May 24, 2003

It’s been a terribly long time since I sat down at the keyboard to hammer one of these out.  No reason to it, really, I just haven’t.  But I do have plenty to say and a trip back home to get down here.  I’ve got that swirling around my head, so I do expect to get it up here fairly soon, like, tomorrow-ish.

But first things being what they are and today being what it is, I decided I’d rather do this first.

Fifteen years ago today Caitlin died.

Technically that’s not accurate, since we made the decision to donate her organs, her body remained hooked up to the equipment that kept her blood circulating and oxygenated until the 25th when the “harvest team” came to get whatever organs were viable for transplant.  I’ve always hated that term in this application btw.  Harvest.  I suppose it’s accurate, but so completely dehumanizing to someone who you love.

At any rate, today, I felt like putting up another excerpt from that weekend, now fifteen years later.

When we were finally led in to Caitlin’s room in the NICU, around 3:00 AM Friday morning, we could hardly believe our eyes.  It, almost literally, took our breath away.

As we walked into her room in the NICU, the first glimpse of Caitlin took my breath away.  That image is one of the things from this time that is indelibly burned into my brain.  She looked so tiny in the huge bed.  Her arms were bundled up in huge rolls of gauze and she was propped up by pillows under both arms and both legs.  Her face was bruised, swollen and distorted.  She had tubes and wires everywhere.  She was on a ventilator.  She had a broken femur in her left leg and a broken tibia in her right leg.  She had a broken humerus in her left arm and a broken ulna in her right arm.  She had a fractured pelvis.  A lacerated liver, a ruptured spleen and contusions on her heart, lungs, and brain.  Even though she hadn’t regained consciousness since the crash, they had her in a medically induced coma because they were already concerned about the bruising on her brain.  The doctors were concerned that the swelling of her brain, left unchecked, would increase pressure on her brain and reduce blood flow to, and oxygen supply for, her brain.  The brain is surrounded by cerebrospinal fluid.  Among other things, it acts as a cushion for the brain so if, for example, you hit your head against something, your brain won’t smash against the inside of your skull causing even more damage.  Typically, at rest, the pressure in your brain is measured in the low teens.  Caitlin’s intracranial pressure (ICP) was already in the low 20’s and, despite the best efforts of the doctors, it showed no signs of slowing down.

Diane sobbed as we walked up to Caitlin’s bedside.  The nurse was speaking to us, explaining everything we were looking at, but I don’t think either of us heard a word she said.  

It was hardly the first time I’d seen something like this.  In my job, it’s not unusual to be on the scene of a crash like the one Caitlin was in, a crash that results in multi-system trauma.  It’s also not uncommon to be passing through the Emergency Department and see someone with the types of injuries Caitlin sustained.  The problem came in, for me, because very early in my career I learned to de-personalize the things I saw.  I learned how potentially easy it was to assign the personality traits or the physical characteristics of a family member to many of the emergency situations I would encounter.  And how unsettling it would be to me unless I removed every bit of emotion from what I needed to do.  So that’s what I always did.  Not this time though.  This, this was so different from anything I’d ever known.  I couldn’t possibly de-personalize this.  Not that I ever wanted to.  I mean, for crying out loud, this was Caitlin lying there, broken and bruised.  This hurt like nothing I’d ever known before.  And I know it was a hundred times worse for Diane.  A thousand times worse.  

How could it not be?  I think the bond between mother and child is probably the strongest human connection.  At least in most cases.  And the bond between Diane and her girls was always strong.  Sure they had their differences, who doesn’t?  But they genuinely enjoyed the company of each other in any number of different settings.  True, most that I’ve mentioned revolved around shopping, but to leave it at that is an oversimplification and it does a great disservice to them.  

