Infancy

Level I - No Response: Total Assistance

Complete absence of observable change in behavior when presented visual, auditory, tactile, proprioceptive, vestibular or painful stimuli.

Level II - Generalized Response: Total Assistance

Demonstrates generalized reflex response to painful stimuli. Responds to repeated auditory stimuli with increased or decreased activity. Responds to external stimuli with physiological changes generalized, gross body movement and/or not purposeful vocalization. Responses noted above may be same regardless of type and location of stimulation. Responses may be significantly delayed.

"So, what number can we expect today?" My aunt asks as she breezes past me into the hospital waiting room, taking a seat at one of the far chairs on the short end of the room, near the lockers.
"Ugh," I say falling into the seat next to her. "Unfortunately, he is a four today, its only noon and I am exhausted!"
"Your exhausted because you have to deal with him AND spend all this time with grandma" my aunt jokes.

We begin to giggle.

"Yeah, I guess," I say as I begin to knaw at my cuticles, " I just have all this homework and I can't think straight. I keep falling asleep in class and doing homework here is not as easy as it used to be," I said, leaning forward to rest my forehead in my hands, "He's so agitated sometimes, he yells and pulls at his tubes and the sitter is too afraid of hurting him, or getting hurt herself, so I have to hold him down until he's calm," I said shaking my head, "Not exactly making it easy to remember the Shakespeare I have to read or work on my biology homework."

"Hey, girl," my aunt says as she stands, "you know damn well that even without doing your homework you'll still pass the class. You're the brillant one in the family, remember?"

I smile, "Yeah, I guess," I say, standing to face her, "well let's get in there before he tears the place apart," I sigh and start towards the ICU doors.

It is now the beginning of September and my father has been in the hospital for four weeks. He has been rapidly, and painfully, progressing through the Rancho Los Amigos Recovery Scale. This scale is a generalization of healing processes the body and brain go through after suffering a traumatic brain injury. It is similar to developing again, from an infant state, only much more quickly.
Last week my father was playing with toddler toys, putting circles into their corresponding holes in a Fisher Price play cube. This week we are practicing writing down people's names and colors and having him point to the corresponding person or object. Sometimes he gets one right, sometimes he looks at the page, confused.

Other times he looks at the page and starts to yell or throw things. We just never know.

In addition to the cognitive development work my father needs, his moods change aggressively and rapidly. Day to day we never know what we are walking into when we enter his room. Will he be a three, where we think he is slipping backwards, perhaps back into a coma?

Level III - Localized Response: Total Assistance.
Demonstrates withdrawal or vocalization to painful stimuli. Turns toward or away from auditory stimuli. Blinks when strong light crosses visual field. Follows moving object passed within visual field. Responds to discomfort by pulling tubes or restraints. Responds inconsistently to simple commands. Responses directly related to type of stimulus. May respond to some persons (especially family and friends) but not to others.

Or will he be a more optimistic, yet exhausting level four:

Level IV - Confused/Agitated: Maximal Assistance
Alert and in heightened state of activity. Purposeful attempts to remove restraints or tubes or crawl out of bed. May perform motor activities such as sitting, reaching and walking but without any apparent purpose or upon another's request. Very brief and usually non-purposeful moments of sustained alternatives and divided attention. Absent short-term memory. May cry out or scream out of proportion to stimulus even after its removal. May exhibit aggressive or flight behavior. Mood may swing from euphoric to hostile with no apparent relationship to environmental events.

We just never know.

Arrangements are being made for my father to be transferred to a rehabilitation hospital. A step down from the "regular" hospital, now known as an Acute Care Facility, but a step-up from a nursing home.
We are told by the doctors and nurses that this facility can handle all of my father's day to day care and that they specialize in recovery with brain injury patients.
I am also told that as my father's guardian I will be fully responsible for approval of the facility and will be the contact person for them as they progress through his case management.

It all sound good to me. Of course it does, what do you I know better? I've never been through this before. I didn't know what my rights were or were not. I had yet to become a parent myself and already I was being ushered into making life or death decisions. It was all too much.

In hindsight I realize I had received some bad advice, some good...but in most cases I realized that with my father there was simply no way to know how things would go.
There was no barometer to measure his recovery against, no yard stick or pamphlet of information could prepare me for the horrible and amazing journey ahead.

I felt like an infant myself at times. Trying to find my way, make sense of what was going on around me. Wondering if this world was really my life or just my imagination.

I never knew that a few days from now the rest of the world would be turned upside down. I never knew that this horrific family tragedy would pale in comparison to the devastation that lie ahead for thousands of people.

I never knew.

None of us did.

Shock

Life seemed to march at a slow, steady beat. The days dragged on and as each day passed and my father lay motionless, my hopes began to dwindle.

I had no reason to believe today would be any different from the last few days, no more hopeful, no more enlightening. There had been nothing since my father's stunt a week ago. No more signs of improvement...no pulling of IVs, just a constant, depressing- nothing.
His blood pressure had come down, slightly- but this was nothing promising.

I awoke to my 6am alarm and sat up slowly in bed. I was beginning to feel the effect of the long, stressful days. I, usually a very healthy eater, had been hardly able to hold much down. My stomach was upset so easily. The dark bluish, purple rings under my eyes had become a permanent fixture and another heavy strain looming ahead...I was beginning my freshman year of college in two weeks!

I swung my short legs to one side of the bed and slowly stood.

My body ached.

I had a headache already.

And quite honestly I dreaded seeing my grandmother at the hospital.

I had gotten to know a lot more about my grandmother through this whole ordeal and was a bit ashamed of the fact that the more I came to know her, the less I liked her.
I still loved her and would do anything for her. But I realized, as a grandchild should never have to, that my grandmother was somewhat delusional, intolerant and extremely controlling.
She knew my father's care was in my hands and this seemed to torment her- she questioned every move or decision I made and challenged me about simple, easy decisions. When a decision I made turned out to be wrong, she blamed me. And when I was right, she was silent.
In hindsight I see how it might be difficult to leave your son's life in the hands of an 18 year old girl, but then again, that 18 year old girl was his daughter, his next of kin, and quite honestly the best and most reliable thing in his life.

My grandmother insisted we should have taken my father to the University of Michigan, because if he had been there he would surely be better cared for. She insisted we do everything possible to hold onto my father's home (so he can give it to me one day).
She didn't seem to realize that I, unlike herself, only cared if my father lived, not if he had an inheritance to leave behind.
She insisted upon financial aspects of his care that left me reeling- I had never known how materialistic she was. Apparently a side effect from living poor most of her life...or from placing far too much importance on money, I wasn't sure which.

This day was no different from any other, I awoke at 6 am and began my routine.
I was particularly cranky today, preparing to hear the words from my grandmother again, "Now you know what you should do..." or "Here's something for you to take care of..."
I was so sick of taking care of everything, of being the one in charge. As my friends packed their things and headed to college I was stuck in the ICU being a parent to a 50 year old man in a coma.
I was beginning to get pissed- life was so unfair.

And I realized that 18 year old friends are not so good of friends at these times...only one friend, a friend I had known since childhood, came to the hospital to visit.
The others called and offered to take me out (you know so I could forget about things for awhile, as if that was possible), but only one sat with me and watched me cry as my father lie helpless.
Brit.

