Journal Excerpts / December 6th (con't)

Baton Rouge General Hospital

Monday December 6, 1993

Part Three

  Word about the tracheostomy gets around.

  Lots of visitors in the evening.

  Too noisy in the room.

  Later, Jen's oxygen saturation is too low. Instead of 90% and above it remains in the 80's. The respiration therapist orders the portable x-ray machine, leaves to page Dr. Moreland. One of the nurses on duty, Suzie, says he suspects that the tube installed during the operation is too small. While standing at the end of the bed, Dee sitting on the fold-out bed, Suzie nearby, checking readouts, Jen's head lifts in a gag-like response, the trach tube dislodging completely and putting her in terrible distress.

  Nurses hurrying into the room. Dee crying, asking what is wrong, what is happening to her baby. Holding on to each other and walking down the hall, getting out of the way, knowing it's bad, better off not seeing. Leaning against the wall, staring back toward the room, people rushing in and out, Suzie hurrying to the Nurse's Station, calling downstairs and asking for a trach kit.

  How long will it take to make one up?

  Think ER will have one?

  Listening, remembering my father dying of a heart attack downstairs, Jennifer not even born yet, reading the list I had typed for him about what medicines he couldn't take, remembering the chaos and uncertainty, fear and confusion.

  Daughter dying, a trach kit not quickly available.

  Dr. Moreland stepping out of the elevator.

  They need help, please, God.

  Moreland hurrying to the room. Suzie asking if we know where the plug is for the inner cannula.

  For Chrissake, it's in the plastic bag tied to the bedrail.

  Dee breaking down, collasping onto the floor, hugging one of my legs.

  I can't take this anymore.

  Sobbing over and over.

  I can't take this anymore I can't take this anymore I can't take this anymore I can't take this anymore . . .

  Detaching somehow, always the observer, a strange calmness, preparing now for Moreland exiting the room, standing a moment, approaching us with the news, with an image, and the words, Jen didn't make it.

Journal Excerpt / December 6th

Baton Rouge General Hospital

Monday December 6th, 1993

Part Two

  Dr. Stewart comes in early in some floppy hat and fuzzy jacket, shakes her head, says that Jen is really sick. She tells Dee that once she had a dog that died, that anytime something like that happens it's real hard. Dee stares at her, so nonplussed she can't even blink.
  Stewart drops by again in the afternoon, floppy hat, fuzzy jacket, checks the medicinal patch she ordered earlier, shakes her head, leaves. Dr. Meadors (Infectious Diseases) sees Jen ten minutes after Stewart leaves and asks if anyone has talked to us about doing a tracheostomy.
  No?
  Twenty minutes later, having found Stewart, Meadors returns and says the surgery is scheduled in two hours, Dr. Moreland is operating. Over and over, Jen is told she's going to surgery, that a tracheostomy is going to be done to help her breath, that everything is going to be okay. Finally, at one point, Jen rises close enough to the surface to open glazed and frightened eyes, lifts up slightly, locks eyes, says something firmly but in word salad.

  We push Jen to the patient elevators and descend to the operating rooms on the second floor, Dee and I standing like guards on each side of the bed, watching the mucus bubbling out of the nose trumpet, waiting with others along the corridor walls, talking to Jen, talking, talking, talking, talking, explaining the operation to her. 
  In the waiting room now, this place of whispered conversations and momentary lull, the jumble of the last two weeks is a hurricane still raging around us, spinning out confusion and stupefying fear. The weight of no control is astonishing. Two weeks, starting with fever and terrible headaches, Dr. Stewart telling Jen to make another appointment when she has some symptoms, deepening anxiousness and confusion, Jen not knowing what is real, what is dream. The emergency room, negative drug test, more and more out of touch. The Behavioral Unit, walking around barefooted, talking incoherently to imaginary people, coming back suddenly for a moment of clarity. Two weeks, no control. Thanksgiving morning, permission given to Dr. Campo for a spinal tap over the telephone, some nurse on an extension, witnessing, but nothing is done until the following Sunday.
  Encephalitis.
  In quick order: from BHU to NE Neuro, the critical care wing. Walk into room #307, expecting a calmer Jen, sedated perhaps, an IV in one arm. But seeing her, attempting to sit up, eyes closed, straining violently against the cloth restraints, instinctively fighting what is happening to her, my soul is house in my plunging stomach. Long night, descending. Dee now yanking Jennifer up to sitting positions, yelling at her, Breath, Jennifer!
  Like long ago, blowing into her face, a baby who can't catch her breath.                         