She was a beautiful, vibrant, young woman turned into a shattered shell of herself.  Her face was swollen and bruised.  Her body was propped up by pillows everywhere.  Soon we learned what her injuries were; broken bones in both arms and both legs, a fractured pelvis, lacerated liver, and bruises on her heart, lungs, and brain.  She had chest tubes in both lungs.  She was on a ventilator.  And, even though she never regained consciousness since the crash, she was in a medically induced coma.  The Trauma Surgeon told us they were concerned about the swelling on her brain and they felt that by keeping her in a deeper coma, they might reduce the risk of more swelling.  With good reason.  Every time the nurses checked Caitlin’s vital signs, indications were that her Intracranial Pressure (ICP) was rising.  Typically, for an adult at rest, ICP is between 7-15 mm Hg.  By the time doctors inserted a monitor through Caitlin’s forehead to continuously measure her ICP, it was already in the high 20’s, still with no indication it would decrease.  As we watched that monitor over the course of Friday and on into Saturday it continued to climb, dangerously high.  Although at the time, we didn’t understand how dangerously.  

As family started to gather in Caitlin’s hospital room, we started trying to anticipate the changes we would need to make.  She’ll need some time to recuperate, we thought.  We can turn the dining room into a temporary recovery room for her so she doesn’t need to worry about the stairs, we told ourselves.  

Cassi had been in St. Louis with one of her sorority sisters.  She flew in to O’Hare and Diane’s sister-in-law went to the airport to pick her up and bring her to the hospital on Friday morning.  We spent all day Friday in Caitlin’s room or in the waiting room shuttling family back and forth so they could see Caitlin and be with Diane.  I don’t think Diane or Cassi left Caitlin’s side for more than a minute or two the whole weekend.  I did most of the shuttling.

I had called off work at about 6:00 Friday morning, once everyone was awake.  Around 7:30, one of the guys that worked the day before me at the firehouse, Skip, brought by coffee and bagels for Diane and me.  He said he didn’t want to stay, knew we had a lot on our minds; he just wanted to drop off some breakfast for us. The first of I-can’t-tell-you-how-many kind gestures we would receive in the days ahead.

By late morning on into early afternoon, the nurses told us they were concerned that Caitlin’s intracranial pressure was still not decreasing.  Every time they checked her vital signs, the ICP was up a little.  So they ushered us out of Caitlin’s room and the doctor came in.  He took a measuring device, I don’t know what it’s called, and inserted it, through Caitlin’s skull, right in the middle of her forehead.  Through this device, they were able to continuously measure Caitlin’s ICP.  We watched the monitor nonstop.  And prayed the same way.  Prayed for the number to drop.  

It never did.  

OK, it fluctuated a little bit.  

Up ten points; down five.  

Up four points; down six.  

Up two points; up two more.  The end result was that every hour it was a little higher than it had been the hour before.  

I’m a huge football fan.  I love the Chicago Bears and I’ve been a fan since I was a little boy.  Walter Payton, Sweetness, was one of my favorite players, a Hall of Famer, one of the all-time greats.  Diane and I actually had the opportunity to meet Walter before he passed away.  We went to his restaurant in Aurora one night with my brother and sister-in-law and Walter was there greeting people as they came in.  We shook his hand and Diane was joking with him about his handshake, until he started to squeeze her hand.  We all had a good laugh about that.  When I think now about the number 34, I don’t think about Walter Payton’s jersey number.  I think about how 34 was as low as Caitlin’s ICP got that night.  It soared up over 100 and stayed there for prolonged periods of time.  

Diane and I talked about the boys, Ryan and Maun, in Iraq.  We decided it was time to let them know what had happened.  I opened up my wallet and took out the little slip of paper with the 800 number for the Red Cross.  “Just for emergencies” Ryan had told me.  This qualified.  The lady I spoke with offered us her prayers and said she’d do everything she could to get the boys home as quickly as possible.  

Hug the ones you love, often.  Tell the ones you love that you love them, often.  And please, not just this holiday weekend, but every day, don’t drive if you’ve been drinking.

Peace