"Hey, you" my mother said as she entered my bedroom and watched me pull on my sweatpants and pull my hair into a ponytail, "why don't you take the day off- you look terrible," she said.
"I can't Mom," I said, "what if something happens?"
"Then they'll call you," she said wrapping her arms around me, "you can't keep going on like this forever.
She was right
She was always right.
She knew me.
Better than anyone.
I began to softly cry and shake against my mother's thin frame. I looked up into her face, a face filled with love, concern and mostly sadness.
"I am so angry Punkin," she said stroking my hair, "I am so angry this had to happen to your father and to you. You deserve to be out being a kid, having fun."
"Yeah," I said wiping the tears onto the back of my hand, "apparently life had other plans."

I didn't take the day off.
I went, faithfully to the hospital- just like every other day.
Today I brought the nurses donuts. A tip for anyone with a loved on in very serious condition. Keep the nurses happy.
They will be the ones that save or take that persons life.
Trust me.

I had no idea what was in store for me at the hospital today.
No idea that today, 13 days after my father's brain surgery I would be given a gift unlike any other I had received before. I would be amazed, shocked, touched and sad all at once...it would be like no other experience.

I rounded the corner and headed into the West Deck of St. John Main in Detroit. I parked on the roof of the parking garage in my usual spot. It was so sad that I had a usual spot...
I took the stairs down and walked across the drive into the West Entrance and followed the long winding hallway to the ICU elevators. Stepping into the elevators I noticed an older couple carrying flowers and a "Its a girl!" balloon.
The couple smiled and discussed how their new baby granddaughter looked so much like her father. They seemed so peaceful, so happy, so content.
Wow, I thought, people can actually come the hospital for something beautiful, instead of something tragic.
I know its true, but lately that thought seemed an utter impossibility.

I pushed the button and felt the car take us to the 2nd floor ICU and as I was stepping off the elevator I looked back at the couple and smiled. The couple smiled back and as the doors to the elevator shut I saw their smiles slowly fade.
They knew.
No one got off on this floor unless someone they were visiting someone very sick, someone dying.
Go welcome that new baby into the world, I thought as I headed through the ICU doors, the nurse, knowing me by name, nodded as I passed, someone in this world should be happy.

I followed the ICU wing around to my father's room. After his stint a week back he had been moved to a room directly in from on the nurses station, so that at all times he could be viewed from any seat.

I carried my orientation packet for the community college I would be attending in 10 short days and some text books I had already bought. I thought it wouldn't be a bad idea to have read the first few chapters before class starts. Its not like there was anything else to do in the hospital room anyway.

When I walked through the door with my head down I heard a strange noise.
Silence.
No hiss.
No ventilator.
No ventilator?
I looked up.
I dropped my books.
I gasped.

My father's bed had been propped up into a semi-seated position and the tube that had been running out of his neck and into the ventilator was gone. In its place was a small white hole secured around his neck firmly with a blue fabric band.
My father's arms were tied down and he had a sheet tied around his middle, holding him tightly to the bed.

But this is not what shocked me.

My father's right index finger slowly tapped the bed rail.


Tap.


Tap.


Tap.

As if counting the beats to some inaudible song.
And there he sat.

Awake.

...and smiling.

Fighting

As the hardest week of my life drew on I found myself getting into a sort of weird, morbid schedule.

6am- get up, shower, get dressed and collect any paperwork, legal documents or other things I needed for the day.
8am- arrive at the hospital to being my daily shift of staring at my father's lifeless body in the oversized hospital bed.
11am- have lunch with my grandmother who was also at the hospital daily, religiously, as I was
1pm- return to my father's hospital room for another shift
4pm- leave the hospital with my grandmother, and other family members or friends who have come to visit after work, for dinner.
6pm- return to the hospital room and update the new shift of nurses on what has been happening...or not happening as is more relevant
8pm- return home, exhausted, dreary and utterly spent.

Of course there would be days here and there where I need to go to the courthouse to file guardianship papers for my father, or to meet with the Police Department about the case.
The police still had not charged the offender as it had only been a week and things were still very uncertain.
My life remained very routine and dull and depressing for these few days after my father's brain surgery. There would be moments of hopefulness when we would see him move every so slightly, just to have our hopes dashed when we were told the movement was nothing more than muscle spasms that naturally occur.
My mind flashed to the horrible stories you hear of corpses moving in their caskets at their funeral. A mouth flying open, an eye-lid coming unglued.
I swallowed.

As the days wore on, so had my patience with my boyfriend. While he had been up to the hospital with me on many occasions and had done the best he could to be supportive, the fact that he remained young, immature and ultimately selfish became more and more evident. I would discus our problems with my mother and she would tell me that times like these test a relationship and many people break up when horrible things happen.
I didn't want that to be the case. I loved him and I knew he loved me.
But, I was constantly disappointed in his level of support. On the weekends when he wasn't working he would agree to go to the hospital with me. I would drive to his house to pick him up and instead of being awake and dressed and ready to go...he would still be sleeping.
So there I would sit waiting for him to get ready wasting what I thought could have been the last few days of my father's live, waiting for him...again.
This happened on a few occasions and as horrible as it sounds I eventually got to a place where I stopped expecting his help or his support. It was just easier.

In those days I also learned many things about my father. What company he had kept, what problems he had hid from me and what things he did on a daily basis.
I learned that he routinely went to shoot pool after getting off of his night shift at noon. He would go, along with several work friends, to shoot pool and drink pitchers of beer and harass young waitresses.
Then, irresponsibly, my father would drive back to his suburban ranch, eat dinner, watch some TV and fall asleep...just to begin the process all over again.

My father had been dating an ex-stripper I had met briefly a few months earlier, but from what I could tell and what my father had told me recently, they were no longer close and he didn't think they would be again. She visited him many times in these first few days along with her mother and sons.

Many people visited my father.
Nothing like being in a coma to bring everyone out of the woodwork who ever cared about you.
I was proud and honestly surprised by the out-pouring of visitors- there were many.

Another inevitable occurrence that happens when one finds themselves as ill as my father was, your family gets to know your deepest, darkest, personal business. Your affairs are now left in their hands, as my father's affairs were left in mine. I found out he was thousands of dollars in credit card debt, he had a nasty habit of eating cold vegetables out of the can, he never cleaned his house and he kept every, single thing I had bought or made for him since I was a little girl.
Seeing a craft I had made in kindergarten displayed proudly on the entertainment center brought me to tears.
How can one man be such a contradiction? How can he be cold, yet loving. Chauvinistic yet protective. Idealistic yet delusional. Happy yet haunted. And now alive but not among the living?
But, my father had always been this way. He has an irreplicatable charm that drew people to him, yet a way about him that pushed people away. He was a man people didn't want to like, and couldn't help but like at the same time.

His addiction to alcohol, beer specifically- Bud Light or Labatt Blue, was what took an otherwise handsome, charming, charismatic man and turned him into a rude, bloated, chauvinist. This addiction played such a role in every one's lives around him that there were few family members he was still close with, and those were usually the ones that would love him regardless of what he said, or did.
Like me.

