I’m standing in the pediatric ICU at UC Med Center. I’m holding the hand of my ten year old nephew. His hand is lifeless, the nurse tells me, because they gave him a paralyzing drug to keep him still. Common practice with a brain injury, she says. “So it’ll be a couple days before we know if there’s damage?” I ask. “Oh, there is damage,” she says, “we just don’t know how much, or if it’s reversible.” I’m grasping for hope with what feel like talons. “So, we might need to teach him things again? He might not remember things? His brain might not work that way?” “It could be more basic,” she says, “like his brain could not remember how to make his heart pump, how to make him breathe.”
I look at the ventilator pumping air into his lungs, the two tubes going into his partially shaved head. One is to gauge the inner cranial pressure, I’ve learned. One is to drain liquid off to relieve the pressure. The last 24 hours have been a crash course in how to treat brain injuries. The doctor, he says, has only seen two worse brain injuries in his career. “C’mon, kid,” I say, “Fight.” “It’s not a matter of him fighting,” the nurse says, “it’s simply a matter of how much his brain will swell.”
It was the night before, the night it happened. He was just riding in the car with his mom. She was going into town. She was on her side of the road. She heard the screeching of the tires, but those curvy Nevada County roads can be unforgiving. There was no shoulder, only a bank. She had no where to go but straight into the car.
The man driving was having a good time. He was wasted on beer, out joyriding. He was not hurt on impact. He got out of the car. “Help me,” my sister-in-law called to him. “My son is trapped. My son won’t wake up.” The drunk guy just ran away.
I had another brother once, too. He was just going through a green light on his motorcycle when a drunk lady ran the light at the intersection. Killed instantly, they told me. Never felt a thing. I was six. I wrote him a note and asked my mom for a helium balloon, so I could send it to him. My family has felt sad ever since. My nephew is named after that dead brother. His parents wanted the name to go on, at least.
For forty eight hours I watch the inner cranial pressure on my nephew’s read out climb and climb. I watch his pupils become fixed and dilated. I watch his mother, face bruised from the impact of the steering wheel, sob over him, beg God to save her baby.
I think of the times I’ve driven after a drink or two. Not going very far, I think. I’ll be extra careful. I’ll drive slow. I think of the time a few weeks ago I tried to talk a girlfriend out of driving. I argued, but I didn’t take her keys away. Didn’t want to get her mad, after all. Didn’t want to push the issue too far.
I go in the conference room with the neurosurgeon and my brother and sister-in-law. They tell us my nephew is brain dead. We sign the papers for organ donation. My brother goes to tell my niece, the boy’s twelve year old big sister and best friend, that her brother won’t wake up. I go hold my nephew’s hand for a little longer. From now on, I tell him, I’m gonna be militant. From now on I’ll yank those keys away. I’ll just picture the ventilator, the fixed and dilated pupils, the readings of the inner cranial pressure. I’ll remember the un-erasable double sadness of my family. “Get out of your car!” I’ll say. “You’re not driving.” I won’t worry about getting anyone mad. From now on it’ll be easy.