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By Gary B. Boyd
AuthorHouseCopyright © 2015 Gary B. Boyd
All rights reserved.
The Silent Scream
"What are they doing now?"
The old man was lying in the hospital bed, only faintly aware of what was taking place. An endotracheal tube in his throat was attached to a ventilator and the annoyingly pulsating apparatus was helping him breath. The tube in his throat restricted his ability to speak, not that he was cognizant enough to speak anyway. The acute-care physiologic monitoring system that tracked his vital signs, in particular his blood pressure and pulse rate, kicked on periodically to make sure his heart was still pumping. The action of the equipment when it activated to measure his blood pressure and pulse was a nuisance and prevented him from drifting into the all encompassing sleep he desired.
"I don't want life support." The angry scream echoed through his mind, unheard by the dark shapes that surrounded his bed. His mindset, his decision was to simply pass. Both he and his wife of more than forty-five years had signed living wills to ensure resuscitation would not result in prolonging the inevitable. Neither of them saw reason to artificially extend their lives, especially if doing so would bring nothing good for anyone. Or better said, if moving on would bring good for someone who needed help, then heroic measures should not be used.
"I'm a donor," his raging mind screamed again. "Someone young out there needs an organ so they can live. They can do something with it. I can't. Let me go!"
A cool hand, trembling, wiped across his forehead. Even in his comatose unconscious state, he could sense that it was Lauren, his younger daughter. She gently caressed the brow that once held the power to stop a misbehaving child in full stride with a simple wrinkle and a look. Unseen, unnoticed by him, she fought against a lump in her throat. Even though his eyelids parted slightly, he could not focus his drying eyes. He sensed more than saw that his older daughter and both of his sons were also in the small ICU room. Without thinking about it, he knew they were gathered for the end, his end.
His family had always been his driver, the force that helped him function. Nothing took precedence over family. Unfortunately, as with most American males raised within boundaries of the so called Protestant Work Ethic, the perception of those around him was that his job always came first. In his own way, doing the job, making the sacrifices necessary to excel at his job, put his family in a position to have those things they needed and wanted. His role was to provide for them. He did that without hesitation. But, it had all come at a price.
His weakening mind filled with thoughts of Juanita, the woman he had met forty-eight years earlier. Her soft blonde hair and blue eyes captivated him the moment he saw her. He thought about the day she became too weak to continue living, about how she had clung to life, waiting for him to arrive at the hospital before she passed. She had come to appreciate the small amount of time he could spare from his job, and she knew he truly cared. So she waited until he was by her side before she slipped away.
He retired from his job after that. Sadly, at the age of sixty-four he walked away from a company where he had worked for more than forty-four years. That was almost five years earlier, and he still felt pangs each morning when he had no place to go ... and no one with whom to spend his time. He had been blessed with a sound mind and a strong body, but he had no hobbies and no friends outside of work. His children, now entering the years when they needed to focus on planning their own retirement, and his grandchildren, all young adults working to achieve their own goals, had little time for an old man who had previously been more unavailable than available.
Even so, they loved him.
"What are they doing now?" The question returned, screaming across his disassociated mind. He wanted to pass. His mind searched for the light that his religion told him would be there.
He sensed a shuffle in the room. Someone else had entered; someone who was important enough that the family shifted their attention away from him to The Someone.
"Hello, Doctor Rosenberg." Groggily, he could identify the sound of his children greeting The Someone in unison. One of them, lost in the haze, was talking with the doctor. He faded back into the haze and lost contact with his surroundings.
* * *
"How is he, Doctor?" asked Lauren, the third child and natural leader of the family.
"Pretty much what you see. His injuries are massive." Doctor Rosenberg was aware of the smallness of the room and the closeness of the five upright adult bodies in it. ICU protocol normally prohibited more than one visitor at a time, but the circumstances dictated otherwise. The family's need to be with the patient was greater than the need to adhere to protocol. Their presence would not make any difference to the patient's outcome, and the patient's condition probably preempted his ability to recognize the overcrowding.
"What does that mean?" David, the older son, asked impatiently, fearing the answer he knew was coming.
"We had to remove his spleen and part of his liver. They were both severely lacerated. I'm not sure the remaining liver will survive. His lower intestines were also ruptured, so there is a serious concern about infection if he can survive, and he is still bleeding inside. We cleaned and repaired what we could, but these things are always serious. The bigger issue is his kidneys. They were both crushed and destroyed in the wreck. There is nothing more we can do for him from this point on, nothing. I am so sorry."
"What about a kidney transplant? I'll give him a kidney." The older daughter, the oldest child, was sobbing and almost screaming in desperation.
The old man lying in that hospital bed was all they had left. They had already lost their mother to cancer only five years earlier. To lose the father who had always been their tower of strength was unfathomable at that time. He was supposed to live forever.