On the fifth day post surgery an amazing thing happened. I was returning for my usual daily stay at my father's bedside when his nurse entered. I sat there with my boyfriend by my side, holding my father's hand.
"Well we had quite the occurrence last night didn't we," the nurse said as she entered the room looking at my father, who still lay lifeless and unmoving on the hospital bed.
"Occurrence?" I asked, looking to my boyfriend, who shrugged.
"Linwood decided to sit up and ripe all of his IVs out last night," the nurse continued, "And I got in here just in time to hold him down before he riped his catheter and feeding tube out."
"What?!?" I exclaimed, "How could he do that? I thought he was in a coma?"
"Well he is in a medically induced coma," the nurse said shaking her head, "we want him to heal for at least another week after his extensive surgery, but it seems his body is not as reactive to the sedation as most people, so we are giving him twice the normal dosage now," she continued, "he had quite the tolerance for drugs."
I looked at my boyfriend, he smirked, "you can say that again," I mumbled.
"Yes, yes," the nurse said softly as she walked around my father's bed checking his intervenous lines and stats that still shone on the monitor above his bed, "I believe he is going to be quite the handful."
And with that the nurse left.
Quite the handful?
Going to be?
Was my father going to make it? Was this the first sign of him coming back? Was he alive in there and thinking and trying to come back to me?
I looked at my father lying there as the nurse slide the glass door behind her, he still lay as I had seen him the day before, motionless and breathing by the steady hiss of the ventilator. But there was something different about him that day. A color had come back into his face and his body seemed ready to move at any moment.
He's in there, I thought.
He's fighting.
He's alive.

Lifeless

After our discussion with the detective, I needed to be alone. I decided to step into the women's room on the surgical floor.
Upon entering the bathroom, I headed for the far stall with my head hanging down, holding my breath. The bathroom was illuminated with florescent lights attached to an electric strip on the ceiling. It held two stalls on opposite sides of a small, white porcelain sink.
When I entered the stall I caught myself leaning against the cool, pale blue tile. I struggled to catch my breath as I began to shake.

Before leaving the small meeting room the detective had left me with another devastating bit of news. Upon arriving at Mt.Clemens General the day before, the hospital had run a routine drug panel on my father's blood. They do this for all unconscious patients to make sure they are aware of any and all drugs or chemicals that may be in a person's system.
My father's blood alcohol level had been 2.4

My father had always had a drinking problem, his entire life. He spent his life either deep in the throws of addiction or fighting the addiction with all his strength, often with the substitution of pot, cigarettes, exercise or sex...anything...anything to give him a high.
I remember the first two years after my parents divorced being so frightened to be left alone with my father. His drinking had raged out of control after my mother left him and the honest truth was I was afraid of him.
He was unpredictable.
His usual pattern being a happy drunk at the beginning of the evening, than as the alcohol continued to flow he would become sloppier and finally...he would become... scary.

He never beat me, hit me or hurt me physically while he was drunk, but the verbal and emotional abuse I endured for years was almost worse. I remember him screaming at me as if I had crashed his car, simply because I had spilled his beer on the living room floor.
I remember my father pouring his beer into a to-go cup as we left the house, with him behind the wheel. As young as I was I never knew how wrong that was...for me it was normal.
It was only when I became an adult that I realized, my father had endangered my life on a nightly basis for well over two years.
I remember being called fat and being told to shut up...but most importantly I remember feeling angry and inferior. Angry that he couldn't spend one night with me sober. Angry that no matter how much he told me he loved me, he would still drink. Angry that he couldn't see what he was doing to me...to himself. And I felt inferior. No matter how much he loved me, he loved beer more. That is what I spent my adolescence believing...
No matter what I did, it was never enough.

But when the morning would come, and the alcohol would wear off, my father was so different. Still not the most calm, collected and supportive man in the world...none the less, he was far different during the day. He was capable, funny, loving, charismatic and extremely intelligent. He would take me horse-back riding in the mountains. We would drive the two hour stretch to the Horse Ranch singing Motown's greatest hits with the windows rolled down.
We would ride for hours at the ranch enjoying the sound, feel and smell of nature...sharing our equal love for horses. On the way back from the ranch we would always stop at the old A&W drive-in cafe and get foot-long hot dogs and french fries. When he was sober I was no longer fat, but strong. When he was sober I was never annoying, but intelligent and articulate. When he was sober he was my father and I was his daughter.
When he was sober I loved him.

But he was rarely sober.

A blood alcohol level of 2.4. Jesus! And that had been a good hour or so after he had gotten into his car. Even though this news upset me, it did not surprise me. I had been in the car with him after drinking 16 beers, and that was simply on a night I had decided to keep count. This was not unusual for my father and as much as I hate to say it, as much as saying it seems to condone it, the truth was my father was probably more sober that day than most days...
With my face pressed against the cool tile, my body shaking, I began to finally allow the tears to roll down my checks, my body wretched with sobs and I began to pound my fist against the tile wall.
Hard.
Harder.
Until my skin became raw.
I kept pounding, until I thought my hand would break.

I could not explain the emotions coursing through my body. Anger. Sadness. Grief. Remorse. Anger. Love. Hopelessness. Revenge. Fear. Anger...but ultimately, strangely...love.

Its unexplainable how you can love so deeply someone who has hurt you so badly. It is almost as if love it programed into the DNA. Just as my father's curly hair, oval face and muscular build had been programmed into me at birth, so had my love for him. No matter what he had done, no matter what role he had played in this horrible incident, I still loved him and I still wanted him back in my life. I still wanted him alive.

Peeling myself off of the tile wall, I unlatched the silver lock of the stall door and walked to the sink. As I cupped my hands under the cool water I bent down to splash the water over my face. I threw my head back and looked into the mirror.
What I saw staring back at me was a stranger. A gaunt, sunken, tired, lifeless stranger. My eyes look wild and lost. My usually olive complexion had gone fair with grief and my face was held in an almost permanent grimace, as if I had smelled something sour.
I turned away from the mirror and left the bathroom.

As I headed back towards the waiting room I saw my mother at the nurses desk. She was walking towards me, fast.
"We can go back and see him now," she said, "He's out of recovery."
"Ok."
"Honey?" she said catching my arm, "try to forget about what the detective said for a little while and just visit with your father."
I looked at her wanting to say what was in my mind. I wanted to tell her that nothing would ever take those words out of my head. I wanted to tell her that years upon years later I would remember every second of the last two days in gruesome detail, that it would haunt me...forever...and that I would be angry that no matter how supportive my friends, family and lovers were...no one would know what I felt...no one would ever be able to know...no matter how much they tried.
But I didn't.
On some level I knew this accident had affected her deeply. She used to be married to my father, she used to love him, more than anyone. She still loved him on some level, and I knew she always would.
And I knew that there was not a day that goes by that she does not look at my face, as I resemble my father greatly, and see him staring back at her.
"Ok, Mom," I said...more for her than for myself.

____________________________________________________________________

Upon entering my fathers room in Intensive Care I at first could not look at the bed that held him, or the shell of what he used to be.
I found myself looking around the room at all of the machines he was attached to. He was connected to a ventilator that made a steady hissing noise as the equalizing air filter expanded and then fell, expanded and then fell...filing my father's lungs with air.
The heart monitor showed spikes of activity as my father's heart beat within his chest at 59 beats per minute.
The oxygenation sensor displayed a 95, than a 97, than a 93 and back again....it constantly changed with each hiss of the ventilator.
A long yellow cord snaked out from under the sheets filing a large bag with urine as it hung from the bottom of the bed.
A blood pressure cuff automatically filled with air as it wrapped my father's arm and then slowly deflated....130/92....displayed in blue across the monitor.
And finally the bags hung from their IV poles with snake-like fingers reaching into all areas of my father's body...I would soon know all of these medications as if I were a nurse myself.

These figures, these numbers on a monitor, would become my lifeline into my father for the next several weeks. I would watch these numbers and believe that by knowing they were stable, that my father too, was stable and on his way back from the brink.
This of course was what I told myself, no one really knew.