The Final Frontier

  In the early days of the space program, Bill Leet and I are always experimenting on lizards in the name of furthering scientific research. And once Bill’s father asks why we are torturing those animals. And we have Orville and Wilbur disbelieving looks on our faces, confused by the question of why the thrill of experiencing flight may not translate to some green lizards. After all, isn’t there a Russian dog orbiting above our heads, sending yip yips back to earth so one day Death Rays can be launched from orbit?

  Having graduated from games of Indians slaughtering Pale Face Settlers, our bows and arrows are now launchers and missles. Borrowed hankerchiefs become parachutes drooped over the point of the arrow, strings on the four corners knotted neatly on the shaft. So before the first lizard is launched into space, Bill’s bicycle is turned over on seat and handlebars, the back wheel now the Johnsville Centrifuge that will generate up to 40 g/s. Strap the first lizard down and start the back-wheel centrifuge slowly, building up to a speed where the spinning pedal is difficult to hold. Apply brakes quickly to test rapid deceleration. Look and find the first scientific principle: when placing the astronaut lizard on the centrifuge, always make sure the head of the astronaut lizard is also secured.

Scientist

Baton Rouge General Hospital
Sunday December 6th, 1993


  Jen descends, not really responsive, having more and more trouble breathing. Everything is labored: breath, the response of the system, decisions, answers. The order for a medicinal patch behind Jen's ear to dry up her saliva is charted at 6 AM but by noon the patch is yet to arrive. Orders are written early, it takes hours to get the medicine, hours to get any response from the patient on that particular course of treatment. Push, push, bitch until the Charge Nurse says she will go track down the doctor's order, the patch riding on the gurney-like Drug Cart, moving slowly along hospital corridors like an old style delivery vehicle.
  Suctioning Jen's airways free of saliva is not enough now. Nurses Geoffery and Maddie come in more and more often, go through Jen's nose to suction her throat, worried glances between them. Because they are bringing up more and more blood they install a nose trumpet, a device shoved into Jen's nose that ends as described, in a bell-shaped flange. Jen's saliva bubbles out of it, drowning her, virus invader within her racing along dark corridors, companions. 


         *                                   *                                            *                                            *                                

  When Jennifer is between her junior and senior years in high school, she is one of 19 girls chosen to attend the Women in Science Program at Harvard University. Math, science, it all comes easily for her, rarely cracking books at Tara High School where she will end up as Salutatorian, always waiting until the last minute to do assignments, the girl as a fearless child with a fistful of earthworms approaching the house and dumping them on the steps for study. And her reasoning and insight extend naturally into discerning the true nature of things. Once, while watching a movie together, a particular scene where actors are so totally emotionally exposed as humans, I remark how much confidence it takes to act that scene out. Jen says, Everyone is insecure, Dad, they just overcome it more than most.

  So it becomes a desperate scramble to raise the $3500.00 for tuition. Don’t have it, nothing of value to quickly sell, salary at the LSU Bookstore laughable, it might as well be millions. Every organization and company in Baton Rouge that might sponsor Jennifer is contacted, the spiel about the opportunity for Jennifer and the opportunity for publicity becomes huckster-smooth, words spilling off my tongue like honey. Truly amazing how much interest there is but days roll on, the departure for Boston ever closer with every polite rejection.

