Jenny's Miracle

Dr. Jenny Bold fell out of bed the morning Princess Diana died. Cried with joy the day the Berlin Wall fell. Laughed with Nelson Mandela during his famous walk of freedom, and cried out in horror when the Twin World Trade Towers fell.

Today would turn out to be the most memorable of all.

Jenny's office stood at the end of a long, bright corridor. Black and white pictures of Darwin and Curie hung on the cream walls. A pair of black pyramid lamps stood beside a four-tiered bookshelf and the open windows, covered by khaki vertical blinds, allowed the winter air in. She drank a cup of Rooibos tea and checked her diary for the day. Her notes were bold and clear:

.
Morningside Facility Med. students - tour of the facility - 11h30.


The Morningside Facility enjoyed a responsible social program thanks to Jenny and her loyalty to the community. Truth be told, the groups of students that came through the doors did not come to see Jenny, or the bricks of the building, or the fancy technical medical equipment, although that was part of the tour.

They came to see Tomas.

An anorexic nurse entered her office and, with wide, darting eyes, announced,
'They're here. We've been invaded!'

'Thank you, Avado.
I'll be there in a minute.'

Jenny gulped down her tea, picked up a pen and clipboard with pages of 'Tomas' data, and walked into the corridor towards OBSERVATION LEVEL A. She stood in front of the students and raised a hand. Silence followed. The power of the hand was magical. For a moment she wished her own son were as obedient as this group. Jenny's thin lips stretched into a smile. Golden hair hung off her ears pageboy style. A gold ring hung from a chain about her neck and she wore no make up. This was her job and she had no time to make herself pretty.
 
 'Hi. I'm Doctor Jenny Bold and this is the place where I work. Allow me to introduce you to a special patient, his name is Tomas Makena.  What you will see may shock you and you are free to leave the room at any time. Please feel free to ask questions. Tomas had a motorcar accident fifteen years ago and since then, he's been comatose. I know his body inside out but I cannot tell you what is going on in his mind. I can only tell you what I believe. He hears and registers everything that is going on around him. Interviews with ex-coma patients have revealed that over 70% of them are aware of their environment and know whether the people around them have negative, positive or impoverished emotions.So be aware, you are being sensed.'

Jenny turned and ascended a flight of steps into the glass chamber that was home to Tomas. It was dark in-side. She flicked a switch and the students gasped as the lights came on below them. Tomas lay on his back with white straps secured to his head, across his tummy, knees and ankles. The bed revolved about a single axis. Jenny's voice came through several speakers in the observation room.  Nurse Avado stood beside the bed and pressed a button on the machine beside her.  The bed stopped rotating and settled in the horizontal position.

 'As can be seen, the bed is in a permanent state of motion. This is to enable his blood to circulate through the remotest veins of his body.'

 A huge plasma screen showed the students a close-up shot of Tomas's body, then his face and eyes with tears streaming down his cheeks.
  
Jenny explained, 'He cries a lot. His eyes often move about in their sockets even tracking his care staff. Now, many physicians believe that he feels nothing.'

The camera took a photo of his fingers.

'Sees nothing, and hears nothing.' The camera zoomed in on his ears.then cut to a close up of Jenny as she spoke.

'However we take a different approach to coma at this hospital. Where some would see coma as a state of unconsciousness, we see it as an extreme altered state of consciousness from which the patient has not been aroused. In the past some have used aggressive arousal treatments. A 650-watt light on one eye for one second, and then the other eye. Stimulating all body senses can take up to eleven hours.  Other caregivers test for loud noises, noxious smells, and strong tastes like chilli, to stimulate the taste of smell. We do not use these treatments in this facility. We believe that the patient is already stimulated through physiotherapy, unexpected sounds in his environment and carers talking. We try and meet the patient where he is. We might not be able to shock him out of the coma, but we could offer him gentle accompaniment by minimizing interruptions of his inner processes, and support him to not only be talked to in a respectful way but also be listened to.'

A student interrupted, '.Listened to?'

'Yes. Watch nurse Avado, otherwise known as a coma care worker.'