I finally looked up into the hospital bed and saw my father. My eyes filled with tears and a single, slow, wet tear escaped down my check.
"Oh, daddy," I whispered walking to the bed.
He lie lifeless, his body swollen about 20% its normal size. His shaved head lie on a pillow bandaged from the forehead-up. His arms lie on pillows elevated above him chest, which rose and fell with each hiss of the ventilator. A feeding tube protruded from his stomach and ran into one of the containers hanging from one of the IV poles. The ventilator tube was fastened around his neck with a soft collar. His eyes were closed and the skin beneath them black; dried blood was still visible at each nostril. His mouth was shut tightly, and I remembered it had been wired shut.

I reached out and touched one of his swollen, coarse hands.
It was cold.
He did not move.
Without the ventilator and the small, slow drip of the IVs there was no movement.
There was no life.

Revelation

When we were finally called into the surgical counseling room at the completion of my father's surgery we could hardly hold our heads up or concentrate on the words the surgeon was saying.
It was nearly noon, yet we felt like we had been in that room for days, weeks.
The surgeon motioned myself, my grandmother and my mother into the small room. This room seemed a smaller version of the emergency room in which we had been waiting just the night before. A small round table sat to the immediate right of the door, and two chairs were pulled up under the table. A small, two person sofa sat to the back wall and a tall floor lamp illuminated the room.
The surgeon asked us to take a seat. My grandmother and I sat, my mother stood behind me with her hands on my shoulders.

"I was able to remove the three clots that were present in Linwood's brain. There were two in his right temporal lobe and one in his frontal lobe," the surgeon began, as he rubbed his hands together and rolled his fingers over the tops of his hands, as if they had been chilled.
"The surgery itself was a success but because of the extensiveness of the injury, and the swelling that has occurred in his brain, I have had to remove a large portion of his skull to allow for swelling in the brain, " he paused looking at us. Testing us, to see if he could continue.
"Without removing this portion, the brain would swell against the bone and cause further brain damage..." he stated.

My mind flashed to the right side of my father's head. The side I had seen caved in the night before.
I shuddered.

"After the swelling has gone down, we can replace this portion of the skull and it will heal, with minimal scaring or deformity," the doctor stated placing his hands behind his back and looking from my grandmother to me and back again, "Additionally, we had to wire Linwood's jaw shut as the X-Rays showed his jaw is also broken in two places. The wiring should be in place for about six weeks, so we have inserted a feeding tube into his stomach and performed a tracheotomy so that he may continue to breath on the ventilator. We want to keep him as sedated as possible for the next week or so to allow his brain, and body, time to heal.," the doctor finished looking at me squarely.
I looked at my grandmother who sat staring at her hand and then up at my mother who looked ready to speak, "What will he be like when he wakes up?" I asked, half wanting, half not-wanting, to know.

"His injuries are great," the doctor said looking down, "we won't really know how he will be when he awakes...if he awakes," he continued, "unfortunately, medical science knows every detail about so many of our organs yet the brain remains somewhat of a mystery. ..I am going to be quite frank when I say he could awaken after we reduce his sedation and function somewhat, or...."the doctors voice trailed, "he may remain in a coma indefinitely."
At this last piece of news my grandmother gasped and clamped her hand over her mouth, "Oh god!" she breathed as tears formed in her eyes.
I looked down.
"I am extremely sorry about this accident," the doctor said as he moved towards the door, "my deepest sympathies go out to all of you," and with that he was gone, shutting the door softly behind him.

I sat back in my seat looking at my lap. I imagined life with my father as a vegetable. I imagined visiting him in the hospital where he lay as days, weeks, months and years passed by, unaware of what was happening around him. His beard being shaven by nurses who spoke over his body as if he wasn't there...

After a few moments my mother opened the door and I began to follow my grandmother out of the room. I shuffled towards the information desk prepared to ask when we would be allowed to see my father when I noticed a tall, handsome police officer at the desk.
"Mr. West's family..." I heard him say.
The nurse behind the desk looked startled when she saw me approach the officer, "that's them," she said motioning to myself and my mother and grandmother. I could tell she was curious as to why a police officer was looking for us, yet fearful of knowing the answer.
"Renee West?" the officer asked turning towards me.
"Um, yes?" I said glancing at my mother.
My mother's face was set. She showed many different emotions, fear, sadness, curiosity and a hint, just a small hint, of anger.
It was this hint of anger that took me back, what is going on?

"I need to speak with you about the incident involving your father," the police officer began. The nurse stepped from behind her desk and motioned us back into the small room from which we had just come.
"Um, ok..." I said looking back to be sure my mother and grandmother were following me.
When we entered the room, we returned to our respective seats and the officer pulled one of the chairs from the back of the room towards the table, "Please sit," he instructed my mother.
She sat.
The officer began, "It has come under our investigation at the Saint Clair Shores police department that your father was the victim of an assault yesterday afternoon."

An assault?
I thought he was in a car accident?
Who would assault my father?
Why?
What is going on!

"At approximately 3pm, " the officer continued looking at a leather binder filled with notes, "your father was proceeding west on Grand Avenue street towards his home at 2543 Grand. At some point your father was involved in an altercation on the road with another driver. From what we can gather your father and this other driver were yelling obscenities at each other from their vehicles, then they both decided to stop their vehicles, exit, and resume the argument face-to-face," he continued.
I looked at my mother, that emotion, anger, flashed across her face again.

"We are still unclear as to what exactly was said but we have witness testimony that at some point the other man struck your father with a fist in the face. Witnesses say your father fell backwards and struck the curb with his head," the officer paused looking up at me.

"Oh!" I exhaled feeling as though all the air had been knocked out of me, feeling as if I had been punched in the stomach. All I could imagine was my father falling back, hitting his head on the curb. I thought about the concrete he must have hit.
So cold.
So hard.
So...deadly.

"Are you ok miss?" the officer said, leaning forward and putting his hand on my arm. I looked up into the officers kind eyes and again noticed how handsome he was.
"Yeah," I said clearing my throat, "so...um...who is this guy?"
"We can't provide you with that information yet, until official charges have been brought," the officer said.
"Well, why?" my grandmother spoke up clenching her small fist as it sat in her lap, "this man almost killed my son and no charges have been brought yet!?!" she exclaimed.
"See," the officer began, looking down again,"there is a statue of limitations we are dealing with in this case. We can charge the man with two different offenses depending on the prognosis of your father's condition."
I shock my head, "I'm sorry I don't understand," I said, "Why can't you just charge him with assault or assault with intent to do harm, or something like that?" I asked.
"Because," the officer began, clearly not wanting to make his thoughts known to us, "while that is the charge we would mostly likely bring upon this man, there is a possibility of another charge, " he continued as he slowly looked up, "depending on how things go...."
"Another charge?" I asked, confused, "what other charge."
The officer closed his notebook and looked at me gently, "Depending on how things go, the other charge," he continued with great difficulty, "would be...involuntary manslaughter."

My eyes opened wide. This was it, this was what was keeping the police from pressing charges quite so soon.
They were waiting for my father to die.

Photos

Some of my favorite photos to take are not photos of things that are pretty, beautiful or even cute...but interesting. I love photos that show emotion and evoke an emotion in the person viewing the image.
Nothing evokes more emotion in me that these images. They are not pretty, but they are real. (All taken in manuel mode)
These images were taken yesterday 2/4/09 in my father's hospital room, as was the blog header photo.

Tick Tock

As we sat in the surgical waiting room, time seemed to slow to a crawl. I was aware of every sound, smell, movement and person sitting around us. But, as aware as I was, I also had the feeling that I wasn't really there- I was in another's shoes, the saddened, swollen-eyed daughter of another man who was in the fight of his life.

This wasn't really happening.
This surely was not happening to me. To my father. To my family. To my life.