  Nights are the hardest, the time after everyone is in bed, the feeling of inadequacy, of artistic paths taken when younger that yield nothing but a slight look of interest when telling people about going to New York to be an actor but coming home to finish college and write, to fulfill that stronger creative urge. So nights it is not self-pity but anger at some path not chosen, one that would have lessened the arguments about the lack of money and the strain on the marriage, anger at the inability to solve the tuition problem.

  Jen packs, scared of the adventure to come, of flying, but despite the look on her face we push her down the boarding tunnel to the plane, a worthless check for the tuition in her purse. Back at the Bookstore, a long day of waiting, of hearing nothing from Jen—whether she got there safely, found her way to her dorm, anything. I am telling the ladies in the Bookstore office about her departure, about calling everyone I could think of about helping out with the tuition, about sending her off with a worthless check, that I might be spending my vacation in jail, when Betty Swain turns and looks at me and tells me her husband knows Senator John Breaux.

  Unexpected, the wheels turning quickly, Senator Breaux contacting Jacobs Engineering, bless their corporate heart, that company coming through and sponsoring Jennifer at Harvard for the summer. But even with the relief and happiness about Jen getting 8 hours of college credit at Harvard while still in high school, those summer nights are still tempered with anger for depending on someone else, on blind luck, anger for the feelings of again skating by, feelings of failing as a father.

Settling in Baton Rouge

   A year of farming, having their first child and naming him Willie, once battling a pair of snakes using their chest-of-drawers as home, a year for W.T. at Wesson Junior College, then on to New Orleans after Onetia's sister-in-law, Zita, writes about a job for W.T. in a grocery as a butcher handling salt meat for $10 a week. At first Onetia and W.T. live on Valmont, renting from Marshall and Effie Wilson (no relation), then later, after W.T. goes to work as a regular butcher for Mr. Saniford at $15 a week, they move to Arabella, near the streetcar barn, and they are living there when Onetia miscarries their second child. They move to Willow Street and rent a place for $7 a month. Being a butcher in New Orleans, even in the tough times of the Depression, seems infinitely better than toiling in the fields under the hot Mississippi sun. Banks continue folding and over 10% of the state's population is unemployed. Onetia's brother, Dick, and his wife, Zita, transfer to the 7-Up plant in Baton Rouge. Tough times striking home for all.

   Back in Mississippi for a while, W.T. jobless after Mr. Saniford's store closes, eventually another letter from Zita arrives, again offering help in finding employment. To raise money so W.T. can go job hunting in Baton Rouge while staying at his brother-in-law's, Onetia sells her wicker furniture to W.T.'s mother for $10, then settles down with her son to wait for word from Baton Rouge.

   It is 1937, maybe a little later, when W.T. finds work at Central Tradeway, again as a butcher, working for Mr. Crespo at $30 a week. Dick and Zita and W.T make the 150 mile journey over rough roads to Mississippi, no doubt visiting relatives while there, bringing Onetia and Willie back to Baton Rouge with them. After Zita and Onetia find a small room to rent, W.T.'s father gets permission to cross the Mississippi state line with a borrowed schoolbus, carting their furniture (minus the wicker set) to their place on Government Street. They settle in for a while, then find a house on Flowerdale Lane, where a second child is born, Wayne, and after a time to help with expenses, renting their front room to a woman and her two children.

   During the next couple of years, their family growing, Onetia and W.T. move to Istrouma Avenue (which later becomes Capital Heights Avenue) before buying a piece of property of their own for $250. Even with the approaching world war, life seems fine; a steady job for W.T., friendly, helpful relatives in the same town, other family within driving distance, two healthy sons, a small piece of the earth of their own.

   It is 1941 when W.T.'s father and another man, perhaps named Hemphill, with materials purchased from Currie Lumber Company, build a small house, on the small lot, on Bernardo Street in Lofaso Town, Lot #48, Square #3, two short blocks from the Baton Rouge General Hospital, where a third son, Raymond, is born in January of 1945.

