s tired. His face is lined and he is greying on the sides. It occurs to me that he has done this more than once. It’s a painful conversation he’s had many times. It can’t be easy. Despite my initial snap judgement of the man, I find compassion for him. I haven’t made this any easier.”

“Thanks for that, Dr. Newman. You’re right. It’s awful.”

Dr. Newman closes Drew’s chart and hands it to Dr. C. “Let’s wait another week. If there’s no change, we can revisit things. How does that sound?”

Kit nods. I reach out to shake his hand.

“Thank you.”