I hadn't slept last night, I kept having nightmares about my father laying in a morgue, grey, cold and dead, but somehow still able to open his eyes and look at me, expecting, waiting, hoping. This accident was already haunting me and haunting my dreams.

I thought back to the nightmares and shivered.

Looking around I could see my grandmother mindlessly knitting to keep her hands from shaking. Her small body engulfed by the round, plastic of the chair- her short legs stretched out in front of her on the end table littered with torn magazines and day old newspapers. My grandmother's boyfriend sat stretched out in the chair next to her, eyes on the television that hung on the wall. My mother sat next to me with her hands in her lap, looking forward, and every once and a while glancing over at me, checking on me, caring-like she always has. My uncles sat talking with my aunt, occasionally laughing or making a joke and then suddenly realizing what they were doing...laughing! At a time like this! Sometimes I wonder who invented those rules, those social-norms or codes of conduct we all grow to learn and know and follow, blindly.
It was this my mind toyed with instead of concentrating on the horrific circumstances at hand. Why can't we laugh in a surgical waiting room? Is laughing or making a joke about a deceased person really going to make a difference? Is laughing going to "jinx" the surgery or make the dead somehow more dead? No, those rules are there to make the living happy. To make the living feel that they are being respectful and appropriate. Well I always had a problem with being appropriate.

I looked at the clock, 9:15am. My father had been in surgery for two hours.
We had no idea how long he would be in surgery, or if he would even awake afterwards.

So much was uncertain.

I looked around the room, suddenly remembering how angry I was that my boyfriend was not with me. He worked late last night and just could not get up and be at the hospital for a 7am surgery. I knew maybe I was being too hard on him, I mean really we were only sitting here waiting, its not like there was anything he could really do. But still I felt like he should be here, to be with me, to support me.

John and I had been dating for over two years. We were high school sweethearts, meeting at the young ages of 15 and 16. We learned a lot while we were together- we taught each other what it was truly like to be in a relationship with another person. We took each other's virginity, we shared each other's secrets. We supported each other through the adolescent turmoil that every teenager experiences- but no matter how close we were, no matter how good our relationship seemed on the surface there was one major matter that separated us and would eventually tear us apart. I was growing up and John was not.
I loved him though, just the same, and still do. But there comes a time when you realize that love really is not enough. It is not enough to sustain a relationship, or undo horrible things. Love is not enough to see you through a financial hardship and love is certainly not enough to bring a loved one back from the brink. It would take me another 4 years before I realized this.

John was very much into being young and irresponsible. He worked a 30 hour work week, spent his money on luxuries like DVDs and Video Games and had little responsibility. He lived in his parents basement with his surround sound system and often smoked pot and played video games until the early morning hours. Despite all of this though, he treated me rather well. He lavished me in gifts and spent time making sure I was happy. He held my hand when we rode in the car and took me out to dinner at least twice a week. He was a good boy, or at least he tried to be what he thought was a good boyfriend. He really did. It is now, looking back on things, that I realize John was as good to me as he could be. But, alas, it was not enough.

"Oh, what the hell!" My uncle yelled, tearing my attention away from my own thoughts, "The damn lid..."
My eldest uncle lept from his seat wiping coffee down the front of his black, Calvin Klein t-shirt. The lid of his coffee cup had come off while he was taking a sip and spilled coffee down the front of his shirt.
My aunt caught my eye and we lost it.
We began giggling and as the pressure of the giggles rose we broke out into full laughter.
"Oh, that's nice," my uncle boomed, clearly embarrassed and angry at the same time.
This only made us laugh louder.
I glanced at my aunt once again who held her hand clamped over her mouth, her green eyes showing above her palm opening wide and shutting again as another laugh erupted, "Don't look at me!" She screamed and closed her eyes, her head shaking.
I titled my head back and laughed, looking at my grandmother, who herself had a smirk and was visibly trying to hold back a laugh, torn between upsetting her son, laughing with her daughter and granddaughter and being appropriate in the surgical lounge.
My mother threw me a dirty look and slapped my thigh, "Rachel!" she hissed.

"Oh, oh- sorry Uncle Ron," I said still laughing, "but that was funny."
"Yeah well, it better not stain," he said grouchily as he took his seat again and grabbed the nearest newspaper.
My aunt erupted again and doubled over in her seat, grabbing her stomach.
"OK, Alicia- enough, it wasn't that funny," Ron snapped.
My aunt looked at him in the eyes, and nearly crying from laughter said, "Bet ya wish ya didn't wear your Calvin Klein shirt today, huh?" she snorted, as laughter erupted again.
Ron ignored her.

After all of the laughter had escaped me I looked again at the clock: 10:05am...three hours. When was this going to be over?

My father's relationship with his family had been turbulant at best. His relationship with is brothers was one of a combined love, resentment, competition and incompatibility. My eldest uncle Ron, openly disagreed with my father on many issues. They openly argued and held deep resentments from their childhood. Ron always felt my father told him what he should do, but did not lead with example. He felt my father was a hypocrite, and my father felt he lacked conviction and gusto- both were right in one way or another. When it comes right down to it my father and Ron were far too much alike, and as they could not identify their own faults, they were quick to identify those faults in each other.
My father's relationship with his youngest brother Jerry was bit different. He felt compelled to protect Jerry, to be his savior- and he often was there for Jerry when he needed it. Of the three Jerry was the kindest, the most slow to anger and frankly the most lovable. Jerry was a tempered soul who made friends easy and kept a good relationship with most members of the family. Jerry was also plagued with a severe alcohol addiction and several medical issues. Jerry was simply sweet and it was hard to find a person who did not like him.
My father's relationship with his sister seemed a combination of his relationships with his brothers. As the oldest brother he felt the need to protect Alicia and give her advice. He would tell me countless times, "I carried her into the house when Mom brought her home from the hospital. I changed her diapers and still she won't listen to me!" My father often disagreed with my aunt's life decisions but had a way of "telling her what to do," instead of "offering her advice"- which did not booed well with my feisty, fiery Aunt's personality.
And finally his relations with my grandmother were complicated and sporadic to say the least. They had a true love-hate relationship. My father relied on her for comfort and assistance, often financial assistance when he needed it; which lately was quite often. Yet, he continued to degrade her as a mother, criticize her and blame her for his medical conditions. She was often angry with him, yet could never turn him down when he needed her. She remained a loyal mother to him despite many years of blame and ridicule. My father blamed her for many problems in his life and particularly his health problems.

My father, and his three siblings, although none of them yet knew, had inherited a rare blood clotting disorder from their mother- Protein S, or in my uncle and aunt's cases C, Deficiency and Factor V Leiden.
Protein S deficiency is a genetic trait that predisposes one to the formation of venous clots. The protein S that is present functions normally, but the amount of protein S present is insufficient to control the coagulation cascade, or the way one's blood forms clots. This means my father does not have enough of this protein to allow his blood to clot normally, so it clots when clotting is not needed.
And to make his health worse he also inherited Factor V Leiden.
Factor V Leiden is characterized by a phenomenon called APCR where a genetic mutation in the factor V gene causes a change in the factor V protein making it resistant to inactivation by protein C. When someone like my father has factor V Leiden, the result is that factor V Leiden is inactivated by activated protein C in the blood at a much slower rate, basically the thing in his blood that says "no, wait- there is no need to clot here!" doesn't work, so his blood randomly forms clots-in his organs, in his arms and mostly in his legs at any given time for no apparent reason.