Escape

   Dee and I and the girls when young escape Baton Rouge with its wild growth of everything green, escape bill collectors and everydayness. A few weeks before leaving I do a time-lapse sequence with the old Topcon camera and reveal in one week's time the constant sway of the grass to the sun and the frightening manner how quickly the rusty fence behind the house disappears from view beneath the heavy canopy. Like wild kudzu swallowing the earth. Dee and the girls and myself escape the vines and briars and grass that daily brush against jeans or bare legs along narrowing paths, escaping toward the white Gulf beaches of Florida. Never mind that those scenic beaches ahead of us are cleaned nightly by machines that filter bottles and beer cans and class rings from those unique grains of sand.

   From the wetlands of south Louisiana through Slidell, feeling like giddy fugitives, to the Mississippi coastal towns of Waveland, Bay St. Louis, Pass Christian, Long Beach, Gulfport, Biloxi, the places as a boy I vacation with my parents, all the gift shops along Highway 90 with statuary and shells signaling adventures of digging for buried treasure in that thin strip of sand and hearty sea grasses so illuminated by the white sun that anything colored reflects light like a mirror. On to Florida, each day of light, wind, and water, for a time moving Dee and I away from swamp and still-water bayous, away from emotional tangles and so much unsaid, away from the stillness of the house--its ticking of the roof from the hot sun like an erratic clock.

Catholic Girls Not Starting Too Late

   Unlike Dee, growing up, moving eight or ten times with her mother and two brothers, moving so often that I joke during high school about dropping her off after school one afternoon, going the next morning to pick her up and the neighbors saying, Oh, the Eislers? . . . They moved to another house last night, unlike Dee I know only the Bernardo Street house, the garage behind it, know only the security of sameness of the neighborhood: the Silvio house next door, old man Silvio's vegetable garden and the mums he grows for All Saints Day, the Parent house on the other side and those daughters of all ages, Marlene, Evelyn, Claudette, as interested in things mysterious as a skinny-legged boy browned by the summer sun, the Calvaruso house two doors down, Shirley Calvaruso, always a bit overweight and a little self-conscious about it but available one summer for holding hands and experimental kisses. Catholics to the north of us, Catholics to the south and west, Catholic families with brave Catholic daughters, willing for garage games: House, Doctor, Spin-the-Bottle.

The Hospital

   It begins with a train wreck at the turn of the century. A physician and surgeon for the Yazoo and Mississippi River Valley Railroad, Dr. T.P. Singletary, treats a couple of men injured in the wreck and has the idea of opening a hospital. In 1908, what will become the Baton Rouge General Hospital begins as a clinic and sanitarium on Government Street. Fifty-five years later, Mama Cothern, my grandmother, succombs in one of the rooms, the explosive stroke in her head too much to overcome. Sixty-two years later, after smoking a Kent cigarette to calm his nerves and ease the pain in his chest, my father walks into the emergency room and dies there an hour or so later. Eighty-five years after Dr. Singletary opens his clinic, her memory faulty with anxious affect, restlessly pacing, with repetitive thoughts loose and disorganized, just one of 45,000 patients that check into the emergency room in 1993, Jennifer Cothern, like her great grandmother and grandfather, is admitted to the Baton Rouge General Hospital and becomes linked to her relatives and to those men injured in the train wreck by one commonality: a painfilled dance of woe. Mama Cothern's death-rattle when breathing, an accordion chorus of my father saying, You're a good Doc, you're a good Doc, while the arteries around his heart are squeezing the life out of him, and while on the Behavioral Unit, suffering from an organic disease for a week without a diagnosis, Jennifer lamenting to release the children.

Daughters

   The first time Laurie visits Jen in the hospital she moves slowly around the bed, her back pressed against walls and furniture, keeping as much distance between her and her little sister as possible. It is that first time shock of seeing someone you love, the unexpectedness of serious illness no one is prepared for, of viewing something hard to understand, accept, something creating changes in the everydayness like the wake of a boat long after it passes.