"There is too much damage overall and his body is in such a tenuous position that he would not survive the transplant. I know you would give your all for him, but that won't help him at this stage. It is in God's hands." Doctor Rosenberg did not know how else to say the words. He felt helpless.
The younger daughter, calmer, asked, "How much longer ... does he have? His eyes were open a few minutes ago."
The doctor stepped to the bed, lifted the old man's eye lids open and tested for responsiveness with a small flashlight. "There is no pupil response. It may have been an involuntary response to something. At this point, only the life support equipment is keeping him alive. Sadly, you must decide when we stop the machinery."
The silence that filled the ICU cubicle was deafening. Doctor Rosenberg slowly drifted out of the area so the family could talk. During his fifteen year career, he had seen similar situations more than he cared to enumerate. He had come to hate automobiles, the mobility contrivance of modern Man. As had occurred too many times in the past, the next of kin would have to either decide to stop the life support, or worse, ask him to make that decision for them.
David spoke first. "What would Dad want?' His voice choked on the words. David, though older than Lauren, was not the family leader, nor was his older sister, Tonya. He had joined the Army at the behest of friends and spent twelve years wandering from base to base and from battlefield to battlefield. He had seen friends and members of his squad die bloody, violent deaths. He did not want to lead anymore. He was a realist nonetheless.
"He has to live. He wants to live. We have to do everything we can to keep him alive. Maybe they will find a way, some medical miracle," cried the older daughter; desperation strained her voice.
"Tonya," Lauren replied sternly, "there are no miracles left. There is nothing left for us to do. Mom didn't want to be kept on life support. Neither does Dad. Whatever he is thinking, it is not that we keep the machine going. He was always independent ... always full of life. He is in pain now and will never get better. Why would he want to hang on like this?"
"You don't know that!" Tonya snapped at her sister. "We can't just let him die!"
David, sucking air hard to keep from crying out loud, said, "Dad was always practical. He signed a living will so we would not have to make the decision. He has already made the decision for us. He always knew when to say when. The doctor pretty much said he's ... he's ... he's ... dead." Saying the word was difficult, but David knew that his physically and mentally powerful father would not want to be remembered the way he was at that moment, hooked to a machine in a hospital bed. David broke down and sobbed out the words, "Let's let him have his dignity."
"You just want him dead so you can have his money," screamed Tonya, burying her face in her hands.
Lauren, the younger daughter, fought against her own urge to cry and snapped angrily, "Stop it! Stop it, Tonya. You know better than that. You know that David is right. We all know it. Dad was always an active person. He said more than once that he didn't want to be kept alive by a machine. If he couldn't live a good life, a quality life, then we were to let him go. He said it when Mom died, and they both said it many times before that. They even wrote it in their living wills. We have to honor his wishes."
"I don't want to." Tonya slumped into the lone chair in the room. She loved her Father. She had relied on the strong man to guide her more than her siblings, even as an adult. She emotionally needed him more than they did.
Lauren steeled herself for what needed to be done. "Do you want me to go talk to the doctor?" She knew by saying the words, she would forever hold in her mind that she had in effect killed her father. But, she also knew it was the right thing to do. Her mind screamed, "Let one of them do it!"
Her three siblings stared at her, eyes blinking against the torrents of tears. After several minutes, David pulled himself to his full six-foot height.
"I'll do it, Sis. Dad would expect me to man-up at a time like this."
Lauren's heart sank. The fear she had for herself, she now felt for her older brother. Nonetheless, she nodded agreement.
David slowly walked out of the room to find the doctor. Tonya began crying louder and reached to clutch the youngest, Chuck, by the forearm.
* * *
"What's going on? What's that beeping? A machine! Turn it off, damn it! Turn it off! Let me go to Juanita." The old man's mind was screaming, trying to be heard. Even though his eyes were closed, he could see the room. His two daughters were sobbing, heads bowed. Tonya was clinging to one of Chuck's arms and the youngest sibling was patting her shoulder with his free hand, face red and head bowed. His own body was lying in a bed. Tubes were running into his nose and mouth. Oxygen was being pumped through the endotracheal tube into the lungs of a pale, gray-haired man he saw lying on the hospital bed. Two IV fluid bags were hooked to a plastic tube taped to the top of his left hand. Tubes ran from beneath the thin hospital blanket into enclosed bags hanging from the side of the bed. The face on the body was lax and looked years older than he remembered himself to be. He watched as one of the machines suddenly sprang to life and an attached arm cuff began to inflate. A soft beeping sound indicated the machine was reading his heartbeat. He screamed again, "Let me go!" but he saw that the old man's mouth did not move. He did not see David in the room. He thought no more of it.
* * *
"Doctor Rosenberg," David called out hesitantly. The doctor was at the nurse's station, softly giving instructions to the ICU nurse behind the desk.
"Yes. How can I help you?" Experienced with human nature at moments such as the family was facing, Doctor Horace Rosenberg had wondered which of the man's children would approach him. The doctor hoped the young man was there to make the decision, but anticipated an anguished plea for a miracle. He was fresh out of miracles.