And although all four of the children inherited this horrible condition, my father was the only one to show symptoms. He had constant, recurrent DVT's, or deep vein blood clots as they are more commonly known- since the age of 10. And it was the treatment for this condition, Coumadin (Warfarin) anti-coagulant therapy which had caused his blood to be too thin to operate yesterday.
Because of his treatment for the clotting disorder, the surgeon was not able to operate immediately on his brain, which may cost him brain functioning and possibly his life.

10:30am- three and a half hours and counting.

Family

After the first doctor left the room I had little time to process the information he gave me. I was to act as my father's medical power and make medical decisions for him. I had never even done that for myself. My mind spun and I returned to my seat.
Soon I could hear my family in the hall.
I stood slowly and turned to my right as I saw a nurse open the door and my grandmother, two uncles, aunt and cousin entered the room. Immediately my aunt rushed towards me and folded me into her arms.
I lost it.
I began to sob hard, for the first time since hearing the news. I let it go into the soft cotton of my aunts t-shirt, half drenching her shoulder.

My aunt and I had always had a wonderful relationship, she was like my older sister. When I was born the day after my aunt's eleventh birthday she was elated to welcome the first girl, other than herself, into the family. I remember hearing stories of how excited she was to get a niece "for her birthday." And true to her intentions our relationship remained strong throughout my life. When my parents needed a babysitter I was often taken to my grandmothers where my aunt did a lot of the caregiving. I remember sitting on the toilet seat watching her apply make-up and begging for some lip gloss for my own tiny lips.
She often gave me pieces of advice that I remember to this day, "Boys don't like girls who wear too much make-up, Rachel" she would say, "so try to make it look natural."
And, "Never sit on a public toilet seat, there so dirty. Always rim the seat in toilet paper before you sit down."
She often took me with her when she spent time with her friends or her boyfriends as a teenager and I remember them always being kind to me and fond of me. We would go for bike-rides and she would take me to the park and the playground. I always had fun with her wherever we went, whatever we did. I often embarrassed her by asking her questions in front of her friends or boyfriends, like if she "rode a horse to school."
She once stuffed my t-shirt with two Nerf balls and I strut my small childish frame around my grandma's house overwhelmed with pride in my new, fake, Nerf-breasts. I remember my aunt and grandma laughing until they cried!
My aunt often took me, along with my grandmother, up north to her father's cottage and to the mall to play in the kid's area. She taught me all the greatest 80's songs and power ballads and we both still remember the dance we made up to, "I Think We're Alone Now," by Tiffany.
Some of my fondest memories of my childhood were spent with my aunt and to this day I look to her for support, love and guidance.

I cried into my aunts shoulder and could here the murmur of my mother telling the rest of my father's family what had happened. My grandmother and cousin made no sound, my uncles gently asked questions and nervously shifted around the room.
I heard my uncle telling my mother how a nurse had almost refused to let them back into the room, and my aunt, gently pulling back, added how my uncle almost "ripped the nurses head off."
As the family quietly murmured and took seats around the room, I sat back on the sofa and stared. My sixteen year old cousin sat across from me, visibly nervous, not making a sound and not meeting my eyes. My eldest uncle continued to complain to his younger brother (these are my dad's little brothers) about "that damn nurse." My grandmother sat rocking slightly back and forth and looking around, stunned, while my aunt and mother sat on either side of me, my aunt slowly stroking my back.

When the surgeon entered the room I looked up slowly, feeling as if I no longer belonged in my body somehow. It was like I was watching these horrific events happen to another family- I could hardly feel the plastic seat beneath me or hear the voices around me. I felt numb, almost floating- not quite in my body, yet trapped in my body all at the same time. Its like the feeling you get when you awake during the night to use the bathroom, your aware of what's going on but your reactions are slow, blurry and your not completely sure of what your doing or what your body is feeling.

I, following my mother and family, rose from my seat to greet the doctor.
The man looked to be in his late sixties, bald with short graying hair wrapping around the lower part of his head. He wore small, round glasses that sat low on his nose. He was a short man with a rather average build. He moved gracefully and his actions were stoic and deliberate.
"Linwood is very sick," the doctor began using the words I heard only a few hours before, "his blood is very thin because of his Coumadin therapy, his INR is 6.9 which is thinner than I have ever seen in a patient," he continued, "to do brain surgery on him at this point would be extremely dangerous and would surely cause him to bleed to death- so we are giving him vitamin K and fresh, frozen plasma to thicken his blood," the doctor said looking at my grandmother first and then myself, "I am hoping that in the morning we will be able to perform the craniotomy he needs," the doctor said as he held up two x-rays, "As you can see," the doctor said, pointing to three large white areas in my father's brain, "he has significant bleeding and clotting in his frontal lobe and right temporal lobe- and the bleeding will need to be stopped and the three clots removed," the doctor stated and stopped, looking around the room.
After a few seconds my uncle moved towards the doctor, "he'll be OK after the surgery?" my uncle asked-or pleaded.
We all looked from my uncle to the doctor, waiting, hoping for the answer we all wanted to hear.
"That is not certain," the doctor said looking down, "we have to do the surgery to save his life, but he will be in a medically-induced coma for some time afterwards to allow his brain to heal and swelling to go down. Depending on how that goes we are not positive he will wake up, let alone what he may be like if he does." The doctor stopped, looked at me, and finished, "this is a very risky, intense operation he will be having, the odds of him surviving are not great- but I can assure you, my team and myself are going to do the very best we can."
"We will need your consent, Miss West," the doctor said handing me a stack of release forms. I took the forms and looked at the words on the paper- I could hardly read them, the text blurred- became clearer and then blurred out again- without another thought I took the pen from the doctors hands and began signing the sheets of illegible paper.
"He has to have this surgery to save his life...save his life...save his life..." the words repeated themselves over and over again in my head like the echo of a long, empty hallway. I handed the forms back to the doctor.
"Two of you will be allowed to see him if you wish," the doctor said moving towards the door of the waiting room.
"You two should go," my uncle said gesturing to myself and my grandmother.
"OK, honey," my grandmother said sliding her small hand into mine.

My grandmother is a tiny woman, only standing about 4' 11" tall, she is soft and slightly plump, but not fat. She has large green eyes and youth-like blond hair that she keeps cut close. At that time she was in good shape for her age, mentally and physically but walked with a slow limp from years of blood clots that had ravaged the veins in her legs. She was always a bit of a "firecracker" and my father and her had a turbulent relationship, at best. It was because they were so much alike really, neither could admit when they were wrong or at fault. Both had very strong, often violent mood swings and neither could see, much less admit, how much alike they really were. But, as expected, my grandmother had a softer side than my father- she was a mother and often nurturing in the best way she could be, she loved my father and wanted the best for him.

We followed the doctor, hand in hand, to the intensive care area of the emergency rooms- this area, unlike most of the emergency room, was eerily quiet and still. My father's gurney was pushed to the back wall of the room and I could see his right hand and fingers dangling from the gurney.
My father's hands have always been a very distinctive feature, they are as wide as they are long. The palm is thick, fat-even, course and wide while the fingers are short, wide and strong- his hands were almost brick-like and could bend metal. These hands are such a noticeable feature because every male member of the family has them. Sure, some are more weather torn, older and scared than others- but the hands themselves pass from male to male in our family as the strongest physical feature, even I have a somewhat female version of these hands. I remember how my father's hands, as a child, could be both a source of comfort and terror for me. The strength of his hands would cause me to scream in fright when they would hold me, poised for a spanking when I misbehaved. And in other times, the strength of his grasp would make me feel safe, secure, like no one could hurt me.
I will never forget the feel of my father's hands.

