September 3, 2010

6:27 A.M.

Johnny stood outside Trauma Nine. It had taken him all of five seconds to decide to follow Dr. Bevan to this room, and it took him even less time to decide to open the door. He was a journalist, after all. He'd made a career out of going where he wasn't wanted.

As he opened the door, he was bumped into hard, pushed aside by a woman in scrubs.

He moved out of her way and slipped into the crowded room. It was glaringly bright and swarming with people in scrubs who had collected around a gurney. They were talking all at once, moving back and forth like piano keys in play. Because of their bodies, he couldn't see the patient-just bare toes sticking up from the end of a blue blanket.

An alarm sounded. Someone yelled, "We lost her. Charge."

A high humming sound thrummed through the room, riding above the voices. He felt the vibration of the sound to his bones.

"All clear."

He heard a high wrrr and then the body on the table arched up and thumped back down. An arm fell sideways, hung off the side of the gurney.

"She's back," someone said.

Johnny saw heartbeats move across the monitor. The swarm seemed to relax. A few of the nurses stepped away from the bed, and for the first time he saw the patient.

Tully.

It felt as if air rushed back into the room. Johnny finally took a breath of it. There was blood all over the floor. A nurse stepped in it and almost fell.

Johnny moved in closer to the bed. Tully lay unconscious, her face battered and bloodied; a bone stuck up through the ripped flesh of her arm.

He whispered her name; or maybe he just thought he did. He slipped in between two nurses-one who was starting an IV, and the other who had pulled a blue blanket up to cover Tully's bare chest.

Dr. Bevan materialized beside him. "You shouldn't be here."

Johnny waved the comment away but couldn't respond. He had so many questions for this man, and yet, as he stood there, shocked by the extent of her injuries, what he felt was shame. Somehow, some way, he had a part to play in this. He'd blamed Tully for something that wasn't her fault and cut her out of his life.

"We need to get her to the OR, Mr. Ryan."

"Will she live?"

"Her chances are not good," Dr. Bevan said. "Step out of the way."

"Save her," Johnny said, stumbling back as the gurney rolled past him.

Feeling numb, he walked out of the room and made his way down the hall and into the fourth-floor surgical waiting area, where a woman sat in the corner, knitting needles in hand, crying.

He checked in with the woman at the desk, told her he was waiting for word on Tully Hart, and then he took a seat beside the blank television. Feeling the first distant ping of a headache, he leaned back.

He tried not to remember all that had gone wrong in the Kate-less years, all the mistakes he'd made-and there were some doozies. Instead, he prayed to a God he'd stopped believing in on the day of his wife's death and turned back to when his daughter disappeared.

For hours, he sat in the waiting room, watching people come and go. He hadn't called anyone yet. He was waiting for word on Tully's condition. There had been enough tragedy calls in their family. Bud and Margie lived in Arizona now; Johnny didn't want Margie to rush to the airport unless it was absolutely necessary. He would have called Tully's mom, even in this early hour, but he had no idea how to reach her.

And then there was Marah. He didn't know if she'd even take his call.

"Mr. Ryan?"

Johnny looked up sharply, saw the neurosurgeon coming toward him.

He wanted to stand, to meet the man halfway, but he felt weak.

The surgeon touched his shoulder. "Mr. Ryan?"

Johnny forced himself to stand. "How is she, Dr. Bevan?"

"She survived the surgeries. Come with me."

Johnny let himself be led out of the public waiting room and into a small, windowless conference room nearby. Instead of a floral arrangement in the middle of the table there was a box of tissue.

He sat down.

Dr. Bevan sat across from him. "Right now, the biggest concern is cerebral edema-the swelling in her brain. She sustained massive head trauma. We've put a shunt in to help with the swelling, but the efficacy of that is uncertain. We have lowered her body temperature and put her into a medically induced coma to help relieve the pressure, but her condition is critical. She's on a ventilator."

"May I see her?" Johnny asked.

The doctor nodded. "Of course. Come with me."

He led Johnny down one white corridor after another, into an elevator and out of it. At last they came to the ICU. Dr. Bevan walked over to a glass-walled private room, one of twelve placed in a U-shape around a busy nurses' station.

Tully lay in a narrow bed, surrounded by machines. Her hair had been shaved and a hole had been drilled into her skull. A catheter and pump were working to relieve the pressure on her brain. There were several tubes going into her-a breathing tube, a feeding tube, a tube into her head. A black screen behind the bed showed the intracranial pressure; another tracked her heartbeat. Her left arm was in a cast. Cold radiated off her pale, bluish skin.

"Brain injuries are impossible to predict," Dr. Bevan said. "We don't really know the extent of her injuries yet. We hope to know more in twenty-four hours. I wish I could be more definitive, but this is uncertain territory."

Johnny knew about brain injuries. He'd suffered one as a reporter covering the first war in Iraq. It had taken him months of therapy to become himself again, and still he couldn't remember the explosion. "Will she be herself when she wakes up?"

"If she wakes up is really the question. Her brain is functioning, although we don't know how well because of the medications we have her on. Her pupils are responsive, and that's a good sign. The coma will give her body time, we hope. But if a bleed develops or the swelling continues..."

He didn't have to finish the sentence. Johnny knew.

The ventilator's thunk-whoosh reminded him with every sound that she wasn't breathing on her own.

This was what it sounded like to play God and keep someone alive-a cacophony of beeping monitors, droning indicators, and the whooshing ventilator. "What happened to her?" Johnny finally asked.

"Car accident, from what I've heard, but I don't have any details." Dr. Bevan turned to him. "Is she a spiritual woman?"

"No. I wouldn't say so."

"That's too bad. Faith can be a comfort at times like this."

"Yes," Johnny said tightly.

"We believe it helps to talk to comatose patients," Dr. Bevan said.