The camera panned across the floor and found Avado.

'She is matching her breathing with his rhythm. She is acknowledging that wherever he is, is OK and she is encouraging him to feel all he is feeling, see all he is seeing, hear all he is hearing.  She watches for tiny signals in response. We have achieved some success. Take a look at his chest, his breathing changes when she talks to him and sometimes his eyes move. She has been trying to get a repeat signal from him so that they can communicate through a binary system of 'yes/no'. The sad thing is there has been no repeat signal from his side. If he was cognisant of touch, and showed signs of understanding, then from that point on she can find out about his inner world and counsel him.'

 She picked up two pieces of wood, and displayed them in the air.

'Some years ago we used these by hitting them together; we hoped to get a response. We do not subscribe to this at all today. Our approach is love and an understanding of the patient's situation by conversing with him. If one is to believe that the brain's ability to heal is far reaching, then using this approach must be seen as important support for his awareness levels.'

A young intern asked,
'Are these tests for those in deep state coma or also for those who have opened their eyes? And what drugs are used to keep the patient from seizure?' He held a note-book in his hands with a pen poised to strike the page as she spoke.

 'The most common test used to assess people in coma is the Glasgow Coma Scale which measures a patient's eye, motor and verbal response in a scale to fifteen. A person in a deep coma measures fewer than nine on this scale. Care staff assess Tomas at least twice a day using this scale. As for drugs, we use diazepam which is Valium, Dilantin, Phenobarbital and an anticonvulsant called Sinemet or Levodopa, which is used for Parkinson's disease.'

A dark haired student asked,
'Is it true that patients who have opened their eyes know what is going on around them?'

'Yes and no. Patients who have opened their eyes within the first few hours and days of their coma have a better chance of survival.'

XXX XXX

'See you tomorrow.see you tomorrow.see you tomorrow.'

Monica - he hears her voice singing in the expectation of another day. He sees her standing in the doorway; young, fresh, the world waiting at her feet. She waves to him as he reverses from the drive.

Another voice comes through, much louder, closer and more intimate, a woman's voice.
Outside.  One of two voices he has heard a thousand million times showering him with words of love.

Rain pours down the windshield as he approaches the onramp to the highway. Her perfume lingers on his hands and lips and neck. He wants a real commitment; wants her to have the best jewellery, cars and homes all over the world.  He wants to take her and make children with her and not feel guilty about touching her soft pink skin. He heads for the next off-ramp and passes a gargantuan Cummins Freightliner cargo truck.

XXX XXX

A young lady with blonde hair off her eyes, bit through her knuckles.

'He doesn't even know that South Africa has changed. The odds are stacked against him. I mean, not many people survive a coma that long.'

Jenny corrected her,
'True and not true. Not many people survive be-cause of complications that arise from being immo-bile - they suffer pneumonia and urinary tract infections. Tomas has an amazing constitution and has always remained healthy other than his coma state. There have been individuals in coma for eighteen and nineteen years in the United States. Both have recuperated to some extent. In one case the patient lost the ability to show any human feeling. In another case, the patient's ability to remember things failed him. Here we have a different case. Tomas is the first to show physical rehabilitation. Six years ago, he lay in a foetal position. We placed him in an intense recovery program and his physical form has returned.  It has taken six years of muscle stimulation with the correct diet.'

Tomas spasmed. Then calmed down. A student asked,

'Has he ever spoken?'

'No.'

Another student asked,
'If he does wake up, do you think his memory will be affected?'

Jenny responded, 'We don't know. The temporal lobes, in the front of the brain, are responsible for encoding memory. There is no damage in that region. On the physical side he may be recuperated, but his mental condition is unknown, and there will of-course be psychological issues he will have to face .'

Jenny was interrupted by another spasm.  She remained silent and watched, frowning at Tomas as his body buckled and writhed beneath the restraints.

He calmed down, the graphs on the machines stabilized.