David struggled against a lump in his throat to form his words. "I'm David Stearman, Mr. Stearman's son. I ... ah ... we ... think, if there is no real hope, none at all ... we think it would be best to honor Dad's wishes, to do what he put in his living will."
Doctor Rosenberg watched the young man's face screw into a pained expression as the husky son of the old man in ICU struggled to overcome the urge to burst into tears. He suspected that the man standing in front of him was a copy of what the pale body in the ICU had once been. The doctor reflected on how family members would always preface their meetings by introducing themselves, except when it was truly necessary. He also knew that before the son of the auto crash victim was able to continue, the lower lip he was biting would be bleeding. "Is there something more you would like from me first?" the doctor asked.
David shook his head, trying to speak past the lump in his throat as tears began to run from his eyes. He stood for what seemed to be an eternity before he could regain his composure and speak. Even then, his words came out in short, strained burst, "No. I reckon not. Can we have a few minutes alone with him? I think his brother and sister might want to spend a little time with him too ... and Grandma. Oh God! This is going to kill her!" He began sobbing harder, sucking air in a vain attempt to control himself.
"Certainly." The doctor stood next to the crestfallen man and placed his hand on the shaking arm. "It will not happen instantly. Are the others here in the hospital?" What was about to transpire was the part of the job he hated. Grief was hard to master, no matter how many times you encountered it. All the training on how to deal with death situations was wonderful, except it did not make it any better for the survivors. The years had made him somewhat detached from the pain himself but the fact remained that a human family was suffering. He turned to the nurse and said, "Prepare for the final visit." Returning his attention to David, he asked, "Do we need to do something for his mother, or his siblings? Are they going to be okay?"
Doctor Rosenberg's concern about his Grandmother and his Aunt Linda and Uncle Steve refocused David's mind. His grief abated slightly and he decided that he needed to stand strong for the older members of his family. He struggled to regain his composure, noting that the doctor stood politely waiting. "I think I need to just bring them in if it is okay. I will explain to them. Grandma is almost 92, but she's a strong woman. It won't be easy. His brother and sister are strong too. All of them are strong." He sucked snot up his nose and swallowed hard. "Give me a couple of minutes to settle down. Can I go get them now?"
"Whenever you are ready Mr. Stearman," replied the doctor. He was relieved inside that the decision was being made in a timely manner. It would eventually be seen as the best move, even if some did not think so at that moment.
David steeled himself for what he had to do. He smiled weakly at a nurse who handed him a tissue and wiped his eyes and cheeks. He walked toward the ICU cubicle to tell his sisters and brother of the plan.
As soon as David disappeared into the cubicle, Doctor Rosenberg asked the ICU nurse, "Have we implemented and maintained proper organ donor protocol?"
The nurse nodded and offered a separate chart to the doctor. "Hct is greater than 30. We have maintained his core temp at 98. All other labs indicate he is ready for harvest when available."
Doctor Rosenberg accepted the chart and picked up the phone to call the organ harvest contact for the hospital. He set the phone back on its hook and shook his head slowly and muttered to no one in particular, "I just hope there are organs worth harvesting. Damned automobiles! It would be a shame if there is too much damage since he apparently was adamant about being a donor. Nurse," he said with a tone of resignation, "call me if they need me." He walked toward another patient's cubicle. That one should survive.
* * *
Stanley Kirsham pulled the wheel hard to his right. He felt the blood drain from his face and tasted the metallic tang of fear in his mouth. His whole body tingled as adrenaline coursed through his veins. His foot pushed the brake pedal so hard he was afraid it would break off and be shoved through the floorboard. The car swerved as he had directed it. He felt the automatic braking system struggle to keep the car from sliding off line. The vehicle did not seem to want to slow down. He heard Melba screaming, "Stanley! Look out!"
Excerpted from Soul's Aperture by Gary B. Boyd. Copyright © 2015 Gary B. Boyd. Excerpted by permission of AuthorHouse.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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Table of Contents
ContentsChapter 1 The Silent Scream, 1,
Chapter 2 The Harvest, 25,
Chapter 3 The Breakthrough, 37,
Chapter 4 The Coming Light, 48,
Chapter 5 The Roller Coaster, 65,
Chapter 6 The Terrible Truth, 79,
Chapter 7 The Turmoil, 94,
Chapter 8 The Remembrance, 113,
Chapter 9 The Path, 128,
Chapter 10 The Awareness, 142,
Chapter 11 The Pain, 156,
Chapter 12 The Connection, 170,
Chapter 13 The Looming, 186,
Chapter 14 The Discovery, 199,
Chapter 15 The Soul, 213,
Chapter 16 The Revelation, 229,
Chapter 17 The Search, 247,
Chapter 18 The Battle, 265,
Chapter 19 The Confrontation, 277,
Chapter 20 The Restoration, 293,
Chapter 21 The Resolution, 305,