Jodi Picoult - Lone Wolf

Years later when I went to live with the wolves, I would feel different about my mother. I would realize that what she did was no different from what any wolf mother does: put her child into the protective care of the elders, who can use their vast knowledge to teach the next generation everything it needs to know. But at that moment, sitting at the kitchen table eating breakfast in an uncomfortable silence, all I knew was that no animal in my life had ever lied to me; whereas the humans, I could no longer trust.

There are stages of shock.

The first one comes when you walk into the hospital room and you see your father, still as a corpse, hooked up to a bunch of machines and monitors. There’s the total disconnect when you try to reconcile that picture with the one in your head: the same man playing tag with a bunch of wolf pups; the same man who stood eye to eye with you and dared you to challenge him.

Then there’s hope. Every flicker of sunlight over the sheets, every hiccup in the ventilator’s even sigh, every trick of your tired eyes has you jumping out of your seat, certain that you’ve just witnessed a twitch, a flutter, a rise to consciousness.

Except, you haven’t.

This is followed by denial. Any moment now, you are going to wake up in your own bed cursing the crazy nightmares that always follow a tequila bender. It’s laughable, really, theater of the absurd: the image of you playing nursemaid to a father you cut out of your life years ago. Then again, you know that you had no tequila last night. That you are not in your own bed but in a hospital.

That leads to catatonia, as you become just as unresponsive as the patient. Nurses and doctors and technicians and social workers parade in and out, but you lose track of the number of visits. These nurses and doctors and technicians and social workers all know your name, which is how you realize that this has become a routine. You stop whispering-an instinct, since patients need their rest-because you realize your father can’t hear you, and not just because ice water is being injected into his left ear.

It’s part of a test, one of an endless series of tests, to measure eye movements. The way it’s been explained to me, if you change the temperature of the inner ear, it should cause reflexive eye movements. In people who are conscious, it can be used to check for damage to the ear nerves that can cause balance problems. In people who are not conscious, it can be used to check for brain stem function.

“So?” I ask the neurology resident who’s performing the test. “Is it good news or bad news?”

She doesn’t look at me. “Dr. Saint-Clare will be able to tell you more,” she says, making notes on my father’s chart.

She leaves a nurse to wipe my father’s face and neck dry. The nurse is the fifteenth one I’ve met since I’ve been here. She’s got intricately twisted braids swirled into a style on top of her head that makes me wonder how she sleeps at night, and her name is Hattie. Sometimes she hums spirituals when she’s taking care of my father: “Swing Low, Sweet Chariot” and “I’ll Take You There.” “You know,” she says, “it wouldn’t hurt to talk to him.”

“Can he hear me?”

Hattie shrugs. “Different doctors believe different things. Me, I think you’ve got nothing to lose.”

That is because she doesn’t know my father. Our last conversation had been far from a positive one; there’s every chance that just the sound of my voice will trigger some angry response.

Then again, at this point, any response would do.

For twenty-four hours I have been living in this room, sleeping upright in a chair, maintaining a vigil. My neck hurts and my shoulders ache. My limbs seem jerky, unfamiliar; the skin of my face is slack as rubber. None of this feels real: not my own exhausted body, not being back here, not having my father comatose four feet away from me. Any minute now, I expect to wake up.

Or my father to.

I have subsisted on coffee and hope, making bets with myself: If I’m still here, there must be a chance for recovery. If the doctors keep finding new tests, they must believe he’s going to get better. If I stay awake just five more minutes watching him, he will surely open his eyes.

When I was a kid, I used to get so scared of the monster that lived in my closet that sometimes I’d hyperventilate, or break out in hives. It was my father who told me to just get the hell out of bed and open the damn door. Not knowing, he said, is a thousand times more horrible than facing your fear.

Of course, when I was a kid and I bravely opened the closet door, there was nothing upsetting inside.

“Um,” I say, when Hattie leaves. “It’s me, Dad. Edward.”

My father doesn’t move.

“Cara came to see you,” I tell him. “She got banged up a little in the crash, but she’s going to be fine.” I don’t mention that she left in tears, or that I’ve been too much of a coward to go to her room and have more than a superficial discussion with her. She’s like the only person in the village willing to point out that the emperor’s not wearing any clothes-or in my case, that the role of dutiful son has been woefully miscast.

I try humor. “If you missed me, you know, you didn’t have to go to this extreme. You could have just invited me home for Thanksgiving.”

But neither of us finds this funny.

The door opens again, and Dr. Saint-Clare enters. “How’s he doing?”

“Aren’t you supposed to be able to tell me that?” I ask.

“Well, we’re still monitoring his condition, which appears to be unchanged.”

Unchanged, I remind myself, must be good. “You know this from injecting water in his ear?”

“Actually, yes,” the doctor says. “What we’re looking for in the ice-water caloric test is a vestibulo-ocular reflex. If both eyes deviate toward the ear with the water in it, the brain stem is functioning normally and consciousness is mildly impaired. Likewise, nystagmus away from the water suggests consciousness. But your father’s eyes didn’t move at all, which suggests severe dysfunction of the pons and the midbrain.”

Suddenly I am tired of the medical jargon, of the parade of experts who come in to do tests on my father, who doesn’t respond. Get the hell out of bed and open the damn door. “Just say it,” I mutter.

“I’m sorry?”

I force myself to meet Dr. Saint-Clare’s eyes. “He isn’t going to wake up, is he?”

“Well.” The neurologist sits down in a chair across from me. “Consciousness has two components,” he explains. “There’s wakefulness, and there’s awareness. You and I are both awake and aware. Someone in a coma is neither. After a few days in a coma, a patient might go one of several routes. He might lose all brain function, and become what we call brain-dead. It’s quite rare, but he might develop locked-in syndrome, which would mean he has both wakefulness and awareness… but is unable to move or speak. Or he might evolve into a vegetative state-which would mean there’s wakefulness… but no awareness of himself or where he is. In other words, his eyes may open and he will have sleep cycles, but he won’t respond to stimuli. From there, a patient might either improve into a minimally conscious state, in which there’s wakefulness and brief interludes of awareness, and eventually regain full consciousness. Alternately, he might remain in what we call a permanent vegetative state, never regaining awareness.”

“So you’re saying my father might wake up…”

“… but the chances of him regaining awareness are extremely slim.”

A vegetative state. “How do you know?”

“The odds are against him. In patients who’ve suffered traumatic brain stem injury, like your father, the outcome isn’t good.”