Jenny grinned at the students, 'Enigmatic, but that's what coma is. Those who have survived coma have often talked about near death or extra sensory experiences. Many face the struggle of rehabilitation from brain injury, which leaves their personality changed and with new physical challenges. Others say it was a gift, a spiritual journey that changed the way they see the world. One thing is certain - we don't understand the wonders of the brain or the purpose of the body going into coma. Not fully.'

XXX XXX

.Into coma.
Not fully.
.Into coma. Not fully.
Tomas's left leg is itchy and he wants to scratch but his arm will not budge a centimetre. Jenny's voice echoing through his mind, but it is Monica's name that escapes his lips in a broken whisper. 'Mnc!'

There is antiseptic in the air.

His eyes snap open.

Colourburst! His head explodes. Pink noses, pink ears and several large pairs of eyes in white overalls and stethoscopes bend over him for closer inspection, all drenched in a soft white aura.

'Oh my God! The man's awake!' A student cries out in the front of the group.
His eyes move faster and faster in their sockets.

Jenny shouts, '10cc's Diazepam, now! Avado!'

Jenny knew he could slip back into the coma but he was more valuable to her awake than in a deep vegetative state. Nurse Avado fled from the ward. She returned a few moments later and soon the diazepam flowed through his veins and the spasms decreased. Jenny sighed, relieved, she said,
'Tomas, can you speak?'

He coughed and splattered like a car trying to start up. 

'I am Jenny Bold. You are in the Morningside Facility. Do you know what your name is?'

The words in his mind read Tomas Makena, a heavy tongue struggled to find a voice.

'Dom Mkna.'

Speech path - he talks!

Auditory path, perfect!

Jenny asked,
'Do you feel any pain?'

No response.

His body twitched.

Valium hung on his eyelids. Jenny dabbed a wet swab to his parched mouth, turned to the group of students, and said,

'Okay everyone, out! We have a recovery in progress.'

The End

Louis Harris


Research: ComaCare - Cape Town

 

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Name

Comment

Date

James Tobias

Interesting article.


I say article, because in parts there is an awful lot of info that is in danger of alienating the likes of me - who either aren’t interested in medical details. Besides that I found the story interesting, wondering if it was true or not.


One question that sprung to mind was who was paying Thomas's medical bills for 15 years?

I know it's a short story but I would have liked to get to know a few of the characters better - not just a dark-haired girl for instance.

Technically the work flowed well and was a pleasure to read.
One sentence that made me reread it a couple of times was:

"For a moment she wished her own son were as obedient as this group."

It might just be me but is it right?

son was?
sons were?

Good work

Points 3 - Very promising piece of writing

2008-01-06

Barbara Durlacher

Interesting piece of writing which to some extent was spoilt by the use of too much medical jargon and detail. I found it difficult to relate the obviously African name of the patient to the love scene with - one presumes, a white woman - and Tomas' desire to spirit her away to a life of luxury. It seemed somewhat unrealistic, and not particularly clear or relevant to the story. I understand that you were attempting to create a sense of mystery and horror with the description of the accident, but it was not very clear what exactly had happened and in what way Tomas had been injured and what bearing this had on his recovery or otherwise.

Points 2 - This writing needs a bit of editing and/or re-writing

2008-01-11

Mandy

Louis, I was captivated by this piece. I think it could do with some minor editing but I really enjoyed it and found it very interesting - Well done!

Points 3 - Very promising piece of writing

2008-01-13

Louis

This is the opening chapter to my novel published in 2006.  Please keep that in mind when reviewing this piece. 

2008-01-14

Ron

Bearing in mind your own comment and those already submitted, I have now re-read the piece. 1st time it not grab me. Half of me wants to know more, the other half doesn’t. A weird feeling. As an actor I once played a brain-damaged man in his forties with the mind of a four-year-old and I related to all your descriptions of stimulating all the senses. Your research is evident. At times on the second read I wanted a sudden change in theme. Jump in Sci-fi! That sprang into my mind. Well done. Going for a third read.

Points 3 - Very promising piece of writing

2008-01-30

James

Congrats. Really enjoyed this. Also on reaching "Scribe" status

2008-02-15