   Still standing away from the bed, still acclimating herself, Laurie calls Jen's name. Visibly, Jen fights her way to the surface, is able to open her eyes for a brief moment, tries to find her sister in the dim room, is able for the last time before descending, to speak with sense, to mouth the words, Hi, Laurie.

   Two years apart, always different in most ways, the girls grow up with our idea that they are coming into our lives, that we are not going to center everything around them. We walk around the house normally when they are sleeping babies, play music, loudly sometimes, have friends over and laugh and argue, Dee and I make all the right moves, disciplining them with a swat on the butt when they are learning right from wrong, no means no, never letting them interrupt adults when they are talking, never letting adults interrupt them, loving them and caring for them, treating them like we wish we could have been treated as children, always aware of everything we are doing is molding them, especially the first two years; during all those days in the late 1960's, early 1970's, referring to Dr. Spock occasionally about ailments, aware we are doing it differently from our parents, we make all the right moves and still fuck our children up.

   Two weeks old and Laurie is sleeping all through the night. (Nothing to this child-raising gig.) Always independent and head-strong about food and clothes and opinions, even as a child, she is looked at by others with a touch of envy because decisions come easily, no debating like most folks over choices and consequences. Choose and move on. Just like her mother. On the other hand, there's a photograph of Jennifer on the front porch on Bernardo Street, in her windup swing, arm on the front of the seat, chin resting on arm, dark eyes staring straight into the lens, questioning, reserved, a weary resignation like she's had enough of this childhood thing.

Chart Excerpts

This is a cautionary post from the memoir. It took a decade and a half before I was able to start writing about what happened to my daughter, about being able to look over my old neighborhood from the hospital window, my daughter struggling for life behind me in the room. It all started with Jennifer suddenly developing cognitive problems; a trip to the emergency room (cursory at best, no blood tests, no spinal tap) lead to her admittance to the Behavioral Unit/Chemical Dependency Unit. No visitors allowed. Lots of chart notes about assessing for encephalitis but it was Thanksgiving morning before there was a call asking for permission to do a spinal tap. It was finally done Sunday, three days later. Lessons to be learned: you are your loved one's best advocate; step on toes, demand things get done. Surprising how much power you have.

From the hospital chart:

1.   BEHAVIORAL UNIT Psycho Social Assessment dated 11/24/93; Jennifer Cothern, 21 years old; admitted; brief reactive psychosis; very anxious; weeks before; 101 fever, complained of very bad headaches, being dizzy.

2.   NURSING SERVICE CALL SHEET dated 11/24/93:

      11:00: Dr. Campo requested neurological consult for encephalitis.

      11:30: Dr. Robertson and nurse notified of consult needed for encephalitis.

      19:35: Dr. Campo told of Dr. Rogers' assessment and recommendations.   

3.   DOCTOR'S ORDER SHEET dated 11/24/93: Patient to be assessed for encephalitis; Dr. Robertson to be notified.

4.  BEHAVIORAL UNIT/CHEMICAL DEPENDENCY UNIT Multidisciplinary Progress Note dated 11/23/93:

      04:00: "thinks she's going crazy."

      07:30: fearful, disoriented, frightened, and disoriented.

      08:20: hallucinations; administered Ativan, Haldol.

      08:45: restraints; intense startle reflex to noise or quick movements.

      09:00: wrist restraints continued; thinks worms are crawling across face.

     23:00: disoriented and saying, "we're had this conversation before" regarding most conversations she has.

5.   BHU/CDU/MPN dated 11/24/93:

       01:00: very delusional and paranoid.

       10:00: hallucinations, violent tendencies.

       11:55: family therapy scheduled for Friday.

       15:10: hallucinating. Valium for sedation.

      19:35: Dr. Rogers recommended Lumbar Puncture under Fluoroscopy and EEG; Dr. Campo called and told Dr. Rogers' recommendations, ordered EEG in a.m.

       21:45: increasingly agitated; coming to nurses' station more frequently, complaining that she is in a dream, rambling, speaking mostly of fear, death; says someone is "tapping into my brain trying to release the children, release the children, release the children . . ."

