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I tell them that she is stable, that nothing has changed overnight. The doctor will be in this morning and, sometime today, a respiratory and physical therapist. I explain how it’s important that we keep coma patients moving as much as we can, to prevent their muscles from atrophying, their skin from breaking down. “Were you able to get any sleep last night?” I ask.
“Some. Not much.”
“Have you eaten?”
“Not yet.”
“You should. You need to be taking care of yourselves, making sure you’re eating and sleeping. A nurse will be here all the time, taking care of your daughter. She’s in good hands,” I say.
“My wife and I are grateful for that, for everything you’re doing for Caitlin.”
“Of course. Please don’t mind me,” I say, going about my business or trying to anyway, but it’s hard. My concentration has been derailed by their presence, by their grief. I look away, gazing at the monitor as I say, “If you have questions about anything, you can always ask.”
“How long will she be like this?”
“It’s hard to say. It varies from patient to patient.” It’s hard to look at Mrs. Beckett when I speak. Her grief is palpable. Most people are in a coma for only days or a few weeks, before they start to slowly regain consciousness and move to something like a vegetative state, where they can breathe on their own or are minimally conscious. But comas like this can also last months or years, and some people never wake up.
Mrs. Beckett’s eyes come to mine and she asks, “What’s it like being in a coma?”
“From what I’ve heard, it’s different for everyone,” I say, letting my gaze drift back to Caitlin, my eyes fixing on the placid, restful look on her face, but seeing flashes of something else: fear, shock, pain, dismay. I think again about the fall itself, of what it would have been like to tumble from that height. I linger on her desperation, a last-ditch effort to undo it, to stop herself, and then spinning, flailing, hitting the earth. I try to be unemotional and clinical, to think of her as I would any patient, but it’s hard. I’m only human. I wonder if the fall and the impact hurt. I wonder if she was unconscious by then or if, in that moment, her nociceptors were insensitive to pain and she was conscious but felt nothing when she hit the ground.
“For some,” I say, moving my eyes away, looking back at Mrs. Beckett’s face, “it’s like coming out of general anesthesia. They’re groggy when they first wake up, but for them, the time they were unconscious passed by in the blink of an eye. For others, they dream.”
“Nightmares?” she asks, visibly panicked, worried that’s what’s happening right now, that her daughter is trapped in her brain with nothing but bad dreams.
“No,” I say, shaking my head, though it’s a lie, because sometimes they do report having had nightmares while unconscious. “Just dreams. Sometimes lucid dreams. Sometimes it’s hard for them to distinguish between the dreams and reality when they first wake up. It takes time.”
“What are they like when they wake up?”
“It’s a process. It’s rarely spontaneous. There is a drifting in and out of consciousness. They might be incoherent at first. There may be memory gaps.”
“Will she remember what happened when she wakes up? Will she remember that she—” she pauses, and then says “—jumped.”
I don’t know what Mrs. Beckett is hoping: that she does or doesn’t remember. The latter would be fortuitous.
“It depends,” I say. “I don’t know. Some do and some don’t.”
Sometimes patients wake up with a black hole in their memory, spanning days or weeks before the accident or illness. They can’t remember what happened to them or why they ended up in a coma, which would be a blessing.
Sometimes patients come out of a coma with flawed memories. They remember things that never actually happened. They make wild claims that can be blamed on things like lucid dreams or a disconnect with reality.
I look away, but still feel Mrs. Beckett’s eyes on me. “Do you have children, Meghan?” she asks after some time.
I look back up and meet her gaze. “Yes,” I tell her. “One. A daughter.” I don’t always like to talk about Sienna when I’m at work. I like to keep my personal life private. But being in an ICU room is a very intimate experience. Today, I only have one other patient besides Caitlin, and I’ll split my day between them. For as much time as I spend with patients and their families, personal topics come up.
“Are you and your daughter close?” she asks, distracted, staring again at her own daughter’s blank face, at the ghastly endotracheal tube in her mouth, taped to her skin to keep it in place.
“Yes. For the most part.”
She confesses, “We haven’t been close to Caitlin in many years. We didn’t even know that she’d come back.”
I swallow. It’s not any of my business, but still I’m curious. I have to know. I ask, “Come back?”
Mrs. Beckett glances over her shoulder at her husband. She’s getting choked up now and can’t speak. Mr. Beckett looks at me and explains. “Caitlin moved to California years ago. As far as we knew, she was still there. The last we heard from her she sounded good, fine, happy. That was a couple months ago. We asked all the time when she was coming to visit, but she always said she didn’t know. She had all sorts of excuses as to why she couldn’t come see us. Work was busy for her. She didn’t have enough vacation time. Airfare was expensive. She didn’t know when she could get away.”
“She was always so busy,” the mother parrots under her breath, and I can tell it’s a sensitive topic from the way she says it. She was hurt Caitlin didn’t make time for them.
“What does she do for work?” I ask, wanting to know more about her and who she really is.