As we approached I took at what was in front of me. A machine was next to the gurney with a hose running from a plug on the machine down into my father's mouth- the machine would fill will air and simultaneously my father's chest would rise- the machine was breathing for him.
My father's head was wrapped in a device to keep it from turning and the blood had been removed from his face. His body looked larger than I remember, almost swollen and his skin had taken on a graying look. It appeared that he was sweating, yet when I slid my hand into his, his skin was surprisingly cold.
"Hi, son- its Mom," I heard my grandmother say behind me as she walked to the other side of the gurney and slide her small hand up onto my father's chest, "I love you son," she said.
"Oh, Dad," I said squeezing his hand.
"Look what you got yourself into," I whispered shaking my head as a small tear escaped from my eyes and fell onto my father's hand.
I watched as the tear hit the top of his swollen hand and slide down onto the emergency room floor. I lifted my head and looked at my father's face- what I saw caused me to suck in a quick breath and then break down all over again.


The right side of my father's skull had been smashed and his head caved in.

An Adult

After hearing the doctors last words, "Your father is very sick, he may not survive, I am so sorry." I just needed to get out of the hospital !
My mother left me to make a few phone calls and I was gone. I dashed through the emergency room doors out into the parking lot, not sure what to do- all I knew was I needed to get out of that room.
I walked to the sidewalk about 50 yards from the entrance and saw a women there talking on her phone and smoking a cigarette.
I walked up to the woman and with my voice shaking I said, "Do you mind if I had one of those?" I asked gesturing to the lit cigarette dangling between her first and second fingers.
The woman looked at me and I could tell she knew how shaken I was, "Sure, honey," and she opened her pack of Cool Light 100s and held them towards me.
I went to pull a cigarette apart from the pack and noticed my shaking hands, I looked up at the woman who was waiting with a lighter already lit. I smiled gently, put the cigarette in my mouth and leaned into the flame.
I heard footsteps behind me and saw my mother approach. She looked from me to the cigarette and back again.
I felt horrible, "I'm sorry Mom," I said, "I just needed one."
"Oh, don't worry about that," She said waving her hand toward the cigarette in my left hand, "just meet me back in there when your done, OK?"
"Sure."
I had been trying to quit smoking since the spring when I had developed a bad case of Bronchitis. Eventhough I was only eighteen I had been smoking for five years already. I wasn't a heavy smoker, I took in maybe 10 to 15 a day, but it was still smoking, it was enough and I knew I needed to stop. But those thoughts were far from my mind, all I cared about was feeling better and calming down right then, right there.

Walking back into the Emergency Room waiting area I saw a different doctor talking to my mom, I slowly approached them and listened.
"We'll be sending him to St. John Main in a few minutes, just as soon as we get an ambulance to transport him, he'll be monitored the whole way and the ER at St. John is waiting for him with a trauma room all ready. They told us their top neuro-surgeon has been notified. You guys can follow the ambulance, I'm sure you want to stay near him."
"Thank you," my mother said.
I just stared at the doctor. I find it amazing in those circumstances how we thank the doctors for telling us such horrible news, granted they save lives and most deserve respect, but I couldn't muster a "thank you" at that moment, all I could think about was throwing up.
I glance behind me to see the lacerated head guy speaking to a nurse.
"Thank God he's going to be OK," the guy said, "I was so worried, I'm still in shock I think, I just felt so bad for hitting him," He said pulling his girlfriend under his chin and closing his eyes.
I hung on his first sentence, "Thank God he's going to be OK," "Thank God, he's going to be OK."
He's not talking about my father, I thought.
I wished he was.

The ride to St. John hospital seemed like the longest of my life. My mother drove behind the ambulance staying within a car length.
"I called your Grandma, and your Dad's family is going to meet us there," She said.
I nodded. We rode the rest of the way in silence.

Upon arriving at the hospital my mother and I parked in the structure adjacent to the West Deck of the hospital near the Emergency Room and made our way through the Emergency Room doors for the second time that afternoon.
Time seemed to stand still somehow. Every step I took seemed like it took hours, every noise was magnified, every smell stronger somehow. Even my mothers words seemed slow and intentional like a record being slowed to a crawl. I had to concentrate more on everything I did, opening the car door, fastening my seat belt, even walking took the greatest of concentration.
When we walked through the doors my mother told the attendant who we were and we were immediately escorted into a small private room.
The room held a small round table with four plastic chairs. Against opposing walls were two blue, plastic-like sofas and a TV stood on a stand in the corner of the room. The room was void of any decorations, magazines or hospital signs.
This is the room they tell people they're family member died in, I thought, this is the room where hearts are broken and lives destroyed.
To this day I can not see a room that reminds me of that room without feeling nauseous.
I took a deep breath and sat at the end of one of the sofas and stared, shocked, scared, sick but mostly re-playing the past two hours over and over again in my head, trying desperately to wrap my brain around the whole thing.
If it wasn't a car accident, I thought, what the hell had happened?

A doctor entered the room ten minutes after we were escorted inside, "Miss West?" he said looking directly at me.
"Yes," I said jumping to my feet.
"We are still waiting for the neuro-surgical team," He said, composed and calm, "they will be here very shortly, once they arrive they will be able to tell you what we plan to do and give you more information on your father's condition."
"Thank you," I said oddly reminding myself of my mother an hour before.
"Um, I don't mean to be harsh," the doctor began, "but you are his ex-wife, am I correct?" he asked my mother.
"Um, yes," my mother said, looking to me, slightly confused.
"And your his only child?" The doctor asked looking back to me, "And your eighteen?"
"Yeah," I said, instantly scared.
"Since your father has become incapacitated and you are his next of kin, we are going to need you to sign for all medical procedures," the doctor stated, "and when you leave the hospital we are going to need all of your contact information to call you in case anything happens."
I looked at my mother and I could see her face drop a little.

That was it. That was the second my life changed forever. I would come to know exactly how much those words changed my life in the years to come. In that instant I became responsible for my father's life, when for the last eighteen years my parents were responsible for me, in an instant, the roles were reversed.
I felt the responsibility like a weight barring down on my chest.
Your eighteen now, I thought to myself, this is what its like to be an adult

So much blood

As I shuffle through the automatic emergency room doors my eyes darted around. I looked for anyone, anyone with a sign or who looked like they could tell me where my father was, what was wrong and what the hell had happened. My mind raced back to the phone-call I received twenty minutes earlier,
"Rachel, your dad's been in an accident, the police dropped his car off at our house- they took him to Mt. Clemens General," Mrs Miller, the elderly woman living next to my father had told me.
The moment she said, accident- I thought, car accident.
The moment she said the police dropped his car off at her place, I thought- if it was a car accident, and the car was could be driven, he must not be hurt that badly...
Then I realized if it was not that bad, my father would be calling me, not Mrs. Miller....
Oh God!
I rushed down the stairs two at a time and scanned the condo for my mother and step-father. I couldn't find them, I ran downstairs- they were not there.
Finally I heard laughter on the back patio, I ran to the glass door and threw it open.
"Mom, that was Mrs. Miller- she said Dad's been in an accident and he's at Mt. Clemens General."
My mother shot my step-father a knowing look and rose. My father had been nothing but trouble to their relationship from its inception, from the late-night drunken calls where my father threatened to "kick my step-dad's ass" to the lack of child support or involvement in my life, he was by far not their favorite person.
But, my mother, being amazing as she is, always encouraged me to keep a relationship with my father, despite his alcoholism and drug addiction and despite the way he treated her.
"I'll follow you to the hospital, Rach." She said, glancing back to my step-father, "And when I know its nothing serious I'll come right back."
My mother and step-father had plans that night to go out and their plans have been interrupted many times through-out the years by my father. I remember packing my things and apprehensively waiting to be dropped off at my father's for our typical every-other-weekend visits. My mother would drive me to his house only to find he wasn't there. And, as usual, any plans my mother had for the weekend were abruptly changed.
This was a regular occurrence until I was about sixteen and obtained my license and my car, now I could chose to see him when I wanted and could come and go as I pleased. This amounted to me seeing him about once a month. It wasn't that I didn't enjoy spending time with my father, I did...when he was sober...which was usually only until about 5pm everyday. After that point he would become loud, angry, hostile and belligerent. I would either run away, hide from him, or get into a fight with him. Most of the time we yelled and screamed, on rare occasions we'd get physical with each other, that's how it was...that's how our relationship was, explosive.