6.   BHU/CDU/MPN dated 11/25/93:

      07:00: documentation of fever and need for spinal tap. Dr. Campo in phone contact with parent, consent obtained for spinal tap.

    11:45: Dr. Carolyn Baker recommended CT of the brain and EEG; Jennifer lying in bed mumbling incoherently.

       19:55: Jennifer confused, disoriented, and paranoid, showing fear and confusion. 

7.   BHU.CDU/MPN dated 11/26/93:

        08:30: Jennifer paranoid, confused, and disoriented; began "word salad."

        13:00: rambling speech, delusional content, confused, disoriented.

        14:30: delusional thought process and paranoia.

        16:25: Jennifer pulling out her hair.

8.   BHU/CDU/MPN dated 11/27/93:

        08:00: has not improved, possible encephalitis.

        11:05: paranoid delusions, hallucinations.

        21:00: can't process answers, aggressive behavior.

        23:00: mumbling in her sleep.

        (no time noted): has not improved, possible encephalitis.

9.   BHU/CDU/MPN dated 11/28/93:

        08:30: lethargic, hard to arouse, speech rambling and incoherent, confused and disoriented.

        13:35: lumbar puncture done.

        14:10: yelling, screaming, anxious, confused, disoriented, clenching bed rails.

        16:30: BP 126/80, HR/82, R/20, T/97 degrees.

        16:45: Dr. Proctor notified of CSF results; new orders noted.

        16:55: Dr. Campo notified of CSF results and to call Dr. Proctor.

        23:00: screaming and putting feet through bed rails. 

10.  BHU/CDU/MPN dated 11/29/93:

         05:00: Zovirax administered.

11.  EEG of 11/29/93: adnormal EEG compatible with a herpes encephalitis.

12..  DISCHARGE SUMMARY dated 11/29/93:

         11:03: transfer to the Medical Floor for further medical attention and treatment.

Shortly after being transferred, Jennifer went into a coma for two months. The battle to save her life really began.

  

Show Biz

   It starts early, this show biz thing.

  Third or fourth grade, the Christmas pageant, the best costumed Wise Man since my mother works in a piece goods store and is a master sewer of everything she wears. So my costume has the blue and white striped look of a shepherd's blowsy outfit cinched up at the waist for authenticity with a rope taken from an old box in the garage. The headpiece is a complimentary subtle tan with a white dressing gown cord with blue touches tied around the forehead that pulls the entire outfit together. No large pillow case with holes for head and arms like the other children. No dung-stained sandals to complete it all but the length of the robe covers the brown school shoes. I am Cary Grant at a Hollywood premiere and the other guys in pillow cases are the publicist and the limo driver.

   And it is on that stage at Bernard Terrace Elementary when I get my first laugh. Not by tripping over the robe or waving to my mother during the dramatic part of the tableaux, but during rehearsal, standing around, bored, wondering why the other kids are having so much trouble with their blocking. What's so hard about remembering to approach the manger and look down into it? So standing around, bored, noticing some of the older kids from other grades watching the rehearsal. So my staff--did I mention I have an actual crooked staff to go with the costume my mother made? So when I get a few chuckles by waving it around like a baton, one end goes between my legs and the other end becomes a divining rod, a Holy Geiger counter pointing to the girls offering the Baby Jesus doll baskets of plastic fruit and jewels, and, finally, actually, God as witness, finally seeking out Mary, portrayed by the prettiest girl in the school, Mary Toups, the younger girl by one grade I have a stomach-churning crush on. Dark haired, serene, friendly to everyone, the lovely Mary. And the laughter rushing over me from the kids watching is holy water.

   The crush is long-lasting. Mary Toups, performance leanings later taking her to the sidelines of the football field and the homecoming court, cheering and bouncing on toes, short white pleated skirt always revealing toned junior high legs and flashes of white shorts like the brief glimpse of the white on the tail of a deer gone in one quick jump.