I finally spotted the Triage receptionist and anxiously approached, "My father, Linwood West, he's been brought here by ambulance- I'm his daughter, can someone tells me what's happening?"
My mind shot back to the last conversation I had with my father, a rarely pleasant conversation that I will never forget. We were discussing my new car and how happy I was with it running. I had to leave to meet some friends for a movie so I told my dad I would call him that Friday before 7:00pm when I know he goes to bed since he works the 3am to noon shift.
I remember he said, "Schootchy, you can call me anytime you want."
One of his warm touching moment, he called me Schootchy- his nickname for me since I was a little girl.
I remember hanging up the phone and knew I would not keep that promise, I would not call him.
I was your typical eighteen year old girl, caught up in my own life, my friends, my boyfriend, clothes, thoughts of college and doing my own thing. I never thought that conversation, or any conversation, might be my last with my father.
I just did not think that way, yet.

"Your Dad's back there with the doctors now," The triage attendant stated, "Do you happen to know his insurance carrier?"
I looked at my mother as she quickly sucked in a breath, "He works for Home Depot, we don't know the type of insurance he carries, " My mother explained, vi sable trying to keep her cool, "Can't you just tell us what his condition is?"
I could tell my mother was starting to get worried herself, and she was visibly agitated by the woman's demeanor.
The woman looked from me to my mother and back again, "Your just gonna have to have-a seat, we'll let you know when the doctors tell us something."

At this point my mind began to race, what could be going on? Do they usually give people the run-around like this in the emergency room? Why cant they just let me back to see him? Whats going on?
My mother and I find our way to the waiting room and sat down. Three seats away from us a young man in his 20s held a stack of bloodied gauze bandages to his head. He was dressed casually in blue jeans with a whole wearing out in one knee and an old black t-shirt. He had a three inch long laceration at his hairline. A young woman, also in her 20s and wearing a blue and white flowered sundress was seated next to him, stroking his back, comforting him.
"I just didn't see the car," the man said over and over, "I just didn't see it, I didn't see it..."
Immediately my mind tried to put the puzzle pieces together, my father was no doubt hit by this stupid guy and now we have no idea whats wrong with him. No doubt it was this immature, probably drunken ass who plowed into my father's car, broadside no doubt, and landed himself and my father in the hospital.
I thought this what happened, I thought I had it figured out.

Thirty-five minutes later I heard a loud bang and crash as the Emergency Room doors swung open, "Get him in for an MRI with contrast right away, we have to find out how bad the bleeding is," The doctor ordered pushing the head of a gurney toward the opposite set of swinging doors across the lobby.
The instant we saw a gurney coming through the doors my mother and I jumped up and ran towards it.
As the hospital staff rushed the gurney through the other set of swinging doors, I saw it was my father. He was unconscious, his face was covered in blood and a machine was breathing for him. He was covered, absolutely covered in red blood. It ran down his face, out of both nostrils, into his mouth and around his eyes, I could hardly make out his distinctive facial features.
So much red, so much blood.
In that instant I felt my legs give out and my mother grabbed my arms to brace me.
"Whats wrong with my dad!" I half screamed, half begged of the doctor who remained in the hall as my father disappeared behind the white doors.
"Mrs. West?" The doctor asked looking at my mother and then to me, and back again.
"Yes," My mother said, "Um, I'm his ex-wife- this is his daughter," She stated guiding me slightly in front of her.
The doctor looked at me with a look I have never, and may never see again. It was a look of sadness, regret, anger, depression and duty all fighting each other to push through.
He straightened his shoulders and began.
"Your father has suffered a severe traumatic brain injury. He has bleeding in two different areas of his right temporal lobe and a bleed in his frontal lobe as well. Because of your father's blood clotting condition and Coumadin therapy, his blood is very thin- dangerously thin, so it is almost impossible for us to stop the bleeding at this point..." the doctor stopped, looked down and began again, "...we do not have the neurosurgical capacity here that they have at St. John hospital in Detroit, so we will transfer him there for proper care. We're doing all we can to thicken his blood to allow for brain surgery, but at this point we have no idea when it will be safe to take him to surgery."
The doctor looked down once again and then looked up at me, glancing at my mother and back. I could tell the next words out of his mouth he didn't want to say, he has rarely had to say and never wanted to become comfortable with saying.
"Your father is very sick, he may not survive, I'm so sorry."

Prologue

Love is fire. But whether it's gonna warm your heart or burn your house down you can never tell.
~ Jason Jordon


Few people can pinpoint the exact moment when their life changed forever. That exact instant when you realize nothing would ever be the same again, you would never be the same again.

I can.
July 30th 2001 at 5:26pm.

That's when I got the phone call that would take everything I'd known, everything I'd thought and everything I'd ever imagined and turn it upside down. Reality would freeze and the sound of my own breath would become magnified. I would learn everything and nothing about the world, about fairness, about truth, all in one instant.

People are not who we think they are.
Everybody lies.
The world is not fair, and is not just, the world just...is.
The body can defy reason and change medical fact.
The heart is capable of actually breaking, splitting in two...and healing again.
We can love far beyond what we ever imagine possible.
We are all capable of taking and saving a life.
We are not all created equal.
We do not get to chose who we love.

This last fact would be tested time and time again, but always, like a stone wall, would prove to stand tall and true and against all reason and show that some of us...few of us...are actually capable of unconditional love.
Unconditional love is defined by our good-ole boy Weber as, "a term that means to love someone regardless of his actions or beliefs."
But, what does that actually mean?

I've learned that means they can hit you, throw you out, swear at you, spit at you, tell you to go to hell, tell you that you mean nothing to them, tell you they hate you, stress your marriage, steal your freedom, break your heart, lie to you...and still you will love them, care for them, sacrifice for them and be there for them.
Most people identify this kind of love as the one a parent has for their child. A love for your child is one that can not be explained, defined or even expressed in words- it is far too great, far too powerful. Love for one's child is the kind of love where you know, without second thought, that you would do anything to protect them, to keep them from hurting, to be sure they are happy.

But what about when the laws of the generations, the rules of parent and child are turned around? Can you honestly say that your child would do the same for you? After all a child is only intellectually capable of experiencing unconditional love once they've reached age 7, when they reach the concrete operations stage of development. For some this development comes even later at age 11 when they move into the formal operational stage of development- the stage where we all learn we are not the only ones that matter, our actions carry consequences and those consequences affect others.

Well, if Piaget is correct that would mean my father is about 10 years old, just shy of the formal operational stage...and if the definition of unconditional love is correct, and if this definition can be demonstrated most profoundly in the love one has for their child, then I have been a mother since I was eighteen years old.